HomeMy WebLinkAboutMiscellaneous - 2 BANNAN DRIVE 4/30/2018 �� s asps aao Date. . ,.�l . . . . ... . . HORTM 0 TOWN OF NORTH ANDOVER p 9 • PERMIT FOR GAS INSTALLATION h �9SSACNUSEtt J ` / This certifies that . .! ._.. ... . . . . . . . . . has permission for gas installation —4 !-. . •----�-4 . . . . . f in the buildings of'. . c. . . . . . . . . !-. . . . . . . . . . . . . . . . . . . . . . . at . .. - . . . . . . . . . . . . . . . ..—.-�-. .. , North Andover, OMass. Fee`" .... . . . Lic. No.€. . . . . . . . . GAS f 'PECTOR Check# /41 6292 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations �`L/1� °� (✓ Permit# Amount$ ���� Owner's Name New Renovation ❑ Replacement Plans Submitted x V zWz LY vy� C `yni O -5 CG W W z O W W O O 0 z C� C7 U w x z Fe m a x > d W W C x aC C W pr, W FO Z Q W Q C F EW. O > W F W a Ems+ W o x `� Q c °o w °S O x 3 o c� .a c c0. H o SUB -BASEM ENT I U > B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7_T H . F L O O R 8TH . FLOOR (Print or type) Check Name AlIKS16A � Ie one: Certificate Installing Company corp. Address 67 ❑ Partner. Business I a ep one J _ —� 3 u Firm/Co. Name of Licensed Plumber'or Gas Fitter INSURANCE COVERAGE Check o : I have a current liability Insurance,policy or it's substantial equivalent. yes No❑ If you have checked des,please i nate the type coverage by checking the appropriate box. Liability insurance policy 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.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ E 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 S 0as ode and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber t� City/Town; ❑ Gas Fitter License Number ❑ Master _ APPROVED(OFFICE USE ONLY) oumeyman 6325 Date.. 2,!v-e9& ......................... toRTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHU This certifies that ..... ........ ....................... has permission toper ............. form .......... .................................................................. wiring 27 ................................ in the building of .... ............... .............. 42 .............. ................ .North Andover,Mass. ...... Lic.No.............. ................ ELEcrRICAL/INSPEGTdk Check # jlfA� Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. [n� `' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked � [Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All worl:to be performed in accordance with the Massachusetts Electrical Cocie(MEC). 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1116166 . City or Town of: AJ, AkJAD vim— To the Inspectoro f ices: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) a ��tN+vont S+ , Owner or Tenant LeN Telephone No. Owner's Address at A Nrio" S"f• Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) 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: • I,2(2-- Do Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures 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 rnd.Above ❑ In- o. o Emergency Lighting rnd. ❑ Battery Units No. of Receptacle Outlets l No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 3 No. of Gas Burners No. of Detection and 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 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 KW No. of No. of Data Wiring: • Heaters Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTH ER: ,'I(tach additional detail i/desired, or as required h-v the Inspector ql 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 the permit issuing office. CHECK ONE: INSURANCE [ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Ie trical Work: (When required by municipal policy.) Work to Start: ffS�6G Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties` of perjury, that the information on this application is true and complete. FIRM NAME: H rJ\1 _1ec-6zscAZ SCry,ce 'g !,c, LIC. NO.: �-(]J' � Licensee: M%ChAeL_ 4L(( 4 Signature I' LIC. NO-: £Zcjko r (//applicable, enter "exempt.1 i`n Ile license member line.j Bus. Tel. No.: Address: a�� f 10d�f�S-\ X17 A'v,1Ne3 0\A . 0)15'a 3 Alt.Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ -� INSPECTION RECORD Date Notes - Remarks Inspector F! Commonwealth of Massachusetts Official Use Only ---- Department of Fire Services Permit No. ��- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked `w- E� / [Rev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wort:to be performed in accordance with the Massachusetts Electrical Code(MEC). 527 CMR 12.00 (PL EASE PRINT IN INK OR TYPE.4LL INFOR/LIATIO.,V) Date: 111616,"-, City or Town of: 4J, ANA) ei— To tltc Inspectorof -!Fines•: By this application the undersigned gives notice of his or her intention to perform the electrical Nvork described below. Location (Street& Number) JL tv tvc,,J 5 Owner or Tenant LC-N L►IkiZ`a�NtC',(�� Telephone No. Owner's Address , ANri6(,j Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) 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: w t R� i w e,_j 4Se 1'� l3ec.A �t a t", 614k ('nm�etion of the followin table may be waived by the Inspector of Wires. No. of Recessed Fixtures No.of Ceil.-Susp.(Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. ofLighting Fixtures Swimming Pool Above El ❑ o. o EmergencyLighting rnd. rnd. Batter Units No. of Receptaelc Outlets _ t No. of Oil Bur,Dki s FERE ALARMS No. of Zones No. of Switches 3 No. of Gas Burners No. of Detection and Initiating Devices No. of Ran es No. of Air Cond. Total l g Tons No. of Alerting Devices No. of Waste Disposers HeatPump Number Tons KW No, of Self-Contained Totals: I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection i No. of Dryers Heating Appliances KW Security Systems: ,No.of Devices or Equivalent No. of Water No. of No. of l Heaters KW Si Data Wiring: ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No. of[Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: tltach additional detail ijdesived, or as required br the Inspector of Noires. 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 covera-ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [I BOND ❑ OTHER ❑ (Specify:) ( (I:��iration tate) Estimated Value of le ti ical Work: (When required by municipal policy.) . y Work to Start: S�� h"spections to be requested in accordance with MEC Rule 10, and upon completion. 3 /c•erlift, under the pains and penalties o/'perjurh, that the inf n-mation on thiv app/icatiort is true and coarptete. FIRM NAl\1E:_ f4 r(Af ���C �.2vCA� `J�''y,�eS (a..G, - _ LIC. NO.: � (IOU,(� Licensee: '1 v -h,qe \A r�. Signature �— tea � ___ LIC. NO.: r'//applicable, enter "exen7pt"u7 he licen.se'nun7ber line.) Bus. Tel. No.: Address: 'U IVB:i"�1� SA - ] ) Af\J Ie:3 ythule . O i 'j Alt.Tel. No.:_ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,.I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature — Telephone No. FEE: $ 35"iy `� � � ��� i Location No. Date No�TH TOWN OF NORTH. ANDOVER Certificate of Occupancy $ �'�s'ncMustt� Building/Frame Permit Fee $ ,2Z/D a Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7�f t 18748 building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT MM RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT ER 0 DATE ISSUED: Or X SIGNATURE: ldi Commissioner/I 'r of Buildings Date - Z SECTION SITE INFORMATION ., A.- 1.1 ;._.1.1 erty Address: . = . ~ 1.2 Assessors Map and Parcel Number: A 3ayl t1 M!3, D r ,_ o 0-�� e AA �, � v Map Number Parcel Number 1..3 Zoning Information: Jl �'Y 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronto ft 1.6 BUHJ>JNG SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Reqdred Provided Regaired. Provided 1.7 Water Supply M.GI—C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: v Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record , o 4,e— ., �t � Ile-Ir Name(Print) Address for Service Sign Telephone J 2.2 Owner of Record: Name Print Address for Service: 2 u a.� ITt Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ II Licensed Construction Supervisor. License Number Address Expiration Date ic Signature Telephone Pe 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M rn Registration Number r Address r Expiration Date ^z Signature Telephone G) SECTION 4-WORKERS COMPENSATION(XG.L C 152 § 25c(6) , Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ 62sku�Buildibg ❑ Repair(s) 11Altera Qns(s Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: , SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost7 7 Dollar b l )to be . 'ICAL DISE Ol!dLY gu r Ua�r�^ Completed b permit applicant m Y h 1. Building (a) Building Permit Fee WOMEN �- 9)00 Multiplier 2 Electrical (b) Estimated Total Cost of WO Construction 3 Plumbing " Building Permit fee(a)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHO T LETED WHEN OWNERS AGENT OR CONTI L4,CTWa BUII.DING PERMIT v 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 I SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Own er/A ent V Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS OT 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBRvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE e >, r 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 at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL 11, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I 0A. The debris will be disposed of in: (Location of Facility) Signature Permit Applicant Fire Department Sign off: 214 Dumpster Permit Date t ,koRTH TOWN OF NORTH ANDOVER p s``o " �" OFFICE OF t �< o p ,e G ! * BUILDING DEPARTMENT 400 Osgood Street < North Andover, Massachusetts 01845 Ssncause Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: r4Z Raio na.4 �l'I V`b Number Street Address Map/Lot HOMEOWNER Name Hofne Phone Work Phone PRESENT MAILING ADDRESS �llG✓erLIKA 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 requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-95.11 CONSERVATION 688-9530 IiE:1LFH 688-9540 PLANNING 689-9535 c NORTH '4 ToVM Of No.3 JK C, o LAKE dover, Mass., A9 '� ' T O — kp Ob COCHICHEWICK y RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 106 BUILDING INSPECTOR THIS CERTIFIES THAT................ �.............. . ....... .... ........................................................... -......... Foundation has permission to erect........................................ buildin on ...j...... .. Rough to be occupied as ..................... .�v �ed ............ Chimney ..... .... . . . ... . . ......... . . . . . .... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ARTS Rough ........................ ........ ..... . .......... ..... _................ Service G INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT a Until Inspected and Approved by the Building Inspector. Burner M Street No. SEE REVERSE SIDE Smoke Det. F XA RTH Town of �. L over 309e � = _ ,3 D E dover, Mass., COCMICMEWIC K V 7,p ADRATED F"IF C:) 1 BOARD OF HEALTH PERMI T Food/Kitchen Septic System �rBUILDING INSPECTOR ........ . THIS CERTIFIES THAT........ .... .... � .... . .. .. ............................................................................ Foundation has permission to erect ) kegs, .. Rough po to be occupied as ....... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PENT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU N START Rough .... ...... .............. Service BUILDING IN Final Occupancy Permit Required to Ocatpy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. r i Location -- No. /// Date0.1 NORTH TOWN OF NORTH ANDOVER a ' Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ `2e) `"'J Check # 17894 / Building I`n.sp6tor 'f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATOR DEMOLISH A ONE OR TWO FAMILY DWELLING - .x m� - BUILDING PERMIT NUMBER DATE ISSUED. Id 'lam O ic_ SIGNATURE: 4jWJ�/( ass'I Building Commissioner/Inspector of Buildings Date z SECTION t-SITE INFORMATION 1.2 Assessors Map and Parcel Number: 0 1.1 Property Address: G�; Dr. /� p / r�r� �M Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Pr osed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard -Required Provide Required Provided Re red Provided v 1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Outside Flood Zone ❑ municipal ❑ On Site Disposal System ❑ Public ❑ Private ❑ Zona tpa posal ys assial J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Nathe(Print) Address for Service - d tgnature // Telephone 2.2 Owner of Record: U 0 Name Print Address for Service: z M Signature Telephone 9w SECTION 3-CONSTRUCTION SERVICES R� 3.1 Licensed Construction Supervisor: Not Applicable LiAnsed Construction Supervisor: 0 License Number M Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ li Company Name M Registration Number r Address z Expiration Date A Signature Telephone 4i) 1 SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check ao a Ilcable New Construction ❑ Existing Building Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: - SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE-ONLY: Completed b permit a licant 1. Building S L a (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(+)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, A/� /'/C2 �C'c��b a/?7/6— as Owner/Authorized Agent of subject property Hereby authorize_ k e J!?,z LRL'o,�'L to act on ' My alt,in all in ttersre ative to work authorized by this building permit application �'� Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, �"� �/�Q 11--991 ri�2 en le'y as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lme and accurate,to the best of my knowledge and belief Prin ame Si attire of Owner/Agent Date NO.OF STORIES SIZE 6O t= BASEMENT OR SLAB a SIZE OF FLOOR TIMBERS 1' 2' 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE t X40 11 '9 Town of No. S/// * ��-_ �AKE over, Mass., �. o C OC HIC HE WICK V ORATED i'PG �y t�77 6 BOARD OF HEALTH PERMIT T D- Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT..........................d&O..................... ................................. .... ............................ Foundation has permission to erect........................................ buildings on Rough to be occupied as 0. Chimney ..... . . . . ...... . . . ..... . . .......................................... provided that the person acce g this per shall in eve respect conform to the terms of the application on file in Final this office, and to the provision of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS. UNLESS CONSTRUCTION �#TLVS ELECTRICAL INSPECTOR hx� Rough Service ...................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. f' SEE REVERSE SIDE Smoke Det. North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of 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 d AORTN OT••�•s y+'�O ♦ ..2fSL. � TOWN OF NORTH ANDOVER +J•^e,� BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 D. Robert Nicetta, Building Commissioner 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print t) DATE ear.,JOB LOCATION P °� n a n Dr) tom. Number Street Address Map/Lot HOMEOWNER amG.2 /�' Ne Home Phone Work Phone PRESENT MAILING ADDRESS 2,529 9Q h City/Town State Zip Code The current exemption for"homeowners"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 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,one or two family dwelling,attached or detached structures attached or detached structures accessory 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 North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL Date'.: . . . . . . P NpRTol TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHUS� This certifies that . .! jam; . ... . . . . . . . . has permission to perform_ . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . n Andover, Mass. Fee. /. . . . .Lic. No.. . . . . . . . . . . 's �"PCUMBING�.NSP CTOR Check # 6837 ;'i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS q �& &4W /� � Date --I �6 Building Location � �� Owners Name 6� � Permit Amount h<7. Type of Occupancy New Renovation Replacement E Plans Submitted Yes ❑ No ❑ FIXTURES E oZcc W U O W W O A4 F A w � W z A A a F v d x > Q 3 a as A A a 3 &. ¢ A a F SL13-1 RASEVM ISL HIM NA FIIOCIt 3M ROCIR 4III HDOR 5M HDOR GIH FLOOR 7IH HDD SIH HDD (Print or type) Check one: Certificate Installing Company Name ,+ C//y! ❑ Corp. Address f vig S Partner. Lo O/e TO/ Business a ep one 0 Firm/Co. Name of Licensed Plumber: Awry�4 l f l( Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy a Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ 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 Massachusett lu ' g Cod- Chapter 142 of the General Laws. By. mgnaiuir01 Lu.unsea dumber Title ype of Plumbing License %City/Town icense er '�' Master ❑ Journeyman APPROVED(OFFICE USE ONLY a. ., 9 a r � J .l4�� �-�a.S�,� � .I� `YY44`` � G,� . .�� t f i i o 4 J 1, z ` !+,''e 1.^ �`e ., � .1 .. F._ 1 Date i TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING a,• ,SSACNUS� fL This certifies that . . . . . . . . . . . !Y . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . `�-. . . . �. at . . . .. . . . . . . . . . . . . . . . . . . . . , North Andover, Mass. .�co Fee . . . . . .Lic. No�40. . . . . . . V PLUM1 G INSPECTOR �. Check # 6€323 vY MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location r �CbcJ wners Name i rmit# bunt Type of Occupancy New13 Renovation Replacement Plans Submitted Yes ❑ No ❑ FIXTURES H z H Upa a a Z v w � x w x a z aa 3 w w Q H 3 3 A a A A raw a E~ x a z d SZBRg1E fi lo `. 'RA91VM `"" 11R.l 117U.�� ll'l� 41JUll �Mi FL JM FI Ml /V M l�lOR M R11XR 91H HJOCIR (Print or type) Check one: Certificate Installing Company Name 11Corp. Address ` � Partner. Busmess e ep one irm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ttype_ofindemnity 0 Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance ignature Owner ❑ Agen I hereby certify that all of the details and information I have submitted(or ente above pplication are and ac)ate to the best of my knowledge and that all plumbing work and installations perfo n r Pe t ue f thi ap icatio ill be in compliance with all pertinent provisions of the Massachusetts State P . g nd apt r 2 the en e Laws. By: Signature DTLicensea MurnDer Tye gfpl�mbing License Title Ls S City/Town icense um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY