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Home My WebLink AboutMiscellaneous - 160 ANDOVER BY-PASS 4/30/2018 (2) � ` Q /✓ � , ---- -- ---- - --- - r- Date. TOWN OF NORTH ANDOVER �.�4'O PERMIT FOR PLUMBING 0. ,SSACMUS� This certifies that . . ��c'��. C u C� .. . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . .!�f? �?!?n.`a. . . . . . . . . . . . . . . . . at . . . , North Andover, Mass. Fee. . . . Lic. No.. .f. 3. a I. . . . . . . . . <2 . PLUMBING INSPECTOR Check # ✓ 5227 r' J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Priv or Type _ Mass. Data _2010-52SPermit ?Per # j Budding Locatlon,/M Abby Owner's Name 5 Vr Telephone -! cg5f? Type Of Occupancy New ❑ Renovation ❑ Repfacemer*1 �W� ns Submitted: Yes 0 Nq FIXTURES z N N N O Z }' > r Vl J y O < w w N Q ¢ r r ¢ H W y 01 W 0 X v r W S r 4 Z 46 O 4 Q A V3z x W o zW < a ac < W a ¢ .r a c 3; o z z Y g6 ¢ r z z < "' w x w O a '3 N 1' z O O N - W r O V < < < x a -K < ° < J J < a: ¢ < O < r o Sue-85MT. BASEMENT IST FLOOR 2NOFLOOR 9R0 FLOOR 4TH FLOOR b ISTM FLOOR GTMFLOOR TTH FLOOR 8TH FLOOR lnsstalf►ng mpany Name C->r. .(�� „ (� Check one: Certificate Address �._ ❑ Corporation lt'/D6L 1 Q 4 0 2 3 ❑ Partnership Business Telephone( 1ER-IM) Fmt,'Co. Name of Licensed Plumber o ) INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch, 142. Yes � No C1If you have c�fiecked ye_s. please indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity L7.. Bond ❑ OWNER'S.INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plurhbing work and installations perfo ed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing and Chapter 14 a oral laws. BY S+g ure o tensed Plumber Title Type of License: Master Journeyman 0 0(y/Town 1AP?FQVED__(0_TF1_CEUSE NL License Number Za 3 4/9 Location A,/o f No. �� V Datea- NpRTM TOWN OF NORTH ANDOVER 60 O L F A Certificate of Occupancy $ CMUSE<�' Building/Frame Permit Fee $ � .. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ al,4 ird Check # t �3 '� 1 c l Building Inspect / TOWN OF NORTH ANDOVER- WELDING DEPARTMENT APPLICATION TOCONSTRU1CiAENOYAT OR DEMOLISH AONEORTWOFAMHYDWEUM ;.. ..fin: � . .. _ - .z- BU&DING PEPMT NUMBER: - DATE ISSUED. SIGNATURE: Bufldinzgmi ofllufl&z Date Z SR.MON 1-SM INFORMATION I - 0 1.1 Property Address: - ' — n 1.2 Asu=o s MV and Parod Number: Ll Map Number Pared Number \� V 13 Zang hdbManion: 1.4 Properly Dimensions: Zarin IX.i Use Lot Area F ft 1.6 BUILDING SETBACKS(ft) - Front Yard Side Yard Rear Yard Rapired PrWde ProvidedProvided r.5. flood zeas aromwim 1.n-._-S--p> S 1.7werer supptybLOLCAd. sat > PA& 0 pmr* 0 Zane I 0msideF7wzM 0 mesielprl 0 OnSbePispaeel System 0 SECTION 2-PROPERTY OWNERSWIAUTDORUZD AGENT m 2.1 Owner of Reodrd Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Servioe: .� m SECTION 3-CONSTRUMON SERVICES go 3.1 Licensed Construction Supervisor•. Not Appffc" 0 S--wcr. t'6 1&OM Licensed Const wbw Supero w CS ( y l Q 0 'thy L o C)f t Cr- 0.4 mi r r+G . LiomtsaNnmbet � Sem— JDLw signature Tdep— r 3.2 Registered Home Improvement Contractor Not Applicable 0 v r g CompanyName n q L G c-yf dr. ,✓e n0t/'i Registnilion NumberMdmd �— S 1111V20#6 Z S' ature Wephone G) i i i I I SECTION 4-WORKERS COMPENSATION(M.G.L C 152 1 250(6) Workers Compemufm Imm om affidEntmort be completed sad sulmu bd wilt this= abm Falun loprovide flus Ad d still remilt in the decal of the issueoec oithe SisneddWAAMW Yes.....X No......A SECTIONS . %A dm"Ak 1 11 New Ca mbuclim'0 Fa(isft Btul" 0 ftws) Vis) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Otho 0 Sp%* Brief Des zom of Proposed Work I&-I-LD mew OyNDeck , Pctiw%it. e7C��'hn of I's 1 r f--co mt PAC &6 l/ qmm 1 + `)cr 1(If%t �ew.o�� -/1e4e.ar� I�ef� DQo� ♦s Q�ef( SECTION 6-ESTIMATED CONSTRUCTION COSTS . Item Estimated Cost(Da11at)to be )lcaru . ryes" t Building 2 6; (a) Bmftg Permit Fee Mnl' 2 Ekchicel (b) Estimated Total Cost of Cambuction 3 PlumbingBuilding Permit fee(.)x-(b) Meci 4 Mechanical AC S FireProAction 6 Total 1+2+3fd+5 Check Number SECTION 7n.OWNER AUTHORVA71ON TO BE COMPLETED WREN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERIIIIT 1. as Owner/Authorized Agent of subject property Hereby auf mine to act cm My beW in all matters relative to work authorized by this building permit application. SI cure Of Owner Date SECTIION 7b 0WNERlAUUTH0RUZD AGENT DECLARATION Stet/r Nl►a7��0 r" .as Owner/Auvrized Agent of subpa pmperty Hereby declare that the statements and information an the foregoing application are true and acxmste,to the best Of my knowledge and belief S'�tJCrJ 61IUO � --Flo si Of owns/ i 0.OF STORIES S12E BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DRJENSIONS OF SII,LS DIMENSIONS OF POSTS DRvMIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF Foam g MATERIAL OF CH WEY B BUILDING ON SOLD OR FILLED LAND 1S BUILDING CONNECTED TO NATURAL GAS LINE I FORM U -,LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************1************APPLICANT FILLS OUT THIS SECTION************************ APPLICANT C '1 r1 ~ PHONE / ?e ZrttP-1� 2� LOCATION: Assessor's Map Number_ J� PARCEL V : 4 4 ft Ice kjT% SUBDIVISION LOT(S) STREET L at Qrft4_& tL ST. NUMBER *****OFFICIAL USE ONLY*********************************** i 0 D OF TO AGENTS: i CONSERVATION ADMINfSTfUkTOW DATE APPROVED DATE REJECTED COMMENTS 2 YVIO t,��nrd•. TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS I FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm � I Ql AID / f -LOT Z N 17,210 S F C, 6' ,Tj. .