HomeMy WebLinkAboutMiscellaneous - 2 BANNAN DRIVE 4/30/2018 ��
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Date. . ,.�l . . . . ... . .
HORTM
0 TOWN OF NORTH ANDOVER
p 9
• PERMIT FOR GAS INSTALLATION
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�9SSACNUSEtt
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This certifies that . .! ._.. ... . . . . . . . . .
has permission for gas installation —4 !-. . •----�-4 . . . . .
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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
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(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
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Date
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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
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(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