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Miscellaneous - 169 HIGH STREET 4/30/2018
169 HIGH STREET 210/067.0-0035-0000.0 i Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Holly Mushaty Property Address: 168 High Street Company: Merrimack Mutual Fire Insurance Company Policy/Claim Number: FP5527973, FP5527973 Date/Cause of Loss: 9/30/2016, Insect Damage Our File Number: 33677-R Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, 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 claim or file number. Ryan Werner, Ext. 116 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. I' i l0 3 )let, Signatu a nd Date ANDERSON ADJUST ENT CO., INC. 50 Nashua Roa , Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: Health Department North Andover Fire Department 1600 Osgood Street 795 Chickering Road Building 20, Unit 2035 North Andover, MA 01845 North Andover, MA 01845 Date. . . . . . .. . . "OR'" TOWN OF NORTH ANDOVER �• o ° p PERMIT FOR PLUMBING ,SSACMUS� This certifies that . . . . .. . . . . . . . . . . . . . . . has permission to perform plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . at �. , . ..� . . . . • . . . . . .,,North Andover, Mass. Fee`- ?.'�:'' .Lic. No���r1 w . �� 'U. . . . . . . . . . . . . ` PL ,MB1NG INSPECTOR Check # 7124 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �W F /�z�� ,S]_ Owners Name Date Building Location �OUdtJG` LSC Permit# Amount Type of Occupancy / fit ell'-;yJ j New Renovation Replacement ® Plans Submitted Yes ❑ No FIXTURES H C a � A H � F w A � SUB.BM &�SIIVIIVl' M HJOC t ZD)HIDM 3M IHIDM / 4IH)H M 5M HfM 6M FLOCR 71H FLOC SIH)H IM (Print or type) Check one: Certificate Installing Company Name f1'4 LLOl?r¢i✓ t'01al jflj V 6i ❑ Corp. Address /00 Ifd x s,7Z Partner. '414 Business Telephone 7e G rs-- R3—ty`T � Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: #Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Insurance Waiver: 1,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent 0 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 Code and Chapter 142 of the General Laws. By: igna ure oi 1-icenseuFlumSer Title Type of Plumbing License City/Town License Num5er Master ❑ Journeyman APPROVED(OFFICE USE ONLY Date.. . . da.� NORT#y Of „.. ,e-14, TOWN OF NORM A OVER O � F • - PERMIT FOR GAS STALLATION r + 9 � h �9SSAC'HUSf'�•f This certifies that . . . .? " -- '. .-�e-•-. ;1r-�' . . . . . . . . . . has permission for gas installation , in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at ,!. . . . ' North Andover, Mass. Fee- .r . . Li No GAS INSPECTOR;:�/ Check# _ 5735 sn•. Aly 1 > MASSACHUSETTS UNIFORM A.PPLICATON FOR PERMIT TO DO GAS MTgG - Type or print) Date -�-7 0(, NORTH ANDOVER, MASSACHUSETTS -r Building Locations /( 6 Ll/d�� sr Permit# v /3� - / Owner's Name Amount S { New❑ Renovation ❑ Replacement ® Plans Submitted ❑ I n n n — n F- — Z r -'� Zt t — =t _ In Z �n L 5U8 -8ASEN( ENT - - - - - - - - `_ HASE .M ENT fs'r. FLOG R 2ND . FLOUR 3 R D . F L O O R 4'r if FLOG R sTif FLOGR 6T 11 F L O O R 7'r if F L 0 0 R 3T f1 . F1, OO R (Print or type) o Check one: Certificate Installing Company Name ISA LCo/twAl /°LuM�`�tle p ❑ Corp. Address `;O. 134Xs7o� ❑ Parmer. L .q/RtAvc e N4- D/8'Yz Business Telephone �7g 8'f= s'Q� ❑ Firm/Co. `I ti, Name of Licensed Plumber or Gas Fitter 7/-/a V f-f f�/�MIX 4A,' INSURANCE COVERAGE Check one: 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. i Liability insurance policy ® 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 iVlass.General Laws,and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent Owner ❑ Agent ai 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.Ivlassachusetu State Gas Code and Chapter 142 of the General Laws. Bv: Signature of Licensed Plumber Or Gas Fitter Title 0 Plumber � o�i�---- City/Town ❑ Gas Fitter License Number ❑ Master �kPPRO VED(oFFICi=USE ONLY) I Journeyman t Date......- ... ...�`............ f IORTPI TOWN OF NORTH ANDOVER o PERMIT FOR WIRING .o+Ano SSACMUS This certifies that ....... .1,..?...........................:............... .................................... has permission to perform ...............` w r............................................. a wiring in the building of '`'`� at.�ln ..l.... ..: Y ... North Andover Mass. Fee. ..Gv..(�Lic.No G�3/.7r�%.... `........... ..'t-r�.............'.......... \ELECTRICAL INSPECTOR x 7�Check # / r 5047 Official "Use Only Permit No. yv '� C77.S Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULAT NS 527 CMR 12:00 APPLICATION FOR PERMIT TO PEiF RM ELECTRICAL WORK All work to be performed in accordance with the Masj ch setts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date To"foe Inspector f'Wffr s: �v inc i wp avr v • u ca. Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number Owner or Tenant �c-�� f�� C � ;fye Y p� -7-7 Owner's Address J/��y'Y S�� = o 6 Is this permit in conjunction with a building permit Yes No 0 (Check Appropriate Box) Purpose of Building X 4L�O�%r d�L/ Utility Authorization No. Existing Service Amps--:z Z 0 Voits Overhead 01-� Undgmd 0 No.of Meters New Service 2 0 0 Amps 2 2.�Voits Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /�'/O tet/ ©� ` Total Np.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 11 In 0 do.of Lighting Fodures Z Swimming Pool gmd 0 gmd 0 Generators KVA No.of Emergency Lighting No.of Receptacles Outlets O No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone / Total No,of Detection and No.of Ranges < No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pum Tons KW No.of Sounding Devices NoJ of Self Contained No.of Dishwashers SpacelArea Heating KW Detection/Sounding Devices a Municipal 0 Other No.of Dryers Heating Devices KW Local . Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wirin 1 No.Hydro Massage Tuds No.of Motors Total HP t OTHER: 1 INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws 1 have a current Liability Insurance Policy includiglZompleted Operations Coverage or its substantial equivale NO hav valid proof of same to the OffiYES= NO - if you have checked YES please indicate the type of coverage by checking the appropriate box. SURANCE BOND a OTHER a (Please Specify) (Expiration Date) Estimated Value of.Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed FIRM AME under the Pe, r ry of 'ury: LIC.NO._� Licensee ��/ rL/C-.:f/.;Yt Signature c %< �yLIC.NO. I Bus.Tel No. g 5-6 0 0 Address 7 5 L17-/.�L /7`G L Cli2 C L Alt Tel.No. _ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coveraefe or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Date...e .... ........ . .......... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU This certifies that .... S..................................... has permission to perform wiring in the building of.../ ...a -M.................................... at J6.9.........41 s5. ................................... .North Andover,Mass. Fee.F4.�00..... Lic.No.'...........7 al�z ........................... ELECTRICAL INSPECTOR Check # 469 .1 A Official Use Only Permit No. q(a ' V&C091M0AWEALWOE 9I1, S,,4CV JSEg7S Department of Tu6tw Safety I Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 I APPLICATION FOR PERMIT TO PERFORM ELECTRICA ORK Al work to be performed in accordance with the Massachusetts Electrical Code 527 R 12: (Please Print in ink or type all information) Date T �- To the or of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number I&9 141 Ci f+- Ir.. Af.. A-4 poyGP— Owner or Tenant Owner's Address U I (t Gt +f" ':5; XL A-4©O.O CS A-- Is this permit in conjunction with a building permit Yes)K No 0 (Check Appropriate Box) Purpose of Building fj E w 1G I TC A-e 4 Utility Authorization No. Existing Service ___j bb Amps 1 0 Vohs Overhead X Undgmd 0 No.of Meters i) New Service Amps Volts Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work L e rnT 5 f V E d Fr j4o u5 C , Q.b c.f ci W f'.'I f-i 44 Total No.of Lighting Outlets , No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of Lighting Fixtures swimming Pool gmd 0 gmd 0 Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units e No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges I No of Air Cond Tons Initiating Devices Heat Total Total No.of Di I No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers I Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring L No.Hydro Massage Tuds No.of Motors Total HP OTHER: r INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES C% NO have submitted valid proof of same to the Office YES C% NO 1i If you have checked YES please indicate the type of coverage by checking the appropriate box. r INSURANCE 0 BOND 0 OTHER 0 (Please Specify) (Expiration Date) Estimated Value of Re tric Work$ 7 DO iJ -o z Work to Start f921IV s Inspection Date Resquested � � Rough Final Signed under the Penalties of perjury: FIRM NAME P-Ogt k 7' tiE$t A r IC - / LIC.NOJW A- E 4-oo n Licensee PoVAC&T- C664,A-4C �L Signature ,G-��Pr� 41604— /�� LIC-NO. 111- 4500017 Bus.Tel No._ / g 7� 531 %17& Address.j , Aj 14$l S L Ab 4 e"&t,"6 db A— 01f,34 Alt Tel.No. 3 too :�f 7 7 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the lnsuranc ge or its substantial equivalent as required by Massachusetts General Laws.And that my signatureonthis permit application waives this requlmmen Owner Agent (Please Check one) L�� 44 ! i Telephone No. !T(1 �CJZ ��VERMIT FEE $.96 ` (Signature of Owner or Ag t) f Location No. 3 Date / )3 NORTH TOWN OF NORTH ANDOVER Of `a° ,•,yG f 3: ` • �c f 9 Certificate of Occupancy $ Eta' Building/Frame Permit Fee $ ncNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 6 ,179 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ..... .. .. .. . BUILDING PERMIT NUMBER: DATE ISSUED: �a- � q-ate© 3 X SIGNATURE: C C Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number W 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided 4- 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infon ation: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Name(Print) Address for Sery ?3 , ,5316. Signature Tele p O 2.2 Qwner of Record: Ni me Print Address for Service: O Z M Signature Telephone M SECTION 3-CONSTRUCTION SERVICES 70 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: O License Number m Address Expiration Date Signalire Telephone r 3.2 Rigistered Home Improvement Contractor Not Applicable v Company Name rn Registration Number r Address r s Expiration Date ^z Signature Telephone V h Q SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check allapplicable) New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition L Accessory Bldg. 0 Demolition Other ❑ Specify 'fit-Cv�e.,Q r Brief Description of Proposed Work: 3 OSS IV- ."SM411 . ill v�( Z , &" i Ovu' 1%� Q. 4•ly uud Z 1 07� N SECTION 6-ESTIMATED CONSTRUCTION COSTS /y�pir,T Item Estimated Cost Dollar to be (Dollar) QFFICIAL ITSE ONLY. 1 0ro Completed b permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Q n Construction 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC / 5-30 5 Fire Protection 6 Total 1+2+3+4+5 /OVA Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on M� calf,in all natters relative to w rk authorized by this building permit applicatioit . i, a� Signature of Owner 0 Date 1 SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief (lil a,r"vim E . MI& Print me Signature of Owner/A ent Date MUM NO. OF STORIES a 4 SIZE Qb BASEMENT OR SLAB r3r k/k ii-42, SIZE OF FLOOR TMERS 1STX/0 2 ') p 3m &If- TMA SS-e S , SPAN DEVIENSIONS OF SILLS DINIENSIONS OF POSTS DIMENSIONS OF GIRDERS 111--IGHT OF FOUNDATION - THICKNESS I SIZE OF FOOTING Z V 7(o MATERIAL OF CMINEY &►1 U 1S BUU DING ON SOLID OR FILLED LAND ,Soc-i 0 IS BUILDING CONNECTED TO NATURAL GAS LINE W/ 15 FORM - U - LOT RELEASE FORM i INSTRUCTIONS: This form is used to verify that allnecessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. .............................................■.....r.......................■ APPLICANT 91P>HONE, ASSESSORS MAP NUMBER CP LOT NUMBER 3S SUBDIVISION _ LOT NUMBER STREET , L Q— `STREET NUMBER l G✓ STREET ■r...■ ■.................................................. .......... OFFICIAL USE ONLY RECO ATIONS OF TOWN AGENTS �.... ............. ........................................ ............ �� DATE APPROVED o� Q _ CONSERVATION ADNIINIS OR DATE REJECTED CONIMENTS J DATE APPROVED TOWN PLANNER DATE REJECTED CONDAENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED CON M ENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTNIENr DATE REJECTED CONMIENTS - -_ RECEIVED BY BUILDING INSPECTOR - - DATE 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: (Locat n of Facility) Signature of Permit AWicant ftMAV Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 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 exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw.The applicant shall provide all of the necessary information as requested below. �.Lf.�lr� ��•cZI' � lam! �• Permit Applicant Property ddress Map/Parcel 977 Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw.I also understand providing this form does not absolve me or any,party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit.Further 1 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 building permit for the enlargement,restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw,provided that no additional residential unit is created. The lot(s)was/were created prior to May 6,1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS FOR REFUSAL BY THE B DING DEPARTMENT TO ISSUE A BUILDING PERMIT. APPLICANTS SIGNATURE DATE THIS FORM TO BE ATTACHED TO THE UJILDING PERMIT APPLICATION • r .. NORTH N 6 077 Town of North Andover Building Department 27 Charles Street �RSSACHUSESS� North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Ab1.7 Number treet Address Section of To "HOMEOWNER - Num er ome Phone Work Phoi PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of 1 or 2 units and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section (108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which of two there is, or is intended to be, a one family dwelling,attached or detached structures accessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements-. HOMEOWNER'S SIGNATURE e,,&✓V�-C/ J, APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet,or larger, will be required to comply with State Building Code Section 127.0 Construction Control. Revised 4.30.03 Home owner Exemptions Form i T — — — — — — — — — — I I I � I --------------�---------- ----------- ---------------------— ------------------- I I Nell I .a I I I I I I I Q s 6 I ______________I - I I I - I x�saffiu�— �mm+mswxusxusn� =g I I — - — y — — — — — — — — — — a� 42'-102" BEDROOM STUDY LIVING ROOM ` IDOUBLE HEIGHT) FULL BA -- -- NEW STRUCTURE o (2-STORY CONDITIONED SPACE WITH BASEMENT BELOW) w V / J /BREAKFAST AREA HALL I DINING ROOM CLOBET / VESTIBULE D y BA PATIO KITCHEN / / NEW STRUCTURE O� tor2-STORY CONDITIONED SPACE O� WITH FOUNDATION BELOW) U �' 1.V �� )�' ✓�_ EXISTING BULKHEAD STING: Rini E v TH fOUNDATI fiLOWf // `fir v * / —EXISTING STRUCTURE (2ST0RYCONDITIONED9PA6E WfjHBASEMENT BELOW) ` rte '`3 EXISTING PORCH I I SEE SITE PUN FOR RELATIONSHIP TO PROPERTY LINES GROUND FLOOR PLAN MCCARTHEY RESIDENCE ADDITION YB"=1'-0" (plotted on 11x17) I I I I I I ' I , I I ^g I LOT 35 1 I I I I I I � I � I � I � I � I I I I I I I I I , I I I I I I I I I I I I I I I I I � I I I , I I I I I , I I I I I I I I I I I I I I � I I I I I _ I I I I I I I I I I I I I I I HIGH STREET EXISTING SITE PLAN MCCARTHEY RESIDENCE ADDITION 1"=20' (plotted on 11x17) TA RTH � 6 ® •� _ Andover 0 LAKE lover, Mass., is- 9-a o 0 3 COCMICKEWICK �d ORATED PP�`��� 7v U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System C BUILDING INSPECTOR THISCERTIFIES THAT........ .I...R.... .............. ......C.A..R..�.. ..................................................... Foundation has permission to erect... ... .�:.......................... b ildings on ..... .`... ........ .��. .........5 ......... ........ Rough to be occupied aS f ,Re «y.dfr t �1!i4 r Al�*#t#A► I v' 40s i//� O y 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 Construgtion of Buildings in the Town of North Andover. �O�N/N�� ��� BAY* % e; S 4r ny S PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. G 17/3 S /S30 Rough i F nal PERMU EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ..... ............. .........................:✓ Service .� BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Ro Display in a Conspicuous Place on the Premises — Do Not Remove Fina No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved .by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY 0K)..or no inspections i INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. I FOOTINGS: Continuous Full 2x4 Keyway i Continuous strip footings for interior columns FOUNDATION: Rebar as required i Anchor bolts or straps Damproofing Foundation drain-pipe/stone/fabric filter/cover and outlet connection. FRAME: irebloc over girts/plates between floor joist Penetrations for plumbing, heat,elec, etc. ! Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. 1 Hip and Valley rafters-watch bearing at walls. t' Ridge&Hip-Provide proper connections. Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. ' Joist hangers-fully nailed w/hanger nails. . Sill plates 2-2X6(1 PT)w/sill seal Girls-solid brick or steel plate bearing at foundations '/"air space at sides in foundation pockets. Lateral bracing at ends. . Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. .� Check headroom clearances-stairways, under beams Attic Access. (min.22x30 w/3'headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). ' Firecode S/R wood frame of"0a clearance fireplaces&stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. '/z of required glazing shall be openable. Bedrooms required min.20x24 egress window or door. Vent attic spaces-"proper vent", soffit and required ridge vents. ` Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish Smooth parging, clean joints,8"solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36" high, Baluster max space 5"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. ` Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to occupying structure. f O o of Andover No. C, tort'" Andover, Mass., /o? /9► o� 3 C OC HIC HE WICK �• .19 A0RATED F' �� S raj' f BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System . BUILDING INSPECTOR THIS CERTIFIES THAT........C.�A.�.R....R.............. C,.. .. .. ..................................................... FoundationBUIL has permission to erect... l�.z. ............... b ildings on ..../.4... ........l !...r�...�.........5................. ........ Rough '- `�` �. V e � r � �V� w� //�� Chimney r to be occupied as.......... ............ ...... ................ ....................... D y •............. .............. -u 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 Construgtion of Buildings in the Town of North Andover. 1DRN 0 So a;% 9 Ok 0 a? S Is^y S PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. G $713, ® ,-3t e '6" C—� -` 9� �S ��� Final �� a2 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR, UNLESS CONSTRUCTION STARTS Rough - ....... ......... ......................... ' .. service BUILDING INSPECTOR Final � p�f Occupancy Permit Required to Occupy Building GAS INSPE `v in a Conspicuous Place on the Premises — Do Not Remove Display P 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. , i i I r S13*11'00"E 82.50' i 1` LOT 35 AREA=14,138 S. F. FOR REGISTRY USE =0. 32 AC. NOTES: o M 1. PROPERTY LINES FROM PLANS AND DEEDS OF RECORD. d� 2. SEE TOWN OF NORTH ANDOVER MAP #67, LOT #35.. j FOR SI TE 3. ZONING IS R-4. 4. SEE DEED BOOK #5059, PAGE #180 FOR SITE. i YW. APPROVED BY THE TOWN OF NORTH ANDOVER ZONING BOARD OF APPEALS w DATE ul _ in (V 0 Lo 2 1/2 STY. r z W.F.D. #169 "I HEREBY CERTIFY THAT THE PROPERTY LINES SHOWN ON THIS PLAN ARE THE LINES DIVIDING EXISTING OWNERSHIPS, AND THE LINES OF THE STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED, AND THAT NO NEW LINES FOR DIVISION OF EXISTING OWNERSHIP OR FOR NEW WAYS ARE SHOWN AND THIS PLAN CONFORMS TO THE ` RULES AND REGULATIONS OF THE REGISTRY OF DEEDS." I 82.50' N09'30'00"W 3/28/03 STEPHEN E. STAPINSKI, R.L.S. DATE TJTGH STREET PRELIMINARY SITE PLAN OF LAND co IN NORTH ANDOVER, MASS , PREPARED FOR OWNER/APPLICANT CLAIRE McCARTHY 0 169 HIGH STREET NORTH ANDOVER, MA TEL. (978) 683-5310 Lo SCALE: 1"=20' DATE: MARCH 28, 2003 3 MERRIMACK ENGINEERING SERVICES 66 PARK STREET 20' 0 20' 40' ANDOVER, MASSACHUSETTS 01810 TEL (978) 475-3555 V I f A i i 1 I.OT b5 14,138 SF .SS A-) as APP VrIOP UX i •p r rA7,, �, .in `4 IIca 0 � U'> i MPVATlalyAPPiP01N f�Oa, p�TA1LEG' P ANS i lvI1KI. V LF. •' f t LiST of nUwWk:s (rI - S1 't; PLAN/VOD�'YLAN N f 6-H 5TKEF-T Al F0.VMDATlOK ; FIKST LPP �'KA )W- rLAN - f A�2 - FIICST FLDnK f AdOF FKAC�I�t�lb- 1°LA1� ------ P'gASol- T- t��r-M©L. ITlop4 A 3 - F LE VA T 1 G X15 --- pµAs� 1[ d>r►-�o�I,�r �.��I � A¢ - $WIPM S i SITE nAN GAZTH 51-(MTN.a. SIT.E t° N LA L� � � vat PN DAT5:: ADD 1TtON N-,PKTN AND67VEIZ, MA w .� t Ft- ---- - ---- --- r~ II t t t t,.! 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I `-�TO Date... .,! . ...� ./ .. 2806 Y �IORTF� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS cm S� f This certifies that .....O.A.+.G N F has permission to perform ...... .......... ....... wiring in the building of ......... � at.....���..��...../Z,y.4.......�.E.......................... .North Andover,Mass. 4 }} _�1�/ N'ee.. .... �/... Lic.No... ...... ............................................................... ELECTRICAL INSPECTOR f I/ �C\ 51�-1/12/96 15:48 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Office use Only of Crammonmm th of Ams Etts Permit No. �s lett rmitnt of Vuhur fmfttg Occupancy A Fee Checker! BOARD OF FIRE PREVE."ON REGULATIONS 527 C'i�R 12:00 30 (leave blank) e/ APPLICATION FOR PERMIT TO PERFORM --ELEC_TRICAL WORK r All work to be performed in accordance with the Massachusetts Electrical Cade, 527 CMR t :00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date QQK( or Town of NORTH ANDOVER To the Ins ector f Wires: ? The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) //fd-/� 7 Owner or Tenant /�2�� `� Y Owner's Address Is this permit in conjunction with a building permit: Yes o C (Ctteck Appropriate Box) Purpose of Building -���� • • �Oas e Utility Authorization No. Existing Service r Amps —1 VC;ts Overhead Undgrnd No. of Meters New Service Amps `/nits Cverhead _ Uncgry,c r No. of Meters Numcer of Feeders and Ampacity Location and Nature of Preposea Electr:cai Were ��� S Td I No. of�ansformers otai No. ct Lighting Outlets I .4 a. Hc: �s KVA Atcve�- :n- No. cf Lighting =,xtures i Swimming P_ci grnd. _ cmc. _ I Generators KV'A iNo. of Emergency Lighting No. of Recectac:e Cutlets No. of Cil turners Battery Units No. of Switch Outlets No. at Gas ?_rners I FIRE ALARMS No. of Zones otat No. of Ze!ec:ion anc No. at Ranges No. cf Air C=nc. s I Initiating Dav ces Heal total Totai I No. of Disoosais I No.--t P bns KL'! No. of Seuncing Devices � No. of Sart Contained No. ct Dishwashers I Scace;Area Heavr.g KW Oetect:cntSouneing Devices Munic:oai ^Other No. of Orvers Heatinc D .V ev:ces K' Local Connection No. of No. at Law Vcttage No. of Water Heaters KIN Sicns ?a:las:s Wirinc No '�vcro Massaceu^s No. ^f `doors 7cia; �- 07'HER: y INSURANCE CCVERAGE: Pursuant to the recuirements of !.'.ass sans cenerat Laws — I have a current Uaotii surance Policy including Cz;mo:ete ceramns Coverage or its sucs:anual ecuivaient. YES NO I have suemittea vaiiC root of same to the Ctfics. YES y0 it you nave cnecxee YES. please indicate the type of coverage ay checxing the aop orate cox. INSURANCE BCNO = OTHER = (Please Scec:fy) • — (Exoirauon Oate) Estimated value of Eiectricat WOM 5 �®c ' 'Nerx ;o Start Inseec::on Cate Racues;ec: Rough Final Signed uncer:he Penalties of perjury: L/3t 2 /`'!`` y~ 2 �cJ<` G i UC. NO. F;RM NAME C Licensee S Signa-.;re t ----Out, et. NO. . Address ltJ $�% GSC _:el. No. CWNER'S INSURANCE WAIVER: I am aware that tre Licensee does not Nave the insurance coverage or its suostannai ecuwalent as re- -e e- duirea by Massachusetts General Laws. and :mat my signature an :rig :errnit acpiicaudn waves this reawrement. Owner Agent (P!ease checK ones O S 'eiecrdne No. PERMIT FEE 3 0-c "rw (Signature of Owner or Agents :6505 Town of North Andover NORTH q O en BuildingDepartment `� �`,� "6'6 0 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 O COCKI<�WKM 7' 9 Building Demolition Affidavit �9SSAC14IlSjo DATE OWNERS NAME &ADDRESS PROPERTY LOCATION �( f'�I � 'I ' DESCRIPTION CONTRACTORS NAME &ADDRESS — DEPARTMENT SIGN-OFFS D.P.W./WATTR ., R k `' F GAS 9 �C ELECTRIC q ,l TELEPHONE XCABLE � TAXES -� POLICFJEJ N d �`1 Y ��( /he� C."l 2 FIRE COys Pl UJj be ���?�``� ;1 ✓G�/�z r �!-/�%. L-�- ;� l/L G EXTERMINATOR YDUMPSTER-ONE OFF STREET fl� � DIG SAFE NUMBER BLDG. INSPECTOR DATE REC'D i� rK11 - ON C-tN41,A_� 4t7 Location 16 ? ` Y SA— No. Date 'VIM 63 �oRT� TOWN OF NORTH ANDOVER ♦ - s Certificate of Occupancy $ �ss+cMustt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 U D Check # 3 2- 163 ,, 6 - 163, 6 Building nspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATISSUED: _ SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION i-SITE INFORMATION I 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: atMap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: N Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard I Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Fl Zone Information: 1.8 Sewerage Disposal System: a Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Name Pri t) Address for Service: * , � 1 Sig a re Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construe+tion Supervisor: Not Applicable Licensed Construction Oupervisor: License Nu r Address10 ���� Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name rn Registration Number r Address r Z Expiration Date Signature Telephone �1� w 7 , 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.......❑ SECTION 5 Description of Proposed Work(check alla licable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ! Brief Description of Proposed Work: 1C Co(V4V'Vd ta' a3'�/- i��� exYnNitu-J/ ��(�Z2 C:Ks J'J a-lIc j -C.4. J • SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USEUNLY : . . Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical WO (b) Estimated Total Cost of (� Construction 3 Plumbing Building Permit fee tel X (b) -� 4 Mechanical HVAC d®I 5 Fire Protection 6 Total 1+2+3+4+5 of OOV Check Number G� SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS//AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ,(�L � V-(fj, � -1 as Owner/Authorized Agent of subject property Hereby uthorize to act on M a ;in all matters relative to wo truth ed by this building permit application; i//�AlJ i Y / Si nature of Owner Date -' SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief r Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3RD SPAN DIN ENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS IIEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIlvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . 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. *****************************APPLICANT FILLS OUT THIS SECTION****** **************** APPLICANT ! ;r 1/► ► PHONE LOCATION: Assessor's Map Number—k-1— PARCEL 3 SUBDIVISION LOT(S) STREET T. NUMBER ************************************OFFICIAL USE RE MMENDATIONS OF TOWN AGENTS: C15NSERVATIONADMINIFIIATOR DATE APPROVED DATE REJECTED COMMENTS i 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-SEWER/WATER CONNECTIONS DRIVE . Y P RMIT FIRE DEPARTMENT i RECEIVED BY BUILDING INSPECTO DATE_ Revised 9197 jm pAORT)l OF�ttieo 9 °<ti0 h0 A Town of North Andover Building Department �94q,r,;;° O pf y G) 27 Charles Street 9Ssac►+LIS Et North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION b � f S Number r t Address Section of Town "HOMEOWNER q1% 6a5Vr+ US V Ulz Number Home Phone Work Phone PRESENT MAILING ADDRESS wt 2w t ooh a M Dugs City Town 8tat& Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner" certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and reqit ments. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. 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: . & (Location of acility) 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 NORT#q ovm E. __ Of ..: :r. Andover No. it FZIM- 0L A dover, Mass., q /'0 DRA rE D P'e,, C:' S H t~ BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....( /V wl .............................................. ..�..... ..................................�............................... Foundation `! f has permission to erect... �, �......., buildings on . .. .......�,......t46 // Rough . ...................................... to be Occupied as • RAZ p .......K.l......�'! ��........AJ................................ ........ !e kl....1. �V Chimney provided that the person accepting this i�� P P p g permit shall m 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. ( t) / 3 r # 3ospow- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough . ... ..N....... .. ..................... m®............. Service BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building , GAS INSPECTOR Rough • Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENTUntil Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. PERMIT NO —" - APPLICATION FOR PERMIT TO BUILD'— NORTH ANDOVER, MASS. pact LOT NO ; g MAEt.#IO. . _ _> 2 RECORDtoF OWNERSHIP DATE BOOK PAGE — 2O—NE r�t—mss SJB DIV. LOT i7b I LOCATION 1 PURPOSK Or BUILDING . OWNER'S NAME ' No. OF •Tonics sl i OWNER'S ADDRESS f /. !;� BASEMENT OR BLOB ARCHITECTS NAM[ SIZE dF FLOOR TIMBERS IST 2HO 3RD BUILDER'S NAM[ O, SPAN •_ - .- OIfTANC[TO N[AR[!T Ill'; ILOINQ DIMENSIONS OF SILL! DISTANCE FROM STREET rosTs - DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILOtyQ NEW SIZE OF FOCTING X IS BUILDING ADDITION MATERIAL OF CHIMN[T--- 1 _ Is BUILDING ALTERATION ) 1! BUILDING ON SOLIO OR FILLED LAN i - e WILL BUILDING CONFORM TO REQUIREMENTS OF CODE vIB BUILDING CONNECTED TO TOWN WATER BOARD OF ArP[AL! ACTION. IF ANY If BUILDING CONNECTED TO TOWN SEWER . i IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS a PROPERTY INFORMATION ![[ BOTH SIDES LANG COST EST. BLDG. COST MG[ I FILL OUT SECTION! I - >f [BT..BLDG. COST PER SQ. FT. .a PAGE 2 FILL OUT SECTIONS I . 12 EST. BLDG. COST ran ROOM ELECTRIC MiT[PS•MUST ■E ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. 1 4 APPROVED BY ATTACHED GARAGESMUST CONFORM TO STATE FIRE REGULATION! PLANS MUST B[FILED AND APPROVED By BUILDING INSPECTOR k 1 OAT[ s .- GI ATURE OF OWNER OR AUT ORIZtO AGENT - - - DIAL 1144 INSPEC`rD/ FEE OWNER TEL ' PERMIT GRANTED CONTR.sir v 19 -COI U ,•x...,-.:'^c---" -•=*_... z�,.+»- >...,:e-.y,._._._ ..a < _. .,..' ._ °-xa' ,.3m,-=;-..+ �x:�. t _ _ ;'.fit- �- ftw� aF � " t :. 44 NORT ' L Tovm- Of `over , 31- 60 * �r= L; b doves, Mas ., s19� 9 . w '9A CO_CMICNENICK' L A- - - - 9 :PERM .I� T T BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............................ .......................... . `. l.... ..........................:.......... .................t........6.... Foundation has permission to ere ... .......... ............ ............ buildings on j 6 #. t..ra..f�F.........X Rough to be occupied as.............................:..-...:......................... :.... ......... ......:................................................................ 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough 4f .................................. Service DING INSPECTOR ; Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. ' Smoke Det. Location* Not T Date ' �6 'kow TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ ki ��� : Building/Frame Permit Fee $ I� s Fou ation Permit Fee $ s�CMust r ermit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ v Building Inspector . �'� 9524 Div. Public Works PE&J11T NO. APPLICATION �� PAGE 1 ----��- APL CATION FOR PERMIT TO BUILD NORTH ANDOVER, MASS. ,,.WAP+4O. dt%O LOT NO. 0035 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE 'ZONE I SUB DIV. LOT NO. �I LOCATION 1 Hij1 h 15-+15-+ POSE OF BUILDING �„�Cwe {OWNER'S NAME 1 NO. OF STORIES �+IVGGSIZE - ,o 6, �raxv.a f r'OWNER'S ADDRESS CJILIM� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2tol 3RD 0-E41LDER'S NAME^I ' SPAN PV. .[ rf DISTANCE TO NEAREST BUILDING 1 `��rr DIMENSIONS OF SILLS {/c DISTANCE FROM STREET ` POSTS `\ DISTANCE FROM LOT LINES jlbES REAR GIRDERS -U AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION - THICKNESS IS BUILDING NEW O SIZE OF FOOTING X IS BUILDING ADDITION g6 MATERIAL OF CHIMNEY IS BUILDING ALTERATION 0^5 � 0� D�..�o IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE hh C� IS BUILDING CONNECTED TO TOWN WATER , BOARD OF APPEALS ACTION, IF ANY ./O IS BUILDING CONNECTED TO TOWN SEWER 1� IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE,BOTH SIDES TN/ T. BLDG. COST% L1 p p 6 'PAGE I FILL OUT SECTIONS 1 - 3 13 L- _C aplP.W-� EST. BLDG. COST PE_RISQ. FT. �`^i PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED/AND APPROVED BY BUILDING INSPECTOR DDATE FILED V' I !/ \ilt"tv� SUILDINO INSPRCTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE OWN ERTEL.# CL � � �" s,T 7 PERMIT GRANTED CONTR.TEL.#19 ...� j CONTR.LIC.k H.I.C.# i BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY _ SroRIt - 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 3 1 2 13 CONCRETE BIL K. IN BRICK OR STONE HARDW"D _ PIERS PLASTER __ _ DRY VJALL _ _ _ < UNFIN. 3 BASEMENT AREA FULL FIN. B M'T' AREA _ 1/1 1/1 1/1 FIN. ATTIC AREA _ N_O B M-T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD1!J'D _ ASBESTOS SIDING COMI.ACN VERT, SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK N MAS N Y ATTIC STIRS. & FLOOR BRICK ON FRAME CONC. OR CINDER K. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER.CLOSET _ ASPHALT SHINGLES ` LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR Y WOOD RAFTERS _ AIR CONDITIONING RADIANT WT'G UNIT HEATERS GAS 7 NO. OF ROOMS OI L M' 8' T 2nd _ ELECTRIC Isar 13rdI NO HEATING NORTH yTown of dOver `? o art dover, Mass., C21 /moi 19 9 COCHICHL-C, may AoRATEo P?�' 1 5- BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT................ Q/!(........ ....../1 ...........i............ . .......................... Foundation has permission to�ere*......i�............. buildings on ........ 1tou;h to be occupied as... ... ..P111/1/. l! 5 .... c� .............. Chimney provided that the per on accepting this permit shall in a ery res t 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 VIOLATION of the Zoning or'Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCT1011 STARTS ELECTRICAL INSPECTOR • Rough ...................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough p y p Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. J Smoke Det. a�Y TOWN of NORTH ANDOVER AFFIDAVIT H®e Tmpmvemait Ca =bor law Sup IMMIt to POMit t%Uratian ML c. 142 A rafAres that the ' altemtian, rM38tirn4 repWr, , ca mmic n, x%xmianxt, reux,al, dmnlitam, or cabb=tLw. of an adhtim tD any pre- edstug azmr-aoped hnldr- i g cmtain i at least me hit mt mxe thanfar d ellirg udis...w to sbmcbz es 4firh are adjam t to aich reS],a or l].Illdire'be dmie by rgpstP it=s, vdth certain ecTdals, alag xath othEr flTl'Ri nts- . -ape of Work: Est. cost Ip , 000 -Address of Work I X04 a I� St C—Owner Name: -Date of Permit Application:_ I hereby certify that: Registration is not required for the following reason(s): Fcr office Use Only Work excluded by law mit ND. .. Jobunder $1,000 Date Building not owner-occupied _Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DFALIM WTIIi UNREGISTERED CONTRACTORS FOR APPLICABIE HOME DfiWJEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER MGL. c. 142A. Signed user peralties of perjury: I hereby apply for a permit as the agent of the owner: II Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the /owner of //the above property: 117 —J0 V" U S YY\Os �y O r2 ML Or , Date Owner Name Date. t HORTM 1 3r�•<� •�;.,tiooL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 41 SSACMU'S� This certifies that ? . . . . . . . . . . - - - - - - - - - - - - - - - - has . . . . . . . . . . . . . . .has permission to perform . 11. . . . . � :- ..,- . . . . . . . . . . . . . . . . a plumbing in the buildings of . . . . . . . . . . . . at ' : . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. ov Fee.//3. .t . ic. No.13aPdy . . . . . . e-! . . . . . . . . . . ... . . . . . . PLUMBIN CTOR Check # 5716 APPLiCA , (Print o, Type) :. . l E b` 5TO 0 WVISINQ, 2e—UP oo���. ass. ate _a_ Permit Building Location s Awner's Name /V f 2 !+ t4 w►�4 C Type of Occupancy Q_14_�- New p renovation ® Replacement ® Plans Submifited:fyes ® No ❑ FIXTURES JLC WN sn o F7_ I d4l = 1 I a N W O07 X � IL U. = " 2 _j t4 9L O Q N _ W }. Y W O Y ®i Al N Q J ar x N aC Q O Q f— LL PAT. BASEMENT BASEMENT 1ST FLOOR. 7 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 0;'i 6T)i-FLOOR 7TH FLOOR 8TH FLOOR Installing Company Narne7)�j,12 62 ; .Check one: Address 2 + Certificate U2 ❑ Corporation Business Telephone` ❑ Partnership, Name of Licensed Plumber 13Firm/Co. � N a i9� a INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirementsMGL Yes C1 No 17 of L Ch. 142. If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy ❑ Other type of Indemnity Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have Bove Chap er 142 of the Mass, the insurance enera( Laws, and that my signature an this permit application waives this requirement. rage required by Check one: ature of Owner or Owner's Agent Owner Agent ❑ I hereby certify that all of the details and information(haves miffed (or entered)in above application are true and accurate knowledge and that all plumbing work and installations erf med under the permit issued for this application�lpertinent provisions of the Massachusetts State Plum ' to the best of my 13y de and Chap r 142 of the General Lawsp will be in compliance with all Signature of licensed Plumb- City/Town Type of License: Diaster yourne� ❑ APPFF?0. (OFFICE i:JS 3NLy, Aman '_acanse ;39umbaT.._..[.,�Z ,Z-