► i i EX15TUAG r-CLINVATION ia.a p 41 70' WIDE ACCESS SASE M G MT -i UTILITY EA`�F MINT N / -75,00' ASS A1�oVE � P7 <_ KOUT E l Z5 �S .4YEPEBY CE.cT/FY 70 7yE T/TLS/,,1.5!/.cO.�Qt/,O 1:7L or PL.4AI 7V T.S'E BAN.f'T.NiQT riS/E'.G+A✓ELL/,Hf/J LaG'ATEQ O.t/ r11W LOT.!s s tta/►vt/ANO T.�GIT/T®AES Cp,�/FA�i)f /N JY/TN T.S/E 7-0 w'.%O�.{/a .fNODVE 2 Z�.v�.vc LE6vc.arnvs sETa cars -W"W sre--C-s�for ci vEs- /y,�, ,q IV I7� �/��'_ 1'� A . X i7/.CTHGf ceeri-e T.iG�T T.y/.S OA►'E!1/N6 /J�voT 4004TE0/�f/ T�YE FELiE.PA4 FiCGioG .5'�?4C0 APEfi. O�P�ilt�iV /�O.P t3�yOIVN ON ��MA' �'OMMt/�t//TY P.IA/GL 25DO�J$ OOpCp C 7UNE 2)lo Of (?UEc--) T F - &AS �v 6381 �' o� ` •� iflE.P.P/rN.4GY E-.f/G�•t�EE.P�.!/6 SE.Pi��'ES - :uRv�� 6,6 .4•P,f� .ST.rEET �� A.VOOYE� /1J.4S.S.vI.�vSETTS O/8/O A The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone 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. Com an name: 02emaddcbour Address 'L City: ir 4L L,0 Phone#: 7-7 9 _76 Z— 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature S Date " 7 J^ Print name J tCJ 04 t316 6 M Phone# Official use only do not write in this area to be completed by city or town official' O Building Dept E]Check if immediate response is required Building Dept p Licensing Board 0 Selectman's Office Contact person: Phone#: [:] Health Department Other FORM WORKMAN'S COMPENSATION 20'-0" —f 0 L o DECK DECK F w/6"step Tom- DECK 0 Tarapata Deck 960 Andover Bypass North Andover, MA. 92 00m BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:.CS 074109 Birthdate: 04/20/1948 Expires:04/21/2006 Tr.no: 23634 Restricted: 00 STEVEN E BLOOM 494 LOCUST STREET DANVERS, MA 01923 Acting C �bne, ✓tie t�an+nnaruvea� ��voactu Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 144857 Expiration: `f1/12/2006 =Type; P.'rivate Corporation THE REMODELING.',GROWP,tNC; STEVEN BLOOM: . ® 494 LOCUST ST ' DANVERS,MA 01923 Administrator North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: C. gt. (Location of Facility) S- Signature of Permit Applicant Date I NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i CONTRACT The Remodeling Group, Inc. PROJECT NAME: Chris&Tara Tarapata Date: 5/11/05 160 Andover Bypass North Andover,MA 01845 Consultant: Steven Bloom (978)394-3613(H) We hereby propose to perform remodeling and/or repair work upon the above mentioned premises per the following description,scope,allowances,exclusions and general conditions. GENERAL NOTES: The homeowner is responsible form in 1 spo moving valuables and breakables from the project area prior to the start of work. We assume all pre-existing conditions to be sound,any additional damage that is found will be addressed on a time and material basis Building permit is included. Area of construction to be broom cleaned at the end of each days work. All job site debris to be hauled away at the completion of work,and the construction area to be left in a Broom-cleaned condition 1.) MULTILEVEL DECK DEMOLITION AND ROUGH CARPENTRY - Remove and dispose of existing deck rails,decking,joists,columns,and stairs - Remove and dispose of existing wood debris under deck. - Remove and dispose of two concrete pads,asphalt walkway and existing footings as determined by layout. - Remove and dispose of sliding glass door,associated moldings and deck ledger board. - Install temporary wall at front porch area. - Remove and dispose of front porch railing and columns. - Build new deck per layout attached. f-,4;r....1„m.,� 4ORTH oNvn Of Q� 4 0 t - _ ver `r 0 No. 17X$ '" y == A o dover, Mass., / O 4 COCMICMEWICK SRATED P'PF`�,�Gj 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... 111& A.... s T� ? r r� P04 ..... �.�...................... .............................................V........................................................... Foundation Fft has permission to erect.... �� . buildings on ..... L �. Ove/` A r� �,. �� +.. . ......................... ................ Rough t0 be occupied 8S 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. y PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR ough ........... ,� ............. 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 J1 Smoke Det. 3757 Date.... .. A 4, TOWN OF NORTH ANDOVER 0 I , PERMIT FOR WIRING o S CHUS This certifies that ........ L/�.......... .... . ... ........ has permission to perform .......10 K....................... wiring in the building of... ....... .. /- 6- at... ................ . . North Andover, as Fee.73..-.00.. Lic.No-",/f. ....... .. ........ ..... ... ..... ELECTRICAL INSPE Check # v _ Commonwealth of Massachusetts Official Use only Department of Fire Services Permit No. 3 7S BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),5527 CMR 12.00 PLEASE PRINT IN INK OR TYP ALL FORMATION) Date: ( __.. City or Town of: To the Inspector of Wires: By`�&_ application the undersigned 'ves notice of his or her int on to perform the elm work described below. Location(Street& Number) D ✓� S v No. Owner or Tenant Telephone Owner's Address I 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❑ Undgrd❑ No.of Meters I New Service Amps / Volts Overbead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Y Location and Nature of Proposed Electrical i Completion o the ollawin table miqy be waived by the Inspector of Wires. 