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HomeMy WebLinkAboutMiscellaneous - 160 HICKORY HILL ROAD 4/30/2018 160 HICKORY HILL ROAD j 210/062.0-0103-0000.0 I� I I i I 33o Bear Hill Road Suite 201 un nin '�1c�!- Waltham, MA 02451 T: 781-890-1696 �,inds eyF: 781-890-3819 Date: o8/07/2015 Building Commissioner/Inspector of Buildings Town Office of the City of North Andover 566 Main Street N Andover, MA 01845 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139,SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed, $1,000.00 or cause Massachusetts General Laws, Chapter 14,, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned. insured,location,policy number,date of loss,and Cunningham Lindsey file number. Insured: Marco Sideri Emily Shippee 16o Hickory Hill Road N Andover,MA o18845 Policy No: 3095011 Loss: Water line on Fridg burst causing water damage to home,etc. Date of Loss: 07/11/2015 Cunningham Lindsey File No: 1oo859697486 Stephen McIsaac Adjuster 08-07-2015 On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Location 160 4tcVorP No. ') Date ( h9o- NORTN TOWN OF NORTH ANDOVER 3 • 0 AL F 9 • i ; « Certificate of Occupancy $ E<� Building/Frame Permit Fee $ 1 oast 0 Acmus Foundation Permit Fee $ is Other Permit Fee $ TOTAL $ eZ O Check # ©a —7 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT'REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .•µ TAiIS Seefi ll�for Q�14`IA gC F. - rn BUILDING PERMIT NUMBER: J�. DATE ISSUED: j J go,_ X SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1-60 It' 602 J,03 c�Cg�2�r Map Number Patrel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronts ft � 1.6 BUILDING SETBACKS ft �.1' Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 0 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record �T ( �/�o Name(Print) �— f Address for Sery e: ` ,/8ignature Telephone 2.2 Owner of c Name Print Address for Service: x rn Si nature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 66 3J7O License Number mn Addres 3 a/ Expira' n Dat S' nature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v 1��0�►`�:,►� s � VJesry,y Company Name L L� Registration Number r• A dd ress r �ll t � �c�a Expiration ate S' nature ele one V/ 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....... No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 9g xgSAM.,]V e 'Ai MAa Tek IS 4rH SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE ONLY , Completed by permit applicant 1. Building (a) Building Permit Fee Q001 10 0 Multiplier 2 Electrical l' (b) Estimated Total Cost of 5DO.00 Construction 3 Plumbing d 0 Building Permit fee(8)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT �lR. /9(Y" D 1 as Owner/Authorized Agent of subject property Hereby t or EA C", p to act on My beha matt lalive to work thorized by th wilding permit application. ,A/ Signature o ier Date SECTION lb OWNER/AUTHORIZED AGENT DECLARATION I> Q PM81-1 14P—L 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 �i2fst� l'i 4A4,1 Ad 4 r' ame Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR Tl vIBERS 1 ST 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS -I MIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM ! I b O-z- 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. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT., PHONE tji y LOCATION: Assessor's Map Number bc� PARCEL SUBDIVISION LOT(S) STREET- � 4-!�2� ST. NUMBERY&O ************************************OFFICIAL UaE ONLY*********************************** RECWWJVIENDATIONS,OF9WN AGENTS: CONSERVATION ADMINISTR R DATE APPROVED 65 X01 DATE REJECTED COMMENTS 1,.uAC% n2_ on Il7e of-opep+a sk Icy l be- Orp4eJeA fro.L, cam- 5���e_ SP�an'«►+��o✓� TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm ��T-l'F'��fl �ot.�t..l A�►T�o i..1 R.A tJ L.�C.ATEt= lU ND. !�l.1�� I MP• . �oSZ.TFd A �-•+�ovE� � M A SS• i L J OT •-221--- •1 K 157; /, `� 30,__ r'•I' t tY 1� F/� •`=.G.�iZTtF�/ T�•1ij. is t ';�?.S�T� �Haw�..1 Ai�.E. Fo�C. TEt�, 1 V ICZP t 6..1 C � +,� .��.1i d►k7�'3���+1Ji;Fa't-; ��:�1..,rr{. �q�..t t> �WG.H VSE. t S Fa tC+ i .� U �! rr-li THEZo►�.�uG ?c{P..�, !lti,;+',iC"lo�..l oF' L�� 10.4¢ s T',/ ' 02, 1.10►.1 Cor.+F'o2�'I fTY s:,• � A N �►J Ca►...�Ste'I�uG-r-E��. � a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations w� Boston, Mass. 02111 ��+M 5�1b 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 I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone#: Insurance.Co. Policv# Company name Aao Got 1 t 2S dtgr4ev 4 Address ? j 8i2iC, —Atz L� City /1z Q, A,-J&V*? Phone#: Insurance Co V 1 I�12 �1-� N �'r✓5 - 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$1,500.00 and/or one years'imprisonment_as weH-as_chni..penalties-inibeform.dA STOP WORK ORDER..and..a.fine_ofl.$]DDM)-a�day-gainst-me... I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. ti 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature --� � Date Print name )*96 IL4 W-aio Phone# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Ucensinu Building Dept ❑Check if immediate response is required .❑ Licensing Board ❑ Selectman's Office Contact person: Phone#. ❑ Health Department ❑ Other I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I I I I I Checked by/Date I I I TITLE: PLAN NO. 3761 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-5-2002 DATE OF PLANS: 11-4-02 PROJECT INFORMATION: ADDITION TO EXISTING HOUSE COMPANY INFORMATION: BRUNO ASSOC. 28 BERKELEY ROAD N. ANDOVER MA 01845 COMPLIANCE: Passes Maximum UA = 246 Your Home = 148 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 576 30.0 30.0 10 WALLS: Wood Frame, 16" O.C. 1152 13.0 13.0 55 BSMT: Conc. 8.0' ht/7.0' bg/8.0' insul 576 19.0 19.0 14 GLAZING: Windows or Doors 135 0.330 45 DOORS 72 0.330 24 HVAC EQUIPMENT: Furnace, 87.5 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer_ Date TITLE: PLAN NO. 3761 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 11-5-2002 Bldg. ) Dept. 1 Use 1 I CEILINGS: [ ] I 1. R-30 + R-30 i Comments/Location I WALLS: [ l I 1. Wood Frame, 16" O.C., R-13 + R-13 I Comments/Location I BASEMENT WALLS: [ l I 1. Conc. 8.0' ht/7.0' bg/8.0' insul, R-19 cavity + R-0 continuous I Comments/Location I I WINDOWS AND GLASS DOORS: [ ) I 1. U-value: 0.33 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I DOORS: [ ] 1 1. U-value: 0.33 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 87.5 AFUE or higher I Make and Model Number I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. i I DUCT INSULATION: [ J I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. i 1 TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I I SWIMMING POOLS: [ ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I I HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in. ) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: [ l I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 1 170-180 0.5 I 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 1 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- 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: lZ i C L4,w►m-;e �J S a A/ (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 NORTH Town of EAndover 11% No. z90 14. � c�,� odover, Mass., / ADRATE D .9S H BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR . THIS CERTIFIES THAT.../re.. ..4A.M.. . .N................................................................................ Foundation . ................. has permission to erect.�.y....�alP..... buildings on.....1.. .....1"T..l. .lam. r'. .... ......( .... Rough to be occupied as J741.!4..!kWA..... .. .M .O.A ..... .�4`..4...C6N................................ 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 th Inspection, Alteration and Construction of Buildings in the Town of North Andover. ` a leo 3 0 APP40 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION111111ARTS 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 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. Location t No. Date ' 14°RT" TOWN OF NORTH ANDOVER affiagidk S Certificate of Occupancy $ Building/Frame Permit Fee $ ' - ,SSACHUSE c�� Foundation Permit Fee - � � Other Permit Fee - �� Sewer Connection Fee $ Mater Connection Fee '- �� TOTAL 7 -\v Building Inspector Div. Public Works r � Location No. Date NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ + ; ' Building/Frame Permit Fee $ Foundation Permit Fee $ .' Other Permit Fee $ /fi sFiO ,Aewer Connection Fee $ - ? Connection Fee $ �TOT $ ! Building Inspector c Div. Public Works Location l No. Date ,40RTN TOWN OF NORTH ANDOVER �;, Certificate of Occupancy $ Building/Frame Permit Fee $ }+►toy . ,�� Foundation Permit Fee $ SSACMUs �Qther Permit Fee $ APWaterr � �onnection Fee $�°/' Connection Fee $ l Cl_Gv cQ,� TOTAL $ 01 Building Inspector / 12 -biv. Public Works — APPLICATION FOR PERMIT TO BUILD – NORTH ANDOVER, MASS. .,( gIV 3 .PAGE 1 • MAP 4d0. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONEP-21I SUB DIV. LO O. 0, S I / p _ / ;:,OCAT Ix ; K j' - PURPOSE OF BUILDING t!� r_ !-a i vV L�� 1 �+ o Y� !LM n OWNER'S NAME NO. OF STORIES • ^ .� OWNER'S ADDRESS r+' ' ) BASEMENT OR SLABN J t X _ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 'x lf o 2ND '? tj 3RD BUILDER'S NAME r { � , SPAN DISTANCE TO NEAREST BUILDING J DIMENSIONS OF SILLS DISTANCE FROM STREET ¢ //�j POSTS 13 �/ ­ ,vc- DISTANCE FROM LOT LINES—SID`Y �c.�ES� Rt L� REA /�w r/) " GIRDERS( L/ `� / / L AREA OF LOT �y� 5 F. FRONTAGE ���}/ HEIGHT OF FOUNDATION A/ THICKNESS--,),),,/ IS BUILDING NEW � �_ J, Gam- SIZE OF FOOTING ? '// X IS BUILDING ADDITION MATERIAL OF CHIMNEY Lo IS BUILDING ALTERATION l I IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER • d'fit" /C3�i� BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER l IS BUILDING CONNECTED TO NATURAL GAS LINE yolls- A INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ' �L•/ EST. BLDG. COST PAGE t FILL OUT SECTIONS 1 - 3 }I EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS t - 12 SEP 2 2 1992 f EST. BLDG. COST PER ROOM O �' f r 1 O .3 EPTIC PERMIT NO. j j /Q.. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING }� 9-tai.� (� eL} APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS LdLiCti133^l5Ii17.'I PLANS MUST BE FILED /AND APPROVED BY BUILDING INSPECTOR DATE FILED !/l /9 7 BOARD OF HEALTH SIGNATURE O WNER OR AUTH ZED AGENT ` OWNER TEL.# �' - r FEE . o UUN I H. ILLA taw CONTR.LIC.# '""- ' 00 PLANNING BOARD PERMIT GRANTED �nI © BOARD OF SELECTMEN .. i60 suILCIN INSPECTOR 4iso i s � BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STQR MULTI. FAMILY IE THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM _ 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 _ d 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL _ FIN. B'M'T' AREA _ '1, '1, FIN. ATTIC AREA _ NO BMT FIRE PLACES LL HEAD ROOM MODERN KITCHEN J 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 ` DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY . ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 11 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES 4Z LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR Ale TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE - FORCED HOT AIR FURN. TIM&R BMSA COLS. STEAM STEE COLS' HOT W'T'R OR VAPOR -_�� _ ' i vJ�._ ..._: ( .`✓ _l WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS - GAS 7 NO. OF ROOMS OIL B'M'T 2nd ELECTRIC 1st y ( 3rd NO HEATING `�' r' r 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 local or state law, regulations or requirements. ****************Applicant fills out this section*****//************ APPLICANT: 7a,L C)A4 i�o Phone LOCATION: Assessor's Map Number R A,ia-41 Iq11 Parcel Subdivision f4 L r1D(1)r )4dl l Lot(s) Street fri (Pill G St. Number i? ************************Official Use only************************ RECOMMENDAT ONS OF TOWN AGENTS: q Date Approved / Conservation Administrator Date Rejected Comments • Date Approved TouW Plan& r Date Rejected Comments Date Approved Health Agent Date Rejected 1 Comments Public Works - sewer/water connections mt I 55l/ ro - driveway permit 11 u-& 9/2/5Z- Fire Department Received by Building Inspector Date < i S l TG PLAA1 I� Ais I i Q << \! N I µ ' I / N \ I LES �+ 13972 0 '�CtS1EQE� L IAfSO S . i l..oc.a�-r�r� l u No. A.►sDa.1EQ. � M�. o A uflo•rccem— s:hss. t f I i Lal I8 g -ZZ-r--- S7" �kp , 11 t t r i S GCS.i�T I K� TH m P"F S%E:'r Si+cw I.J t41Z E. F-o tom. TH E 'T{d d F'1s S>C:TS l�SrG O T'�1-►�. V m,17 t 6.0 Cir ►J SPp—C1b C7 K O�a1 ti..t Go1��lPL. �O t..b C..J1� A•..�Q 6 tom.H U S F� l S �'o ii�� � _'• �� •' rr-H 'THF—: -EC>UlUG �rGTE'+�Mt►�..I i�TlO1.J dF' ���.� r►�ICy a j CouPo2.M Ty oil 1,10► ContF-o2�'1(TY =; S Ebry L..Avtl S F' •���Q �b to m \Aj N E,►,..1 Co U—srr.r.uG-'rE,r>. •v to E gZ L' 1 N,R rM To'w' n of 6Andover o. { ( 'lVEWAY ENTRY PERMIT -= W11 �.•� A E-, n� er, Mass., 19 to P� '4f BOARD OF HEALTH IPERMIT LD THIS CERTIFIES THAT.. . ..10A1.10,f..P... WAAWA11-11210')....0....A11• g � •�. ••� BUILDING INSPECTOR has permission to erectiffi.00f.WS41 ildin s on 0 , .. Rough Chimney to be occupied as. �. � �� � •• •• •�� Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,WMEOWUNWOWNLY Rough IMLAIM BY PARA. 114.8,E U. Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. A fa� } Af�1�_a N�F v„ p-{y— ELECTRICAL INSPECTOR PERMIT EXPIRES IN 6 MO o�� Rough PERMIT FOR FRAMEBUILM GLESS CONS TRU TIO START Service Final DATE:/ FEE PAIN.2.LF`-(2_d . ..... . .. .. .. . .. . BUILDING NSP CTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector i CERTIFICATE OF USE & OCCUPANCY Vows 0 oglh A, m0o ea, Building Permit Number 445 Date DECEMBER 23 , 1992 THIS CERTIFIES THAT THE BUILDING LOCATED ON LOT 19 HICKORY HILL ROAD (#160) MAY BE OCCUPIED AS SINGLE FAMILY DWELIDU W/2-CAR GARAG FIN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUII.DING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. E 40 oTt, H 320tt ,a eh�L CERTIFICATE ISSUED TO Thomas D . Z a h o r u i k o 185 Hickory Hil Rd. = E� AD DRESSNorthAndover, MA 01845 9SSACHUSEt Building Inspector I� I Litil V44"tl W smsfM I W.- fl/ NAL PLAN 111 N U I ownV410TtV,11 , -.' 10(o ndover ,f 0 4 ��,, No. 45 ERMITnK C,- '1'VEWAY ENTRY P9'� ��OHE .9 r.2 �An over, Mass., 19 C' I 19 9 BOARD F-HEALTH V, P. E 961LD THIS CERTIFIES T.AT7. .1J'0-Ph*4--P...tZ- 4-40 •••• - •....... BUILDING INSPECTOR has permission to;,ergctifif.4$JP#CA"CildingsonA.6.rl*-.19-RIep Rough 4'g-1 'At As &As Chim;jy �, tobeoccupied"Ir�'Ar/PJAM AONIAPIPOSALAW.C. Final provided that the person accepting this permit shall in every respect conform to the terms of the application on rile in �L�A idC PL B CfN To .,.,;his office,and to the provisions of the Codes and By-Laws relating to the Inspection,feWFOROUNWOWNLY R KWLATW BY PARA. 114.8,5. B.C. & Buildings in the Tqrn of North Andover. VIOLATION of the Zoning or Building Regulations Voids this Permit. Avr LIM a I n d' PERMIT EXPIRES IN 6 MON ELECTR Rough 6 PERMIT FOR FRAMUBUILMNGLESS CONSTRUCTIO STARTS Service Final DATL"/L4::..V FEE PAID' 2S_'L-Q j . ..... BUILDING NSP CTOR GAS INSPECTO 11C Del- Rough Occupa y Mit Required to Occupy Building Display in a Conspicuous Placeon the Premises A FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Appiaved by Smoke Det. �1t lr• 14 6 dk_Ale Building Inspector R Date.0.4 NORT1y <40RT" ho TOWN OF NORTH ANDOVER �? •_� O p PERMIT FOR PLUMBING SSACNUS� This certifies that . . .s . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . .'. . - :: . l!. . .. .. .. . . . ...... plumbing in the buildings of �': --�. . . . . . . . . . . . . . . . . . . . at /l n. . . {.`'`.f'.'. . . !. . . . . . . . . . , North Andover, Mass. Fee/.ie. . Lic. No.) . . . . . . . . . . . . . . �r PL'UMSING INSPECTOR Check # / - 5507 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) ,r" NORTH ANDOVER,MASSACHUSETTS � Date Building Location (0o 1&6 Owners Name Permit# 1.5-6 o 7 ` Amount , /f Z °� Type of Occupancy (Ze s e✓I�-! f -- New Renovation ReplacementD Plans Submitted Yes No FIXTURES Cf Cr rA Cr SMME �A1T ]STADf�i 1 � 1 An " sa >H '. moo* - � 7.lIT:) t (Print or type) N� p I Check one: Certificate Installing Company Name 3 " i 1 l�r►'t�l�l `� } 11 Corp. Address 0 Partner. W Q 6-r MA o o I E 3Tu's esus Telephone �j 1 — cm3 ;J P1 Firm/Co. Name of Licensed Plumber: v� 1 VI P UI 4?1 Insurance Coverage: Indicate the typ6 of insurance coverage by checking the appropriate box: r+ Liability insurance policyEl Other type of indemnity D Bond D Insurance Waiver. L the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance ignature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Cha to 2 of G eral Laws..- u By: signature-orri—censea MEm Type of Plumbing Licens Title i�g City/Town Licensem e'er Master Journeyman D APPROVED(OFFICE USE ONLY t Date . r'.. .. pORTH °`��``°:•�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING �SSACHU ,,This certifies that J has permission to perform wiring in the building of .......� :... '. .................................................. - `: ... at.........1................. .. ....f r .........f......... ,North Andover,Mass. Fee..................... Lic.No. �` �... "...�.p .. 4.r....................... f Check # ELECTRICAL INSPECTOR t/ � ��7 41 , ,.15 TRE COAMOATUETHOFAM5',4CU,SL+'M Office Use only DEPARTAffl IOFPUXJCS4FM Permit No. BOAMOFMEPREVEMONRMUL4HONSR7CM12.W Occupancy&Fees Checked APPLICATTONFOR 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 Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) KV 9L ` p Owner or Tenant /011 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 Underground No. of Meters New Service Amps / Volts Overhead Underground 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 ground round 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 Pum s Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No. Dryers Heating Devices KW LocalMunicipal Other F Connections �. No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• h>s<.uanceCoWrdgletRnu>allt9�th7e�re �v�r o(f�Massa�ch>sdtsGale�-al�LawXs 7�7l� Ihawaamal L alnuly) Je yrri kig�'`'p Co.w,'ponts51]) alegvaht YES i O IhawmbmftdvaJidP00f0fSXW1DtheOffi=YES ffyoubawdledodYES,plcminicafethetypeofwo mWby clalgdle - box -- IIVSUI'�AhICE BO1�ID � - CIII�R � ([�eSpedfy) Val<xd1!chica1Wotk$ WotictoStact S _ bspectionDaleReWeWd RCU41 Final Sigrledunda-aieP�i�altiesofpegtay. n _ FIRMNAME O (,L.11/VSC �1 Iicer>seNa �y 7 - ' j 'Licensee �/�m��. Slgpahue !/ ' IxenseNo BtnulessTel.No. 9 )� ; 62 ?.-Z2-YZ A1tTeINo. �� OWNER'SINSURANCEWAIVER;Iamawatetot theLkensedoesnothavetheinstua mCovn-PeoritsstlttantWegnvalaltastectmedbyeC*rletalLaws uxl diatmy @goahueon ttnspearutawhcahon waives ft mglmernu t Please check one) Owner ® Agent d Telephone No. PERMIT FEE$ Signature of Uwner or Agent