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Miscellaneous - 21 PARKER STREET 4/30/2018 (2)
N Date TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .413.{...... �.?-'1....... ?--�'`........ z .1 ............................ has permission to perform..............................fJ....:� ................... �.�................. �....l...... wiring in the building of,,,,,,,,,,,,,,,,,,,,, at .:.................................................. ...... . ................ . North Andover, Mass. Fee, . .'.......... Lic. No.1�7'!...................................................................................... ELECTRICAL INSPECTOR Check # iC9-IIz --f 2 ly, �- _................. ..---- ------- ---.... - _ . _ ..__..- --- .. _ 041 taer . Z4 i � `� ���P� af Sa MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK WIff CITY D r � MA � %' ��� �---- -- . DATE, �'�� PERMIT # JOBSITE ADDRESS r -1------.-.1----1-.--1---1 r c„ �r a r OWNER'S NAME GOWNER ADDRESS TE �'L—°7 7 5 - FAX 1 .a TYPE OR PRINT CLEARLY OCCUPANCY TYPE COMMERCIAL - EDUCATIONAL Fj a RESIDENTIAL NEW:d RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES! v NO APPLIANCES -1 FLOORS- 2 3 4 5 77 8 9 10 11 12 13 14 BOILERWig E44 BOOSTER I COOK STOVE GENERATOR GRILLE INFRARED HEATER LABORATORY COCI MAKEUP AIR UNIT OVEN UNIT NEA INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES ;� NO I__,� I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAG CHECKING THE APPROPRIATE BOX BELOW LI4BILITY INSURANCE POLICY ' OTHER TYPE INDEMNITY Lj BOND OWNER'S INSURANCE WAIVER, I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER L-1 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my :mowiedge and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. / PLUMBER-GASFITTER NAME 0 t1 (,c LICENSE SIGNATURE D� _ _ MPO MGF [J JP EI JGF LPGI CORPORATION [J# =PARTNERSHIP LLC �.,,]#R,~ COMPANY NAME: ADDRESS CITY - 44 STATE �j ZIP ��, TEL FAX rLCELL �EMAILL M za o c g W a 11 l ACC>R V®CERTIFICATE OF LIABILITY INSURANCE 6/95 rr) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED , "ESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. I,... RTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Braley & Wellington Insurance Agency 44 Park Avenue P.O. BOX 15127 Worcester MA 01615-0127 CONTACT Diane DeCaria NAME: PHONE(508) 754-7255 FaxNolm (508)797-3507 EMAIL AMRr:ss.ddecaria@braleywellingtonaroup.com INSURER(S) AFFORDING COVERAGE NAIC 0 INSURERA:United States Fire Ins CO 21113 INSURED HEG Inc. 2 International Way Lawrence MA 01843 INSURER 8: INSURER C: INSURER D: INSURER E : NSURER F • rnvCDAn=Q rPDTICIrATC NI IMP= -2 n1 R -2n16 RFVICInN NI IMRFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE im POLICY NUMBER POLICY EFF MDD M EXP M/DDf LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx-1 OCCUR 03-773065-9 /1/2015 /1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISES Ea occurrence NTED $ 250,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ TOMOBILE LIABILITY ANY AUTO A 1' ALL OWNED SCHEDULED AUTOS X AUTOS X X NON -OWNED HIRED AUTOS AUTOS X MCS90 X Pollution 33-734904-2 /1/2015 /1/2016 COMBINED Ea accident SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident Uninsured motorist BI split limit $ 20,00 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 23-800100-8 /1/2015 /1/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION$ 1,00 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STAT_LMU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMB $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) (978)688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 1600 Osgood St. AUTHORIZED REPRESENTATIVE North Andover, iA 01845 Diane DeCaria/DIANE �/�e c_ �- • �'' �'" ACORD 25 (2010/05) ©1985-2010 AGORD CORPORATION. All rlgnts reserves. WfSVS/r4Mk9H with nrifFartnnt fri3MhCi9FE1R4►..s Arnon WORKERS COMPENSATION AND EMPLOYERS LIABILITY COVERAGE CERTIFICATE INFORMATION PAGE Policy Endorsed Effective 111/2016 to reduce payrolls per Clients Request Correct Locations Automotive Industries Compensation Corporation P.O. Box 1528 Springfield MA 01101-1528 Information Page Certificate Number WC 150016-16 Date of Issue: 12101%2015 I s Flame of Member. HEG, Inc. Mailing Address: 2 International Bray Lawrence, MA 01843 Additional Famed Insureds: X/A Additional Workplaces: 69 Parker Street, Lawrence, MA 01843 46363-469 Havezbill Street, Lake, INA 01843 96 Pleasant Valley Street, Methuen, MA 01844 564 Chickering Road, North Andover, MA 01845 186-18.9 Appleton Street, Lowell, MA 01850 2221-2225 Main Street, Tew4esbury, MA 01826 224 Lowell Straet, Medmen, MA 01841 262 Lawrence Street, Lawrence, MA 01843 1150 Bridge Street, Lowell, MA 01850 73 Plaistow Roam, Haverhill, MA 01830 194 South Broadway, Lawrence, MA 01843 215 Dutton Street, Lowell, MA 01852 425 Market Street, Lawrence, MA 01843 330 South Broadway, Lawrence, MA 01843 63 Plaistow Rowel, Haverhill, MA 01830 2. The certificate period is from January 1, 2016 (12:01 am. Standard Time) to but not including January 1, 2017 at the member's mailing address. 