0.o ot No. of Recessed Fixtures No.of CeiL-Susp.(Paddle)Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA ave n.. o.o mergency ag ng No. of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Batte Units No. of Receptacle Outlets Na of Oil Burners FIRE ALARMS No.of Zones a.o etechon an No. of Switches No.of Gats Burners InitialiRg Devices Tal No. of Ranges No. of Air Cond. Tons No.of Alerting Devices ined !� No.of Waste Disposers a Totals ---um er on _. e o - oat . _..........—_. Detection/Alerting Devices No. of Dishwashers SpacelAreaHeating KW Local ❑ C n ection ❑ Other ux Heating Appliances KW stems: No. of Dryers o.ollevices or E uivalent No. o atero.o No. o Data Wiring: Heaters KW Signs Ballasts No.of Devices or E uivalent ecommumcaUons irtng: No. Hydromassage Bathtubs No. of Motors Toial HP No.of Devices or E udvalent OTHER. Attach additional detail if desired or as required by the Inspector of Wires. 0 electrical work may issue unless E: Unless waived b e fee y INSURANCE COVERAGE: Y the owner,no permit for the performance, 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 CC BOND ❑ OTHER ❑ (Specify:) (Lkpiralion ate) 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. I cernfX,under the pains and penalties of perjury,that the information on this pplicgtion is it completes FIRM NAME: : Ka riel Arakelian LIC.NO.: 15893A j Licensee Sign LIC.NO.: 31702E (If applicable,enter"exempt"in the license number line), Bus.TeL'No.: 508-261-1141 Address: P.O Box 466 Mansfield MA 02048 Alt. Tel.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)D owner ❑owner's a ent. Owner/Agent TETT a I Date. . .. . . . .... . . 4 l Of 40 RTH ,9'►. of O TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION -Sq USES This certifies that zx-�4 . .. . . . . . . . . . . . . . •� r has permission for gas installation . . . . : . . . . . . . . . . in the buildings of ::'' �� `. . . .. . . . . . ... . . . . . . . . . . . . . . at . . . ... . . . . . . . ` " oNh Andover, Mass. G Fee;/ . . . . Lic. No.. . . . . . . . . . . r.'. . . . . . . . . GAS INSPECTOR 1 ' Check# r 36 ` S � MASSACHUSETTS nt VORM APPLICATON FOR PERMIT TO DO GAS FITTING ��Type or print.) �`�ate 0 .5- 03 '200 NORTH ANDOVER, MASSACHUSETTS , Building Locations /60 Radoyer 13:/ PO S S kle. �h 4�4r/e`°Ir Permit g Amount S GA rl5 rpt t'ql (J4 9 a- Owner's Name New❑ Renovation ❑ Replacement Plans Submitted ❑ .n - ri :J ..I `•� v � n iIn W nn :sl J n. J Z ..c! Z % _ ? n — ? L S U [3 -6 A 5 ENI ENT RASE .M E N 'r � Is,r. FLOGR 2ND . FLOUR 3RD . FLOOR 1"r if FLOG It 37 11 F I. o O R 6T 11 . F1,00 R 7'T it . FLO U It 3 Ttl F L O O R (Prtor e) Check one: Certificate Installing Company Na e h� e ,�� G�r"P � Corp. dr c Address 80k ?z8 ❑ Partner. X10, A-tidever" . Ma dl84s Business Telephone Cl ?R ?ZS ¢2Q5j ❑ FirmiCo. Name of Licensed Plumber or Gas Fitter Qo t) e!-+ e INSURANCE COVERAGE Checkone: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked ves.please indicate the type coverage by checking the appropriate box J-iabiliry insurance policy � Other type of indemnity ❑ Bond ❑ 7wner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 1421 of the Mass.General Laws.and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best ofmy knowledge and that all plumbing work and installations pertbrmed under Permit [ss ed fbr this application will be in compliance with all pertinent provisions of the Nlassachuslys State as Code d Chapter I f th neral Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber 8 59Z CitviTown ❑ Gas Fitter 7-7-9-774 umoer Master Journe,man A-PPRO'v'EDioi,i cv-osF.')Ni_Y, TA Date... ,o ?�.✓..u'. f V - 2378 f NORTH TOWN OF NORTH ANDOVER o? �� PERMIT FOR GAS INSTALLATION g i SSACMuSE e This certifies that . . . .�`�t. has permission for gas installation . . ...t`:<— . . . . . . . . . . in the buildings of . . .� .k?.fit. . N. ... . . . . . . . . . . . . . . . . . . at . . . rr� North Andover, Mass. f Fee.7d:W. . Lic. No.. . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File M MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) o, v 1Z ., Mass. Date 6 If6 19 Permit# Building location 1 6 O Owner's Name QJ�) Type of Occupancy SINGLE FAMILY New 2- Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No D FIXTURES to Z V � N puoZX `e' -ap �• r. a h ; '� C O 2 tY itA Z = N W V ~ z < Z � < eZatt v0 16 0 `� � O ' � s '� ui � Z3c Sum 3oL SUB-BSMT. BASEMENT 1 Ist FLOOR t 2nd FLOOR 3rd FLOOR 4th'FLOOR Sth FLOOR 6th FLOOR 7th FLOOR 8th FLOOR Installing Company 'Name L GALINSKY PLUMBING & HEATING INC. Check one: Certificate Address P-0-BOX 1701 M Corporation 1906 HAVERHILL, MA 01831 0 Partnership Business Telephone 508-374-1743 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter STEPHEN C. GALINSKY INSURANCE COVERAGE: I have a current-liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. �C Yes No D If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policyX Other type of indemnity❑ Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application valves this requirement. Check one: Owner t✓ Agent= Signature of Owner or Owner's Agent I here,certify tha:all of the deta+ts and informa".,on I have submitted tot entered,in the abo.T app!icahor.are true and accurate to the best or mo y knwtedze and that at'p!umbing work and ine.a%ations periormed under-n-pear.issue'iY this app',ation wit:be in co-np':ar�ce with a! pemr>nni pro,isions of d-Massachusetts State Gas Code and Chapter 142 of riff Genera!La..s Ttiye rf license. 9 Gat=:tter Title !L '.aster S:g:ature of Uc sec.?!uab•r o•Gas F, FINAL INSPECTIONS SKETCHES BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME & TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER UC. NO. PERMIT GRANTED Date 19 Gas Merc. Final Insp. Gas Inspector P �i'�• '��`� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 NiAP 4-4 LOT LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK :PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING A J OWNER'S NAME (2LX� NO. OF STORIES SIZE OWNER'S ADDRESS c,/O��'1'9..Q� BASEMENT OR SLAB ARCHITECT'S NAME cUJ SIZE OF FLOOR TIMBERS 1ST T_['7 , 2ND `(,�T 3RD BUILDER'S NAME ' SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS OL �J DISTANCE FROM STREET POSTS 1(v DISTANCE FROM LOT LINES-.�., �-SIDES/ REAR GIRDERS C�1� AREA OF LOT Cy�-y<✓y FRONTAGE :5D L �. HEIGHT OF FOUNDATION /�'( THICKNESS ,n / IS BUILDING NEW ft- �C/ SIZE OF FOOTING /o X ; �! X v IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND . zz WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER /�� BOARD OF APPEALS ACTION. IF ANY W IS BUILDING CONNECTED TO TOWN SEWER .106a-T IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS s PROPERTY INFORMATION , LAND COST SEE BOTH SIDES EST. BLDG. COST f � r . BLDG. COST PER SQ. FT7? PAGE 1 FILL OUT SECTIONS 1 - 3 ESTTi��1S EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR ' DATE FILED -All�,/ BUILDING INSPECTOR SIGbfATURE OF OWNER R AUTHO ZED AGENT FEE O� OWNER TEL.� r, :3 66I:Ft PERMIT GRANTED BLDG. PE"VM 8 CONTR.TEL.# X/ 19 LESS FDA FES lf3-t� n DUE FIR" «r:RMIT T2 CONTR.LIC.# H.I.C.A �� I � rR 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. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE CONCRETE BL'K. PINE ✓ BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ v, 1/2 % FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN i 4 WALLS I 9 FLOORS -G6*Psmtm b B 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVJ D _ ASBESTOS SIDING COMMCN _ VERT. SIDING —A-SPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOROOR _ ADEQUATE I NONE 5 R F 10 PLUMBING GABLE I i HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. )2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK J SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING I MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING L,11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. a COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING V j" RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC 1st 3 13rd NO HEATING ��ll v , i I FORM U - IAT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** I APPLICANT: Ph one LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) C�_ Street St. Number 16 D *********************** fficial Use Only************************ RECO NDA ONS OF AGENTS: j RConservation Ad i is rator Date Approved /� 1 Date Refected Comments �— Date Approved bTown Planner Date Rejected Comments Food Inspector-Health Date Approved Date Rejected Septic Inspector-Health Date Approved Date Rejected I Comments I Public Works - sewer/water connections - driveway permit y Fire Department � Received by Building Inspector Date � I ' I r. Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Address of Property for Permit(below) Map and Parcel : Purpose of Application (check below) Phone Number of Applicant: (/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 North Andover 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 by-law,provided that no additional residential unit is created. �The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this 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.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons 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 a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density, (buildable lots), below the density,(buildable lots),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 and/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 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 building permits,(i.e.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 supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed 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 and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowledge or n t, is grounds for r fusal by the Building Department to issue a Building Permit o Ik SignatLffe of Owner or AuThoifz ent who signed V1p Attached Building Permit Da;_ �- This form must be attached t the Building Per upon application for such permit. Li WIX COMM WAY e ACCE55, e o• \Q��(' G S � �•JQ. ape'. Zp1x a � a4 Ile 3b _ 2 / 30, ��►' \ 246 p� k 4Q' O� \0 A 3 \ r Dr� Q�Q�v ti& f \ 7 r�, -37 I A-4 A-36 A.3* Zq4 \ :� ._ NpRTF•j m. Town of 4Andover 0 �'-'j W. No. S q6 dower, Mass., 19 O n.5 A.COCMICKEWICK V s, 7 AERATED BOARD OF HEALTH Food/Kitchen Sep 'c SystePERMIT TDm UILDING INSPECTOR Q zf.... ��c...... i ..... oun THIS CERTIFIES THAT.. • ............