HomeMy WebLinkAboutMiscellaneous - 18 LEXINGTON STREET 4/30/2018 (2)Town of North Andover
"'= t f' A 1) s Office of the Zoning Board of Appeals
i OVIN CLERK ,
%J ;T ; +� i unity Development and Services Division
27 Charles Street
IWO AUG L Q P 3: L18 North Andover, Massachusetts 01845
D. Robert Nicetta Telephone (978) 688-9541
Building Commissioner Fax (978) 688-9542
Any appeal shall be filed Notice of Decision
within (20) days after the Year 2003
date of filing of this notice
in the office of the Town Clerk. Property at: 18 Lexington Street
NAME: Mavis V. Dushame HEARING(S): 6/10, 7/8, & 8/12/03
ADDRESS: 18 Lexington Street PETITION: 2003-017
North Andover, MA 01845 TYPING DATE: August 18, 2003
The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, August 12,
2003 at 7:30 PM in the Senior Center, 120R Main Street, North Andover, MA upon the application of
Mavis V. Dushame, 18 Lexington Street North Andover, MA requesting a Finding for a Special Permit to
divide an existing 12,000 sq. ft. lot with 75 feet of frontage on Lexington and 75 feet on Bunker Hill Streets
into two separate lots; Lot #I with 6,000 sq. ft. and 75 feet of frontage (with existing dwelling) on
Lexington Street and Lot #2 with 6,000 sq. ft. and 75 feet of frontage on Bunker Hill Street. The said
premises affected are properties with frontage on the Southeast side of Lexington Street within the R-4
zoning district.
The following members were present: William J. Sullivan, Walter F. Soule, Robert P. Ford, Ellen P.
McIntyre, and Joseph D. LaGrasse.
Upon a motion by Walter F. Soule and 2nd by Robert P. Ford, the Board voted to allow the petitioner to
WITHDRAW THE PETITION WITHOUT PREJUDICE. Voting in favor of the withdrawal: William
J. Sullivan, Walter F. Soule, Robert P. Ford, Ellen P. McIntyre, and Joseph D. LaGrasse.
Town of North Andover
Board of Avveals,
WX,t I
William J.
Decision 2003-017.
Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535
Location i�1 �/V .�. ..�( -�
Loca 00
No. Date
4
14011TH TOWN OF NORTH ANDOVER
� 9
Certificate of Occupancy $
1'�s' •EZ� Building/Frame Permit Fee $
swCHus
Foundation Permit Fee $
Other Permit Fee $ /
TOTAL $
• Check #
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Jul spa
BUILDING PERMIT NUMBER: - DATE ISSUED: 3-3c) -3c)
i
SIGNATURE: A#
Building Commissioner/InEtwor of Buildings Date
SECTION t- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number/Parcel Number
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Area Fronto ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided ReqWred Provided
1.7 Water Supply M.G L.C.40. § 54) 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 1e Lwt,ict: Yes—,10
2.1 Owner of Record
,e en/G !-/,'as
Name (Print) Address for Service
1 -evas
Signature /��\) L 1 Telephone
/J-� ) l . / /
2.2 Owner of Record: e
zV !/G S QuJhyo-z� %a �Yyl.-r.
Name Print ess for Service:
Tele hone
P
N 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
09
M
X
0
E
SECTION 4 - WORKERS COMPENSATION (KG.L C 152 f 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 it.
Signed affidavit Attached Yes .......0 No ....... 0
SECTION 5 Descri tion of Proposed Work dwck as a bk
New Construction ❑ 1 Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ I Demolition ❑ I Other ❑ Specify
Brief Description of Proposed Work:
MVAO'Afflarz W WON't I
/G -Y"
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICIAL USE ONLY
1. Building ✓�
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
d ! 3 ��--
3 Plumbing
Building Permit fee (a) x (b)
O2
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR'APPLIES FOR BUELDING PERMIT .
Comer/ thorized Agent of subject property
Hereby authorize to act on
My behalf n all matters rela ' to work(uthorized by this builduig permit application.
Signature of owner Dateo�—
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge
and belief
Print Name
Si ture of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR T ABERS 1 2 NO 3RD
SPAN '
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DINIENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
1S BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
CL
D
Front
UP Deck
ry Existing Deck Area
Laundry Area
A 12'X 12'
4 season room
Will be constructed here
Opening
into House
house
�E)= °
Current Mud
Room /
a
Entrance
To Be
Current Stairway
Removed
Moved to end
Shower
Office
A Mud room / Entrance — Exit
UP
To be added on to back of
house
Current
Dormer Area
Dormer out
the rest of
this area
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North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11,S150A.
The debris will be disposed of in:
t rn`�
(Location of cility)
Signature of Permit Applicant
749L
Date
NOTE: Demolition permit orover must be obtained for
this project through the Office of the Building Inspect
D. Robert Nicetta,
Building Commissioner
Please print
DATE:_j
JOB LOCATION:
HOMEOWNER
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
Number
Address
M
Telephone (978) 688-95454
Fax (978)688-9542
ME
Map/Lot
Name Home Phone Work Phone
PRESENT MAILING ADDRESS—
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" certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requir�d that he/she will comply with said procedures and
requirements. /'„ 101*1
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
RO.ARDOF, WPE.ALS 688-9541 CONSERVATION r;RR 9530 tw.m,ri1 68X-9540 PLANNING 688-9535
':;� a --0-5—
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
APPLICANT FILLS OUT THIS SECTION
APPLICANT
LOCATION:
SUBDIVISIC
STREET -7C
COMMENTS
Assessors Map Number o e?6'
NTS:
PHONE- a7.
PARCEL
LOT (3)
ST. NUMBER_
IAL USE ONLY*"""***,
DATE APPROVED
DATE REJECTED
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
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Date ..... .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........ ........ .................................................
has permission to perform .... .......... . ...............................................
wiring in the building of. . ..... ............................................
at ...AeP ......... -,.-/V .............. . North Andover, Mass.
It'd
....... ") .................
Fee.�� ........ Lic. No . .........
EucrmcPE
m"INS CTa
Check # 0
Sb -ii
Date .. !...../I1 ..........
~- TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies thatll�z��r...�.,,7,,//`
has permission for gas installation ....T!. 1. ..................
in the buildings of . �.7 �.�'.' �. �...........................
f.
at ../J... !el f!h j ��... �-......lrr. , North Andover, Mass.
Fee...(/.... Lic. .........
GAS INSPECTOR
Check # '3 ' ` I ';
"50.
MiASSACHUSETTS UNIFORM APPLICATION' FOR PERMIT TO DO GASFITTING
(P ' i or T _ {ry
r{ J V �/
Mass- Date Permit # _ ,
s Building ocatioh ILpwner's Name
Type of Occupancy 1%-..
New p Renovation )] AeplacemerA E Plans Submitted: - Yesfl No
QL- ATE ZO—NE(ARS _ Check one: Cerbfi e
24 NOrmaC Rd. ii—COrporation
Woburn, IWA 09801
E]. Partnership
781-460-2089 , L7 Firrn/Co-
Name° of, Licensed r lumber; or Gas ,i-rtter r_ me,
INSURANCE COVERAGE:
I have a current r ,rrty insurance policy or its substantial equivalent wtich meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy I�/ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass Genece)Laws, and thai my signature on this permit application waives this requirement.
Check one:
Owner❑ Agent [
.Srg$afure 71 Owner or owner's Ageal
I hereby certify that all of the details and inforrnation t have submitted (or entewd)in above application are true and accurate to the best of my
knc.vledge and that all plumbing work and installations performed under the perrni issued for this applicaii, n will be in compliance with all
pertinent provisions of the Massachusetts State ,Gas Code and Chapter 142 of the eral .Laws .
By—: Tie of License: C, ' ' N i Lk kiaLl
(Plumber n lure of Lice se4 U ber or Gas rlti -
title_ slitter
!aster license Number �% 1 1,3
City/Tovrn Journeyman
900/Z00'd 1968# SE:80 6002/190/60 S60ZOSVLBL SHV / 3NOZ 31dWI10:wo.13
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SUB—BSMT.
BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR
_
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOoR
o, -r u El - n o
QL- ATE ZO—NE(ARS _ Check one: Cerbfi e
24 NOrmaC Rd. ii—COrporation
Woburn, IWA 09801
E]. Partnership
781-460-2089 , L7 Firrn/Co-
Name° of, Licensed r lumber; or Gas ,i-rtter r_ me,
INSURANCE COVERAGE:
I have a current r ,rrty insurance policy or its substantial equivalent wtich meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy I�/ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass Genece)Laws, and thai my signature on this permit application waives this requirement.
Check one:
Owner❑ Agent [
.Srg$afure 71 Owner or owner's Ageal
I hereby certify that all of the details and inforrnation t have submitted (or entewd)in above application are true and accurate to the best of my
knc.vledge and that all plumbing work and installations performed under the perrni issued for this applicaii, n will be in compliance with all
pertinent provisions of the Massachusetts State ,Gas Code and Chapter 142 of the eral .Laws .
By—: Tie of License: C, ' ' N i Lk kiaLl
(Plumber n lure of Lice se4 U ber or Gas rlti -
title_ slitter
!aster license Number �% 1 1,3
City/Tovrn Journeyman
900/Z00'd 1968# SE:80 6002/190/60 S60ZOSVLBL SHV / 3NOZ 31dWI10:wo.13
MASSACHUSETTS UMFORM APPLICATIO*01 RM IT TO DO PLUNMING
(PriDt
_ M -ss. Daft� Pt #
ding , on l.srr
r s/ Typ':- of Gccupar►rry
New Q Rer,0vatian D Repiacernerd PL-ris Submrde:d: Yes Cl No i�i
FIXTURES
CLIMATE ZONEIARS
24 Normac Rd. check one:. Certificate
_Woburn. Meq 01801 a�ot�orabon T-
781-460-208
781-460-2089 D Partnership
D Frm/Co_
Name,of /�f Licensed Plumber / iia f J / A V S
INSURANCE COVERAGE:
!"have a current liabflity insurance policy or Its substantial equivalent which meets the requirements or MGL Ch. 142:
Yes CtY No O
If you i•savc checked YU, please Micate the type coverage by checking the appropriate box
A tizNity insurance p411cy {9ther type of Indemnity D Send 13.
OWNERS INSURANCE WAfvER: I am ;aware that the licensee docs not have the insurance coveragc required by
Chapteti 142 of the Mass_ GPPneral l&Ivs, and that my signature on this perTA application waives this requirement
_ Check one:
Agent '
! hereby certify That al1 Of the details rad iniotmaiion !have sub ,tied !or onto in above application are Ilea and acwrata to the best of my
tnu*ledpe and thai all p)umbing work and irutallatims pert under 'the permit issaed Implication will be in compliance with all
pertinent provisions of the Massadursetis State Plvmbin9 Code VW Chapter 142 of n
Titles gnatura n umber
City/Town Type of License: Master�%j Journeyman D
/+PP I NL I Li(ense Number !/ -i
900/E00•d 069# 9E:80 6002/00/60
980209OLSL
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:ST FioDR
2ND FLOOR
3RD FLOOR
4Tii FLOOR
STH FLOOR
'eTH FLUOR
7TH FLOOR
CLIMATE ZONEIARS
24 Normac Rd. check one:. Certificate
_Woburn. Meq 01801 a�ot�orabon T-
781-460-208
781-460-2089 D Partnership
D Frm/Co_
Name,of /�f Licensed Plumber / iia f J / A V S
INSURANCE COVERAGE:
!"have a current liabflity insurance policy or Its substantial equivalent which meets the requirements or MGL Ch. 142:
Yes CtY No O
If you i•savc checked YU, please Micate the type coverage by checking the appropriate box
A tizNity insurance p411cy {9ther type of Indemnity D Send 13.
OWNERS INSURANCE WAfvER: I am ;aware that the licensee docs not have the insurance coveragc required by
Chapteti 142 of the Mass_ GPPneral l&Ivs, and that my signature on this perTA application waives this requirement
_ Check one:
Agent '
! hereby certify That al1 Of the details rad iniotmaiion !have sub ,tied !or onto in above application are Ilea and acwrata to the best of my
tnu*ledpe and thai all p)umbing work and irutallatims pert under 'the permit issaed Implication will be in compliance with all
pertinent provisions of the Massadursetis State Plvmbin9 Code VW Chapter 142 of n
Titles gnatura n umber
City/Town Type of License: Master�%j Journeyman D
/+PP I NL I Li(ense Number !/ -i
900/E00•d 069# 9E:80 6002/00/60
980209OLSL
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UseOnly
BOARD OF FIRE PREVENTION REGULATIONS : Checked
blank?
APPLiC1ATIOwork bN FOR PERcperlbrnicd MIT �`t
MITTO PEl?l=Ol�lY9 ELECTRICAL 11V
c vctrit:al Cod c (N1EC), sz7 ChtR l2.00 O}� K
(PLL•'i1SCPiUIVTiN1NKOti'TYI-)EALLIXFORXf.•!T-ON) Datc; r] c -6
City -'1 ., of. /'�, / oUrl?— To the I11SPectot 1/
By this application the undersigned gives notice ofilis or her intention to perform the electrical kdescribed below.
Location (Street S-Number)t„ t"' i N - I � S'•V
Owner or Tenan t MAU t �u
Owner's Address A r" t5 Tcleplzonc 1't j _ k , �7ti
Is this permit in conjuttctiod with n building pormit?47 . Yes ❑/'
Purliose of Ilullding 1 ) W LCL iN&—
Existing Service Amps / Volts
tlen' Service Amps / Volts
Number of Feeders and Aznpacity
n ins Nature bf Proposed EleSqical ?York:
No ❑ (Check Appropriate Box)
Utility Authorimmion No.
Overhead ❑ Uudgrd ❑ Nu- of tlleters .
Overhead ❑ Undgrd [] No. ofNleters, --~
COII,DIP,iMI nid,o Wr........ .-._ar
No- of Recessed Fixtures
No. o ,Coil.-Susp. (!'addle) Falls
•�•••�
••�•� •'+w ua na,v�t b • the bs• cera,• 0 1Virns.
1 °• o •Tota
No. of Lighting Outlets
No. of I•lot Tubs
Transformers I{VA
Generators Ii,V,er,
No. of Lighting Fixtures
Silimmiug Poolove ❑ rz-
❑
t o. o mergerWzb ztl►tg
ted- grnd.
Bette Units
No. of Receptacle Outlets
No. of 011 Burners
FIRE AL•ARd•I;; No. of Zones
Pio. of De ectiozr-and
No. of Sivifches
No. of Gas Burners
InItiatino Eevlces
No. of Ranges
No. tit Air Cond. Tons
No. of AIerting Devices
No. of Waste Disposers
Heat YuniP I.Number i Tons KxY
Totals:Detecti:ozUAlert:in
11 o- of e11= ontaincd
Devices
No, of Dlsh�vashers
Space/Area Beating KW
Local ❑ l4l1114clp2
Glenec ion C1 Other
No. of Dryers
Heating, Appliances xW
Security
y ysten�s:
t u. of ater
Heaters KVv
i o- o , o- or
No- of Devil:es or E uivnlent
4
Data Wiring:
$lyra Ball Ballasts
No. of Devices or E uivalent
No. Hydromassage Bathtubs
No. of i%lotors Total 1II'
TC1eCDmniuj1icalions Wiring:
No. of Devices or Equivalent
OTHER:
.rnacrt additional detail if desired, or as required by rhe h,sFecror of Mres.
INSMR NCE 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" coveiagc or its subsrzntial equivalent. The
undersigned certifies chat such coverage is in force, and has e:chibited proof of same to the permit issuing office.
CHECK ONE: INNSUYUr NCE (" DOND ❑ OTI.3ER ❑ (Specify:)
Estimated Value of Elcciricol Worl•:' (Wizen required by municipal policy,) (Expiration Datc)
Work to Start: -• O ,!� Inspections to be requested in accordance with iv1EC Rule 10, and aeon completion.
I certff}•,'it►tier the pains acrd peirafties gfperjury, that the infortuation ott this application is trite att,i courplete.
MUNI NAME. fzkQ1- LIC. NO.: 6�b�
Licensee: Sf—M Si;nature
L1C- N
(ljnpplicab/a. t tEr•wr, pr"h the li,:m n b 0-:
]3trs, s�
Add ress: T.I. No. � Alt. Tel. No.:
OWNERS INS a;'CE W.,U ER: I ant a e that the Lictnsee dors no -1 /race the iability insurance coverage normally
required by law. 13y my signature below, I hereby waive this requirement. I azn tie (clicck onc) ❑ ow-ner a,?enc.
Owner/Aocnt
SleTl:ltul'C relepiioneNo. [PL-RillIT FEE -:.S
d3
c
Cor"4011cvsa19 o///tuedac�%1444d official sc Only
2eivarr`menf ol.}irs �¢rvwad Permit No.
--J--
BOARD OF FIRE PREVENTION REGULATIONS ev 1 .199 �
and Fe: Clte:ked
] tlM1... tir.,.,t,%
Rev. 1 1 '99—
APPLiCATION FOR PERMIT TO PERFORM ELECTRICAL ICAL WORK
All work to be perforntetl in accortlanee with thlaias; 01USCM Ocetrical Code (MEC), 527 CAIR 13.00
(PLEASC PRINT1tVINK OR TYPE:ILL iWORALI ON) Datc:
City - of: vut To the Ins1�ector of !i%fres:
By this application t1u undersigned gives uottce o ltis or her iuteation t pe;form the electrical work described below,
Location (Street S Number) �, �( i t't7� 11 Crh S�;
Owner or Tenant
Owner's Address
J'YOt@y ! 5 to . A M Telephone 1N
Is this permit in conjunction with a buildin-v permit? Yes /❑�
i`io ❑ (Check Appropriate Box)
Purpose of EuildingUtility Authuri>~ntion No.
Ezistin- Service _ Amps 1 , Volts
New Service Antps / _tions
Number of Feeders and Ampacity
Nature bf Proposed E1e jfic0 Work:
Overhead ❑ Undgrd ❑
Overhead ❑ Undgrd ❑
No. of ttilcters .
Na. of Meters.
No. of Recessed Fixtures
.+..• 0 -WW" at rue auatrute
No. of CeiL-Susp. (Pt addle) Fans
table Ana be waiver/ b • the his' cctor o MI- s•
No. ° Tota
AM
I' ansforntcrs I{yA,
No, of Llgltting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Sirinnniu; pool ove ❑ n-
❑
t o. o mergeric} rg uutg
tald. rnd.
Bette Lunits
No. of Receptacle Outlets
No. of On Burners
FIRE ALARt1.13
No. of Zoues
1`io. of S►vitches
iYo. of Gas Burners
No. o De eRUa—it-and
Initiat9nv DeAces
Nu_ of Ranges
No. 01 Air Cond. Tons
No. of AIerting Devices
No. of Waste Disposers
Heat MP tum er 'ons
Totals:
t o. o ell= ontatncd
DeteciionUAlert' Devices
No. of Dishes aslters
SpacdArea Hestting ICY
Local ❑ hlwti;cipa ❑Other
Connection
No. of Dryers
Heating Appliances KNy
Security ystert•is.
L70-0 F Water
Heaters KW
o
► o. � o. of
MatNo. of Devil:es or Equivalent
a Nvirirta:
S;x»s Ballasts
No. of Jfevic:cs or Equivalent
No. H}•droinassage Bathtubs
No. of 5lotors Total HP,
!!�tions Wiring:
es or Equivalent
OTHER:
ntracn aaaivanat arta," q desired, or as reru;red by t/ie ltsFeeror of Wires
INSURANCE COV EIL%GE: Unless waived by the owner, no permit for the performance of clectric:tt work may issue unless
the licensee providts proof of liability insurance including "completed operation' covet'agc or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has e:thibited proof of same to die permit issuing office.
CHECK ONE: INSURANCE V BOND ❑ OTI3ER ❑ (Specify:)
E-stitnated Value of Electrical Wo6.:(Expiration Date)
(When required by municipal policy,)
Work to Start: ~(" � D J Inspections to be requested in accordance with INJEC Rule 10, and u -.Don completion.
l certifj', udttier the pains acrd petraflies of perjwq, drat tlrr infor»tation ort flus applicatiar is true atr,l complete
MIUM NAME.Cl�ta3fllZ� G,
LIC. NO.: 6�bS
Licensee: M _ Signature
LIC.NO.: I �-
(lf applieabir. F c,• y,".rr r" i d is h':rt lb
Address
Alt. Tel. No.:
OWNER S INS . A; 'CE WAIVE R: I ant;22mt the Licensee dors not have the liability insurance coverage normally
required by law. 13v my sicnature below, I here Y waive this requirement. I ant the (clicek one)❑ o��ner ❑ o��ncr's na ent.
Owner/;local
Signature I'cicpituneNu. PtsRil11T F,L•E•: S 126
a, -ry
ko vYA1 0 k F- 1-7- o P(7 ,
zwP11-YPO'ca
C9 t- I � ��-
i
Date `4-. �? .C?.: 'r
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ?,'. !� r'.� . �7"./Y-�.......... .
has+ermission to perform-_-.' ...........
plurrtbing in the buildings of ...�-�-�.: -� �........
at...North , North Andover, Mass.
Fee �/ . -" .. Lic. No. . r ..t. '......... .
PLUMB 6IY6PECTOR
Check #
6379
r
MASSACHUSETTS UNVersNMame/14AOS
PPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
m j Date ��-�� �—
Building Location %f LEiI' )J�/C�l/�% s% O //C1 S//�% Permit # 103 �9
Amount
Type of Occupancy 'RES �7 7�} (J "-
New 0 Renovation ElReplacement ❑ Plans Submitted Yes No EL
FIXTURES
(Print or type) �i ��Z-56A/ /L.(i/%% /�il/� 6T/Al�,In
stalling Company Name��(/ �j
Check one: Certificate
11 Corp.
El Partner.
Q- Finn/Co.
Name of Licensed Plumber: Aui'�\ i LSc&
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy l Other type of indemnity D Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
reeinsurance
r na ure Owner Agent El
I hereby certify that all of the details and information I have bmitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work an ' sl
ns pe ormed under Permit ued for this application will be in
compliance with all pertinent provisions of the M sac usett tat lumbi od n apter 142 of the General Laws.
By: i e o (cense um
Type of Plumbing License
Title I - 3� I
City/Town icense um er Master ❑ Journeyman
APPROVED (OFFICE USE ONLY
J -01 -o S
Date..................................
N TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
4L
This certifies that .... f . of ......... 0 . A . -1. .. A .. ( . ...........................................
.... ..... .... ... ... .. ... . ...
1.
has permission to perform 13/-4
.................................. ...........................................
vls
wiring in the building of I U Sh P W 4-
...........................................................
at ........ I.e ... LeYIY44 0---j
W ............................................ ,North Andover, Mass.
Fee ..................... Lic.No.F-..�..).q!P ....... ...... 4 . .....
. ........ ... .... .....
ELECrRICAL IQPECTOR
Check # CAS P
1-----
565-/- --
VJ( LV( GVVJ iL. LG
All
B
APPLIC
All
(PLEASE PRINT
By this app Ii do
Location (Sire t
Owner or Tena
Owner's Address
J. VJI TLV.d, i11V1 VV, iVl .r1�. JL -1\v iVV 1 PI\AV VL/ VL
Carnmonceoa(Lh o�//IR�daCftrt�s�fd Official Use
..LJe�rart�nrsref o�.,j`ira Jarwice9 �errtlit I`1p.
OA OF FIRE PREVENTION REGULATIONS Occupancy and Fe- Checked
Rev. 1 1199] (leave blank) /
�4 I�t N. FOR PERMIT TO PERFORM ELECTRICAL W���
irk to be pert'ormcd in acconlance with the Mas;: cbusctts Glcctrical Codc (titEC). 3Z9 Ch 1200
,V INK OR TYPA�L•"J� �ILL tV1--0kV 7"10N)
tJu undersigned loves nonce ofhis or her intention to erforntelcctri
t l �l � kdescribed j.t(
Nutubcr)�_ �gXl �(� �t 1'� V� below.
Telephone 1'o.,6 F7—
IS—
Is this permit in conjulictiod with a builditurpermit? Yrs ❑ No
t;'
Purpose of Building z�1 po � (Clteck appropriate Box)
UtilityAutirori7tiott No,
Existing. Service AmpsI;Voits Overhead
❑ Undgrd ❑ No. of ntilcters
NOV Bettie[ Amps / volts Overhead ❑ UndgrdNn
❑ —�
Number of keeders and Arnpacity . of
Location ind Nature br Proposed Electrical Work.-
No.
ork:
No. of Recessed Fixtures
d
No. ofLIghting Outlets
' INC. of Lighting Futures
No. of Receptacle Outlets
No. of Switches
No. of Ranges
No. of Svaste Disposers
No. of Dish washers
No. of Dryers
x t o. of ater
Heaters KW
t No. Hydromassage 13atlitubs
OTHER:
Coni lepton afthe
No. of Ceil.-Susp. (Paddle) Fans
No. of I•lot Tubs
Strimmiug fool ov e ❑ rt-
t,rnd. ern
No. of On Burners
No. of G2s Burners
No. of Air Coad. otal
rbrg table May be n aive<I b ' tlrc 1-?W9ctor o(t Y o s.
No. o sT—'-
T ansiornners KVt1
Generators XVA
❑ t 0. o taergericy tg rturg
Batte y Units
FIRE ALLAIRLIMSNo. of Zones
No, o De ecitonttrtd
Irtitiatinal;evices ?
No. of Alertfitg Devices
h-40. ormia
teiArea Heating KLV Locn
tial; Appliances Ktiy Seca;
or —_ 1
'�0• 01 Data
stens Ballasts
No. ormotors Total HP
❑IVIUM,ctpal
Connection Other
or
Attach additional detail ijdesired, or as ['aqui ed by the lnvecror of Wires.
INSUR.AINCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work niay issue unless
the licensee provides proof of liability insurance including "completed operation' coverage or its subsunlial equivalent. The
undersigned certifies that such coverage is in force, and has e:thibited proof of sarue to the permit issuing office.
CHECK ONE: lNFSUTUkNCE 6Q BOND ❑ OTHER• ❑ (Specify:)
Estimated Value of Electrical Work:' (When required by municipal policy) (Expiration Daic)
Work to Start: Inspections to be requested in accordance with IvIEC Rule 10, aild u"on completion.
o I ccvtlfj•, "'tiler the pains and pent ties v perjurf; fhai the infornrotion otr (tris application is true art,l Complete
� ir•Iium NarlE .Ao
Licensce:5� Signator LIC. IN0.:
M (lfapplica6/ enter ' r„ pt" irr t1 , rr li c.) LIC. i`i 0.
Address (3!I' flus. Tel. No.:
OWNER'S I F'LANC WAIVE• : K rn aware that the Licensers not have the iobility insurance coverage normally
required by law. 13y my siunature below, i hereby waive this requircmcm. I am the (check one
Owner/Aggent oN%ncr ❑ owner agent.
S1otl:nturC _'1 elepi,one Nu.Pi:Rt� fI3" FE- E- S
UJi LVJ GVf•!J it. GL J I VU/ l �(. yJV r av, Lv r iV1 rrr4.. .JVI\v aVV r r-�wr,. VL/ VL
Cornnronwaa[!h o� //laedaC�irc�e4d Official Use
! c� cc77 /
' ...Cl�parin�ent o`,}ira �arvicee Pemtit No.
BOA OF FIRE PREVENTION REGULATIONS Occupancy and Fe: Checked
Rev. 111991 (!cave blank)
APPLiOA ION. FOR PERMIT TO PERFORM) ELECTRICAL WOE
All ork to be perrormcd in occonlaltce with the Macbuscus Clectrical Code (NIEC). 527 Ch 12.00
(PLEASC PUNT NlJVK OR TYXxivrow,TION)Ct °r• nJ d Ug'— To the Ills )ector
of By this appti djj
o the undersigned gives notice o his or her intention to erform the electrical k'described below: 7
Location (Sir t • Nuu,bcr)_ G�XJ�Z 7'
Owner or ?etta U%S�;
Owner's Address �.0�,a 1`clepl�one NO.
c
Is this permit In conjunction with a building permit? Yes No
g� Jxr �j eo � ❑ (Check Appropriate Box)
Purpose of 13ulldin UtililyAutlturiz�tiott ivo.
Existing Ser -vice " �\mps 1 -_Volts Overhead ❑ Undgrd ❑
No. of,Meters ,
Nett' Ser�icc " Amps / _Volts Overhead ❑ Undgrd ❑
Na. ofltileters:
Number of Feeders and Ampacity D "j ', f./%F 1,7V 'i.
Location ind Nature bf Proposer! Electrical Work:
ramololinn
No. of Recessed Fixtures
No. of Lighting Outlets
"'a=`M'lra
No. of Ceil.-Susp. (Peddle) Funs
No. of !dot Tubs
ue %?'atVed b� rite ln�hertor o jPims.
o• o 'Total`—
•I' ansformers ____ Ky
Generators I.:VA
No. of Lighting Fixtures
Sirimsuiva Fool ore tc-
❑
► o. o taergericl; ca tang
❑
ted- rr,d.
Batte Units
No. of Receptacle Outlets
No. of 00 Burners
FIRE ALARitiI,3 No. of Zones
No. of Switches
No. of Gas Burners
No. o De cellon And
ltnitlatine Devices ?
No. of Ranges
No. of Air Conti. ')Cons
No. of Alerting Devices
\o. of NVaVe Disposers
Heat mP t u er 'ons
Totals:
, o. o _el —f- COW Wined
Detecttoll/Ale�rti Devices
No. of Dish�'sasliers
SpacrlAres Henting KtiY
Local ❑ hlu,ci;cipa
° ion ❑Other
No. of Dryers
Heating Appliances K1Y
Security r,,$-
Y ystenrts:
t o. of Water
Heaters Klin
t O. O 1 O. Of
No- of Devifts or Equivalent
Data tiYiriug:
Sitlns Ballasts
No. of 1)eviees or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
I'elecomrnunccatioos Wiring:
OTHER:
No. of evices or Eouivalent
Atrad► additional detail if decked, or as w, uircd by the Ltspecror of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
tIte licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. Tile
undersigned certifies that such coverage is in force, and has Gthibited proof of some to the permit issuing office.
CHECK ONE: INSURANCE V BOND ❑ OTHER, ❑ (Snecify:)
Estimated Value of Electrical Work.' (Wizen required by munici al 1' (Expiration Date)
P Po icy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, acid upon completion.
T car•rTy, ruttier!/re pains acrd pelrr tiers u perjury, limit tate Pttfornratiort ort 111is application ktrice and call, Ke �
FI101 NaAI ' LIC. NO.:
Licensee: 5: '" Signatur _ LIC. N O.
(ifappltcob/ enter ' ru pr"ire t! ' M9206"Agm
- 13us. Tel. i`N
AddressQ L—M,� � Alt. Tei. No.:
01YNER'S I -k iC NVA VE t the Licensee dors icor have the iability insum ce coverage normally
required by law. I3p my signature below, I hereby %vaivc this requircrncnt. I ant rile (clicek otic ❑ owner ❑ owner's agent.
Owner/Agent � _._.._�
Sienatun•e Telephone No. Pj—,R1 fI7' FC.i_ $ '