3, A. Worker' Compensation Coverage: Part One of the Certificate applies to the Workers° Compensation Law of the Commonwealth of Massachusetts. B. Employers' Liability Coverage: Part Two of the Certificate applies to the workplace(s) listed in item L The limits ofour liability under Part Two are: Bodily Injury by Accident: $1,000,000 each accident Bodily Injury by Disease: $1,000,000 certificate limit Bodily Injury by Disease: $1,000,000 each employee C. This certificate includes these endorsements and schedules: See Schedule. Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. T Occupancy and Fee Checked (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 03-15-2016 City or Town of. NORTH ANDOVER to the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number 21 PARKER STREET Owner or Tenant BOGHOS FAMILY Telephone No. Owner's Address 21 PARKER STREET Is this permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Box) Purpose of Building SINGLE FAMILY RESIDENTIAL Utility Authorization No. N/A Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity WORK Location and Nature of Proposed Electrical Work: RENOVATION OF EXISTING KITCHEN, MUD AND DINNING ROOMNo. No. of Recessed Fixtures 17 No. of Ceil. -Su sp. (Paddle) Fans Tra o Total �C l INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) 10-01-2016 (Expiration Date) Estimated Value of Electrical Work: $7,000.00 (When required by municipal policy.) Work to Start: 03-15-2016 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J. IANNAZZI, INC. LIC. NO.: 13592A Licensee: WILLIAM J. IANNAZZI Signature UheC:w*f. J. iwi a..y,� LIC. NO.: 13592A Bus. Tel. No.: 978-686-7300 Address: 191 CHANDLER ROAD ANDOVER, MA 01810 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ Transformers KVA No. of Lighting Outlets 2 No. of Hot Tubs Generators KVA No. of Lighting Fixtures 22 Swimming Pool Above ❑ In- ❑ rnd. d. o. o Emergency t tmg Battery Units No. of Receptacle Outlets 4 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 9 No. of Gas Burners No. o -Detection an Initiating Devices No. of Ranges 1 No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number 1 2 Tons :5 I.KW No. of Self -Contained 12 Detection/Alertft Devices No. of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. o Water KW Heaters No. of No. Of Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydro massage Bathtubs No. of Motors Total IIP Telecommunications Wiring: No. of Devices or Equivalent OTHER: �C l INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) 10-01-2016 (Expiration Date) Estimated Value of Electrical Work: $7,000.00 (When required by municipal policy.) Work to Start: 03-15-2016 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J. IANNAZZI, INC. LIC. NO.: 13592A Licensee: WILLIAM J. IANNAZZI Signature UheC:w*f. J. iwi a..y,� LIC. NO.: 13592A Bus. Tel. No.: 978-686-7300 Address: 191 CHANDLER ROAD ANDOVER, MA 01810 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ --o The Commonwealth of Massachusetts Department of Indastriar-Aceldents 1 Congress Street, Suite 100 ' d02114-2017 z Boston, .1t2A. ' �C www mass.gov/dia b�M Sy V yq'nrlkers' Compensation insurance Affidavit: Builders/Contxaetoxs/Electricians/Pinmbexs. TO SE FILER WITH THE PERI TT) NG AU Please Blease Print Le bI A-6 licant Information �, Name, (Burinass/Oirganization&dividual): 1,1 i I( r{ hn �; I a yr h 7-1'_ 1 H Address: f'(i'CG►���e�l>3Y �►Gz.� City/State/Zip: 40 ov� Phone .Areyou an employer? Checkthe appropriate box: 1. M 1 am a employer with_einployees (fitll and/or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees Working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ 1 am a homeowner doing all work myself; [No workers' comp. insurance required.] t 4. ❑lam a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractor's either have workers' compensation insurance or are sole proprietors with nq employees. 5. ❑ I am a general contracfo a and 1 have hued the sub -contractors listed on the attached sheet. s have employees and have workers' comp. insurance.t These sub-contractor 6.0 We are a corpo 152, §1(4), and "Any applicant that ck i Homeowners who sut $Contractors that check Tfthe ;,officers have exercised their right of exemption per MGL c. employd;e [No workers, comp. insurance required] 0 Type aproject (Vegiiii, 7. ❑ NeWdonstriiciion 8. IZemodelifig 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical'repairs or additions j2. � 'I?lu ubing repairs' or additions 13:[] Roof repairs 14.Q Other. ' li information:' have �lsofillout the section belowshowing their workers compensafionpo cy indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such of the sub -contractors and state whether of not those, entities e hav lobed an additional sheet showing the name Aw must provide their workers' comp. policy number. lam an employer that is providingworkers' information. Insurance Company Policy # or Self -ins. Lac. #: compensation inszrrance for my employees. Below is the policy and)ob site Expiration Date: r, e City/State/Zip: Job Site Address: 21 Pam Attach a copy of the wolrkexs' compensation policy declaration page (shocriminal violation vaing the policy number and expiration date). 25A is a Failure to secure coverage as required under rM enalties?inthe foam of OP WORK ORDER and a fine of up to $250.00 a and/or one-year imprisonment, as well a p day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. and penalties of perjury that the information provided above is trrae and' correct X do hereby certifty under the pains . Official use only. Do not write in this area, to be completed by city or town official Permit/License # City, or Town: Issuing Authority (circle one): 1. Board of Ifealth 2. Building Aepartment 3. CityiTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Phone Contact Person' Information and Instructions Massachusetts General Laws chapter 152 requires all emplbyers to provide workers' compensation for their enililoy es: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract oil' f dire, express or implied, oral or written." An employer is' defvied 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 receiv6f6 trusted 6f 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 df `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 b6 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 appUcant•whdj has inoi produced -acceptable evidence of compliance with the insurance coverage r' 4idred. " Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter intp any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have beenpresented 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.= contra ctors) name(s), address(es) and phone number(s) along with their ceriificate(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. B e advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. ,Also be sure to sign and date the affidavit. The affidavit should be retained 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' compensatiorl'poHey, please call the Department at the number listed below. Self-insured companies should enter their self4asurance 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 thai must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) and under "Job Site Address" the applicant should write "alt 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-AMSSAFE Fax # 61.7-727-7749 Revised 02-23-15 www.mass.gov/dia c COMMONWEALTH OF MASSACHUSETTS , o �x. BOARD OF 'ELECTRICIANS ISSUES THE FOLLOWING LICENSE AS—A REGISTERED PtASTE.R ELECTRICIAN WILLIAM J IANNAllI uj 21'Z EDGEWATER DRtVE G I LFORD NFI 032+9-6300 13592 A 01/31/t-6 54965 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .,.,.,.,,.,'P"',,,;L—GZ �— has permission to perform ....k ;7- wiring %wiring in the building of .................... , 1 ............. 1... �........... §...... ...................... , North Andover, Mass. Fee.................. Lic. No�................ / ... ELECTRICAL INSPECTOR ' Check # X09 fo.N- Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No, 1 2"�` !� 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 TYPE ALL MFORMATION) Date: L D6-- I City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) a \ QAt �<-tr 5i, Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Yes �f Purpose of Buildings } �W. o�VS2 / \Utili Existing Service ' tt Amps ['}u / 7`lG Volts Overhead New Service , Amps / Volts Overhead ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: OA� CSC -VI 3- AI'C.:b- Telephone No. q7,8--560-�4j No ❑ (Check Appropriate Box) Authorization No. Undgrd ❑ No. of Meters Undgrd ❑ No. of Meters inSOC+�u►'?• 'Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. o Emergency Lighting rnd. rnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump I Number Tons KW No. of Self Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal E] F1 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 Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: tq- Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: DO (When required by municipal policy.) f 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 certify, under the pains aiind enalties of perjury, that the information on this application is true and complete. FIRM NAME: �%u,1t,� t\cc � �� T1/�C • LIC. NO.:80 C', Licensee: Signature _ LIC. NO.: (If applicable, enter "exem t" in the license numbennr lint�,.),-n " Bus. Tel. No.; q78 -891 --?130 Address: '�` �1wN u{, 1�cXF�'r t%. ©t�'3S A1t.Tel.No.: Gid *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 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. G.L 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 maybe-deemed_by-the-Inspector_of_Wires abandoned.and_inyalid.ifhe—.. _ 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 permitted 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. El 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 effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. l�Rule 8—Permit/Date Closed: r✓K lb -41-3,` Mote: Reapply for new permi 0 Permit Extension Act - Permit/Date Closed: ti A Date ..... -)— .................... 0 - TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ...... ..... ............. . .............................. ........ 1�7 —" A/f'- has permission to perform ... i Aaepp ........................... wiring in the building of .....'01� ��A.K ................................. at ........ 01f ..... /'� V/?. /4 ........ S.17 ....................... North Andover, Mass. .... .. .......... ... .. ... ,s Fee.. . Lic. No.' .�. .......... ELECTRICAL INSPECTOR , Check # 64.6 t)rtieial t:;e t)n1> Commonwealth of Massachusetts Permit No. " Department of Fire Services t = Occupancy and Fee Checked 7f on, BOARD OF FIRE PREVENTION REGULATIONSRev.9,0� i 1 (lc,t,e blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK til work to he performed in accordance %%ith the Massachusetts Electrical Code (ME0. 527 C" SIR 12.00 (I'LLISE PRINT LV INK OR TYP�ILL INFORM. I TIO,�) / Date:-417/oS Citv or Town of: ; )\JO Ajov / To 1he h7.V clnr• o '1Vire.v: 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 Owner's Address 0 Telephone No. I /7yag 75j Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building I pr.���,, Utility Authorization No. Existing Service oCAA__� Amps 1106-40 Volts Overhead 2", Undgrd ❑ New Service c2DO Amps tjD / LJ.OVolts Overhead 01-- Undgrd ❑ Number of Feeders and Ampacity DW F Djje�& ozo ro AN P Location and Nature of Proposed Electrical Work: aR3 A--Lvl�0tj No. of ;deters ' No. of Meters SONS Oc ('one lelion o/ the i,lluuing !able m ov be waived by the In )ec'hir o1'll'iresl No. of Recessed Luminaires %7 No. of Ceil.-Susp. (Paddle) Fans ____ No. of Total Transformers KVA No. of Luminaire Outlets ��.--1 No. of Hot Tubs OA)t Generators KVA No. of Luminaires Above In- Swimming Pool ,rnd. ❑ rnd. ElBatter , o. o Emergency Lighting Units No. of Receptacle Outlets 45 No, of Oil Burners -- �FIRE ALARMS No. of Zones No. of Switches /Q No. of Gas Burners No. of Detection and InitiatingDevices No. of Ranges --� No. of Air Cond. Total Tons No, of Alerting Devices g No. of Waste Disposers ---- Heat Pump Totals: Number 1 Tons KW No. of Self -Contained 11 'Detection/A lerting Devices No. of Dishwashers Space/Area Heating KW ---. Local ❑ Municipal ❑ Other Connection No. of Dryers , Heating Appliances — KW— Security Systerns:* No. of Devices or Equivalent No. of Water Heaters KW No. of No. o Si ns Ballasts Data Wiring:o. No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP _ Telecommunications Wiring: No. of Devices or Equivalent OTHER: Much addiliunui delad r/ desired, or• us rcrluirrd by lik- 1l1.dXel0l' 0/ Estimated Value of Electrical Work: 0�J V�ork to Start: Ci6 Insp. ( When required by municipal policy.) 3 ections to be requested in accordance with ,NIEC' Rule 10, and upon completion. INSURANCE OV AGE: 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. "I'he undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuin •office. (:'HECK ONE: INSURANCE 2' 13OND ❑ t)TIIFR ❑ (Spccily:) I cer10,, !roller the pains and penalties of perjurr, :hal the information on this application is truce aid cool Vete. FIRINI NAME: I CSI 04, LIC. rio.: Licensee: ,4 MR -1 &ZECT? ct/W ;�i;nature us,_ _ LIC. N0.: /% J "r. em n" in I/.e iiccrr.rc r:rrnrb r iine.i Bus. Tel. No.: /57 s1 Address: � � ©� 1!1 Ssi % G� � s -ot,) Aft. Tel. No.:_ Security System Contractor License required for this work; if applicable, enter the license number here: _ OWNER'S INSURANCE WAIVER: I a n aware that the Licensee (100S !mt have the liability insurance covcra<e nt>rmally required by law, By my siIgnature below, I hereby waive this requirement. I arn the (check one) ❑ owner ❑ owner's agent. Owner/Agent :3ignature Tclephonc No. I -PERMIT FvF..Q 7.5 -fin r the performanceii rcitecr��a.-::u. ). oration" coverage or its substantial equivalent. The �ime to the permit issuin-, office. IoFof s CHECK ONE: INSURANCE BOND (Spccily:) I c•erlifil, airier the pains am/ pet{allies of perjuq, tltut lite ittjorntuliun on this applicwtintt is true u, aal comp/etc. FIR�INI NAME: i GqO3C- / - AVL t ,Rp�o LIC. PD.: Awa' S b Licensee:gnaatua e 1 LIC..N0.: F�%g/ % (1j*,,,;p1icut.,1c. cuter "rsent C ill Ihr t CUiSC MIMber line j tats. Tel. No.: -7,*'8 address: �c7 V��v il��W � /Jo Aft. Tel. No.:_ *Seata•ity System Contractor License required for this work; if applicable, enter the license number here: �,,� OWNER'S INSI RANCE WAIVER: I ain aware that the Licensee (h)es not htti,e the liability insinance covcra��e normally r ltJ� ?� �rec uired b law. f3 i � sig=nature•bclow I hercb waive this ra uiremcnt. I am Che (check one I Y� Y � Y 1 ) ❑owner ❑owner's ;ren k.,JO )C S , /,KOwner/Agent _ k 3ignaWk-e r cphoaae No. FPE7RMIT FF_F,':.1 7.5 1 -- c� C Commonwealth of Massachusetts 01,licial t:se 011IN - �' ( Permit No. i; Department of Fire Services j Occupancy and Fere Checked x BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9.05] 1leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK SII \cork to he performed in accordance %pith the %•IassachuseIts HcclricaI Code (NIEC). 53' (AIR 12.00 (PLE, ISE PRINT l,V INK OR TYP "I LL LVFOR.1 L I TION) Date: _Zji7/0 S- City or Town of: ;,2 D/✓ �" ovpN Tn /hc I17.5'hc�clnt uj 6Virc�,ti: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Z/ /"!Q'�lkety sq— <X -A, 75 7— 70 Owner or Tenant y Owner's Address �, ky i ) ' yKAVr Is this permit in conjunction with a building permit? Yes 1� No ❑ Telephone No. 1 79&T %4a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 0-03 Amps t a o4W Volts Overhead Undgrd ❑ New Service c2DO Amps f D / 1/��olts Overhead 5r Undgrd ❑ Number of Feeders and Ampacity 0IV�i Location and Nature of Proposed Electrical Work: No. of Meters t No. of Meters S 2"/ V11A — VIH ('omplelion u/ IlteJr,Nolth1.z> luble Inav be waived by the hispecl r o II'ires No. of Recessed Luminaires 17 No. of Ceil.-Susp. (Paddle) Fans, _ No. of Total Transformers KVA No. of Luminaire Outlets ��--� No. of Hot Tubs (9/Z Generators KVA No. of Luminaires ,kbove In- Swimming Pool rnd. ❑ rod. ❑ o. o Emergency Lighting Battery units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches /Q _� No. of Gas Burners No. of De Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No, of Waste Disposers ----. Heat Pump Totals: Number. __ Tons .._ .............._.................._.....I KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers' ..-- Space/Area Heating KW ------ . Local ❑ itilunicipal ❑ Other Connection__ No. of Dryers Heating Appliances -KW_ _ Security Systems:* No. of Devices or Equivalent No. of Water I Heaters No. o No. of Signs Ballasts Data Wiring: g� No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Illuch ,ulcliliurud ,lrmiJ 1f dt sired, ur ,r.c rrytiiacl he: the hispcchor ..:j l t `,r,i::. Estimated Value of Electr'cal Work: U,9J.. OGG ( When required by municipal policy.) \kork to Start: :il% 3 0G Inspections to be requested in accordance with NIEC Rule 10, and upon completion. INSURANCE OV AC:E: Unless waived by the owner, no permit for the performance ofclectrical work inay issue urllcs; the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The• undersigned certifies thilt SUCK co\crage is in force, and has c%hibited proofofsanle to the permit is :uin r, office. ("HECK ONE: INSURANCE [R BOND ❑ OFIi "R ❑ (Spccily:) I 4_'ertg5,, .under the pains rnht pelfulties of perjury, ;/tut the i i fin-mulion on this application A bice and c•oml Vete. FIRM NAME: l .����, sC / -�� r ( LIC. 11I0.: tcZO Licensee: Ll� L &ZJMM(C(1W ;iignature LIC. N0.: % liccIbIc, liter ..cc -ern t" itt Ihr Iiccti,`L' twntbwVlle.i { Bus. Tel. No.: Z Address: C-,/- VI w � / JS�'�c,.� Aft. Tel. No.: _ Security System Contractor License required for this v of k; if applicable, enter the license number here: _ OWNER'S INSURANCE WAIVER: I and aware that the Licensee does not huvc the liability insurance covera<e nC1'111ally required by law. By my signature below, I hereby waive this requirement. I and the (check one) ❑ owner ❑owner's mcnt. Owner/Agent ;3ikuature d leilhone Flo. PFPi;Vf!T FF.F,:.i f R6 -"A &/, -11-S - � e ---o C, f 3 vN919 SN30n ~ Z cn w wcv CO Ln :! Q S t :5m N 5G U LL. .0, w op �- Q : z w:< ~ Z v w Ln :! Q S t :5m N X / Date ..... ....d`.. . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SACMUS This certifies that .... has permission to perform ... ..... .. ..... .. ... . plumbing i -the, buildings of /. ...................... at .l... (-..�-�! ... :...... , North Andover, Mass. Fee`2a..... Lic. No. ... ...... PLUMBING INSPECTOR Check # 6953 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS _ Date .' O Building Location Permit # �S Amount Owner New D Renovation D Replacement D Plans Submitted Yes No FIXTURES (P;int or type) 'installing Company Name �\T�G�� �pG�+.n� Cc )J 1i Address 1 CA Business I -e ep one Check one: ❑ Corp. Partner Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 13 Other type of indemnity D Bond D Certificate Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 1-1 Agent El I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum 13141ing Code d hapter 142 of the General Laws. BY igna ure Or icense um er Type of Plumbi g License Title /30/5 City/Town Icense MumDer Master Journeyman D APPROVED (OFFICE USE ONLY F I kw 4- ?A -i (:-.Q S' , % I -13 LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 —352-2858 cell 978-502-5921 May 24, 2006 Mr. David Perry 21 Parker Street. North Andover, Ma. 01845 RE: Residence, 21 Parker Street, North Andover Dear Mr. Perry As you requested I visited your residence at 21 Parker Street, to review the Engineered LVL beam in the basement of the new addition. The beam is shown on plans prepared by Mr. Stephen Foster dated 7/25/05. I verified by calculation the adequacy of this beam. I therefore and can certify that it is adequate to support the superimposed loads as required by the Massachusetts State Building Code and that to the best of my knowledge it is installed properly. Should you have any questions please do not hesitate to call. Yours truly, awrence H. Ogden P.E. OF Mqs� 9 LAWRENCE HAROLD U DEN , N A 27 p FSS�oN L ':9 / a-e'� CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE. -I"=20' DATE:8/19/2005 Nuc I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BYLAWS OF NORTH ANDOVER WHEN 8UILT '1014 - OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON -CONFORMITY WHEN CONSTRUCTED. Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road North Andover, Mass. NOTE: SEE VARIANCE GRANTED. THIS FOUNDATION CERTIf 8/19/2005 13972 L40 7V5 I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BYLAWS OF NORTH ANDOVER WHEN BUILT ;00,C+ / /01` OFFSETS SHOWN ARE FOR THE USE�y�tM Of OF THE BUILDING INSPECTOR ONLYo�'� AND SUCH USE IS FOR THE Jit! 8 DETERMINATION OF ZONING K/0*4 13972 CONFORMITY OR NON -CONFORMITY EaE� lAtN 5 WHEN CONSTRUCTED. CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALEI"=20' DATE.8/1912005 Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road p'9jQ North Andover, Mass. NOTE. SEE VARIANCE GRANTED. THIS FOUNDATION CERT/F 8/19/2005 Vo .� s Nps Fkis�, '�Nptisc� ae�k I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BYLAWS OF NORTH ANDOVER WHEN BUILT ;00,C+ / /01` OFFSETS SHOWN ARE FOR THE USE�y�tM Of OF THE BUILDING INSPECTOR ONLYo�'� AND SUCH USE IS FOR THE Jit! 8 DETERMINATION OF ZONING K/0*4 13972 CONFORMITY OR NON -CONFORMITY EaE� lAtN 5 WHEN CONSTRUCTED. D t� Location ,` a No. J Date 7 TOWN OR NORTH ANDOVER + Certificate of Occupancy $ Building/Frame Permit Fee $ OL Foundation Permit Fee $ Other Permit Fee $ TOTAL $op f Check # i 8366 �.-- Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATFft OR DEMOLISH A ONE OR TWO FAMILY DWELLING s ftr –� BUILDING PERMIT NUMBER: q �S— DATE ISSUED:4jt� (( SIGNATURE: Building Commissioner/19gWor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Address: �� a ` yv� Number 1.2 Assessors Map and Parcel Numb 33 � Map Number Parcel Number 1.3 Zoning Information: Zoninix District Proposed Use 1.4 Property Dimensions: Lot Area F 8 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide RegWred. Provided red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.3. Flood Zane InfomWioa: 1./ Sewersp Disposal System: Public ❑ Private ❑ Zone Outside Flood Zane ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 111.717 11 1% +I8tnct: 2.1 Own of Record f - Name (Print) %Qn Address for Service : Signatur Telephone 2.2 Owner of Record: a Name Print Address for Service: Signature Tele one SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable License Number Expiration Date J Registered Home Improvement Contractor 1 Not Applicable 0 company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (KG.L C 152 g 25c(6) , Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... ❑ SECTION 5 Descri tion otProposed Work check ■ bk New Construction ❑ Existing Building 0 . Repair(s) 0 Alteratioms(s) 77"❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: }Ucl CA c.� �ire� A('C) r CF.CTTON 6 - F.CT1MATTII iYINQTDiTr -r1rf%N nnvnrr Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) �--- - 4 Mechanical (HVAC)eco 5 Fire Protection 6 Total 1+2+3+4+5 ® Q-vb -- CL'r'`TiAN 7. A�17NVD A7T7'K7nDT7 � �r v .� wr .. Check Number i Gil niAMI'l OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behal , 'n all mners relative to work authorized by this building permit application. ST >ature of Owner ✓ / �^ Date SECTION 7b OW 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 Frmt Name Si ature of Owner/Aizent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 07 2• 3 SPAN RD DIMENSIONS OF SILLS DIMENSIONS OF POSTS D11V1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FII LED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTIO APPLICANT RPHONE 97 T- T� LOCATION: Assessors Map Number . PARCEL SUBDIVISION LOT (S) STREET_d re�,-Y—Xr ST. NUMBER TOR OFFICIAL USE ON - DATE APPROVED TOWN PLANNER DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE______ R@vWW 07 jm 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 t ,k°RTH TOWN OF NORTH ANDOVER OFFICE OF p BUILDING DEPARTMENT + 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta, Building Commissioner HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: Number HOMEOWNER U av\. e Name PRESENT MAILING ADDRESS City Street Address Home Phone State Telephone (978) 688-95454 Fax (978)688-9542 Map/Lot (l `-,I ,6' Work Phone 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. I �1 HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL BOARD OF APPEALS 688-9541 CONST RV ATION 6889530 Iff"AL H 688-9540 PLANNING (3880535 9-) 0- L}-- - - IP— -�? I -()II /KS -,�s t y II II II II LJ - S T - - I .N w . 3:% h Town of North Andover Town Clerk Time Stamp Community Development and Services Division t?� r;'dF0 Office of the Zoning Board of Appeals ,JYCF.tE)SNAIU 400 Osgood Street T;; its �J CK ;:;.; 1, , ! i ��? North Andover, Massachusetts 01845 `; E;: D. IRobert Nicetta ThiBs' d' itiCy ► 0) days have elapsed from date of decision. filed withoutfiling.of po appeal. Dat Jq^ ®tedshaw Town Clerk Any appeal shall be filed within (20) days after the date of filing of this notice in the office of the Town Clerk, per Mass. Gen. L. ch. Telephone (978) 688-9541 Fax (978) 688-9542 Notice of Decision Year 2005 2005 MAY 2h P 4: 11 ATTEST: A True Copy a..�� . Town Clerk 40A, § 17 Property at: 21 Parker Street NAME: _ Karen & David Perry HEARING(S): May 12, 2005 ADDRESS: 21 Parker Street PETITION: 2005-008 North Andover, MA 01845 TYPING DATE: May 23, 2005 ids'( The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top floor "etiing..;, room, 120 Main Street, North Andover, MA on Tuesday, May 12, 2005 at 7:30 PM upon the application of Kien Sul David Perry, 21 Parker Street, North Andover requesting a dimensional Variance from Section 7, Paragrgp1i 7.3 art<d, Table 2 of the Zoning Bylaw for relief of lot line setback in order to construct a family room and study and fd Special Permit from Section 9 and Paragraph 9.2 of the Zoning Bylaw in order to extend a preexisting, norm- C,, -- conforming structure on a pre-existing, non -conforming lot. Said premises affected is property with fronta ` y p the -a South side of Parker Street within the R4 zoning district. The legal notice was mailed to all abutters and ptq% ed inj the Eagle -Tribune on April 25 tit May 2, 2005. _0 The'following members were present: John M Pallone, Joseph D. LaGrasse, Richard L Byers, Albert P.ry and David R. Webster. The following non-voting members were present: Ellen P. McIntyre, Thomas D. �to, III, a&& Richard Ni V911ancourt Upon a motion by John M. Pallone and 20d by Richard L Byers the Board voted to GRANT a dimensional Variance from Section 7, Paragraph 7.3 and Table. 2 of the Zoning Bylaw for relief of 2' from the Beech Street setback in order to construct a proposed addition, and upon a motion by John M. Pallone and 2°d by Richard J. Byers the Board voted o to GRANT a Special Permit from Section 9, Paragraph 9.2 of the Zoning Bylaw in order to allow a pre-existing, no conforming building to be extended by a two-story addition of a family room, study and bedroom on a pre-existing, non -conforming lot per Plan of Land in North Andover, Mass. owned by David P. and Karen J. Perry, Date: 8/18/2004, 2/14/2005 [by] Scott L. Giles, R.L.S. #13972, Scott L. Giles R.P.L.S., Frank S. Giles R.P.L.S., 50 Deer Meadow Road, North Andover, Mss a. and Perry Residence, 21 Parker Street, North Andover, MA Date: 9-30-04, [4 N sheets]. With the following condition: 1. The proposed addition roof peak shall be no higher than the existing roof peak of 251. Voting in favor: John M Pallone, Joseph D. LaGrasse, Richard J. Byers, Albert P. Manzi, III, and David R. Webster. The Board finds that the shape of this applicant's five -sided corner parcel has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw in that the granting of this Variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Also, the Board fords that the applicant has satisfied the provisions of Section 9, Paragraph 9.2 of the zoning bylaw and that this change, extension or alteration shall not be substantially more detrimental than the existing structure to the neighborhood Page 1 of 2 Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 97888-9530 Health 978-688-9540 Planning 978-688-9535 Town of North Andover . ' Office of the Zoning Board of Appeals Community Development and Services Division 400 Osgood S(reet North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Telephone (978)688-9541 Fax (978)688-9542 Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Page 2 of 2 Town of North Andover Board of Appeals, Ellen P. McIntyre, Chan Decision 2005-008. N133P38. „ C 1 Board of Appeals 979-698-9541 Building 978.688-9545 Conservation 978-688-9530 Health 978.688-9540 Planning 978-688-9535 ESSEX NORTH REGISTRY qE DEE. LAWRENCE, MASS. I A TRUE COPY: ATTEST: 1 R�T�+R dF DP�!D , � 381 Common Street ^ ' -^ KAREN PERRY KA " Essex North County Registry of Deeds � 381 Common Street Lawrence, Massachusetts 0184O / O6/17/O5 KAREN PERRY KA # 45 Rec: T PL 5O 21771 �� 721771C. ^ OO C. P. 2100 R. D. 0 46 Rec: Type'-- 100 5U0O , DOC 21772 A F% 29,00 R. 1 # 47 Cert copies 5.00 � ^ ^"p 3.00 � Total 153. 