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HomeMy WebLinkAboutMiscellaneous - 17 COBBLESTONE CIRCLE 4/30/2018 f17 CaBBLESTONE CIRCLE y 21oross.aoo 8g0000.o \. I BUILDING F i I I i NEW ENGLAND CLAIMSE S RVICE INC. Incorporated 1985 Reply To �« . Reply To Mansfield, MA 02048 131 Dodge Street, Suite 6 P.O. Box 345 ASSOC^'"" Beverly, MA 01915 TEL. f5081337-8058 TEL. {978}927-3000 FAX(5081339-5835 FAX {978}927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings City Hall RECEIVED ml North Andover,MA 01845 To: Board of Health or JUL 25 2012 Board of Selectman TOWN OF NORTH ANDOVER City Hall HEALTH DEPARTMENT North Andover,MA 01845 RE: Insured: John Kelley Property Address: 17 Cobblestone Circle,North Andover,MA 01845 Cause of Loss/Date: Water Damage Loss of 6/7/2012 File or Claim No: BOS 050207 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. Robert L. Smith,Jr. Adjuster 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. 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 Signature Date 1 i i 7707 . ..... pORTM Of o: °0 TOWN OF NORTH ANDOVER f F • PERMIT FOR GAS INSTALLATION SACHUSE� t This certifies that . V✓t. . . . . . . . . . . . . . . . . . . . r has permission for gas installation in the buildings of . . . . . . . . . . . . . . . . . . r at 1 North Andover, Mass. Fee�0°R Lic. No.. .7. �?.�.F . . . . . . . -7 GAS INSPECTOR Check# 615 MIASSACNUSET i S UNIFORM APFUCATION FOR PERAM17 TO GO GAS FITTING CitjtTown' O`C\N(I Nn QlIQ•.'S',MA. Date: 1 2,�`%.l Perm# Buildin Location. a111Q. `fit.Q, Owners Name: a h .r. Type of Occupancy: Cct:-mercial❑ Educat:Cral Q !;.dust al❑ irsttutioraf❑ Residential New:Q Abraticn: ❑ Renevaticn:❑ Replacement: Plans Submitted: Yes❑ No F1X3URES UJI M M = O w W U W Ft- 0 = cc W O Z y Z O �� H z at w 0 Q F=- W WLU X t» v Z rn t? ~4 W V} O Q FW- 2 U. W t~.} l'1 Q O J W ? C rA y W v} � Z W C > W Z t— P O Z J Ce, lL W W LU 0 o W i > 0 a 0 w z z w a g 0 a . 0 > > > 3 0 SUB SSMT. BASEMENT 1 ' FLOOR 2' FLOOR 3 FLOOR 4' FLOOR 6.14 FLOOR I 7 FLOOR I I I 8' FLOOR { t Check Cee Only Certificate 9 Installin .Corn an Nar'-,,e 9 F Y S c� �Coronation C,1jt7cwn,\),.'knC o�n State. BusinessFax: ❑FirmlCcmpany Name of Licensed Plur^ber,'Gas Firer.7- r L�"r�C IK INSURANCE COVERAGE: I have a currant liatilitr insurance policy or its subs`arLat aquivalent which meets tie rsquiramerts of MGL.Ch.142 Yes r No❑ If you i a•+e checkad Xas,please indicate the tjre of c:.vara,e by checking Lhe aperopdats box below. A liabilitj insurance policy ; Ct:'^er type of irdermitj ❑ Bend Q CLV'{=R's INSURANCE wAN=,J:t IM W.M:1 3`rat Lhe licensee does nct ha-r4 he insunncs coverage reGuirad by Chapter 142 of tte Massachusef Gerecal Lava,and that my signature on this permit application w3ivss this reGuirsmert. Check One Only Owner ❑ Agent ❑ S rattre of Cwrer or bwrees Agent By checking this lbox I hereby camtj that all of the details and intcrtnaticn t have submitted(or entered)warding this application are time and accurate,to It*best of my Knowledge and that all plumbing work and Installations performed under the permit sued for itis appUcat:on will be in campilarcew{.4 all PsMnent provision of the MaWachusett State Plumbing Code and Chapter 142 of the General Laws. Tyre of License: BY (2 Plumber Ttle Q Gas Fitter Signature of Licensad PiumberiGas Fitter [S Master c _0P/f7cwn ❑.Journeyman License Number APPROVISO!CF?icE USE ONLY) C1 L?Installer • e FINAL,INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS IPISCGC'f IC)TILS� FGE:: $ PLRAlly lI Y APPLICATION FOR PERMIT TD DO CTAS I'rVVMG NAME&TYPE OF UUMAHC; LOCATION or-11UU plNQ • s%c-rrn i LUMUER_GASFIUL1L LP tNSTA1 LER LICENSE HUMBGR: i PERMFV GRANTED LSE: a1. - GAS TUiT1140 111SPECTIOR t3, 9 0 U'/ Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,S3 CNUSE� / r P This certifies that . .��.C'.W�,. . . .�{.VA:t.6t-Y. . . . . . . . . . . . . . . . . has permission to perform . Lk., . . . 0—C i, :L... . . . . . . . plumbing in the buildings of . V%(-.U., . . . . . . . . . . at C o.W4. Slitiv,. ... . . , North Andov ass. Feee .0,09.Lic. No.. ��2 �. . . . �� . . . PLUM ING INSPECTOR ,/ Check # L�� S I i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/TownA)c-N�) Ary-A o—r MA. Date: S 2rz %i Permit# _ - - -Building Location17 C�b��QSohRr \t'C Q. OwnersNam9--V'nV-t �AA%14 I � Type of Occupancy: - Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential I New:❑ -�Alteration:❑ Renovation:❑ Replacement: Pians Submitted: Yes❑ No FIXTURES z y o Y v7 ca U as N zuj toY >-. J 0 . W 0 it N IL Z a Q y Z i UXjI- Lu H of 0 m rn w p a H z a Z N rn D V a l Q W F Q N 0 Q W O D W W J z a, o O y $ v Za 0 O a X a = W W W oc a s ° a o > > = O a oa a a1-- 0 SUB BSMT. T BASEMENT 1 FLOOR 2Nu FLOOR 3KuFLOOR _.........,�-.-FLOOR 5 FLOOR 6 FLOOR ff FLOOR 8 FLOOR ` Check One Only Certificate# Installing Company NamejG-E,M ��aMb�nc. ry\cQS 1 enc 2�,�� ®Corporation Address.-M& DIV %� �Ta City/Town: An Partnership Business Tel: \ 6 cl "A"V`d! Fax: ❑Firm/Company Name of Licensed Plumber: "'r 9. er Ck \K) o-4 t,vn INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes Q No❑ If you have checked,Yes,please indicate the type of coverage by checking the appropriate box below. A liability insuranci e policy Iq 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and Information 1 have submitted(or entered)regarding this application are true and accurate to the bast of my Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. i By Type of License: Title -.. ❑Plumber Signature of Licensed Plumber City/Tmn ❑Master License Number.Z\ APPROVED OFFICE USE ONL ❑Journeyman I ty icgl N: .al`s.: r T tnU Rp Ilk i EA e'rs .4v F. fi, '-�• r.: ,Z- '�a. s y •a i i•� .'¢J F.. ! ''d` _.hd:_���,*!a'S1• s.F�.n'J•• r ,: , i 0 Y 1 Vi. 1 Z : ' -.-.. ..... . .. .. �..... -iS ..1>iP iY:-.t�_J. ...t rS)•J�7$�Yi�}"t ,. ........ '� -" .rte: }P! .f, '•i'e {,] I i NEW ENGLAND CLAIMS SERVICE INC. Lacorporated 1,985 Reply To K � Reply To Mansfield, MA 02048 _ � 131 Dodge Street, Suite 6 P.O. Box 345 �;sia<�� Beverly, MA 01915 a LX'(whlMi TEL. {508}337-8058 a vsi�p` } TEL. {978}927-3000 FAX{508}339-5835 FAX{978}927-3002 wrandall@newenglandclaims.com Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings City Hall North Andover,MA 01845 To: Board of Health or Board of Selectman City Hall North Andover,MA 01845 ISE: Insured: John Kelley Property Address: 17 Cobblestone Circle,North Andover,MA 01845 Cause of Loss/Date: Water Damage Loss of 6/7/2012 File or Claim No: BOS 050207 i 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 andi claim or file number. Robert L. Smith,Jr. Adjuster 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. 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. Signature D e i i i TOWER GROUP" COMPANIES �'lassaeJStaseC[sHntaeP at�11151cranceCompany June 18, 2012 Building Inspector's Office 1600 Osgood Street North Andover MA 01845 Insured: John F.Kelley Property Address: 17 Cobblestone Circle,North Andover, MA, 01845 Underwriting Company: Massachusetts Homeland Insurance Company Policy Number: HBIP44090 Date of Loss: 6/7/2012 Claim Number: OAA938074 BGSQ Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 313 is appropriate,please direct it to the attention of this writer and include a reference to the above-captioned insured, location, policy number, date of loss and claim number. On this date, I caused copies of this notice to be sent to the persons named above at the address indicated above by first class mail. I Signah4re: Melissa Tripp, Property Specialist i i i 3"o Tower Group Companies Claims Department PO Box 5155,Buffalo,NY, 14240 Phone:(781)332-8484 Fax: (781)394-2592 www.twrgrp.com Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 00 0 0` �- BOARD OF FIRE PREVENTION REGULA ONS Occupancy and Fee Checked J [Rev. 11/99] leave blank APPLICATION FOR PERMIT T PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL NFO AT ON) Date: 6A0�tr. City or Town of: j To the Inspector of Wires: By this application the undersigned gives notice of his o her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant�._° ' ,, : ,� 4°°R Telephone No o Owner's Address wAjlth!�pirutri � njuctialt,,wih gip# 1pg�permit?• - e� y; �Nroc`1^❑ :(Cbeck Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Volts•:► R O�'eY head Q ' 'Untlgri�' '`,No.of Meters • r New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Am aci Z.) - Z_ P h' Location and Nature of Proposed Electrical Work: �J`! �,,,yq Completion o the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures a 2-- No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Lighting Outlets 1� No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- El Battery o mergency Lighting rnd. rnd. Batte Units No.of Receptacle Outlets Ljgr No.of Oil Burners FIRE ALARMS No.of Zones No.o Detection and No.of Switches U No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Total No,of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of elf- ontained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ umcipal El Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.o Water KWNo.of o.o Data Wiring: 3 Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Z No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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 cWBONDEJ e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OTHER ❑ (Specify:) 1010S (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 6/V C}� Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains andpenal;, s of perjuryp L that the information on this application is true and complete. FIRM NAME: 'G f$� ��eJ ✓l LIC.NO.: S/9 Licensee: 7i/,Y– /eCZ(4A Signature LIC.NO.: �/ (If applicable,enter "exem t"in the license number line.) g .l Address:— I o rt C�/ Bus.Tel.No.: 511_8 S 3 3 6 7 7r �l mm 0�yA . Tel.No.: Y33, 88 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 a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No. RW*ko �. 07- FK FSC k6Xr Location No. Date T— NORTH TOWN OF NORTH ANDOVER Ottt�a° ,•1�0 10 p Certificate of Occupancy $ ;;,10-� + • : Building/Frame Permit Fee $ Arta'Std' A sE Foundation Permit Fee $ odd'• scHu Other Permit Fee $ Sewer Connection Fee Water Connection Fee $ JZL TOTAL Building Inspector J u 6829 Div. Public Works ..location-/— No. Date /2- A _ f NORTh TOWN OF NORTH ANDOVER I- cp Certificate of Occupancy $ + Building/Frame Permit Fee $ Foundation Permit Fee $ ,f •1• f� JAGMUS s Other Permit Fee $ - Sewer Connection Fee $ — Water Connection Fee $ j• TOTAL $ Building Inspector t = 6775 Div. Public Works F A* '. I Location F 17 4661e=::56WC:n_ circ le No. Date '" °RTM TOWN OF NORTH ANDOVER O? ,e ;L „ Certificate of Occupancy $ • Building/Frame Permit Fee $ Foundation Permit Fee $ scMuS t F Other Permit Fee $ G� Sewer Connection Fee $ ' Water Connection Fee $ -� TOTAL $ � X i Building Inspector D Public Works L..sl - t PERl$P!,40. 1� APPLICATION FOR PERMIT TO BUILD -- NORTH ANDOVER, MASS. ///,W / 1 PAGE 1 MAP 440. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK 'PAGE - ZONE SUB DIV. LOT LOCATI 0 PURPOSE OF BUILDING OWNER'S NAM NO. OF STORIES -C�SIZE OWNER'S ADDRESS Twu"Id ' ' ASEME OR SLAB ARCHITECT'S NAME l M i o SIZE OF FLOOR TIMBERS 1S2ND A Ga 3RD BUILDER'S NAME ��,_ C �CNA��1 SPAN // // - DISTANCE TO NEAREST BUILDING / DIMENSIONS OF SILLS DISTANCE FROM STREET f i* POSTS DISTANCE FROM LOT LINES-SIDES ,} REAR /' &* " " GIRDERS I� !/ AREA OF LOT � r-yt� A[ FRONTAGE HEIGHT OF FOUNDATION �Q THICKNESS/(n // IS BUILDING NEW CV„ C SIZE OF FOOTING Q// X IS BUILDING ADDITIO c•„JQ MATERIAL OF CHIMNEY 0. IS BUILDING ALTERATION IS BUILDING ON OLI R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER �'C BOARD OF APPEALS ACTION. IF ANY NIA IS BUILDING CONNECTED TO TOWN SEWER u�CJS �I IS BUILDING CONNECTED TO NATURAL GAS LINE GS (INSTRUCTIONS s PROPERTY INFORMATION OMAN LAND COST O - SEE BOTH SIDES P�Q�. IT fa FDA pp EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 8 LESS FDA FEE. ir.rna��r� EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 MEi'fil AEPOW EST. BLDG. COST PER ROOM 4mbo �Q SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING S %�ppROVE B�4 ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE loFILED _ BOARD OF HEALTH IGNATURE OF OWNER 6R AUTHORIZED AGENT j FEE Id D/ //'�'�� Q OWNER TEL.# ' PLANNING BOARD PERMIT GRANTE 4 O CONTR.TEL.# . 19 _ CONTR.LIC.# BOARD OF SELECTMEN / r �I &,6 ol BUILDING INSPECTOR i t BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY 1,6k 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 I 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D — PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'T' AREA _ '/_ '/7 'h FIN. ATTIC AREA NO B M T FIRE PLACES 4_- HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D �_ S ASBESTOS SIDING _ COMRACN _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME _ �_ BRICK N MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME I - i -' .• CONC. OR CINDER BLK. .. -w•+�ws*+n+�•sn .++w_xrM s`t,� tiw•� STONE ON MASONRY WIRING STONE ON FRAME. -- .e,r.►at«.o. vw y? 2t: 7."Y e!• t { ;• SUPERIOR _ ADEQUATE I NONPOORE 5 ROOF 10 PLUMBING GABIE IF, 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 e WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING s 1 ,d E r M FORM U _ LOT RELEASE FORK r INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction J 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: CAS — Phone 7• // Z g LOCATION: Assessor'//s Map Number Parcel Subdivision C0Ab1 Cs�fo =:s Ct �i�-.4 Lot(s) i Street �._, C' wC St. Number ************************Official Use only************************ RECONNENDATIONS OF TOWN AGENTS: - - Date Approved Conservation Administrator Date Rejected Comments Date Approved 1�1,qwn P Xnnek Date Rejected Comment.4 ��► Date Approved Health Agent Date Rejected Comments Public works - sewer/water connections J - driveway permi _ g Fire Department Received by Building Inspector Date 1 J Z07- 0 28 70 Ad. I i • Gp13 /vdTE,' �p�vOAT/6 n/ 44A7-/0�/ �.v5 r,Lu��CyiT Sti,C�v1�� � DEC 2 71993 TDs ,/E"EB y Tor Er/TGE 7.41 f'G O T BAN,!'T.i�gT THE O/✓ELG/.ti6/S GOCATEO ON Tf/E LoT AS S.5l7/Y.t/ANO 7W.4T17-Oc4rS !Y/Tf1 Tf/E fou°^/ * OF Alo.gNoovE� ZONv.vG �E6vLAT,t�.�/S �QL�6v4.P0/N6 :r67-,f 46<V FEOW ST.PEETS�407- L/�✓ES. '' ��TN �vpa ���/ /f/JOSS 1 FU.CTif�G'.0 CECT/FY TiNi4T TiY/.S OA✓EGL/N6 /S�/OT LOG4TE0 /i{/ TiYE FEOE,PAG FGOOp H•9ZA.�0 A.PE.4. O,PA�it/ FDiP ISyawAv a v FE�+.t C .virY P•r vct ''r C.QBBc�STONE�.2GSSivG �EvcGOG/!��'.vT Y/.k�f ..,..�.•-�..�`cS'rr�� D T p ��iS/8.3 Ca.�P. /993 •"" `•`'`w; "� /ffE.P,P//f1.9Gf'E',f�G�•t�EE.P/.!/6 SE.PI�/G'ES BOUNO.P'/.G1ETE•Pill�iti!.'�.�� �BDUNOA.PY/i(/FOiP�3!' AT/O�f/ TA,rE.S/ F,PO�I EX/STi.�/G .PEL'v,PpS. 66 f'q.P� ST.PEET ." A.t/ODYE.� /y1.4S.S,4l.Yf/SETTS O/8/O �`D 1-1-f'" - Town ver 0 .p Zo ��`Nort i dower, Mass DACi0 3 �.3 •, 19 ' BOARD OF HEALTH Food/Kitchen PERMIT T UILD Septic System +� BUILDING INSPECTOR • THIS CERTIFIES THAT....�� .JAv.wit.� r �II` �.Iy.... ;Ore T Foundation / has permission to erectMr f. 1. buildings on ��. ��t. t.�Sr�. t f.1010it 1444rAl Rough to be occupied as.S�1.i /!�,I. .. ...A, �. 4. �. ..O..,Dn...a`o.4m Ac Chimney provided that the person accepting this permit shall iff every respect conform to the terms of theapplication Y res p � tron file m Final X11- this office, and to the provisions of the Codes and By-Laws relating to the Inspecti t&ffigWMbjfNyf Buildings in the Town of North Andover. REGULATED BY PARA, 114.84 B.C. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough P PERMIT EXPIRES IN 6 MORA ` � ' FEE PAID 0 -� Final / v .vn �� � ELECTRICAL INSPECTOR PERMIT FOR FRAME/�i 81kS CONSTRUCTION STARTS Rough A Z& ............................... ... ...... ....... ........ .... ............. DATE:����FEE PAID' ' ..... d s � BU.ILDING. ..INS CTOR Service Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough -- No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT AFFICES M. �U'I'lii\I.ti pT,.r�l•� I;� It.t.iiil '.Il •i•I lillll.l)IN(� '`'js•"r' -jNORTH AN�� ��l���� i. (:ONSERVATION t'""' I 1 t\'I:iIIINIII� .Ilii illit4!i•li i'i I'.I.ANNIN(i 1'l,l1.NN1Nl;. & (:i)Ill[►111N1'1"1• ME 11.1'. NI;I til IN. CHIMNEY APPLIC'AH014 AND 110311 CATION4 zv� NER'S•NAME: ALDER'S NAME-.- SON'S AME":SON'S NAME: SON'S ADDRESS: 3ON'S TELEPHONE: FERIAL OF CHIMNEyI IFERIOR C1IIMNEV: _ EXI ERIOR Cillhilkv: _ I-IBER AND SIZE OF FLUES: (C1.NESS OF ffCARTIf. Chblllley un. 6iAepeace con(Imin to Vie ne•(iu.i)IeuleII-(:6 u( the curie and have :tuft-6 and juto, ow been. Aeeetved: -- — i '.E: 43 NATURE OF b(ASONs WIT GRANTED: ILL O o ')L-RT NICETTA !LDING INSPECTOR iPECTEIJ: IIIARKS: SOLID BLUCK 11 LQ U� IItEh �� THIS PERMIT I,IIISr GR VISPLAYLU 014 111E I'IZLI,II SL_'l CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date 5 THIS CERTIFIES THAT THE BUILDING LOCATED ON q MAY BE OCCUPIED AS P _� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. o• &ONT" CERTIFICATE ISSUED TO o p ADDRESS sACHU5-' Pudding Inspector tf - O NORT1y � . Town of dover No.57S O dover, Mass.,&"a 3 19?.3 2COC HIC HE WICK �� A0 R.4TED S D - -BOARD OF HEALTH-- PERMIT. T Food/Kitchen Septic System BUILDING INSPECTOR PECTOR THIS CERTIFIES THAT o.I�..41.4ra.jolt.44jr � o% . /1� � Foundation has permission to erectMr 0#00 uildings on /.7. IDII�. �. .�'T1...11�I�r.�!.�/�>Q �. �� Rough S� •�E. i�1�.�. ��. ..�wem Ac Chimney�.t ,wto be occupied as ,����. .... provided that the person accepting this permit shall id'eve respect conform to the terms of the application on file in v�: P P P 9 P every P P P F> . l'j -G this office, and to the provisions of the Codes and By-Laws relating to the Inspectir �� bjf8Wyfz �'_a— Buildings in the Town of North Andover. REGULATED BY PARA 114.8.5 B.C. PLC /'rm VIOLATION of the Zoning or Building Regulations Voids this Permit. P� PERMIT EXPIRES IN 6 MOIL 4"_"FEE PAID �d �a s LL 1�1�IF S CONSTRUCTION STARTS ELECTRICAL INSPECTOR PERMIT FOR fRAME/BUICDIt'� 4 Rough A o& #"#. 1 "T' ................................... .............................k*ii4' � ..... Seryice DATE, FEE PAID' d S 6 BUILDINTOR Final 0.era Occupancy Permit Required to Occupy Building GAS IN PE TOR Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done - Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT -I�u�ner PLANNING 16ZC51 l JINAL CONSERVATIO FINAL Nay Street No.l�r� �2/z�� ri�/4L Smoke Det. CVt37/K.!y y ! 3 SEWER/WATER -1-4 FINAL DRIVEWAY ENTRY PERMIT:rul i1 n/�,(` 2 y Date. . 4,, TOWN OF NORTH ANDOVER -r 1� 3? ��.r .'• pL p PERMIT FOR PLUMBING SSACMUS� This certifies that �- . ..- P, U . . . . . . . has permission to perform . . .. . . . . . . . . lumbin Wtebu�ildin s of . �� �j �at .l. . �'. . _. .. . .. ' .-�! , North And• er, Mass. Fee! !/. >. .Lic. MV . . . . .%. .. . . . . . . . . PLUMBING INSPT rn h Check !t .,4 64613 A / Date....{/................................ f HORTM 1 TOWN OF NORTH ANDOVER o PERMIT FOR WIRING S Us This certifies that ......... .1..... .... U ........... has permission to perform :!.��1............................ wiring in the �ildin o .: �..-........ �. "................. at . .:.... ........ .. Ldover,Maso: ,4Fee..V,e1.t.......... Lic.Iota NZ?.. .;'✓ ...f; �Fl k ELECTRICAL INSPECTOR f� 4-"- ec # v Commonwealth of Massachusetts Official Use Only Department of Fire Services Permtt No. 0 BOARD OF FIRE PREVENTION REGULA ONS Occupancy and Fee Checked .J y [Rev. 11/991 leave blank APPLICATION FOR PERMIT T PERFORM ELECTRICAL WORK All work to be performed in accordance with th assachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL NFO AT ON) Date: (0 L& City or Town of: To the Inspector of Wires: By this application the undersigned gives notice of h1s o her intention to perform the electrical work described below. Location(Street&Number) i 'V� 6r Owner or Tenant / Telephone No. Owner's Address Is this permit in conjunction with a b 'Idling permit? Yes No ❑ (Check Appropriate Box) Purpose of Building ;:A 7 f/h t , Utility Authorization No. Existing Service 2,40 Amps /LD / iO Volts Overhead ❑ Undgrd[y No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 249-� - Z- Location and Nature of Proposed Electrical Work: Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures d�2- No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ at o Units cy Lighting rnd. rnd. Battery Units No.of Receptacle Outlets 411' No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and U Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ........................ ...."""" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water K`,�, No.of No.of Data Wiring: 3 !, Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 2- OTHER:OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ✓BOND ❑ OTHER ❑ (Specify:) 10oS (Expiration Date) Estimated Value of Electrical Work: -# 1,90 (When required by municipal policy.) Work to Start: 6!� 6� Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pains and penalt' s of perjury that the information on this application is true and complete. FIRM NAME: LIC.NO.: j/7^ Licensee: /47//'ce /l1�6r� Signature � � LIC.NO.: 3 o/ (If applicable,enter "ezem t"in the license number line.) �/ �� Bus.Tel.No.: .SOB -653' S 6 7 Address: Xy , arty &�uf mm Gyro Alt.Tel.No.: 579-03' /3;?/- OWNER 8/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 PERMIT FEE: $ Signature Telephone No. - (Prini at Type) in NORTH ANDOVER, Masa. Date_v23ap C?S Building Pertnk *• - '/ Locailon . Owner's ' Nam New p Renovation p placement p Plans Submitted: Yes Q No p IXTUAES w w < N w F- } M = M < at et j M r w ` �MM w i Y r < w < !. ! L w J a. .- 0 Q Q W < at ! k M- V !K Q MM 74 A Ila 3P a Is BASKMaNT {/ IST FLOOR !N0 FLOOR $RD FLOOR 4TH FLOOR rTH-FLOOR STH FLOOR, TTH FLOOR - OEM aTHFLOOR +1i _iA Check one: Carivicate Installing Com ny Name r �.-r g 7 l.m • 13 Corp. Address O ❑Partnetship -.-- _ 0. 13*itm/Co. Business Telepho e� 0 Name of Licensed Plumber 1�/,a P_/ •_�— ,s� x INSURANCE COVERAGE: ChecK one 1 have a current liability Insurance Olcy or its substantial equhWenL Yes [8 No p It you have checked ygj, please Indicate the type coverage by checking the appropriate box A liabilityf insurance policy- � .' -Other type d Indemnity O 8.orxf - , OWNER'S-INSURANCE WAIVER: I am aware that the licensee does not have the In urince•coveiage'tequlred by-' Chapter 142 of the Maas. General Laws, and that my signature on this permit application waives.this-requirement. - Check one: - _ Owner p -Agent p Sonsture of et or-Owner i Agent I hmby certify that aA of lhs daialls and Informatlon I have t&nMed lot entered)In above application ara irue.and.aoaaste•lathe best of_my, knowledge and that aA plumbing wak and initalfattons performth ed under e pertM Issued for this app#"; ba irl comp Withall pertinent wovislons of the Massachusetts Slate Plumbkp Code and Chapter 142 of the General lawn. This nature 04 uOrn _. Clty/Town Uanse Number t AHTUYED(OFFICE USE ONLY) Type of Plumbing lkanse: Master Journeyman '� Location rob 6le"s4,41c- Cr No. (0 %3 - Date � f r p ,.ORT1y TOWN OF NORTH ANDOVER � 9 + Certificate of Occupancy $ sACNUS t� Building/Frame Permit Fee $ _1f70 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # .�� Building Inspector I I ° TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAOR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: / �, DATE ISSUED. �—_ a d 0 SIGNATURE: Building Commissioner/InEpedor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Propaty Address: 1.2 Assessors Map and Pared Number: -VxK 6.461;c oa 9 ©/S7j Map Number Parcel Numbs / 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Area Frontage(IL) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Rcquired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 34) 1.3. Flood 7A=Infamdioa: 1.1 Sewerap Disposal Sydem: Public ❑ P&M ❑ Zane Oxhide Flood Zane 0 Mm icipal 0 On Site Dhposal Sydem 0 SECTION 2-PROPERTY OWNERSEV/AUTHORIZED AGENT 'irtrict: 2.1 Owner of Record Na (Pri Address for Service: N. AA1W)fti' , I 6�/SSIO • r✓ 7� 6 3- 3Di 7 � 0 . Telephone Q �I 2.2 Owner of Record: Name Print Address for Service: Signature Telephone _ SERVICES SECTTON 3 CONSTRUCTION 3.1 Licensed Construction Supervisor: Not Applicable r LA, N� Licensed Construction Supervisor: 1140 License Number , Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address z Expiration Date G) Signature Telephone V�' SECTION 4-WORKERS COMPENSATION(MG.L. C 152 1 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 unit. signed affidavit Attached Yes.......0 No.......0 SECTION S Description of Proposed Work(check al a bk New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant ,. 1. Building (a) Building Permit Fee Z' O0v Multiplier 2 Electrical /7-00 — b O C/ Estimated Total Cost of /� " Construction 3 Plumbing 20 o Building Permit fee(a)x (b) 4 Mechanical HVAC Opv :E., � 5 Fire Protection — 6 Total 1+2+3+4+5 O v Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER§AGEN OR CONTRACTOAPPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Herebyrite to act on My beh f,in atters rel k authorized by this buildnig permit application. LIS W/3 lure Owner Date SEC1100ft OWNER/AUTHO AGENT DECLARATION I 1, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 S72 3 SPAN DIMENSIONS OF SILLS DQvIENSIONS OF POSTS DMNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X 11° MATERIAL OF CBIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4 I North Andover Building d ng 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 resultingfrom this s w ork 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 Facility) I . Signature of Permit A p cant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 1 9 f NORTI� TOWN OF NORTH ANDOVER o OFFICE OF 0? BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 1SSACIM�gE� D. Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: /7 &3346' X OY& 6496f6- Number 496f 6Number Street Address Map/Lot 11 ` q7r HOMEOWNER �U1 /c.�ZCG`y� �l 7i �,�- �30�7 ew'���9 Name Home Phone Work Phone PRESENT MAILING ADDRESS /7 4y&34 c�zh)& 44 GC tv ,, Ava),gooz x1 l City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifipp that he/she understands the Town of North Andover Building Department minimum inspection procedures and uirem is and that he/s a wi ply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFI f3().\R1)OF.\ITEM S 698-9541 CONSFRVAT1ON 688-9530 11F:A A]i 6SX-9540 PLANNING 6)X9!)535 V40 H Town of Andover . 1 / O . 0 A dover, Mass., �� �• oZ ISO COCHICHEWICK �• ORATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT....... 0 ..........f..................K..............i:.y............................. .................................... Foundation has permission to erect..... h......... buildings q .. p........ ..............0......... ....04.....................C�.!N.4 Rough t0 be Occupied 8S..............3 A& ,L VK 6^0+........`~.........R 04 41,&AJ&�"�....... 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 relati g to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. S"')P8 q PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rom PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION T TS ELECTRICAL INSPECTOR Rough .... ............................. Service BUILDING INSIPFCMR FrW - -- - - - - -Occupancy 'Permit Required to Occupy Building----- -- - - - - GM INS F POR Rough Display- in-a--Conspicuous Place on the Premises — Do Not Remove Fina 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. V Off F��✓. l Sru�f�gaps9v v;� RnQ "-Uj h ati _,yo f .� 9jje g3N Llf Iv PO ' �,4ctr oS d� M° T OLS' Zh r• Lr '17 = 1- - - --- - - - - : - • - I r r 5� h