•••... . ' . F tion . lQ buildings on .. .... .... Rough has permission to erect.............." / to be occupied as.........................:j..;................... ./.., .C� ? •`. ............................... ......... Chimney provided that the person accepting this permit shall in every respect conform to the ter sof the application on file of Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of PLUMBING INSPECTOR Buildings in the Town of North Andover. ' Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. MONTHS Final PERMIT EVIRES IN 6 MON S ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STAR S Rough Service .................................. ... BUIL ING INSPECTOR Final i Occupancy Permit Required to Occupy Building GAS INSPECTOR 2r 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. Smoke Det. Town of North Andover Planning Board This form represents the schedule for allowing the following lots to be considered as eligible for ' building permits under the Town of North Andover Growth Management by-law Section 8.7 of the Zoning by-law. Pursuant to 8.7 .5 this Development Schedule must be filed in the Registry of Deeds and be referenced on the deed of each of the lots below and be filed with the Planning Board prior to the issuance of any building permit or permit for construction. Name and Address of Applicant for Lots: Name of Development: Qup_:s4 C-A_� roti r� 12 o Map and Parcel of Original Lot: aryl ; 160 Date of Application for Lots Division: Lots Covered by this Schedule: The Planning Board by their signature below, or a signature of a duly authorized representative, do hereby establish for the above named development the following Development Schedule for the purpose of Section 8.7 of the Growth management By-Law. The applicant, their assignees, successors and or subsequent property owners shall conform to the following schedule that limits the eligibility of the following lots for building permits. This form must be filed in the Registry of Deeds,6y the property owner or representative and be referenced on each deed for each of the following lots. Such deed reference for the deed of each lot shall at a minimum reference the book and page in.which this Development Schedule is filed and contain the language : " This lot is subject to a Development Schedule pursuant to the Town of North Andover Zoning By-Law all owners,-representatives, and future purchasers should avail themselves of said restriction by reviewing the approved Development Schedule as riled in Book insert here and Page insert here. The fact that a lot is eligible for a building permit is subject to the limitation of the number of building permits per year pursuant to section 8.7.2.d of the Zoning By-Law." The Planning Board hereby schedule the lot(s) for the above development as follows: NOV �0G i^3 :510 Year Eligible Number of Building Office Use Building Office Use Lots Eligible Date Lot Eligibility Notes Completely Utilized i Signature of Planning Board member or Authorized Representative Date Signature of Pro erty Owner or A uthorized Representative Date yra.rn.z, As '4 L-zrc �wR�k NoRTy q T Rv�cop MSS R �y o" . Y.�arTesr. R Opp ` NORTH '� Town of 4Andover 0 -- o dover, Mass., l l Y 19 94 COCHIC HE WICK �� A0RATED PPS\ S BOARD OF HEALTH PERMIT T D Food/Kitchen Sep is System UILDING INSPECTOR THIS CERTIFIES THAT J.nuion has permission to erect.............. buildings on ......../. .. ?...... .....D,��1 �2:: .. �c..,,,,,,A-S ............. .... ugh C to be occupied as.................................................. �..r ..G.�.�..............��.... ..... . yprovided that the person accepting this permit shall in every respect conform to the ter sof the application on file in al 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. PLUMBUSAG INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ou 0 � 7/9. > PiaELE&RiCAL PERMIT EXPIRES IN 6 MONTHS INSPE TO UNLESS CONSTRUCTION STAR S ....................................... C...... .......... .............................:......... etff BUIL ING INSPECTOR � � / ti �,/ a / Occupancy Permit Required t0 Occupy Building AS INSPECTOR t t t/;7l5 7��w✓ .Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done FIR DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner j Street No. Smoke Det. I CERTIFICATE OF USE & OCCUPANCY i Town of North Andover I Building Permit Number 545 (1996) Date March 25, 1997 I THIS CERTIFIES THAT THE BUILDING LOCATED ON 160 ANDOVER BY-PASS MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Quest Enterprize Inc. 200 Park S t. ADDRESS North. Reddinsz. sACMt1S�� it 'n nspector Office Use Only �iOMIU911Wralfij Df tt6�tttjjli�P�t Permit No. ' Department of Vublic tafet0 Occupancy A Fee Checked .r_ BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I 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/2 -//—9� City or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work work described below. Location (Street & Number) Owner or Tenant l -C,S Owner's Address Is this permit in conjunction with $ building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building �'/uV C �>y Utility Authorization No. L 53 5 i Existing Service Amps _I Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service 7-On Amps IZ'O ZyU Volts Overhead Undgrnd ❑ No. of Meters _� F f Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work_ A /e Ax d A YA f't'r`�� `• No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting FixturesSwimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners c- Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total s Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑ ❑Other Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: t INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Competed 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 appopriate box. /` INSURANCE BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) ;. Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough-ALL/ C6Z/(l Final Signed under the Penalties of perjury: FIRM NAME _ 1 LIC. NO. Licensee { 3 Im Signature ! LIC. NO. Bus. Tel. No. Address ,44 i/U p_ a/Li Alt. Tel. No. OWNER'S INSURANCE AIVER: I am aware that the Licensee does 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) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) x-6565 Location 10 � c No. Date r NORTp TOWN OF NORTH ANDOVER A s : Certificate of Occupancy $ _ �sskHuSE<�' Building/Frame Permit Fee $ J V Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 17844 `Building Inspector f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER:A 3 DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION LI Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number CQ 1.3 Zoning Information: 0�y ` ■ 1 1.4 Property Dimensions: � Zoning Dist ,ct Proposed Use Lot Area Frontage ft 1.6 BUII.DING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide ReqWred Pr0vi&dEfReqWrcd Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record ri 1-k5 p-a'7" 0-v-7PUi Name(Print) Address for Service: Signature Telephone Q 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ s 1 w 2 hr Q) l b Q r-A C� O'7`J l Licensed Construction Supervisor: 7 License Number Address t'�C] 1✓ieT/V Vy /�^�Y�. 7d ��Z• T�� / Erpi tin Dat Z6 Signature g Telephone II 3.2 Registered Home Improvement Contractor Not Applicable ❑m Company Name f J t Da,�Lts y��AddressRegistration Number { ' A / cow QCCJ/�-{ t�� 7U 2 - V& 7 Expira n Date ^z Si nature Tel hone �• 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......41 No.......❑ SECTION 5 Desch tion of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: fi ll NI[AFS(l dfWS -nV gel 6wj- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 01 IAL USE ONLY Completed by permit applicant- 1. licant1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 16 Q Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Ng.-maeg, as Owner/Authorized Agent of subject property Hereby authorize _S'T'EM! —&aOM (Tl� &&SfTto act on My behal in all matters r five to work authorized by this building permit application. 22-Nave Zo Si tune of OwAer Date SECTION 7b OWNER/AUT //HORIZED AGENT DECLARATION I, S-f:PJ to 2(S h, 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 P� e `!�7-21 e y Signature of Owner/Aent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlVIBERS 1 2 3 SPAN DIN ENSIONS OF SILLS DINIENSIONS OF POSTS J DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE u North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall-be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: � rA :If erz rt � / 3 3 r 11GhU (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector z The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am an employer providing workers'compensation for n Ty employees working on this job. Company name: t Address q L 0 Cj City l/'I /ry1 A- _ Phone#: Insurance.Co. Policv# Company name: i 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$1,5oo.00 and/or one years'imprisonment.as_weti_as_cMi_penaltiesin16elmn-d-a-STOPYAKM ORDFRand_afire-f.(,$110o.DD)-ajlayagainstme I understand that a copy of this statement may be forwarded to the office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone.# 9 2?'7W Official use only do not write in this area to be completed by city or town officiaf I City or Town Permit/Licensing D Building Dept E]Check if immediate response is required I] Licensing Board p Selectman's Officc Contact person: Phone#. ❑ Health Depa/tmen O Other THE COMMONWEALTH OF MASSACHUSETTS Office Use only DEPARTA1Eff0FPM1CSVL7Y Permit No. BOARDOFFIREPREVEMONREGUMHONS527CAR 12:00 Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wire The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes F-1 No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service AmpsVolts Overhead Underground 1:3 No.of Meters New Service Amps Volts Overhead Underground r-1 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 No.of Lighting Fixtures Swimming Pool Above Below Generators KVA rc 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 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 Si ns Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER.- YES D NO E] Ihawsubrrtetedvafdptoofofsa=tDdrOffim YES IfyoulnNed edmdYES pkmeint therypeofoc)vaageby drddng INSURANCE F-1 BOND �� ( may) Fxpita�orrDa� FstirrotedValueo[TichicalWork$ WO&IOStatt bToctionD&RaWestcd Ru# Final Signed underlie anabes of petjtuy: FIRMNAME LicemeNo. Lioerrsee Signahue Lioe MNo BusQirassTel.No. Alt Tel No. OW[sWSINSURANCEWAIVEP IamawaretlutheLmwdoesnothavetlrmsuru>ceoovdageoritsmbsontblequivalentasrequiredbyMa%admseMCealeralLaws and thatmysignahnEonthispeurvtapphcatmwaivesthisregikernci t (Please check one) Owner Agent Telephone No. PERMIT FEE$ igna ure o . wner or Agent 'i AGORD INSURANCE BINDER OP IDKm DATE i1i19/04 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. I PRODUCER PXCNE .---- -- (AIC,Nc,E.,r 781-455-0700 COMPANY ;91NC'cRk 13488 -- j i 781-449-8976 Continental Casulaty Company I _ I EFFECTIVE EXPIRATION Roblin Insurance Agency, Inc. LATE j TIME DATE TINE 144 Gould Street l`_' ! AM I ti 12.01 Aa; Needham MA 02494 11/1-1/05 NCO% 11/11/04 12:01 I I PMj James Smith I THIS SINGER IS 155UE0 TO EXTEND COVERAGE:N TY.E ABClVE NAME^.COM?ANY CODE: SUB CODE: PER EXPIRING POLICY k: 6 j AGENCY BINDER E CUSTOMER ID: REMOD-1 DESCRIPTION OF OPERATIONSNEHICLES)PROPERTY;Ix1uE?na Loc H—) INSURED Remodeling Group, Inc Steven Bloom PO Box 332 f ! Topsfield Mr1 01983 s 1 I COVERAGES LIMITS T17E OF INSURANCE COVERAGEIFORMS DECUC^SLS ( COINS% !1 AMOUNT ,.PER_ O P ?ERTY CAUSES OF TOSS 1 30S!C I j BROAD SPEC I i I I I I I �G\ERALIIAS.U.. , I EACH OCCURRENCE $ COMMERCIAL GENERAL UABiIfiY --� _�� I FRE DAMAGE(Ay opo Sre) I$ CLAIMS CMS MACE uOCCUR 1 -- i II MED ESP(A•ry me Perron) S -- I PERSONAL&ADV:NJURY 1 5 ---�— I GENERALAGGREGATE L RETRO DATE FOR CLAIMS MADE: 7RCDUCG $ ADTOMCBILE UASIU iY I ----� !CCMB:NEO SINGLE O.V.;i L l5 i ANY AUTO P----I BOO,LY MJURY:Per oorsen) S ALL OVNNED AUTOS 1 e 900:LY INJURY:P_•zcc!Een!1 'S !!( I SCHEDULEDAUTOS I I PROPER)Y DAMAGE I$ ` F:IREDAUTOS I MEDICAL PAYMENTS I$ ! I NON{VMED AUTOS PERSONAL IN.'URY PROT I$ LNINSUREDMOTORIST $ S AUTO PHYSICAL CAMAGE 1! DI VEHICLES ALLVHICLS SCHEDULED Ii I ACTUAL CASH VALUE COLLISION: I jir I i STATED AMOUNT �$ OTHER THAN CDL: I � I OTHER I { i GARAGE UABIL'T`! AUTO ONLY-EA ACCIDENT S — 'ANY AUTO 1 --- �--J I OTH ER THAN A'TO ONLY: I - EACH ACO:OENT ;$ ( 1 AGGP.EGATE EXCESS UABIUTY ! ----Ii EACH OCCURRENCE 1 S _z !UMBP.ELLAFORM 1 S ;---; AGGREGATE j OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: S SELF-;NS-REO RETENTION e I X 1 NO STATU.ORY LIMITS ! 1'A:RKER'S CCMPENSAT.ON I E.L. 100000 15 —? AND _ I EMPLOYERS UABIL17Y DISEASE EA EWPLO"EE I S 100000 I 1 6 .E.L.DISEASE-POLICY lc%fc 1 s 500000 44 SPECIAL 1 FEES S 0 CONOMONS/ i OTHER i TAXES I S I COVERAGES I ESTP ED TOTAL PREMIUM j$7588 j NAME&ADDRESS MORTGAGEE I AOO:TIONAL INSURED i ({ LOSS PAYEE I ! LOAN a —� fAUTHOR2EDREPRESENTATIVE ACORD 75-S(1198) NOTE:IMPORTANT STATE INFORMATION ON REVERSE SIDE CACORD CORPORATION 1993 I �� ✓fie L�anvrrco�uuen�z a�✓�aaaac�u�ae�a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 074109 ; Birthdate: 04/20/1948 Expires-04/21/2006 Tr.no: 23634 Restricted: 00 STEVEN E BLOOM j 494 LOCUST STREET DANVERS, MA 01923 Acting Oc mis oner 74 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 144857 ExiPi r-ation: 11/12/2006 Type: Private Corporation THE REMODELING:GROUP,INC. STEVEN BLOOM 494 LOCUST ST DANVERS,MA 01923 Administrator Chris&Tara Tarapata Basement Remodel 160 Andover Bypass North Andover,MA.01845 I � "s,a.er atr,rrr--- I lechazli I I —E� ow on I 1 oom cY�- I room I Center tvfrom end of o cabinet to outer wait TJ Room (Fi w I �-T i. Install&map speaker 1 1 I I wire for future Use. \ I i 2. Install conduit from tv to ' stereo caoinet for firwre ! a u � r use. 3. Lights in game room:to be placed center center I � 4 C') f Cleane®axress panel � i 's r2_2" I Exercise Area Erecytc aC'xss panel Storage b1b woew panel i Chris&Tara Tarapata Basement Remodel 1160 Andover Bypass North Andover,MA.01845 - --- -- 2-O" Necnanicai Center window on game Room room o N Room +1 I i j T-6" .. , _ I � Cleanout acres panel - i0 CJ i— I (7 I Game Room Stairweii w �o I Storage a Exercise Area clect�c axes panel � f Hose bib access panel ! -- - - I p4 md-I'v- FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments havingjurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with an applicable or Y PP requirements. ******APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT C r)I 't-A rG ib d►dl PHONE LOCATION: Assessors Map Number PARCEL SUBDIVISION LOT (S) STREET (ay (4rd W I r 15s !?G JJ ST. NUMBER OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED i SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS I i i PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT_ 1� t � cva�o 1 �c�(2 t ST)-,/jk, RECEIVED BY BUILDING INSPECTOR DATE / Revised 9197 jm CONTRACT The Remodeling Group, Inc. PROJECT NAME: Chris&Tara Tarapata Date: 11-09-04 160 Andover Bypass North Andover,MA 01845 Consultant: Steven Bloom (978)394-3613(M We hereby propose to perform remodeling and/or repair work upon the above mentioned premises per the following description, scope, allowances, exclusions and general conditions, GENERAL NOTES: The homeowner i responsible form vin all valuables and breakables from the project area prior to the start of work. s p moving P J We assume all pre-existing conditions to be sound,any additional damage that is found will be addressed on a time and material basis Homeowner to make plans for house pets that may be affected by the project. Building permit is included. Provide dust protection at basement door. Area of construction to be broom cleaned at the end of each days work. All job site debris to be hauled away at the completion of work,and the construction area to be left in a broom-cleaned condition 1.) BASEMENT REMODEL: - Remodel existing basement per layout and specifications attached. DEMOLITION AND ROUGH CARPENTRY - Furnish and install 5/8" tongue and groove plywood in attic approx. 