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Miscellaneous - 20 ROSEMONT DRIVE 4/30/2018
N J Q �r1r� V �' L. Town of North Andover, MA Q Q - 20924 *Plumbing Permit- New Construction (Commercial or Residential NOT in conjunction with a Building Permit) TlAfFUNE ®Submission received Ju114, 2016 at 2:51 pm Plumbing Permit Review In P-gass [/may V P T-nP o 1 -6. 0-- ,7 7D Thursday, Jul 14, 2016 02:51 PM r� Your request is in progress r we'll let you know of any updates_ via email. Feel free to check the status at anytime by coming back to this page. °oo trrt kevin gillesple ® G? T ct 0! f1� L., -,i 20 ROSEMONT DRIVE, NORTH ANDOVER, MA GYORD& PETER]. Attachments v 'q-OTGOOFIOOIF Thujui_14_2010 18:51:.PDF JejJ A 4 Gfr74mimor u, o (o z:stwn m' 711412016 The Commonwealth of Massachusetts z . Department of IndustrialAccidents I Congress Sheet, Suite 100 Boston, AM 02114-2017 �.t www.mass.gov/dia s• Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHOMY. Applicant Information p j r Please Print Legibly Name (Business/Organization/Individual): , G - I ( UpA Y% JT i9 f hof Address: City eAde ftC••P- .e/Zi ,�,, Ls �� V'y Phone #: P 1) Are you an employer? Check the appropriate box: 1. ❑ I am a employer with ! employees (full and/or part-time).* 2.4 1 am a sole proprietor or partnership and have no employees working for me in ,any capacity. [No workers' comp. insurance required.] 3.FJ I am a homeowner doing all work myself [No workers' compAnsurance required.] 4.F] I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. [] New construction 8. 0 Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions 1Plumbing repairs or additions 13. F] Roof repairs 14.0 Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submif #his affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must -attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. lain an employer that is providing workers' compensation insurance for my employees.' Belo* is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: 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 MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. I do hereby cgtify under the pains and penalties of pe►; jury that the information provided above is true and correct. 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): ; l.. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their eidployees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract'o4'hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver -or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant 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. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill -out -the workers' compensation affidavit completely, by checking the•boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees 'other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents fbi confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be 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' compensatioii policy, please call the Department at the number listed below. Self-insured companies should'enter their self-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 at the bottom of 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 burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia 7/15/2016 20924 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointcloud.com/#/records/20924 OF NORTI{ qti 209 4SSACHUS � TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that Kevin P Gillespie has permission to perform install 2nd meter and backflow for irrigation system plumbing in the buildings of GYORDA. PETER J. at 20 ROSEMONT DRIVE, North Andover, Mass. Lic. No. 26158 Date: July 15, 2016 11`9 %ji. Mir - 1/1 A %9666 Date ..... !—..'7..�zz ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that. ................................................................ ✓:i. has permission to perform ...... .............................. wiring in the building of ......... rr ... ....................................... at ........r20 .... .....5.7 . ............. North Andover, Mass. Feeg.�: .... Lic. No...1117 4�70 .... . t . . ........ ....... �CK4 0. - YCMCALI R/' Check # �70 5:: = 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance-with the provisions of M.G.L. c. 143, § 3L, the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. GI c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall-be limited as to the time Of Ongoing construction activity, and may be.deemed_by the Inspector_of_Wires abandoned_and_invalid,if he—_ . or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period. Upon written application, an extension of time for completion of work shall be pemiittell for reasonable cause. A permit shall be terminated upon the written request of either the owner or -the installing entity stated on the permit application. . / The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effector existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. FRule — Permit/Date Closed:Dote: Reapply for new permt Extension Act — Permit/Date Closed: if 1 �•\ Commonwea6Er<i, of M�amachuJeEEs Official Use 011)yvU¢P arEmertE ol.}ire Servicei [[Rev.]/071 ermit No. Occupancy and Fee Checked I BOARD OF FIRE PREVENTION REGULATIONS leave blank I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYP� 4LL NFORMATION) Date: I a-13 j It Q City or Town of: N. N 06/f2 To the Inspector of Wares: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant j o Telephone No. Owner's Address 514 h-, (-- Is -Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ _N 1 _ C a No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of [Vires. 3q No. of Recessed Luminaires No. of CeilSusp. (Paddle) Fans : o. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above n- Swimming Pool rnd. 1:1 In' F,Batte o. Emergency Lighting Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. eteng D an Initiatin Devices ,I No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices iDetection/Alertingu No. of Waste Disposers P ea pu Totals: • .um er .................................. ons s................................... K No. of Self-Coit—ained Devices- evices- No. of Dishwashers Space/Area Heating KW Municipal Local❑ Connection ❑ Other No. of Dryers iY Heating Appliances KWr Security ystems: No. of Devices or E uivalent No. o at KW Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs _ No. of Motors Total HP Telecommunications Wiring No. of Devices or Equivalent OTHER: � Attach additional detail if desired, or as required by the Inspector of Hires. Estimated Value of Ele trical Work: %U (When required by municipal policy.) Work to Start: ' —;,L,D g"'I (Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COV RAG : Unless waived by the owner, no permit for the performance of electrical work may issue unless the Ii. ensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cover is in force, and has exhibited proof of sante to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the painsand enalties of perjury, that the information on this application is true and complete. FIRM NAME: i L 6 z f"1' LIC. NO.,: II ITC Licensee:` [( (� t S L<(. (. tV Signature ' LIC. NO.: o, (If applicable enter "exempt" In the licen a nttmb�-epr line.) Bus. Tel. No.: Address: �aCJ �� ` �IYI i111�j �'3� Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. (; QQC0 13 4 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 7S 7t A 976L t Z. Date ..... /P:7.40 .... 0 "00 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................ has permission to perform45- mgd." ...... .......... .............. . .. ...... ............... wiring in the building of ..... 4.77q.q ..... -�1944...... t V ..... at Ras4aver ........... Lpz ............... /,rNorth Andover, Mass. Fee ... Lic. No..,c).1-02 1............. Check # -� 7 ?-L ELECMCAL INsppcToi' 4 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. W, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPEALL INFO TION) Date: 77A0 City or Town of: r To the Inspector of Wires: By this application the undersi ed gives not' e of his or her intention to perform the electrical work described below. Location (Street & Number) KC&EMON Owner or Tenant A`+9& p.i,, R ELaea, Owner's Addressq lQK�t„t;� Is this permit in conjunction with a building permit? YeFs ❑v' Telephone No. No ❑ BLDG PERMIT # Purpose of Building *.S. ,77 ij O 011 & Utility Authorization No. Existing Service 20& Amps Ab / NQ Volts Overhead ❑ New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Q Lr=T:' Overhead ❑ t0/R/� Undgrd Undgrd ❑ No. of Meters / No. of Meters W#TCt1 Completion of the following tab le_.r be waived b the Ins t ` y ec or of W No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans C3 z, tea. No. of Total. Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Q Generators KVA No. of Luminaires Swimming Pool Above ❑ In- E] rnd. rnd. No. of Emerg-e-n-e-y-L-ig-Ming Battery Units No. of Receptacle Outlets No. of Oil Burners c7 FIRE ALARMS No. of Zones 0 No. of Switches No. of Gas Burners V No. of Detection and Initiating Devices No. of RangesNo. of Air Cond. TotaTonal I�` No. of Alerting Devices (� No. of Waste Disposers Heat Pump Totals: Number ................................................... Tons KW .... No. of Self -Contained Detection/AlertingDevices No. of Dishwashers 6 Space/Area Heating KW r t� %� Local ❑ Municipal ❑ other Connection No. of Dryers No. of Water �, Heaters Heating Appliances KW No. of No. of Signs Ballasts Security Systems:* No. of Devices or E uivalent/' Data Wiring: No. of Devices or E uivalent a No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent -,L�P�� OTHER:3 J",OFetkt;Mg WRA dlSdi 1� OCA 004ttach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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:) I cert, under the pains andpenalties ofperjury, that the information on this applicadonhtrue and complete. FIRM NAME: LI . NO Licensee: U Signature (If applicable, enter '-'exempt " in th license umber li ) Address: , �,'; , W 4� � �fti�'+, M *Per M.G.L. c.147, s. 57-61, security work requires Department of Public Safety "S" OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have t required by law. By my signature below, I hereby waive this requirement. I am the Owner/Agent Signature Telephone No. L.:A Ole JJC. NO.: tZ-&U 4640 ibfh - insurance coverage normally k one) ❑ owner 22'owner's agent. PERMIT FEE. $ ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR - DOUG SMALL 1. ROUGH INSPECTION: Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: 4. - no initials) Date 2. FINAL INSPECTION: Passed — K Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - no initials) Date 3. UNDER GROUND INSPECTION: Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: 1. (Inspectors' Signature - no initials) Date 4. INSPECTION — SERVICE: DATE CALLED NATIONAL GRID: NAME: Passed — [ ] Failed — [ ] Re -inspection required ($50.00) - Inspectors' comments: (Inspectors' Signature - no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TO BE CHARGED. Date. / .Z .- ............... . N.""OP'N' TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. /-9 1-, '-' C - t , --e .................. -( ............... has permission for gas installation . . . P T. F '. G r . /I. t -.— in the buildings of ...................... at . ,2.1,). A., T ........ North Andover, Mass. Fee. . Lic. No..r?� GAS INSPECTOR Check# 7. 2 4243 't ,'as - MASSACHUSETTS UNIMRMAPPUCATONFORPERNU TO DO GAS FITTING (Type or print) — Date NORTH ANDOVER, MASSACHUSETTS Building Locations lb Rose—frlan t Permit # Amount $ Owner's Name Chi, s t. � � Gce.e imwn New ❑ Renovation Replacement © Plans Submitted (Print or type) Check one: Certificate Installing Company Name PmAdt-P r plicncy . t �ta . tn. Inc . © Corp. 212'7.• Address 20 1Aeaeo..r� T -)r . l) n. f- Partner. 4U Business Te ep one Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes ff No If you have checked }_es, please ' dicate the type coverage by checking the appropriate box. Liability insurance policy ff Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the 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 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 installationspe ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts States Code and Cttaple; 142 of the General Laws. (OFFICE USE ONLY) 'Signature Licensed Plumber Or Gas Fitter Plumber�3 Gas Fitter License Number Master Journeyman � w a OU CW7 z ►a Cn 9 W F O F >" z F g O 'r' F W w a z U a zz F Z C7 F z F z a W O W �W. U a F z W o 5 zE+ .. 3 oa o z o A a U a A a H o SUB -BA SEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) Check one: Certificate Installing Company Name PmAdt-P r plicncy . t �ta . tn. Inc . © Corp. 212'7.• Address 20 1Aeaeo..r� T -)r . l) n. f- Partner. 4U Business Te ep one Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes ff No If you have checked }_es, please ' dicate the type coverage by checking the appropriate box. Liability insurance policy ff Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the 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 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 installationspe ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts States Code and Cttaple; 142 of the General Laws. (OFFICE USE ONLY) 'Signature Licensed Plumber Or Gas Fitter Plumber�3 Gas Fitter License Number Master Journeyman 3 7.'%"0 5 Date..y TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... r 1P7 Y . ......... ............................................. has permission to perform ..... G. �ti. ...... Lu.!.�..) ......... NNring in the building of ........kre.:R..P .... M.qA.t ........................................... at'.10 ..... til SJ j t ................ ..... . North Andover, as ... ....... ...... Fee..Y Check # �/� >A ELECTRICAL NSPEcr6i Official Use On Permit No. Z' -A44& --e 4 P44'1- Sam Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date 5-t 2 -0 To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number !� dose fYlo►l t Dr Owner or Tenant C 0r + an1Shnif ±re-YnO-f) Owner's Address —/ Is this permit in conjunction with a building permit Yes. h2 No ❑ (Check Appropriate Box) Purpose of Building1 S�1 bQSPrn°l.n/ Utility Authorization No. Existing�ervice 0520 Amps '�/7 O Voits Overhead ❑ Undgrnd No. of Meters New Service Amps Volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work d- AAhetn ¢- C 04zQD ff& T OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: f�- /fit j FIRM NAME C,Z - "`�iJ LIC. NO. Lkensee Signature y LIC. NO. )'I Bus. Tel No. ( Z/ Address Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance covge or its substantial equivalent as required by Massachusetts General Laws. And that my signature 9R,4ft permit application waives this requlreme Owner Agent (Please Check one) Telephone No. /f �r *0 PERMITIPEE $ or Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA l/f_ ' ^ /f Above ❑ In ❑ No. of Lighting Fixtures ,�[�(f'� !r7( Swimming Pool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting � 'a ' No. of Receptacles Outlets.r/ No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. cf.Ran es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di osal 1 No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other 4V' &KW No. of Dryers Heating Devices - Local Connection No. of No. of Low Voltage ? )_ No. of Water Heaters KW 1-6e-5_Signs Bailases Wiring7 No. Hydro Massage Tuds I No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: f�- /fit j FIRM NAME C,Z - "`�iJ LIC. NO. Lkensee Signature y LIC. NO. )'I Bus. Tel No. ( Z/ Address Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance covge or its substantial equivalent as required by Massachusetts General Laws. And that my signature 9R,4ft permit application waives this requlreme Owner Agent (Please Check one) Telephone No. /f �r *0 PERMITIPEE $ or (A No , I,- L Date ... ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... : .............. : .................... ;';.� .............................. has permission to perform ................................. ................................................ wiring in the building of ................. ....... I ............ .......................... .................... at ......................... ................ . . ...................................... North Andover, Mass. Lic. ND2-':'n-.-( . ............................................................... ELECTRICAL INSPECTOR 07/02/98 14:13 292.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only Permit No_ Gr' efyilt%KO�i1(/ lr?p 1,51S�Gr' x775 Occupancy & Fee Checked 9 .c 4 P•k& Sir BOARD OF FIRE PREVENTION REGULATIONS 27 CMR 12:00 APPLICATION FOR PERMIT TO PERFORELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 Date i4�i� (Please Print in ink or type all information) To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number © Owner or Tenant — .-% .. , e Owner's Address 95, Is this permit in conjunction with a building permit Yes V No ❑ (Check Appropriate Bax) / G _Utility Authorization No. Purpose of Budding V Q Volts Overhead V1,11,Undgmd C3 No. of Meters F�Osting Service 'fps New Service 2 C)Q Amps .22- 0 Volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Arrtpacity Location and Nature of Proposed Electrical Work No.Hydro massage Tutls , No. Of Motors OTHER: INSURANCE COVERAGE. Pursuant to the requiremenSts of Massachusetts General Laws I have a current LiabilityRA Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = yg,g lid proof of same to the Office YES = NO = If you have check�,YES p� � iindI tee type of coverage by checking the appropriate box INSURANCE OND = OTHER = (Please Specify) '� '( Expiretlon Date)) q ta=zwd ue of El cal W tS �,%��ifl Rou h flr�z Final Cf�/./ Worts to Start Inspection Date Resquested can g Signed under the Pena es of perjury:�— LIC. NO. "a FIRM NAME Signatures LIC. No. Lloensee /� �� Bus. Tel No. 6—R /'j L„r� p%n/ ! Alt Tel. No. Address OWNER'S INSURANCE WAIVER: I am aware that the Licen esu oesveatthiaVrequelrementncAwn Owner or Its �substantialeraae Check one) required by Massachusetts General taws. And that my signature on this permit app ` Telephone No. PERMIT FEES ? t�i../1 (Signature of Owner or Agent) Total No. of Transformers KVA 3 No. of Hot fuse No of Li nt8n Outlets 3v Above ❑ ❑ In ❑ and ❑ Generators KVA No. of LJ--"— Fixtures Sw"mm"n Pool amd No. of Emergency Lighting BattUnits No. of Oil Burners No. of Receptacles Outlets FIRE ALARMS No. of Zone No. of Switch Oudets p No of Gas Burners Tial No. of Detection and No of Air Cond Tons initiating Devices No of Ran es Heat Total Total No. of Sounding Devices I 1 No. Pum s Tons KW No.] of Self Contained No. or Oi KW Detecton/Sounding Devices S ace/Ar Heatin ❑ Municipal ❑ Other No. of Dishwashers KW Local Connection No. of D rs CHeatin Oev+ces No. of Low Voltage G No. of Si ns Badases Winn No. Of Water Heaters KW No.Hydro massage Tutls , No. Of Motors OTHER: INSURANCE COVERAGE. Pursuant to the requiremenSts of Massachusetts General Laws I have a current LiabilityRA Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = yg,g lid proof of same to the Office YES = NO = If you have check�,YES p� � iindI tee type of coverage by checking the appropriate box INSURANCE OND = OTHER = (Please Specify) '� '( Expiretlon Date)) q ta=zwd ue of El cal W tS �,%��ifl Rou h flr�z Final Cf�/./ Worts to Start Inspection Date Resquested can g Signed under the Pena es of perjury:�— LIC. NO. "a FIRM NAME Signatures LIC. No. Lloensee /� �� Bus. Tel No. 6—R /'j L„r� p%n/ ! Alt Tel. No. Address OWNER'S INSURANCE WAIVER: I am aware that the Licen esu oesveatthiaVrequelrementncAwn Owner or Its �substantialeraae Check one) required by Massachusetts General taws. And that my signature on this permit app ` Telephone No. PERMIT FEES ? t�i../1 (Signature of Owner or Agent) CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 14 7 Date /99,Or THIS CERTIFIES THAT THE BUILDING LOCATED ONS MAY BE OCCUPIED A ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSE S STATE B LDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. "T ; �tog CERTIFICATE ISSUED TO •`r o c ADDRESS Y1— Building`ln8pector fT� ON x � =o no c� t M 0 w a v.0 - E f I U) O z O U U) 14 `I m 0 co O co �• L O V Z a) CL O y � C IO pf C ca O CA CD O � m m co 0 CD CL Z O� O O C O L �Q c CA ev ■Q CL 0 43 C Z ts G3 0 CL U CA O C C_ C d CIO C k =o c � O � c H O C O o u A ea :Z O �y0 t .. v IMS At to 0 cm a 3 t O0 zip N C A N O .� O n 7 Camm LZ fA m CC CR p � p � m cull Z .S O co 0 0 0 CL cm c = H m •O+ :m�3 � d O N ~ N O W O O y0,, CD ��.■�t Z .N O H CL= C Z LU C.3 CD m� oQ g CO3 a _ A .0 o y O =4-a�mzip M 0 w a v.0 - E f I U) O z O U U) 14 `I m 0 co O co �• L O V Z a) CL O y � C IO pf C ca O CA CD O � m m co 0 CD CL Z O� O O C O L �Q c CA ev ■Q CL 0 43 C Z ts G3 0 CL U CA O C C_ C d CIO C k Date.. . ... ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .!.......'.. =. :... `{: "r'� .. has permission for gas installation ...... A, - e :................. in the buildings of .......... ..:.r ............................ at ..... .......... t ............... . North Andover, Mass. Fee./4698 i3i�3 No.. �: �:.�`. . .......................... 75.40 PAID GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATOR FOR P TO DO GAS FITTING or print) lvvKlri ANDOVER, MASSACHUSETTS Building Locations Owner's Name Date 7-L 19 �F6 NewoRenovation ❑ Replacement F]Plans Submitted ❑ Permit Amount Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ff-Eirm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does net 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: of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and informanof I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work a d ins01latns ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mas chuate Gas de and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber <� 2 5 Gas Fitter LiCenSe Number ❑ Journeyman w C w " x C F v z C n x o z F z C7 F Z .7 % z� W W L C i z C C z w : a w -i C z C SUB-BASEM ENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOG R 5TH. FLOOR 6T H. F L O O R 7T 11. FLOGR 8'r Ii . F L O O R Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ff-Eirm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does net 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: of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and informanof I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work a d ins01latns ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mas chuate Gas de and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber <� 2 5 Gas Fitter LiCenSe Number ❑ Journeyman ' Date . : G ..... . �= 3750 •�� oma TOWN OF NORTH ANDOVER •.'• ° PERMIT FOR PLUMBING (:�This certifies that,,..... !. , :. . , , , , , , has permission to perform ........................ . plumbing in the buildings of . ..................... at.. )0 ..., , , .. , North Andover, Mass. Lic. No../. ' .............................. PLUMBING INSPECTOR 07/06/98 13.52 292.00 RAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATIOFOR PERMIT TO DO PLUMBING :ype or print) NORTH, Building Locations 4, n --- New ,g Renovation Replacement Date Permit Amount �',a ✓ Plans Submitted n FIXT_jRES • . MOWN M No MMOMMOMMM NO ME (Print or type) Check one: Certificate Installing Company Name 1/G' Ci Corp. , Partner. Address N 14 63C711 P Firm/Co. Business Telephone Name of Licensed Plumber: C� h Insurance Coveraee: Indicate the, type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been mdde aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent El a> I hereby certify that all of the details and infgMch 'sub itt (or entered) in above application are true and accurate to the best of my knowledge and that all plumbingati n p ed under Permit Issued for this application will be in �R► compliance with all pertinent provisions of thes S Pl mb g Code and Chapter 142 of the General Laws. By: lumbing License Title City/Town License um er Master Journeyman ❑ APPROVED (OFFICE USE ONLY Location a� mS�M o-u��Z No. Date NORTH TOWN OF NORTH ANDOVER 0 p Certificate of Occupancy $ C. S�cHusE�� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # 1553;; rte _ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: Qa DATE ISSUED: 6-`P? L p 'rte C SIGNATURE: Building Commissioner/Ing3wor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 2o 'Ro6mo4 Priv, qQ3 D'/ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record G rP e !ry 6. + M . Chn sfi�n� �reerna n X Name (Print Address for Service . 40048 Signature Telephone 2.2 Owner of Record: Name P t Address for Service: q� -1 Q� 604-9 Si ature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ r�s� o1�.r ave Supervisor: 0 3�l 7 V Licensed Construction �( License Number a Shn y pur � ?Ord 0 ► �(,f u- O Address qqs -' ?j� Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ u r)�n Ol v -r J. Do-wj 1 ZSIo Company Name 6 L5b&9,d r P_-,/ 5 Pond YV Registration Number /6&62 Address L '- J — Il L(J Expiration Date Signature Telephone O Z rn 90 O mn r 0 r _r Z^^ Y+ 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 .......❑ No ........ 0 SECTION 5 Descri tion of Proposed Work checkaH applicable New Construction ❑ Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ I Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: a- T�Vl (4�kl 1A6nrk d ,n I SF,(TTnN 6. - FRTTMAT-P" rnNQTDTT!-TTnu n.r►a1r11 X Item Estimated Cost (Dollar) to be Completed b permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing N Building Permit fee (a) x tbl �- 4 Mechanical HVAC AIF 5 Fire Protection 6 Total 1+2+3+4+5 CCrTi/1W ^/., d'WRIXTIP" ♦ Trmri�rr.� . Check Number u�a.viav LG 1.v1Tir Jum JLru Wrml'N OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION Date to act on 1, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name of Owner/. Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS 1 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS lIFIGHT 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 tJ/t6 [/rOh7L»t44i!!JP-G[G�b Oa./`�R.�:7CdCl6EiJ 3 BOARD OF BUILDING REGULATIONS s 'Litietse: CONSTRUCTION SUPERVISOR Number. CS •034690 Birthdate:.ifi6wlg59 f e Expires 12/09/2003 ,e tr rio: 10640 i Restricted 00,,' + CHRISTOPHER J DAVEY 7 545 SHARPNERS POND RD -'r +� f N ANDOVER,,, MA ,01895 Administrator... HOME IMPROVENIENiCONTRACTOR Registration: 110256 I Ek latlaoF 10/13/2002. (+ -INDjViDUAL CHRISTOPHER Y CHRISTOPHER 545 SHARPNER5 POND F2D ,� ! N A!`'.DO`JE'R,11A 01$45 Adwiai4trater Pro' coal CM STOPHER I)AVEY 545 ,tfiirpehers * nd Rd. N6'. ANDW975-3736 MA0.1845, (97 8) LIC. 0034690 MICR #110256 PROPOSAL SUBMITTED TO PHONE DAT 71md-1 STREET JOB NAME 7— CITY, STATE and ZIP CODE JOB LOCATION 01645— ARCHITECT DATE-OFDATE-OF PLANS JOB PHONE Or Propose h�o furnish material and lab6 complete in accordance with specifications below, for the sum of: as — 1-1 Oh dollars ($ All material is guaranteed to be as specified. All work to be completed in -6 Workmanlike e according to.is - standard practices: Any al , teratio , n: 'Authorized.: manner or �deviation from specifications be- 47 -, Ir ow involving extra e'd', only upon writteri--o"rd'ers, and - will become an Sign�ture Aj 01' costs will be ex6cut ome e4ta charge'�over 'and above the estimate. All agmemei6ts6ontindent upon strikes, acci. dentsor delays beyond our� control. Owner to 'fire, and cessdry. may .-carry, -tornado, , �,ojopr.n6 ite: This proposal h( insurance. Our workers are fully covered by Workrnain's�b o I mpen-sa - t , ion lnis6fa'66e. Withdrawn. by us if not accepted within days. We hereby submit specifications, and estimates for: L ow�ex 7' a/w, 19 14140 � _W/a( ave "Y1q.5esq- 6�we) /-7 AWil-l' P P N,F. (NIIJ she e— LAgZ( To P4wdsr 900,223,� or nsbe.00m The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 workers' Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity Q! am an empl er providing workers' compensation for my employees working on this job. Company name: V . fA � _ „ I riswre W secu era and/or one yews i under section 25A or MGL 152 can lead to the imposition d criminal l penaities.d a tine up to $1,500.00 form of a STOP � ORDERand fine aorwarded understand that a o of this state t may be to the OMCe of invesisRK a a ($e ver0) a day against me. t y gations of the DA for coverage verification. . I do herby cerfiry t and allies of perfury that the information provided above is bue and cavrect Signature Date Print name , - Phone # - Official use ly d n ©check /mm is it this be co leted by city or town official*Building Dept ' a is u' Building Dept p Licensing Board Contact on: p selectman's office Phone # Q Health Department ❑ Other RM WORKMAN freemo-ti 20 eoerno rrr Dh ve- FieDv" 20 eWfWp+ PrIV Location Zot' No. Date rZ 4 47 CP CP TOWN OF NORTH/ANDOVER Certificate of Occupancy ' $ Building/Framd Permit Fee $ N Foundation Permit Fee $ 1 d U 01taer Permit Fee $ Z� Sewer Connection Fee Water Connection Fee $ 1002,CV9 TOTAL "P 9t~9� 10:28 $ Building nspec or 1+'()0 Div. 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W ^ OOQ 8 I- O b v mr-4 >02 �iN N m (,rLq RIDm 0 Z m °c �nI 000 o;f mX iron U,oo MZ_ a m m � Z. nmo MEZ r 0Z0 -Iclr �oy0 Z�Z -10 _° of �Z mn mm m c� A rl T Z Z O N N O O Y I r' a T iw w Z> T Z N z .• y i Y = n 0 0 n ^ ?;IooO IGa C V c 0Ni; m DO � ^ ZlO T X nY Y 0 < > > w O 0 M Z I I I . �IvI I w b v mr-4 >02 �iN N m (,rLq RIDm 0 Z m °c �nI 000 o;f mX iron U,oo MZ_ a m m � Z. nmo MEZ r 0Z0 -Iclr �oy0 Z�Z -10 _° of �Z mn mm m c� A rl 0 N° 1294 APPLICATION FOR4SEWER SERVICE CONNECTION North Andover Mass. Z�'2�C� C 19 Application by the undersigned is hereby made to connect with the town sewer main in /-����'n?� Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. 7t--1 3d or subdivision lot no. /A Owner / Address Contractor Street PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at subject to the rules and regulations of the Division of Public Works.. Inspected by Date Street Division of Public Works By See back for rules and regulations n 0 N2 794 i APPLICATION FOR,WATER SERVICE CONNECTIONS North Andover, Mass. T 19 7L Application by the undersigned is hereby made to connect with the town water main in �� G Street, subject to the rules and regulations of the Division of Pudic Works. The premises are known as No. J�� [/� Street or subdivision lot no� Owner Address Contractor subject to the rules and regulations of the Division of Public Works Inspected by Date Board of Public Works By r See back for rules and regulations GEORGE PERNA DIRECTOR TOWN OF NORTH ANDOVER. MASSACHUSETTS DIVISION OF PUBLIC WORKS 1-84 OSGOOD STREET 01845 I NOPTN OF L t c r s Uo SAC U5 ' DRIVEWAY PERMIT Date: Telephone (508) 685-0950 Fax (508) 688-9573 LOCATION: 1� BUILDER: phone: OWNER: �� f j��;� phone: 6� X155 The North Andover Superintendent of Highway Utilities & Operations MUST be notified of the grade and set -back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. ■ Remarks: Approval: FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and ^Apartments having jurisdiction have been obtained. This does the applicant and/or landowner from compliance with any applicable or re qui not relieve rements. *** * *****APPLICANT FILLS OUT THIS SECTION APPLICANTIf -Ell x PHONE S SSSS LOCATION: Assessor's Map Number � CARCELSUBDIVISIO%- STREET ST. NUMBFR CONSERVATION IONS�021fo 1M NISTRATOR SIC I UwN PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH USE ONLY AGENTS: DATE APPROVED DATE REJECTED NIto11� u)k�, A DATE APPROVED DATE REJECTED -1 , -J _ . DATE APPROVED DATE REJECTED UA I E APPROVED DATE REJECTED COMMENTS --------------------------------- PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT C�5 RECEIVED BY BUILDING INSPECTOR DATE C2 W d CA CM) "0 O CD n Z y O. O c� CL y O cu c v CD CDCL O cr CD cc CD C CD C*. av y —• o cv CD � v CA O 1 Z CD � o � CD 0 CD m cn VJ n O z cn . N Z oo ?= g C•y -a = 91 C O O Q d0�m y -0 Co � CA�J ?7 m Cdn G� m x O O a tzrD C7 ' ="v = P -0m H N TI ?dr►d O O y O CO) O O N ? m; m 2 > m >. o O C .�► 2 p O Z�.n '4 O LA !-) ac O W C� ?H ..►. n Om a -" O =r O N CD C.)= C O m n CD t „ C '� M=N d cr l 4 CL N m C 10 rr ^^ VJm IE CA 1 y .O_rt O O O O O ' CD 1--, C/)m CD :L JU CD Vim: go p, CL_. c� Cl) �. CA ___ O jam, o m J �q Cn N Z Cb 'z7 w 91 C ?? w C � CA�J ?7 x G� � `" x O O a tzrD C7 p O E rA v H 0 0 c Nem XHill -P O p o0 EZ3 EZ3 r O Z D r I�u" bp� FOUNDATION LOCATION PLAN CLIENT: YANKEE R. T. THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION:NORTH ANDOVER,MA. SCALE. l "=40' DATE, 4/21/98 CHRI S TIA NSEN &SERGI P LAND SURVEYORS ERS 160 SUMMER ST. HAVERH/LL.MA. 01830 TEL 878-373-0310 Q 1888 BY CHRISAANSEN & SEW INC. I CER7IFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS 117 THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY-LAWS /N EFFECT WHEN CONSTRUCTED. (THIS CERTIF/CAT/ON DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVEN4NI3,WEnANDS EASEUWM ORDERS OF CONDITIONS ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE.DlCEPT W17H THE WRITTEN PERMISSION OF CHRISTIANSEN h SERGI INC. FURTHERMORE THIS DRAWING /S THE COPYRIGHTED PROPERTY OF CURIS77ANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PRONIB/IED.CHRIS7LIN TAKES NO RESPONSIBILITY FOR THE UNAUIHORI 0# WING Old ANY /NFiOR- MA71ON CONTAINED 9 r� J No. DWG. NO.: 97054009 --1 0') Ul P Cs! N -' cn ■ o a v y a 0 �CD CD y a 0 -'- -U o D CD � ;:;:',< r, 0� cD cn ,, a o 0- CD rn — 5 CD n p—• Co rn N o rn o vo 0 n. .. CT rt p_ O N�f- O CSD q CD N O 0 O ''" r -t- CU '.+_ O _ (n j CD En CD 5' CL CD o c� p m 0 �i p o' ❑ rTl o v cD Z5 En o 0 ❑ o _ cn 0 c7 -TlCD -�, 0 ❑ 0 � 0 ❑ O o . • .+ CD cD En � cu to 0 N ..- 0 m 0 0 0 nC: o E" n o' ❑ cD sn3 ❑❑ rt .+ C Q Oto 0 ❑.. 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