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Miscellaneous - 171 LIBERTY STREET 4/30/2018
171 LIBERTY STREET 210/090.6-0064-0000.0 i � .I Date �T"" . .. . . .. ,ORTH Of'-- TOWN OF NORTH ANDOVER k, f O F 41PERMIT FOR GAS INSTALLATION 9 SACMUSESS This certifies that . . /° I . . . .e .` . . . . . . . . . . . . . . . . . . . . . . . 'r has permission for gas installation . . � .'. 1A �I/`. �' . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at .,�.�. . .�! S.C�. >. . ` . . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . Lic. No. GAS INSPECTOR Check 5343 * r N MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASPITTING (Print or Type) Mass. Date Moo City, Town - Permit # Building / Owner 's AT: LocationL�i �V�C T_ Name Type of Occupancy: .492�1-)a New RenovationEl Replacement Plans Submitted Yes [-] No Ix R W O Z f/9 N O N WpC O Cb F'. Z' O W ~ Q c Z D O F- W Q U9 6' W W ® ® O W F^ L>v W O W Q Z F. !� O IL a > W W W V9 j Z Q Y OC CC CW7 M W t- W I- do A Z Q J Q cc .~ Fa WVy ® > W Z W 0 0 W W A^ Q W >" W M g Q t� Y O W O to x Z O t7 W inJ U W > ® d i- O SUB—BSMTa BASEMENT 1ST FLOOR 2MDFLOOR 3Rd FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR (Print or Type) 6 Check One: �j Certificate Installing Company Name I + IzCorp. Address q1 I I aP ! �r + El Partnership P j q ❑ Firm/Company Business Telephone 1_ Name of Licensed Plumber or Gasfitter 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 Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations coverage. By TYPE LICENSE: 4Q J— /-4mo/ Title ❑ Plumber Signature of Licensed Plumber or Gasfitter City/Town Gasfitter APPROVED (OFFICE USE ONLY) ❑ Master h ®0 ❑ Journeyman License Number FORM 1243 A.M.SULKIN CO. 1989 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME & TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE GASINSPECTOR 1 j � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,K4 02111 °« 5� www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/lwividual): 4�_D C 01,L //,/C-- I-Address: 91 lJ_ /vnt t=14 L_b �,STR E F- City/State/Zip: �t4 ,C��,�� ; /119 o&o Phone#: 9Z L-a9E� Are you an employer? Check the-appropriate box: Type of project(required): 1. I am a employer with 1-15 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2'❑ I am a sole proprietor or partner- listed on the attached sheet. # 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition 5. ❑ We are a corporation and its [No workers' comp.insurance �° 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13F] other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their wormers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:UihbL_rS�d&—r,9-1 Policy#or Self-ins.Lic. #: " poo-3i441— 4 Expiration Date: 01/0, L,;�00!7= Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: — Dater Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I Information and Instructions •ii [assachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. rrsuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, cpress or implied,oral or written." n employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more Fthe foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the sceiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the caner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the welling house of another who employs persons to do maintenance, construction or repair work on such dwelling house r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." 2GL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or enewal of a license or permit to operate a business or to construct buildings in the commonwealth for any pplicant who has not produced acceptable evidence of compliance with the insurance coverage required." additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall :rater into any contract for the performance of public work until acceptable evidence of compliance with the insurance equirements of this chapter have been presented to the contracting authority." applicants 'lease fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if tecessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of usurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the nembers or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have ;mployees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial kccidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should re returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' =Venation policy,please call the Department at the number listed below. Self-insured companies should enter their ;elf-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space afthe bottom )f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. Che Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 .vised 5-26-05 www.mass.gov/dia i Date... . OF NORTH A �O o= °` °� TOWN OF NORTH ANDOVER a a PERMIT FOR GAS INSTALLATION 9 . h ACMUSE�I( e ` This certifies that . ._:l �'�'�'. . ��� . . . . . . . . . . . . . has permission for gas`installation . G �K in the buildings of . . . . . - �. . . . . . . . . . . . . . . . . . . . . . . at /. . . . . . . , North Andover, Mass. Fee��. . . . . . Lic. No.�'/..',? `�` . . . . . . . . . . . . INSCTOR Check# VVV 5340 MASSACHUSETTS UNIFORM APPUCATON FOR PERIVU TO DO GAS HTnNG (Type or print) Date I �/a�lodl000� NORTH ANDOVER,9t� MASSACHUSETTS Building Locations l 1 Permit Amount$ ld f ' Owner's Name r1 New a Renovation Replacement Plans Submitted 2 " 0 '� ° z o E$ w a UH a a z0 0 a 0 SUB •BASEM ENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOG R 7TH . FLOOR 8TH . FLOOR U11 11 (Print or type) ,,`` C C e one: Certificate Installing Company Name44 V OU Corp. Address �7)vnl ) I " c Partner. Business77) 71707 Telephone' Firm/Co. Name of Licensed Plumber or Gas Fitter --:Vy,U L MCl cog INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 NoO If you have checked yes,please indic a type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 0 t 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 Gas Code and Chapter 142 o the General Laws. Signature of Licensed Plumber Or s Fitter Title Plumber M — I3� C�'3 Tit City/Town 0 Gas Fitter License Number aster r3PPROVED(OFMCE USE ONLY) Journeyman i 0 C/' Date..... ......................... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU NYr,, G�............................. ................................ This certifies that .......Ten—. AIC has permission to perform ................'It.�((/.A-)........................................ ..... ..... ...... wiring in the building of.............. .............................................. at........... ......./4.,k:7eLl ...... North Andover,Mass. Fee..P?.C)K Lic.No../ ELEcrRicAL NSiECTOR Check # N94-- 515 ,19 rf sV :ta Commonwealth of MassachttsettsY z' n x� '*t '� �3 f 7' t,:zl+s'ff+�F4t+•.S.qr'�-�•F:t; M�.�rl�e'��.r'"4�,y �� ! � � �t•,,' �� } ,}�£ U ?Y g Depa tti�ent'o'f F1re Services =Penirit BOARD OF FIRE PREVENTION REGIJ ' IONS ` Occupancyand Fee Check F , ev. 11/99] eave lilaiik APPLICATION FOR PERMIT O ERFORM ELECTRICAL WORK All work to be performed in accordance with-the assachusetts Electrical --- Code(MEC),527 CMR 12.00 LEASE PRINT (�' W INK ORi ALL INFORMA7+7 Date: — City or Town of: P / !� �PZ To the Inspector"of By this application the undersigned gives notice o his or her intention to perform the electrical work described below. Location(Street&Number) Z�` ,-j201t-W� Owner or Tenantj 'af77/ 1�l� Telephone No. Owner's Address `P Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion o the ollowin table m be waived by the I for o Wires. No.of Recessed Fixtures3® No.of Ceil.-Susp.(Paddle)Fans °•of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting FIztures Swimming Pool Above ❑ n- ❑ o'o mergency g ng rnd. rnd. BatteryUnits No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches3� No.of Gas Burners o.o Detection an —Initiating Devices No.of Ranges No.of Air Cond. ota No.of Alertin Devices Tons g No.of Waste Disposers eat Pump um umber ons o.oSelf-Contained— Totals: e - ontame Totals: - Detection/AlertingDevices No.of Dishwashers l� Space/Area Heating KW Local ❑ Municipal11 Other Connection No.of Dryers Heating Appliances KW ecurtty 3stems: No.of Devices or Equivalent No.o Water o.o o.o Heaters KW Signs Ballasts Dat WiriNo.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommu ca ons r g: OTHER: No.of Devices or Equivalent Attach additional detail iifdesired,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 coverage is in force,and.has exhibited proof of same to theP ermit issuing office. CHECK ONE: INSURANCE O'BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: When required by municipal policy.) (Expiration Date) IWork to Start: •ons to be requested in accordance with MEC Rule 10,and upon completion. certify,unde th pains and penalties of perjury,that the information on this application is true and complete. FIRM N LIC.NO.: Licensee. ' �:• Signatur LIC.NO.: el (Ijapphcable,fnier'exempt' the license number line.) Address: Bus.Tel.No.• ':1—� � ( � �J 13 Alt.TeL No.• �c��!-4 �c/ 2 _ OWNER'S INS CE WAIVER: I am aware tha 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)Downer owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE:.S s5z+r � ry COmmonftalth of Ma ` T C pS@ttS� >n x� ���yYyyy�. onl rr eta y s.:tF7L �`� pcd j , ;v, ` 19c t ; } r� :2Y N Departthent'of F! Serylees - ''PernnE No: .r" i'<,. .� BOARD OF FIRE PR ION REGULATIONS Occupancy and Fee Checkod / 9j eave blank 0 APPLICATION FOR ERMITTO PERFORM ELECTRICA -- All work to be L WORK performed in accordance with the Massachusetts Electrical Code(MEC);527 CMR 12.00 - (PLEASE PRINT WINK OR TYPE ALL INFORMATI011g Date: l d�— nJ T' City or Town of: To the Inspector of Wir By this application the undersigned gives notice of his or her intention to perform the electrical work descnbed below. Location(Street&Number)_ 2)� Owner or Tenant ��'�' (_"27 12s Telephone No. Owner's Address ,,5;t}/f�c� Is this permit In conjunction with a building permit? Yes " No ❑ (Check Appropriate Boz) Purpose of Building (A) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No,of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: I-Ove`, 2g< el1eAj Completion o the 110 in table m be waived b the Inspector o Mires. No.of Recessed Fixtures 0 `No.of Ceil.-Susp.(Paddle)Fans -o-.o ota Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ n- ❑ o.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets- No.of Oil Burners To. E ALARMS No.of Zones No.of Switches '...� No.of Gas Burnerso electron an Initiating Devices No.of No Ranges .of Air Cond. Rang Total Tons No.of Alerting Devices No.of Waste Disposers fleatrump um erons_ o.oSelf-Contained Totals: — Detection/Alertin Devices No.of Dishwashers l` SpaceJArea Heating KW Local ❑ un c p ❑ Other Connection No.of Dryers Heating Appliances KW Security ystems: o.o Water No.of Devices or Equivalent No.o No.—:of Heaters ' Si ns Ballasts Dat No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommu ca ons rmg: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Htres. 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 0""B OND OTHER ❑ (Specify:) . Estimated Value of Electrical Work: �tobe (Expiration Date) (When required by municipal policy.) Work Start: S ested in accordance with MEC Rule 10 I cent unde th ,and uta completion. certify, pains and penalties of perjury,that the informadon on this application is true and complete- FIRM NAME LIC.NO.: Licensee: C,16 _ tgs..•.- A C� Signatur ,�� LIC.NO.: �% pfapplleab/e,.peter" p ' the license number line.) Bus.Tel.No.; d- '- Address: � ?si. t CS d Alt.Tel.No.- OWNER'S INSURANCE WAIVER: I am aware the- 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 Signature Telephone No. �E"f�JTFEE_- �J Y J I, 9 FORM U - LOT RRTFnSE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Phone b 3 LOCATION: Assessor's Map Number �� 13 Parcel G� Subdivision Lot(s) Street -/ Z/ r C Qy St. Number 7 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Date Approved Date Rejected - Comments � Date Approved Town Planner Date Rejected Comments Hea th Agent Date Approved Date Rejected Comments Public Works - sewer/water connections drivewa yermit P Fire Department Received by Building Inspector Date OCT 1 51992 jo olL ' 0 Tit / J" V ov X./. dkc(ov ( � ) 15 s d you 0 A/ A l i1 e .k.� 0 1,/ S 0 t\1 7� �/ c 1� � v � •t e u s e �l tic< c<---", � ,v 4e k,e( /v v <C 4 o c r - VV 5 L � e SS. / 1 own ot .F ► 6 °Ln ® ter No. l� f er, Mamp Ae_:FAZ& I 9�fi� CK 0S COCIIICKEWI�AR SS BOARD OF HEALTH ,PERMIT T THIS CERTIFIES THAT... �.. .. .�...A ..�.ra...`rel......................... r ��� BUILDING INSPECTOR .�.� ' ' ....�..... buildings on ....... ...,. .. ......� ..... Rough has permission to erect � Chimney i 6 ^ to be occupied as...... �. .�. .. .�: ...49 �*. .C.... Fi I p0% provided that the person accepting this permit shall in every respect conform to the terms of the. application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction_ of Rough �PERMITfOR FOUNDATION UNIY Buildings in the Town of North Andover. REGULATEDBY-PARA.^-114.8-S.-B.-C.:. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. , PERMIT EXPIRES IN 6 .M0NFT602/ 2L-=T=FEEPAID , dv- a 0'_ ELECTRICAL INSPECTOR -y f/ Rough CONSTRUCTION STARTS Service PERMIT FOR FRAME/BUILDQGLESS �Vao • Final ......... .. .. . ....... DATE: FEE PAID: _ BUILDING INSPECTOR GAS INSPECTOR Rough Occupancy Permit Required to Occupy Building Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner N Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector : ,_5 ORTH omm of � 110 over 0 . fn ZPJAge o� o� 1 A Lfirth Andover, Mass., �! 19 cl A0"'ATE0 'tC) . BUILD BOARD OF HEALTH PERMIT TO Food/Kitchen Septic System THIS BU ILDING INSPECTOR r !� I ;M.0 CERTIFIES THAT....... ......s ....... ...... ...... ................................................. Foundation has permission to erectle"...At ......'buildings on .....4*.. ...tsexry....> Rough to be occupied as........S-kV. -A . .../.. 00.00t.. ..00.40.LA .�. .0..... . ...... Chimney e provided that the person accepting this permit shall in every resp ct 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 IN f OL VIOLATION of the Zoning or Building Regulations Voids this Permit. P *W=ONLY Rough REGU"8Y NK u4" It PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION TION DATF _�. .,-1 FEE PAID Ia U O ° ELECTRICAL INSPECTOR Q"006 ' J Q,a(.� Rough PERMIT FOR FRAME/BUILDINGA of S_b Service BUILDING INSPECTOR Final DATE: FEE P�(Q Ucc-upancy Permit Required to Occupy Building GAS INSPECTOR Displayin a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry wall To Be Done FIRE DEPARTMENT Until Inspected a9d Approved Building Inspector. a6 v Burner PLANNING FINAL 15Z 15'311;1 70A3 CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT Yph Tow of NoA Andover ;1" z No. -7j� )RIVEWAY ENTRY PERMIT W.44a, CeL, North Andover, Mass.AAA,z194'/ BO RD OF EALTH . PERMIT TO BUILD THIS CERTIFIES THAT. r7.0 �1..�..1=ARf.Ci'.A1.....;rA. ... `` BUILDING INSPECTOR has permission to erect .W..Q0l0.t.j�j����18ings on '.7.1..�.4.�.��,��..��...... Rough '7/Z'1 j7 j to be occupied as. • .1,..�� ,A. ...am/,, .. .. Chi ne C'Wit' Fi provided that the person accepting this permit shall in every respect conform to the terms of the application on file in . �1 "J-- ING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of rRoug Buildings in the Town of North Andover. PfRir 1' FOR Pt))HPATION OFTY '•` n L VIOLATION of the Zoning or Building Regulations Voids this Permit_. �,�„u�,��,.AIED Y PAR ... C . �f...:.... �._ E I'A011):...., r... :. : ELECTRICAL.INSPECTOR Rough �'ER',HT FOR Service Final ' r '---�-•- �f �t Rt� f.,.,._ ,,�J}e ...... ••... ••. BWLDING INSPECTOR GAS INSPECTOR Rough Final Display in a Conspicuous Place on the Premises FIRE DEP . Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. .��`' Building Inspector I Location f ��/ a ��Azy No. Date N°RTM TOWN OF NORTH ANDOVER p Certificate of Occupancy $ •��"� 3 Building/Frame Permit Fee a Foundation Permit Fee Ss�CHusE OtherPermitFee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 762, ,,Building Inspector 021 7x94 10:54 712.54 PAID t: �_ 7023Div. Public Works s Location : I�.' •.��•_�,.�• ?✓ No. 1/ Date N°"T" 4, TOWN OF NORTH ANDOVER I p Certificate of Occupancy $ �G- 41 BuildiVV6me Permit Fee $ ,SSAGNUSEt�'fo F9 ndation Permit Fee $ p� t Other, mit Fee $ ©G' !&Qer Connection Fee $ Water Connection Fee $ TOTAL $ .� Building Inspector Cr Div. Public Works PERMIT, NO. / /PAGE APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. 1�� � � i MAP 4.40. � LOT NO. / �C 2 RECORD OF OWNERSHIP ;DATE (BOOK ;PAGE ZONE I SUB DIV. LOT NO. LOCATION �_- / PURPOSE OF BUILDING i ( /� • 1 OWNER'S NAME ^ NO. OF STORIES Z SIZE 'Z V Y ;1 l 'A s toc _ X CJ OWNER'S ADDRESS k� BASEMENT OR SLAB - r _ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 2ND 3RD BUILDER'S NAME 1w5 E ` SPAN DISTANCE TO NEAREST BUILDING c(a 1 DIMENSIONS OF SILLS _ .2 L.( X 9/J - DISTANCE FROM STREET 7-5-0 ( POSTS DISTANCE FROM LOT LINES-SIDES /�Q REAR GIRDERS AREA OF-LOT ,3 A e.e. S FRONTAGE! S O 1 HEIGHT OF FOUNDATION ° G t1 ,t THICKNESS ` 1 IS BUILDING NEW Owe y SIZE OF FOOTING Q D X C-0 IS BUILDING ADDITION 'l .J MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE y e 5 IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY I IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EBT. BLDG. COST �- S / a PAGE 1 FILL OUT SECTIONS 1 - 3 EBT. BLDG. COST PER %^ ' R.a ' E8T. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 MR.TEL w��i{ .. 8EPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING CONTR.LIC.p 4 APPROVED BY t ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR V/ DATE FI ED / V = BOARD OF HEALTH SIGN URE dF OWNER OR AUT ED AGENT 1_ FEE �02 • �(/ O PLANNING BOARD PERMIT GRANTEp' ////___�• Q{} p�tMiT FUel c•�iittlFaf� rte,19 i.c., FDA r1:� 0, 0 C? _ 4 DUEFRAMEPERMIT$ I^ r {` BOARD Of ..SELECTMEN o a' � MT i 5 I99? ' BUILDING INSPECTOR i t BUILDING RECORD 1 OCCUPANCY 12 i SINGLE FAMILYS"Okit 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 _ a 2 13 CONCRETE BL'K. ---III PINE BRICK OR STONE HARDw D PIERS PLASTER VJA_LL UNFIN. 3 BASEMENT AREA FULL FIN. B M TAREA — '/ 1/1 1/1 FIN. ATTIC AREA NO 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 HARDW 0 ASBESTOS SIDING COMfACN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME 1 CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME T1s jT QT.gn SUPERIOR ( I POOR ADEQUATE I NONE •^-x` 5 ROOF 10 PLUMBING GABLE HIP BATH Q FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ T TAR & GRAVEL STALL SHOWER ROIL ROOFING MODERN FIXTURES 1 �T TILE FLOOR TILE DADO t I 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE •*T FORCED HOT AIR FURN. -.. .___ p 1 ` '• 'Y'` TIMBER BMS. R COLS. STEAM STEEL BMS. 6 COLS. _ HOT W'T'R OR VAPOR n.,,,. __ ,__ •..-- ,.L , a •N WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G -- - ` UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd ELECTRIC 1st 13rd NO HEATING f ' RIP CERTIFIED FOUND4T/ON LOCATION a °' PLAN LOC4TEO IN: - - �-d.t�-T i--�_ . . . . . .+v.�411.'E lz_. . . . . co SCALE: /u. = 4 D� D.[lTE.• a t CHR/ST/AMEN 4 SERG/, iNc. /GO SUMMER ST. --H4VERB/LL M,4. 0/830 A - b Qi CL/ENT: �.o �� P. �. . . . �- . . � . . . . . . . . . . . t T1 CERT/F/CAT/ON /S "WDE AND L/MMED TO ,b = 3.0 .Qc,= THE ABOVE CL/ENT. T CERTIFY .TIM THE STRUCTURE SNOWN CONFORMS c TO• TiVE DIMENSIONAL REOU/REMENTS OF Tf/E ' ZONING BY-LAWS OF THE . . . . . . . . . . . . . . . . . . OF . Q A-.,j o o v �>�-. . . WREN CONSTRUCTED. OFFSETS SHOWN ARE FOR ZONING DETERM/N.47/0N ONLY AND ARE NOT TO BE L/SED TO ESTABL/.Sy Mti PROPERTY LIMES OR TO DETERMINE LOCAT/ONS OF BU/L D/NG ADD/TIONS. r TO THE,BEST OF MY KNOWLEDGE AND BEL/EF D ..a, THE PR/MARY STRUCTURE SHOWN ON TN/S PLAN w /S NOT LOCATED W/771/1V A FLOOD HAZAF'cD ZONE N AS s, owAl ON DE 4RTMENT H.U.D. FEDERAL a Q //1/5URANCE ADM/N/STR.4T/ON lww:5. COMMUNITY NUMBER: .2 0 0 16. . o S. C AIA OF 4 ` �i 3 Z�.4 2- 91 3'1.2 ��� MigIAEL yc q'p SERGI v, No. 91 14 ^`+ Nal LAN S� P — W'gay G . Q D � ' CERTIFIED FOUNDATION LOCATION PLAN n � LOCATED /N: .D-aZl'4 . . . o�.E - . . . . \ SCALE= /N 4 v' DOTE. 1 CHRISTIANSEN 4' SERG/, iNc. _ \ y /60 SUMMER ST. ---HAVERfV/LL, MA. 0/830 L�o CLIENT.- T915 L/ENT. TH/S CERnFlcArlON /S MADE AND LIMITED 70 Ac- THE ABOVE CL/ENT. I CERT/FY THAT THE STRUCTURE SNOwN CONFORMS r TO; THE DIMENSIONAL REOUIREMENTS OF THE ' ZONING BY-LAWS OF THE 7 w ' OF k.,j o a v r, WREN CONSTRUCTED. OFFSETS SHOWN ARE FOR.ZON/NG DETERM/N•4T/ON �L ONLY AND ARE NOT TO BE L/SED TO ESTABLAW PROPERTY L/NES OR TO DETERMINE LOG4T7ONS OF SUM DING ADD/TIONS. r TO THE,BE5T OF MY KNOWLEDGE AND BEL/EF THE PR/MARY STRUCTURE SHOWN ON TN/S PLAN /S NOT LOCATED W/77-1IN A FL OOD /IAZARD ZONE AS SyOWN ON DF°ARrmEvr N.LID. FEDER.4L c ;. INSURANCE ADM/N/STRATION MAP5. COMMUNITY NUMBER: 0 98. . o S. Z J Q 1 j Qk . i OF SZG1u p Z 3 S S•GQ a IANC 5 a D ' � � REGISTERED STRUCTURAL ENGINEERS DENO C LSV •MBIU N'Gr, INC, NEN YORK L----- S�U--------- 17101 7VA"amonwas NAIVE -------- •-•------- 1519 ,y�148 Park Street. .p/ NEW IM SHIRB--------- ---- ---•••----- 1196 North Reading,MA 01864 VERHONT -••-- - -•-••• 1009 NASEAcausaTTl;----- --•- eaa9 (617)944-8440 .(508)6W788 CONNECTICUT •••--•--•--•- T197 RHODE ISL>1HD --•--------- 1017 KENNETH DENNIEDPE PROFESSIONAL ENGINEERING SERVICE SINCE 1956 MEl18ER AMERICAN 7W SOCIETY OT CIVIL ENGINEERS BARN FOR J. RICH 1 400 SHRET cf? lO6NP 28-92 . NORTH ANDOVER, MASSACHUSETTS 'DRAWN sT KF...-D 3/17/92 o�Tg REVISED .__ OATS CO 1992 DENCO ENGINEERING, INC. CLIENT J. Saia, Architect' Second Floor• Framing Live Load at 40 psf Dead Load at 10 psf Total Load = 50 psf Joist spacing at 16" o/c Span = 12 ' -0" Joist load per foot = 50 x 1. 33 67 ps.f �``H OF k9,��� Max. bending moment = 67 x 12 /8 = 1206. ft.. lbs �� KENNETH icy 3 o DENNISON GN 2 x .10' joists Sx = 21 .4" TURAL 4 89 H fb = 1206 x 12/21 .4 = 6.77 psi Allowable Fc 1050 psi �Fc Center steel girder with span of 30'-0" design: Uniform load = 50 x 12 = 600 + beam (40) =. 640 plf . Max. bending moment = 640 x 302/8 = 72,000 ft . lbs . Req'd. section modulus at 24,000 psi fb = 72000 x 12/24000 = 36 0 Allow -15% nailer bolt holes =-----=-------------------- = 5 „4 End reaction = 640 x 15 = 9600 lbs Required S "3 -- = 41 .4 Select W16X31 section Sx =. 47 . 2"3 greater , than 41.4"3 x Check deflection: 6 x 72 x 302/1000. x 375 1 .037" at total load condition 1/360 x 30 x 12 = 1 . 0.0" Revise beam size up one size to W16X36 Sx 56 . 5113 IX = 448"4 Revised deflection =1.037 x $ = 0 . 868" I -t6 NCLUSION: USE STEEL GIRDER SIZE W16x36 r---- Column and footing design: Load = 640 x 17 . 75 = 11360 lbs + col . 400 = 11760 lbs 4” HW Lally Footing area = 11760/3x3 = 1307 psf o.k for soil conditions if minimum value is as low as 3/4 ton/sq. ft. Field check. CONCLUSION: Use 4" SHW Lally on 3 ft. sq. x ; 1211 concrete footing. _ + SHEET NO. 2 OF 2 JOB N0. 28-92 DENCO ENGINEERING 7NC. _,._ - STRUCn%4ZRNCiA S"X8CO 1992 DENCO ENGINEERING, INC. Design overhead door lintels : Roof load 40 x 13 . 5 = 540 Wall load 120 2nd floor 50 x 6 300 Design load 960 plf Max. M = 960 x 12 . 672/8 = 19263 ft lbs Req'd. Sx = 19263 x 12/2600 = 88. 9'!3 Use 3 - 13 x 111 LVL = 36 . 9 x 3 =. 110. 7"3 End reaction =. 960 x 12/2=5760 lbs Use 6x6 post or 4-2x6 built-up j CONCLUSION: Use 3-14. x 114 LVL over each overhead 12 ' door opening r S'- Lo c at i o n 'Location Zi6 F� S� P No. Z/ _ Date /14, 1 N°RTS TOWN OF NORTH ANDOVER =Certificate of Occupancy $ }'b Building/Frame Permit Fee $ 12 cx� ,ssACMUSES Permit Fee Oo t � R Other a it Fee $44- � '590er Connection Fee $ Ay14 tV ter-Connection Fee $ /11 T $ ll5v Buildingansp`ector Div. Public Works Location foo. y` a Date „pR,►, TOWN OF NORTH ANDOVER Certificate of Occupancy $ i a ;+ Building/Frame Permit Fee $ + Foundation Permit Fee $ o �C" Other Permit Fee $ ��'er Connection Fee $ VL Y�+ Water Connection Fee $ 91 TOTAL j $ Cr d fo 19tot d � Coed 't Building Inspector 1540 ' �j Div. Public Works } PETIT �0.�� CYC APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. )/ PAGE 1 MAP 4-40. l I LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE /J` / SUB DIV. LOT NO. � I 1 F LOCATION I f ID RPOSE OF BUILDING S RM 1 wev I ' e 01NNER'S NAME ' ` e � NO. OF STORIES SIZE q DD OWNER'S ADDRESS r !i C •s Lpja JD BASEMENT OR SLAB �Sn N q , it ARCHITECT'S NAME V ` SIZE OF FLOOR TIMBERS IST�lry ,�`q`-t2NND x 1 3RD BUILDER'S NAME r--� SPANe/�`_�C�' `�-� '� a N 5 DISTANCE TO NEAREST BUILDIN6 DIMENSIONS OF SILLS t t r DISTANCE FROM STREET ` �( " POSTS Lt DISTANCE FROM LOT LINES-SIDES 1 I j REAR 2 ya 1 GIRDERS t( AREA OF LOT i ^ {/,L�, FRONTAGE J ( HEIGHT OF FOUNDATION THICKNESS ee IS BUILDINGNEW/ lJ e L SIZE OF FOOTING ll X t IS BUILDING ADDITION MATERIAL OF CHIMNEY l G IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 5 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE a IS BUILDING CONNECTED TO TOWN WATER o I BOARD OF APPEALS ACTION. IF ANY A ,� IS BUILDING CONNECTED TO TOWN SEWER O w IV IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 0 3 PROPERTY INFORMATION PERMIT( LAND COST / ZD I D O� SEE BOTH SIDES OR FOUNDATION ONLY _EST. BLDG. COST REGULATED BY PAREST. BLDG. COST PER SQ. FT. PAGE I FILL OUT SECTIONS I - 3 A: 114. ^ ff�a 8•S� B.V. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 DATE. / FEE PAID: �� —� 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 y rc - DATE FILED /O ' 441LI, Y BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT �y vv RMIll FM FEE /� ® 0 . E c r�C �i A FEE - - O'� PLANNING BOARD PERMIT GRANTED '"AfiIT a; e-o �. To - BOARD OF SELECTMEN TERMIT FOR FRAME/BUILDINGOWNER TEL.#�- 1633 i .. l i � CONTR.TEL.# �� � I 10 lC�i DATE: FEE PAID R.LIC."— — -- BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYAoO� STORIES THIS SECTIO_N MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION Q INTERIOR FINISH n N /y.� CONCRETE d 1 2 I3 A >� 4 l y .. CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _� DRY WALL ,� gq UNFIN. +� ri�'�tiA •.Il.�. tF 3 BASEMENT il AREA FULL Alo, FIN. B'M'T AREA _ '/. IF, V. FIN. ATTIC AREA NO BMT FIRE PLACES _ HEAD RC7M MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDV✓'D Y _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE , STUCCO ON MASONRY �_ + STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI-1 PNOOOR ADEQUATE NE $ ROOF 10 PLUMBING GABLE I HIP BATH Q 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 TOFING MODERN FIXTURES _ T FL E,F LOOR TILE DADO 6 1. FRAMING I 11 HEATING, WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. �_ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G _ UNIT' HEATERS 7 NO. OF ROOMS GAS ` e OIL B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING. Q e• s � , n t4 J u DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH 1010 COMMONWEALTH AVE- OF BOSTON,MASS.02215 ENCLOSE CHECK OR MONEY ORDER MASSACHUSETTS FOR REQUIRED FEE, L I L E`3 EXPIRATION DATE CONSTR. SUPE 1.V 1s 0 k MADE PAYABLE TO 06/30/1 991 (� EFFECTIVE DATE LIC-NO., ,COMMISSIONER OF PUBLIC SAFETY" RESTRICTIONS > I NONE �06f3(, / i9`) 019Q39 " (DO NOT SEND CASH). AJOSEPH F RlCta 393 R SOLEI STREET z: SS 023-44-0140 iallf* I14LT0N MA Cl 867 PLEASE NCTE FEE I(vCREASE ,{ � PHOTO(BLASTING OPR ONLY) FEE: E F F r t 100.00 SIGN NAME IN FULL-ABOVE SIGNATURE NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPE -OR -SIGNATURE OF THE COMMISSIONER A Jµ�/' DOB: f� O 6/0 2/1 9 5 3 SIGN NAME IN FU6L-ABOME SIGNATURE LINE THIS DOCUMENT MUST BE SIGNATURE O ICENSEE CARRIED ON THE PERSON OF • • THE HOLDER WHEN ENGAG- Zr. MMISSIONER �,. OTHERS -RIGHT THUMB PRINT ED IN THIS OCCUPATION. { - _ H k Y F r CHRISTIANSEN & SERGI, INC. Professional Engineers and Land Surveyors ? • . 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830 (508) 373-0310 x April 11 , 1991 Mr . _Toseph Rich 3938 Salem Street Wilmington , MA 0188 Dear Mr . Rich I have reviewed the soils data and plans for 171 Liberty Street , North th Andover and find that a perimeter drain is not necessary . I have reached this ;enc i us i cn because the soil is y. sandy gravel which is extremely well drained and 1..'•!i l l not I trap water in the foundation . I t.Jer;r ru y `rour;_. � F' A i i P G. C;hr i st i ans.en �a•' OF PGC: l c P41LIP G CHRISTIANSEN Wo. 26895 ��57pAL � FORM U " TOWN OF NORTH ANDOVER , LOT RELEASE FORM SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) / 6e L STREET r 7 APPLICANT PHONE —W,33 DATE OF. APPLICATION TOWN USE BELOW THIS LINE PLANNING BOA t` J1 DATE APPROVED TOVN' PLANNER DATE REJECTED CONSERVATION COM1iISS ON < DATE APPaPVED CONSERVATION ADMIN. ATE R CTED BOARD OF HEALTH `(O 16";Z, 'e . - ... 11 DATE APPROVED HEALTW SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS ,{r DRIVEWAY PERMIT / SEWER/WATER CONNECTIONS Aja 8� FIRE DEPT. . ,�e /�aG e Ke kb CCT? `Z0 Rd a r"c fJ r 247:4 RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from- the compliance of any applicable Town requirement or Bylaw. e covi 71loo r o � � 1 e. CERTIFIED FOUNDATION LOCATION E PLAN LOCATED IN: I .a x \ �cl SC,4L E: P' = d 0� D47-E. \ CHR/sT/ANSEN e SERGI, INC. \ IGO SUMMER ST. HAVERH/LL, MA. 0/830 CL/ENT: .ca S P. t4 . . �_ . . t. . TH/S CERT/F/C.4T/ON /S MADE AND LIMITED TO = THE ABOVE CL/ENT. a I CERT/FY THAT THE STRUCTURE SHOWN 'CONFORMS TO THE D/MENS/OVAL REOU/REUENTS OF THE ZONING BY-LAWS OF THE . . 7�+� �? . . . . . . . . . _ OF . Q Q , .4.14 o 0 v �:-n.. . . WHEN CONSTRUCTED. G OFFSETS SHOWN ARE FOR.ZON/NG DETERMINATION ONLY AND A PROPERTY /NES OR TO D=RM/NE LOBT/CAONS OF BU/L D/NG ADD/TIONS. + 7- TO T/IE BEST OF MY KNOWLEDGE AND BELIEF THE PR/MARY STRUCTURE SHOWN ON TN/S PLAN /S NOT LOCATED W/Tx//N A FL OOD HAZARD ZONE AS sNOWiV ON DEPARTMENT H.LID. FEDERAL + a INSURANCE ADM/N/STRAT/ON M,4PS. 7- COMMON/TY NUMBER: r DATE: K of o'r MICHAEL��yG iQ'o ' SERGI H �! : 2 9 1991 1��! _ _ ElhjERRYA � II ��� N V A T PLANiVII Ji�� L. a�ys , NORown ofTdy — •', F m9 4� 6 AndoverS )RIVE' AY ENTRY PERMIT � rt er, Mass. QPAy*Z19q1! C r Hi ME WIC o i_ _ e �0R BOARD OF HEALTH THIS CERTIFIES THAT..17l t=.. . P W. • • g /.7.1.•4.4•&•6tt•toy••�(•••••••••• RoughBUILDING INSPECTOR has permission to erect . .>�� •� kI!J.���Bil�in son �1 . f •�••� '� Chimney to be occupied as. .. ... ... ►.I. .�I....E°P.V. . '.. .............. Final provided that the person accepting this permit shall in every respect conform to the terms of the application on fele in PLUMBING INSPECTOR this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY Final VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA: 114. 8-S. B.C. PERMIT EXPIRES IN 6 MONTFTE: j FEEPAID: ©� � ELECTRICAL INSPECTOR __((__11 Rough PERMIT FOR FRAME/BRN66SS CONSTR TION STARTS Service 6 Final DATE: '2- -?� FEE PAID:! °0 BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be. Done Until Inspected and Approved by Smoke Det. Building Inspector Location Date -^ NORTIy , TOWN OF NORTH ANDOVER p Certificate of Occupancy $ a _ • Building/Frame Permit Fee $ S.?""CH a Foundation Permit Fee $ � s�cMus c Other Permit Fee-Yx /IUP(d $ Sewer Connection Fee $ RECEIVED PAYAA Ner Connection Fee $ _ fl�J TOTAL $ ✓�`� VIM 5 199 Building'Inspector Mo. AfIdover Collector Div. Public Works . t Ol l lc:I sc)1 . 1°. �� ovvII o I:� inl;iiii `;lis t I n t iiin1�1►ilvc, N01ITA 1 .t1.ND0VL1Z �� �,:� r.l;i�;tirili►i ;i•IltitllFs.t; I (:ONti1:I VAI'IONIN 4W Ilil r'IIiF{!i IT'T,'i ff PLANNING I'l-ANNINI; & (;O1l1f�lUNl't'1' 1)l:Vt:LUI'I111:N"t' I:,\I,I;I` 1 1.1 . NF LSO )N, I ►I l tl:(: I t )I t "k CHIMNEY APPLICATION ANO I'EI:('111 DATE: PL1ZrII"I' # z 43 C° LOCATION 7l ,L gz 8 OWNER'S NAME: Ox `, iiUILUER'S NAME: S1-e SON'S NAME: mc'! Cz u` ;.MASON'S ADDRESS: 2 4 c?-� 17 /F STb MASON'S TELEPHONE:_ �� w 33 MATERIAL OF CHIMNEY.- IN FE R 10 R HIMNEY:INTERIOR CHIMNEY: F'k 67 LXIERIOIZ CHIMNEY: y �� `:,NUMBER AND SIZE OF FLUES: ,c :.THICKNESS OF HEARTH: - WiU chblliey on. 6iAep.Caee eon(jon►n to Vie. )ce.qub(cme►I.t:5 a() the carie a,Id have lcuft6 alit( : hegu,Cati.ou6 been neeesved: 'DATE: - SIGNATURE OF MASON: _ PERMIT GRANTED: / I"EE� S ROBERT NICETTA BUILDING INSPECTOR Y INSPECTED: REMARKS: So�� C� �ll��7Z %Z�I�S%—�Goo�?�T• _ +' SOLID BLOCK 1tEQUIRED '4 THIS PERMIT IIIISf BE UISI'LAYEU 014 111E I'RLhLISES h CERTIFICATE OF USE & OCCUPANCY Building Permit Number 143 1 9 9 1 ) Date FEBRUARY 2 1 , 1 9 9 2 THIS CERTIFIES THAT THE BUILDING LOCATED ON 171 LIBERTY STRFFT MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. OF NORTH - �2 o CERTIFICATE ISSUED TO Joseph F . Rich , J n. .. m e r_ " ADDRESS 10 Lacy St. , No4th Andoven , MA Building Inspector f T Location ! �� !? No. Date c NOItT1y TOWN OF NORTH ANDOVER 3? � •SOL f � 9 ` Certificate of Occupancy $ ;�s',•' E<�' Building/Frame Permit Fee $ S p �cNus Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check # `Z(.3 1 t Building Inspector TOWN OF NORTH ANDOVER � BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING MIN :V`" '}3 4 � p. ,i.,,. '� _..a' ,,1�i �"r ''ra '""h x rr i ..a' ' s •::a# s . BUILDING PERMIT NUMBER: DATE ISSUED. 65,A'-) SIGNATURE: Building Commissioner/In for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: )2�15F F Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Reuired Provided 0" /W k I/3-O 1.7 Water Supply M.G.L.C.411. 4) 1.5. Flood Zone information: / 1.8 Sewerage Disposal System: Public ❑ Private Zone Outside Flood Zone $ Municipal ❑ On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT SioriC iSt(fCt: yes �jO 2.1 Owner of Recor / �-� n RI t b*s,# q L%aorp ry SV. Nam (P t) F dd ss 'r Service V — � - Si tore Telephone 2.2 Owner of Record: r Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable j Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name t Registration.Number rM Address ' Expiration Date Signature Telephone i S SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 g 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 Pro osed Work chemckall applicable) New Construction 9/' Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Y-3Cl7®lU / %?�" a2 13 � �. L sib SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be �� OFF'TCIALu ONF:�' Completed by permit applicant 1. Building �OO�czlo —/6a1Ozx) (a) Building Permit Fee ,Multiplier 2 Electrical + (b) Estimated Total Cost of Construction 3 PlumbinE Building Permit fee(a)x (b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total 1+2+3+4+5 /fF st. Check Number 3 SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize_ to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION.7b. OWNER/AUTHORIZED AGENT DECLARATION I, ets a ("if 44 as Owner/Authorized Agent of subject A 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 ame Si a ire of weer/A ent Date NO. STORIES SIZE CASENffin2R SLAB S OOR TIMBERS yt Z isr 2 3 SPAN DIMENSIONS OF SILLS ) DIMENSIONS OF POSTS D130ENSIONS OF GIRDERS j) HEIGHT OF FOUNDATION THICKNESS " SIZE OF FOOTING X MATERIAL OF CHERNEY ,vae IS BUILDING ON SOLID OR FILLED LAND �u IS BUII DING CONNECTED TO NATURAL,GAS LINE 1tYo Add4 OA FORINT - U - LOT RELEASE FOS 1VI� (p r� ( �I NO -INSTRUCTIONS: This form is used.to verify that all necessary approval!pernutsfrom 2- Boards and Departments.having jurisdiction have been obtained. This does not relieve the applicant and`or landowner from comp a with any applicable requirementsME Emma won a as a. .................r.•...�..:.a...■ .. ......... ■.........a.. APPLICANT /as �r��4 � PHONE_7�' ASSESSORS MAP NUMBER 10 ,3 LOT NUMBER_ 4� f SUBDIVISION LOT NUMBER STREET 24 B&r y STREET NUMBER l 7/ .......:.........r.........-........s............i■r....r......................-■r...........■ OFFICIAL USE ONLY ...................:..........r....s.a......:.....S...W.........................,....monsoon RECONEV ENDATIONS OF TOWN AGENTS .... ......f....a...........isms mass ...............■,.................-.......... DATE APPROVED CONSERVATION ADr, TRATOR DATE REJECTED COMIvI M Q4406 coom re_AAg4,J 4a d4P_rmll., too i* ?roo" 0,4.Sje. �o' .- ne�, w DATE APPROVED TOWN PLANNER DATE REJECTED CONEVIENIS DATE APPROVED FOOD INS CT -HEALTH DATE REJECTED DATE APPROVED AS S CTOR- -- DATE REJECTED �I COMMENTS 4 PUBLIC WORDS—SEWER/WATER CONNECTTONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTNfEI�I T DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR --_.- - DATE I GERALD GOODSTEIN Fax:1-781-639-1450 May 24 2004 14:48 P.01 MORTGAGE INSPECTION z BAY STATE SURVEYING ASSOCIATES INC_ JOB# 100 CUMMINGS CENTER, SUITE#316J.-BEVERLY,MA.,01915 LOCATION ,IVoRM__AM�av6ew.,rErg.,_ No�5: 7n)This is a mortgage inspection surrey and not an 3 Z4-C� i mp surrey,therefore this plot plan is for SCALE . 'I., = DATE .....---- •---.-` ........ mortgage Inspection purposes only.It is Not to Sa x • be used to establish boundartrs or for the REFERENCE : K: `g.___��►_Z4+ . " Construction of any type of Improvements. 2) ush This survey is based on survey marks of others_ shrubs,fences and tree lines do not .................. neeessoray indicame ply lines. 4)Wherhever'an offset is T+-or less.an Instrument To: _._.. r2 l•?_PCs�n)•T....�x!c , 'TG�4GE... 'survey is raeonhrr a to determine property The location of the buildings}as shown,eitlines.and any possible encroachments- hercempiied with the local zoning setbacks at the time of 5)CMsets shown are Abe'and are to be construction or i9 exempt from violation enforcement 4med only.-for the determination ofaoning.Not to Kl action under ass_G_L Tale VIl Chapter.40A Section 7 be.used to establish properly fines-• 6)In my professional opinion the bulidinWs)are not.. located in.the special flood hsaard zone,as deflnedbyMUM-MAPr: ZSca��g G-a-93 Act C2 d - z=sir e,e.� L o7r 1 A I • f!l.3to - 31. 31.19 • �la,l¢ 3`► _ . . `TI+EPIAALISAGQfY _ T9►7 WOO e n 9E ASSUMED TQ CCNTAW uW^LA HAD ACTMAT7aNs- . THSDOC�I 1r IMALL NOT APPLY . TO COP6FS_ ----------____._a___ - - -- -- - -_w--M.- r � � �� u � �J� �" --- � a 4 � ��`' t �----•---�—e �' ��'� 3�_ -,-- ��g,� - _- /f - - _i�.�®l _- _� _:mss®q_. �.. f f w � r vel 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 c 11, S 150 A. T debris will be dis `sed of in: 3 (Locatio f Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I' t%ORTPt Town of North Andover Building Department 27 Charles Street �4 North Andover MA. 01845 , SSMCP90 D. Robert Nicetta . Building Commissioner (978) 688-9545 (978) 688-9542.Fax HOMEOWNER LICENSE EXEMPTION Please print. DAfiE //�o;f JOB LOCATION / 7/ L `/3 ell Y Number Street Address Map/lot "HOMEOWNER `76(-�2_`{/ – 36 7 6— Name Horne Phone Work Phone PRESENT MAILING ADDRESS Sl�1�2 City Town State Zip Code The current exemption for"homedwners"was extended to include owner-occupied dwellings of 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 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 or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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 procedure;and; irements and that he/she will comply with said procedures and requir ents. HOMEOWNER'S SIGNATURE L:i_ r. APPROVAL OF BUILDING OFFICIAL N The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02911 1b``0w Workers'Compensation Insurance Affrdavit Name Please Print Name: c �' Location: t`7l i K`�, Ci ).s Phone I am a homeowner performing all work myself. FI am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone#: Insurance.Co. Policy# Company name: Address City Phone#: Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment.as.well as_civii.penattiesinfheformof-a_STOP WORK_ORDER..and_afine of_(.$100.00.)_aday against-me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required Licensing Board Selectman's Office Contact persona Phone#: ❑ Health Department Other 4 I i _ i C A I 1' .. M to tip', $ �� �. a , � 4 r 6 T Lt y 1 �'k 4a •;3 nr 1 w i yds � f t qq 'HP Fax K1220xi Log for NORTH ANDOVER 9786889542 Jul 15 2004 11:14am Last Transaction Date Time Type Identification Duration Pages Result Jul 15 11:13am Fax Sent 89786836163 0:34 2 OK i Ir _-_-- i 4et) 47).el r Q SPS e vc�4 t 1 4 It t 000 NO Fc - f Town of _ 4Andover VA No. o A E dover, Mass., I� COCMICMEWICK V ' RATED PPS\ C BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ` BUILDING INSPECTOR THIS CERTIFIES THAT...�,1.�� ..�1° �a,n�......1'.Z..... ............. d.................................................. . .................... Foundation has permission to erect......90.0 to............... buildings on..../.Y!.... J.....5.. Rough v c AA to be occupied as.. r yya�'� 1� � ��dNvr y, �!v �` /�� y/ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in S Final this office, and to the provisions of the Codes and By-Laws r ating to the Ins ection, Alteration and Construction of Buildings in the Town of North Andover. p�D �S� E PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Perm' . Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T S Rough CC.. .....................................✓...�. .. Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Bumer Street No. SEE REVERSE SIDE J1 Smoke Det. `�, tom! 4 .. f - .+•.,�`�,.A' - }. ^� �". .. ` • A 9 't- _ - : co`VZ i . tj ' }. , .P . - _ F • � •. •+ - � r M AL L . t � .. r'1 T` - v - � �° '�n '4. nr1r.�,wrar.+✓.+.s-++n.'.���" •�'s. •� � �"�. V AN I TY } g, .t S ��* +• _fir "4'�"y a •� y WU A 11A .s. .W Z i', :� Y t ._ -Mr.'nwY�•+w-...ice•••T�•..{n .. jy,��{} ;.. .•6 1 �C '^• S •;� �' . i bra (y•..� �� ���•����, ♦ -� y - � +F it ar t A LA le-A�',tr" ir l f,•an y f3E f t u e /,maQ Twy�/� ,.`jam .h a A j �. La . Ov Ca � �A ` .. . r 17- 0 x t - . ITf CIO • '` ! P s:i i C Lt • '' . -� 1,� N F- ; --- , • ' r 'L:r4o ..o�J_ •'i"mss. -' - • ,� , - t } - +} • , f offNf •, 'M w tz .ate."-t � .slq� - .• tc c� �ft.��J�,° .` "` .. 'r • .- __s 'y��J' w�'j'M�j;' � Rj .Y�� .. !_ lam �� .� ..° 's f /��... *, *• "� ` .. v Y { � ' ry ... ••� I i a p t � y - �•� r'M14 5, • jj4ID � � AIt�r-! t-. .,w µ ��.. •IrM,:.. • f J 7 .w y_ , +� }ins�p • ' ",�.'X 9 . 7Ot Nol • - • T- IdX if At f " y " ' • t ��.�. r'" �'1�.�'• , k .. t., err. .� ,�� _LLLOA �p :R 1 . �� '� I Date. ".0 +° TOWN OF NORTH ANDOVER ° 0 PERMIT FOR PLUMBING 41 SACHUSE� This certifies that . . . . . . . �. . .�. . . . . . . . . . . . . . . . has permission to perform . . . . . . �. plumbing int 4auildings of . . . ��1"!. at �� . ��L C�%r�!C . . . ... . . . . . . . . . .. North Andover, Mass. Feez • .Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # / 6 2 81 MASSACHUSETTS UNIF-^ M APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) k)0R771 14ND O Mass. Date l�' Permit # Building Lo on L Owner's Name Type of Occupancy r�N 1, New Ve ovation O Replacement O Plans Submitted: Yes No O FIXTURES �y _z zY Q '' W 2 ~ W W z W (41 Q Q M _ ~ z O O W W T W H U u�1 W Y a W W ? O. 3 X CJ Z tL >a Q W } ~ W z a Q W C7 ¢ a Q O F U- W►— 2VY J m~ a Y s O z2 z2 LU O z O O W 00 2W r"W-3+ WWW O H 02CDW O C co LL 0 Cr Q O W W &0 SUB-8SMT. BASEMENT 1ST FLOOR f 2ND FLOOR 3RD FLOOR 4TH FLOOR 6TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Check one: Certificate Installing Company Name L Corporation Address Sb G A D S A111 %ZD O Partnership 4% A)10 fAA.�" O Firm/Co. Business Te!sphone ? s f 5 Name of Licensed Plumber PPJNT 1. INSURANCE COVERAGE I have amced ability policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes e O If you ha yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy O Other type of indemnity O Bond O OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement Check one: Signature of Owner or Owner's Agent Owner " Agent O 1 hereby certify that all of the details and information 1 have (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and i lati performed un the it issued for this application will be in compliance with all pertinent provisions of the Massa"use Plu ing Code an ter)42 of the General taws. Signature of Licensed Plumber r Type of License:Master-L m Joumeyan`4q-- - License Number ora 't 3) BELOW FOR OFFICE USE ONLY R � FINAL INSPECTIONS SKETCHES FEE PROGRESS INSPECTIONS NO. APPLICATION FOR PERMIT TO DO PLUMBING UNDERGROUND ROUGH COMPLETE ROUGH FINAL INSPECTION 1 PERMIT GRANTED DATE 19 PLUMBING INSPECTOR