30' x 24' - Cut in new window opening to match existing windows in size. Owner to decide location. - Frame new walls per plan with 2"x 4" studs. - Outside rear wall to have step with pine shelf along length. - Furnish and install R-11 Kraft faced insulation on outside walls and furnace wall. - Furnish&install 1/2" blue board with slick finished skim coat plaster MECHANICAL Install electric,to code, per electric plans. ** No work has been included to upgrade existing plumbing service or H.V.A.C. systems. INSTALLATION AND FINISH WORK - All doors to be 6 panel paint grade solid core Masonite doors. - All trim to be 1-piece,paint-grade to match existing. - Furnish and install 3 new Andersen vinyl clad double hung windows to match sizing of 2 existing windows that are being replaced. - Furnish and install two access panel doors at electric panel and sewer cleanout. - Build paint grade combination m.d.f. and wood cabinet/countertop to separate game room from television area with two columns. - Furnish and install Armstrong 585 B 2'x2' ceiling the in finished area. - All walls and woodworking to receive two coats of Benjamin Moore latex paint, colors selected by owner. - Furnish and install flooring, selected by owner per allowance. li INCLUDED ALLOWANCES: Carpeting labor,pad and material @ $20.00 per sq. yd. installed ADD ALTERNATES: Sprinkler heads @ $100.00 per head added per inspector's layout The Remodeling Group,Inc. PO Box 332 Topsfield,MA.01983 494 Locust Street Danvers,MA.01923 (978)762-4687 Tele(978)762-7346 Fax stevenbloom@earthlink.net CONTRACT The Remodeling Group, Inca PROJECT NAME: Chris&Tara Tarapata Date: 11-09-04 160 Andover Bypass North Andover,MA 01845 Consultant: Steven Bloom (978)394-3613(I) The lumpsum bid rice of this project as described above is Fifty Four P P J ty Thousand Seven Hundred and Seventy Dollar. PAYMENT will be made as follows: 1. $13,692.00 due at contract signing 2. $13,692.00 due at project start 3. $9,000.00 at start of blue board work f 4. $9,000.00 at start of painting 5. $6,000.00 at start of flooring 6. $3,336.00 net upon completion License Number: CS-074 i 09 Expiration Date: 4/21/2006 Reg.Number: 144857 Expiration Date 11/12/2006 Fed.ID Number: 84-I660787 START DATE:The Remodeling Group will contact the owner within three to five business days upon receipt of signed Decision/Selection sheet to schedule work. NOTE: This proposal may be withdrawn by The Remodeling Group if not accepted within 15 days of presentation, ACCEPTANCE: The above prices..specifications,conditions,and`Terms and Conditions'on the attached sheets are hereby accepted. You are authorized to perform the work specified. Please refer to General Conditions on back of contract. You have the right to rescind this Contract within three days of signing. r Do not sign this contract if there are any blank spaces. i Steven E.Bloom,President Date Owner Date The Remodeling Group,Inc. I i i The Remodeling Group,Inc. PO Box 332 Topsfield,MA.01983 494 Locust Street Danvers,MA.01923 (978)762-4687 Tele(978)762-7346 Fax stevenbloom@earthlink.net tAORT#q Town of Andover No. 36 aw dw C 0 L A 0 ver, Mass., COCHICHEMCK �7S RATED BOA"OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.... e JF%......... BUILDING INSPECTOR ... ...... .................................................... Foundation has permission to erect.... ....... buildings on .14A.... C/040*r....,dy- ............. ...A-#3 Rough to be occupied as............ #4 419 4L Chimney 10 AA .................................. !..... .... provided that the person accepting this'P**ei'rWiha'*11'*In" very.respect conform to the term s of the app.lication..o.n..file in Final this office, and-to the provisions of the Codes and By-Ljws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. '07C / I & Y PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION START ELEC Rough 04 Service ....... ....... ... ...................A....I. ..... /ril......JBUILDING 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 Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det • 630 � NORTH 1 TOWN OF NORTH ANDOVER Q PERMIT FOR WIRING a SSACHUS� This certifies that ....... � � _ , �Ve ; has permission to perform M _.Wiring in thrbi ngof........ ..�.t . .s. ... .�!. r? ��P 5........ .y�e. ... .. ..... ,North Andover,Massr" Fee 2S2 !Lv Lic.No. .L.�.. .. A............. .......... ........................... ELECTRICAL INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer