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HomeMy WebLinkAboutMiscellaneous - 164 OLD FARM ROAD 4/30/2018 164 OLD FARM ROAD 210/062.0-0078-0000.0 i i s i i Date � 6tMtG8b>�va�. TOWN OF NORTH ANDOVER � f PERMIT FOR WIRING This certifies that . . . . . . . . . T�.D . . . . . . . . . . . . . . has permission to perform . 1alP_. . P444W_al. . . . . . . . . . . . . . . . . wiring in the building of . . . . .�'4�- Iv. . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . , rth Andover, Mass. Fee Lic. No. . �/�� , y , ELECTRICAL INSPECTOR # Check#_�1�9 :7 11148 Commonwealth of Massachusetts Official Use jOnly Ulf Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 (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 WINK OR TYPE ALL INFORMATION Date: 10-15--191 City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives noticeofhis or her intention to perform the electrical work described below. Location(Street&Number) 1 6 y OICA 7�1. M !! l< Owner or Tenant Telephone No.9/-.25e- Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building �{,�y� Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters e Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ¢ lac 2 -PX t'a'i c� 'ZtOA R4,c111 ,,-d � wiIltw !dGi 7COA P11116ara{ p �',.,�/�G!/ rtxw Jerre k��I- wllb4.e� �.,GQ bex Completion o the ollowin table m be waived b the Ins ector o Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ n- ❑ o.Of mergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets Z No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump umber Tons o.of e - ontamed Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ municipal El other r No.of Dryers Heating Appliances KW SecuritySystems:* No.of Devices or Equivalent No.o Water KW o.of o.of Data Wiring: Heaters Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications ' - No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of E ectri al Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the and penalties✓. perjury,that the information on this application is true and complete: FIRM NAME: / .w !Y_ , 51? f1Z' LIC.NO.: "Z-� `� Licensee: >I"I it'He,., ,._ ft-A t/TeI1es Signature `- LIC.NO.:CJS'12 �;'Iy (If applicable,enter" t'in the license nber line.) Bus.Tel.No.: '72 11-7�Y-f?l 2 Address: J �dR R I Sd1/ u D Gr/ �,�Zzs'-)ti, A-P4 Q' Za Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one_)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE.$ .�. _. _. _ Fes.�.�'-f. ! ! .il •i � __ .t -. �., r _._.�... .-.....*- __- _ --_ _ "-_ r —_... �f x ... .di . 173+f1�.. {y..._ ..._._ i_,—i _ ._. . i1. €"+ -_� !_ —_.. _ _ .t u.�_1 __— ♦ _ I Date . . '.30.-/.7 I TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . . . . r /7t—.QDST has permission to perform . . .kc% . . . . wiring in the building of . . . . . . . . . . . . . . . . . . . . . . . . . . . +at . . .�/ . OLD.6-W w. . '0 . . . . . . . . . North Andover, Mass. Fee . -S0 . . . Lic. No. .c� b3 . . . . . . . j . ELECTRICAL INSPECTOR Check# 2 ff-3_ 11053 08/29/2012 20:27 4102901667 PAGE 01/01 � � Cem�,uuaal�b.��adeac�a�e O!�"icial Un! Only cc °I Permit No. .C1a� ..lira Ja+Wea�oe Occupancy and Fee Checkcd BOARD OF FiRE PREVENTION REGULATIONS Vkv.1/071 b�,k APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK }}�+,�(1yy�. }�A�ll%Vtrkk t,o,Jbee�p}�erfooTMeyd inracwdtfloe jjv,,ij,ryth}e miLmd usetts ElTcct cal Cad[c 041X/)).527 CNIR 12.00 plEA L' Pl4U V/ I /LMA\OR TYPE ALL IjYFOB Al7014) Date: City or Town of: �JOAL ., wo—e, To the Inspector of hires: By this application the undersigned gives notice of his or her intention to parform the electrical work described below. Location(Street&Number) Owner or Tenant pr. A G e vca Telephone Na �i 7 g � �i 6 4S Owner's Address s+41'` Is this permit in conlunctbn with a buildinperntit? Yes No ❑ (Check Appropriate Box) purpose of Bonding Utility Aatborization Na Existing Service Amps _ ! Volts Overhead[] Undgrd❑ Iva of Meters Mw ftpdo Amps / Volts Overhead❑ Undgrd® No.of Meters Number of Feeders and Ampneity Location and Nature of Proposed Electrieat Work: 14 u l:Om letkn p fha p/toWNt table nt be wcri+red the hweefor Wiwi. No.of Recessed Luminaires '� Na of Ccil Sus . addle FAtis °" Total A p (Paddle) Trans ormers KVA • No,of I.Aiminaire Outlets No.of Hot Tubs Generators K A Opting No.of Lamin ;, Swimming Pool de - a�d, ❑ > itsNo ot No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.Initiatin bev cries No.of Ranges No.of Air Con& TTotal No.of Alerting Devices No.of Waste Disposers T mp ,�um r ''ons De oft n/Ak�neD vices No.of Dishwashers Space/Am Pleating KWLocal[] C une;a"on No.of Anvers Heating Appliances XW rarity s .tems: Na of DevIces or Equtvalent No.of oterKW o.o o.of Data Wiring: Heaters Signs Ballasts No of Devices or Equivalent Na Hydromassage Bathtubs No.of Motors Total HP 1 et Neortt£aDenviica or E aivA1t OTHER: Attach additional detail ifderir4 or as required by ihr Im,pecmr o11i Mra, arstiniked Value of Eieclricai Work: Z,Or->0 MThen requlmd by municipal policy.) Work w Stan; r 1nspEdaons to be requested in accordance with M Rule 10,and upon completion. ;INSURANCE COVERAGE: Unless waived by die owner,no permit for the performance of electrical work may issue unless t1,c licensee provides proof of liability insurance Including"completed operadon"coverage or its subsimflal equivalent. The undersigned certifies that such coverage is in forcer mid has exhibited proof of same to the permit issuing office. CHECK piVir': INSURANCE 9 BOND ❑ OTHER 0 (Specify:) I calif+,varier the pains and penalties d peri ,that the informalivn on this anplakon Pa true and cam#dte FIRMNAME: 1'ti a�}1�,,„s at.-. ��T t, r E�c t(rf"c i c.�, LIC.NO.:7,1031 �1 Licensee. k4., A. Signature �• may..�. _ LIC. 1 ZV9Y 8 (if aWicablt,enter"asempt"in to icense number litre.) Bus.Td.No.-77'9I—'7 a y..S%�> /�� O� t.r/ '•t 7 7. A.t�resLc. !6 /"'leri�ta_ 2.f. �, � _M.�4 Alt Tel.Na. *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety`°S"License: Lic.No. OWNER'S INSURANCE WAIVER: I mn aware that the licensee does not have the liability insurance coverage normally required by taw. By my signature below,I hereby waive this requirement. I am the(check one)[I owner owner's agent. Owner/Agent NZA Telephone No. PERW`,I EE. $ Signature p � - -' � - _ ter'. _ .. _ _ � -T . .1 _ . ._ -_� _, _ _. •. } r • Ac R® CERTIFICATE OF LIABILITY INSURANCE °�'�`""�'°°"Y'"' so 8/30/12 § -,THCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(es) must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer ruts to the certificate holder in lieu of such endorsemen PRODUCER NAME: Benevento insurance Agency Inc PHONE 781 599-3411 FAX N : (7a1) 581-7200 497 Humphrey Street ADMAN' Swampscott, MA 01907 INSUREALS)AFFORDING COVERAGE NAIC0 INSURER A:Norfolk & Dedham INSURED INSURER B: Matthew A Piantedosi INSURERC: Commercial INSURER D: 16 Morrisohn Rd. INSURER E: Watertown, MA 02472-0309 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CC�LLyAIIMg+S. ?LTR TYPE OF INSURANCE ADDU SUBR POLICY NUMBER PM/DD/YE� MMIDWYYYY LIMITS A GENERAL LIABILITY R0652736A 7/22/12 7/22/13 EAICHOCCURRENCE $ 1,000,000 $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000 CLAIMS-MADE ®OCCUR MED EXP(Arty one person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-OOMP/OP AGG $ 2,000,000 POLICY PRO- RO LOC $ AUTOMOBILE LIABILITY COMBINED S N L O (Eaaccident) ANYAUM BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED er acddeM HIRED AUTOS _AUTOS S UMBRELLA UAB OOCUR EACH OCCURRENCE $ EXCESS LIAa CLAIMS-MADE AGGREGATE $ DED RETENTION WORKERS COMPENSATIONWC STA TU- OTH- AND EMPLOYERS'LIABILITY Y/N S — ANY PROPRIEMR/PARTNER/EXECUTIVE 7 N/A E.L.EACH ACd DENT OFFICERMIEMBER EXCLUDED? (Mandabry in NH) EL.DISEASE-EA EMPLOYEE If yes.describe under DESCRIPTION OF OPERATIONS bebw EL.DISEASE-POLICY LIMB DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Addidonel Renerks Schedule,H more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Inspector of Wires- ACCORDANCE WITH THE POLICY PROVISIONS. North Andover 1600 Osgood St AUTHORIZED REPRESENTATIVE North Andover, MA 01845 Anthony Benevento ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The AC ORD name and logo are registered marks of ACIDRD Phone: Fax: E-Mail: T 8971 Date. ./� II. . . L. V TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� This certifies that . . . . .46 41 . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . .—tkV. w.► q< .`. . . . . . . plumbing in the buildings of . . . . !�t �C. . . ./.�'Axelod . . . . . . at . . .1�.y. . . . . . G./ . . . . . . '"�. . . . . , North Andover, Mass. .� . . . . . .lel Fee S:�1U.Lic. No. U -� ,. ,.�.. PLUMBING INSPECTOR Check # -YS ASSACHUSET'I'S UNIFORM APPeCICATIOIN SOK PERMIT TO DO PCI U e1 WING (Tye nr pru5t) NORTH ANDOVER,MASSACHUSETTS //// �/-� �' DatS � 0_!I Building Location ((J�� Q lid/ �`{n-7 Owners Name 10/�� � � � Permit# _- Amount /w� � Wh�C.TjpeofOccupancy k3aw -- -- ---__.__:--. New 2 E Rmov ltion } RepiliitiGIIlLi t Flans Sawn ted es j ( 1140 0 FIXTURES cc SLBUM is-Tisa� j .T%HnM M� Pl.00R 11� SM i7.1.A.11. lf].All Qp���l�yUryryA.i��\ 011l C13Jl.i\ (Print or type) Check one: Certificate Installing Company Name / &a kt A Rio E) Corp. Address �`� ` 4Y Q° Partner. - jsr �Emu=. i Name of Licensed Plumber: j" (41 Insurance Coverage: Indicate th type of insurance overage by checking the appropriate boa: Liability insurance policy Other type of indemnity (, Bond rl 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 e Chvner r Amt I hereby certify'that all of the details and information I have submitted(or entered)in applicatio are hue and accurate to the best bi mN knowledge and that all plumbing Hoek and installations perTtriineit antler t Issu- for s application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code d ha 142 f the Ge S. Signature oT Liccnseaum r Title Type of Plumbing License rte-/roan rcense um er Master ® Journeyman APPROVED ioym'E 05/10/2011 TUE 11: 16 FAX 978 794 8583 JOdnne K Mille InS AgnCy /002/002 ACORaL. CERTIFICATE OF LIABILITY INSURANCE D 05/10/2011 Y) PROOUCER 978-8$6-0826 THIS CERTIFICATE 1$ ISSUED AS A MATTER OF INFORMATION JOANNE K MILLS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 156 HAVERHILL ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. METHUEN,MA 01844 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: NAUTILUS DAIGLE ENTERPRISES INC. INSURERS: SAFETY INSURANCE DBA ROOTERMAN INSURER 0:CNA INSURANCE 46AS PORTLAND ST INSURER D; LAWRENCE,MA 01843 INSURER E; COVERAGE$ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCC AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH y POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ IM9R WO POLICYNUMB2R DATE LICY■PP■CTIVB P' LI�4YiXP11�11 LR♦t1TB G■N■RALUABILITY EACHOCCURRENCE a 2 MILLION A X COMMERCIALGENERAL LIABILITY NNO74753 11-17-2010 11-17-2011 a 50000 CLAIMS MADE F-1 OCCUR MED EXP(Any oneparson) $ 5000 PERSONAL&ADV INJURY $ 2 MILLION OENERALAOOREOATE ✓4 2 MILLION OEN'LAGO REGATELIMIT APPLIES PER: PRODUCTS•COMP/OP AGO $ 2 MILLION POLICY PR LOC — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s 1 MI LLION ANY AUTO 2433404 08-10-110 08-10-11 Me eccldenO ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per Peraen) $ HIRED AUTOS BODILY INJURY NOWOWNEDAUTOS (Per90dtlenl) a PROPERTY DAMAGE $ (PatdoadsnU GARAGE LIABILITY AUTO ONLY•EA ACCIDENT a ANY AUTO OTHER THAN EAACC a AUTO ONLY: AGO 6 ift GGIUMBRELLAUABILITY EACHOCCURRENCE $ _ OCOUR FICLAIMSMADE AGGREGATE a .. DEDUCTIBLE ; RETENTION a S WORNMRSCOMPORSATIONANO x STATU• OTH C EMPLOYERS'LIABILITY 6S59UB-7537A95-6-08 08-30.10 06-30-11 E L EACH ACCIDENT $ 9 00,000 ANY PROPRIETORIPARTNER/EXECUTIVE OFFIOERIMEMIKA EXCLUDED? E L.DISEASE•EA EMPLOYEE S ^500,000 If yea,doNA0e under SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT 1.S 100,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VMHICL■S 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPSCIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORR THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL MORAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CER 1 TB HOLDER NAMED PT75 LEFT,BUT PAILU O D O SNALL TOWN OF NORTH ANDOVER IMPOSE NO ORL! T OR LIABILITY OF AN K1r UPON THE IN ■R,ITS ■NTs OR REPRES AUTN ZBD Lym H ACORD 26(20011081 RD CORPORATION 1988 # 1, Office Use Only 01 4r &MMVnutr# of ,lfflttu#ugefts Permit No. �� ttt000JJJ 3epartment of Public -E1fEttj occupancy,& Fee Checked �4 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 390 (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 INFORMATION) Date .S 2, (jar or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) � � 1—/��� / �� 7-,42 Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building ,riL+/r — �2azS�Oti� Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd No. of Meters New Service Amps __/ Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No. of Transformers No. of Lighting Outlets I No. of Hot Tubs KVA No. of Lighting Fixtures Swimming Pool Above In- No. g grnd. ❑ grnd. ❑ 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 Ranges No. of Air Cond. Total No. of Detection and No. of Ran 9 tons Initiating Devices No. of Disposals Dis No.of Heat Total Total P Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices 1 I Municipal No. of Dryers Heating Devices KW Local ❑Other 1:1Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Complett5j..Zperations Coverage or its substantial equivalent. YES NO = I have submitted valid pro f of same to the Office. YES Z If you have checked YES, please indicate the type of coverage by checking the appro to box. INSURANCE BOND = OTHER �— (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed under the Pe (ties of perjury: FIRM NAME T `�C�� /C f L- LIC. NO. �✓���$ Licensee �� LIC. NO. �7�� Signature Bus. Tel. o. 5 S 33 Address _�.? w'� S tiC� ul� Alt. T No. OWNER'S INSURANCE WAIVER: 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 At (Please check one) Telephone No. PERMIT FEES � v (Signature of Owner or Agent) x•6565 .__._ _ _ ,�.....'ti TYi.tiV-r�Y"` ,.. -..^L,r.��,,dl••....... .moi I r T1263Date. .. . ... . . ... . . ....... , , . ,,ORTM TOWN OF N_ORT��H,dp 11ANDOVER ' 3�py`„to '6,'rpL o A PERMIT FOR "S INSTALLATION= .k 'ISS.— � � gCMUSE� ~ I F This certifies that n.�. . ` `.I. . . . C. �ry!�f Chas permission for go installation r. �. . . . in the buildings of . . . ./f Kf� . . . . . . . . . . . . . . . . . . . . . . . . . . . at . l `r�.4, �.v.�r!! . . !�. . .. . . . . . . . .. North Andover, Mag. Fee. ./. '. . . . Lic. N`o l. ... . g. . . . . . . . . . . . . . . . . . . . . . . . . . . a qsf I G$INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File Location No. Date f NORTh TOWN OF NORTH ANDOVER Ot•t�an .,40 „ Certificate of Occupancy $ # Building/Frame Permit Fee $ A � a as�cmus Eta Foundation Permit Fee $ �l 1 -Ot,lier Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 1 4R Building Inspector � 9804 Div. Public Works s , •- NORTH ANDOVER, MASS. PAGE pEbt�trr xo. APPLICATION FOR PERMIT TO BUILD — s, 2 RECORD OF OWNERSHIP (DATE BOOK :PAGE - X MAP +40. LOT NO. I ZONE I SUB DIV. LOT NO. Y PURPOSE OF BUILDING thry., Q LOCATION q 33 OL 0 i, r7 SIZE G. � B NO. OF STORIES OWNER'S NAME .� �� ..tp �$ f3AMENT OR SLAB OWNER'S ADDRESS 1 3RD 1.494% OF FLOOR TIMBERS 1ST 2ND iy�^►.�'7 ARCHITECT'�NA mBUILDER'S !l Q NSIONS OF SILl3 _ t '_ f �'c�."r. j i� DISTANCE TO NEAREST BUILDING - y ----- POSTS e r •'�� „y'}$ 4 DISTANCE FROM STREET p.. IaLLI• t REAR GIRDERS DISTANCE FROM LOT LINES—SIDES THICKNESS �I HEIGHT OF FOUNDATION v"�e.. �pQ AREA OF LOT FRONTAGE F SIZE OF FOOTING X -y IS BUILDING NEW MATERIAL OF CHIMNEY IS BUILDING ADDITION IS BUILDING ON SOLID OR FILLED LAND IS BUILDING ALTERATION V by L 1 IS BUILDING CONNECTED TO TOWN WATER WILL BUILDING CONFORM TO REOUIREMENT5 yr )6DE IS BUILDING CONNECTED TO TOWN SEWER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST EST. BLDG. COST -- SEE BOTH SIDES .. EST. BLDG. COST R SQ• FT. PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER ROOM y PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. A APPROVED BY ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ` ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILEDANO APPROVED BY BUILDING INSPECTOR 'ADATE FILED :5:1,2e `+' / BUILDING INGractOI !1 - SIGNATURE OF OWNER OR AU HORIZED AGENT OWNER TEL.# (/ FEE 3sa y CONTR.TEL.A PERMIT GRANTED 1g = CONTR.LIC.N H.I.C. _ OWIl^ _ - T _.. . . .. OFFICES OF: _ . _. � - ----- � _ .... ,of �- -._ �"-- -- _ ..120 Main Street - ��'E�-s •�, .y' =NORTH ANDOVER rronh,�ndover. BUILDING t - Massdi:husetts O 184s CONSERVATION DMISION OF HERL.TH - - r"N'ING PLANNING COMMUNITY DEVELOPMENT KAREN H-P.NELSON.DIRECTOR g - 1n-,acc--rd2rce-with the ­7 w. S 3 cDndiCCR' at gLLtldlRs D Nurtoe: -- s t5Zt t::d jctr- _ s resaitint frcr r this work sh ll'be disnoset!ci iz a?rcne::"s� _=s:c sclid wastc •5:s7csz, :a_.. - s- _.... 5y tit G,i:.,,c.LI1..-5....._._,....-._• - i ne debris will be disposed cf in: - - Signature of Pcrtnit Aepiicam _ _.. . Date _ NOT=: Demolition permit from the Tou3 of :forth Andover must be obtained for ~ this project through the Office of the Building Inspector. NORTH j F own of Over No. zoo ►- .` . : ,_ I L Krt " dower, Mass., 19 COCHICHEWICK ADRATED S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT... ...........................1/.l�..�-�1.��'f�..Q.......A..[��.�.�..�............................................... Foundation has permission to erec . . —Cd—%.... buildin s on ....��q.. ......O1. .... 1....... '... Rough ! to be occupied as........................................................... ,,r.�.t....` ' ...................... .. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR h' VIOLATION of the Zoning or Building Regulations voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START. ELECTRICAL INSPECTOR Rough ............................................... . ........ Service UIL G 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. FIRE DEPARTMENT Burner Street No. Smoke Det.