00 M 48 Pavmnt Check p '-_- 153.00 THANK YOU! Thomas J� Burke Register of Deeds (Opt v� N C) lit 0 moo �C13z w 4c a• ', w 0 s� um .04 +: o ` o f•' ,' ' y= Q �' cu f: 10 4t 0 Q vj fD LL `taGOrO.L Z "0 _ = — B} ` V *` V'. -'3 0 0 °' O 3 O C � O «+ in U amCU QQ: D. V c �•o O C_ >O = O ' x .0� c. E O ~ - L ` �� � O � � yy� C N V O O A \ O O co t Of I y a c c_ v .r E o c c 3 E U N U- 0. r o. 9 �y I °�N o q- "IMo w -o Z a. Q o '0 c � (A ~ z g o a, Ln z > �IM Cd w c� o u w° U w a w w a w a�' w a a�' w a� cn cn I y „000 s�=0 o ca C.) t y; %: CL c :om Ea V 46 V wQ: I �_ n� C is Q-..om N cm w d C �� M t 0 «• a H f m E� o :mo dV I.: � 3. c o Q v C ` G cm CLO C H m� N m C �C x o�0�3 N ~ r0,, vi m $ 10O CO W C .'O *;=c w-401-1 .. c •tyA atoC Z O r g� F - y a 5. = GO 2`y co �- s CL :a m I 42 4..1 O co C cm C CO) Q -0 C *cm O O 0 CD O � i cc o a CL CMCC c CO3 � c O 2 C CD CL C.7 CO) c C C cc C CO2 . D 0 U) CO)LLI ce W W 19 LLIW 50 h lis air- �� PLAN OF LAND IN NORTH ANDOVER, MASS. • OWNED BY DAVID P. AND KAREN J. PERRY SCALE.• 1 "= 20' DATE.•81812004 21412003 . 01 20" 40' 60' Scott L. Giles R.P.L.S. Frank. S. Giles R.P.L.S. 50 Deer Meadow Road NOTE. -SUBJECT PROPERTY IS SHOWN ON North Andover, Mass. ASSESSORS MAP 33 AS PARCEL38. 0VMrNU yr rirrcrlw O� i1�b DA E OF FILING: • D3 DATE OF HEARING: DATE OF APPROVAL: S I an MEN ::_ ��� now RIGHT ELEVATION NO SCALE Mat r. Register of Deeds D rS AN op Location � l Nr�. Date NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy. $ Building/Frame Permit Fee $ cHusts Foundation Permit Fee. $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ i--:t'UULl:�-:i Building Inspector Div. Public Works a �Ia Y 0 0 A 0 rp 1 W < Z 0 N - w N h N F W w Z > ; m 8 0 Z W 0 s 0 ` ~ 0 0 0 J ec 0 Z W m N W L I a 8 c I 0 w w O NN m r 6 Z O N m �I 0 W d s 0 o 0IL tri d1 Z o 0 W W i e < Z R W. o Z z < m F O M W ^ea Z ux I< 2 Z = "!.J 0 0 0 m W W 0 l 0 I 1 W u F z 0 C LL w W Z IE Z u � LL 0 0 4 J LL 0 W W N w m Z )z O 0 0 V, W ID m u < J J W L L LL 0 0 0 m A r i i 0 m Z 0 f it 0 z N < J u W L (/)= Z W wu O C Z o 0 H u LL m w 0 'J ui D0 � h i f O m wo 0 m y m J Z Z O Z rc V A ~ 0 0 Z Z d L ^ tl) Z 0 - dl Z 0 O 0 W m F ) < p Z O W p > 0 > 0 W K F < w m I- J J_ LL J J_ LL w 0 O u W F 7 0 m ^ w N �W rc , = u < Z h L L W < L 0 g r WZ K zV W W 0 w i F X O Z W 0 F` pF Z K 0 V) a 0 u u m u L m x w a It F m o o O < 3 0 d< J ; m m m u z m z> G Z F F F 0< A j W W W a J0 O J F F Z 0 0 0 Z 0 0 0 0 1 W u F z 0 C LL w W Z IE Z u � LL 0 0 4 J LL 0 W W N w m Z )z O 0 0 V, W ID m u < J J W L L LL 0 0 0 m A r i i 0 m Z 0 f it 0 N < J u W L (/)= Z W wu O C Z n 0 H u LL m w 0 'J ui D0 � h i f O m wo 0 m y m J Z Z O Z rc V A ~ 0 0 Z Z d L ^ tl) Z 0 - dl Z 0 O 0 W m F ) < p Z O W p > 0 > 0 W K F < w m I- J J_ LL J J_ LL w 0 O u W F 7 0 m ^ w N �W rc , = u < Z h L L W < L A r i i 0 , N z n e W ui LU i F• H J L ��=i Z O Z Z V A r i i 0 , N z uC W i L ��=i i O� Iz w O O FM4 W I T C z c o m c c .r O N O • "V`V` a C lV A O � m Ea C C3 d N = CD A w O J c• 1111``mC n M� H .. v E m m ca � 3 = N r �m O O O �"• Npo GIM TV a C c Oa A cN il(� rt a z m � o J:y� VO 0 4 C : � m N o a C 'C = o `o t„ o3 N Z W r c F- .y C- Z �E uiC 'CO •N p LU o wo mr c g -. CL O� • F- z $ a. r m �• CD O E C L V Z a3 Q. O CO) o c cm � c CD c .� Ca O O mm 3� O G O O U.d �Q c c= c O C3 �v CL as C Z 0 CL V y O C 0. C c CIO D w cc 00 v w W a�' w W a w°' c�' w a C2.w rA cn -ld cn C z c o m c c .r O N O • "V`V` a C lV A O � m Ea C C3 d N = CD A w O J c• 1111``mC n M� H .. v E m m ca � 3 = N r �m O O O �"• Npo GIM TV a C c Oa A cN il(� rt a z m � o J:y� VO 0 4 C : � m N o a C 'C = o `o t„ o3 N Z W r c F- .y C- Z �E uiC 'CO •N p LU o wo mr c g -. CL O� • F- z $ a. r m �• CD O E C L V Z a3 Q. O CO) o c cm � c CD c .� Ca O O mm 3� O G O O U.d �Q c c= c O C3 �v CL as C Z 0 CL V y O C 0. C c CIO D ,N Q_.... _Dirwer7s10 N hot: Rey A. ry Ai xz0ne.x A review of the Flood Insurance Rate Map, This mortgage inspection plan is for mortgage Mortgage b Community -Panel Number Zl C purposes only, it is not an instrument survey. O0,9a x003 Hence it is not to be used to establish property Inspection dated-7—IL," e 2993 has been conducted lines, fences, driveways, hedges, etc., or to be used for any purpose other than its original intent. Plan and to the best of our interpretation this property *is eY-j;2 2�: located within the flood zone. I hereby certify `%D k)t L CIA" F B)o "t ek �yAO OF k(S Location,?/ /'4� " Z"/'. 1117da fi ff / " MA Mat the principal building on this plan is approximately o't� COSMO DAMIANO ill located on the ground as shoum, and it conforms to the 3 CAPOBIANCO H Scale: 1 in. = 9Q ft. Date dimensional setback requirements of the zoning and building 17104 Plan Reference 5 5 �"'S 5 Q i S laws of the city/town of N &NnQ VEX 4 f cisrtR whe000nstructed and to the restrictions on r ,y yp OSUR�E MORTGAGE INSPECTIONS INC. r SUITE 311.286 MEDFORD ST., SOMERVILLE. MASS. File # 'r—L3 ` !�� • r Job # 30 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 not relieve the applicant and/or landowner from compliance with any applicable or requirements. '"APPLICANT FILLS OUT THIS SECTION r APPLICANT E#/,LL�/_-&_Sk/j P.C7 LOCATION: Assessors Map Number OS3 oo3!& SUBDIVISION STREET 4�R S1 CONSERVATION OFFICIAL USE ONLY S OF/FOWN440GENTS: PHONE 9 7 R q?� SS 4 3 PARCEL__ LOT (S) ST. NUMBER DATE APPROVED 14 DATE REJECTFn TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED 6--__—SEP�TICNSPECTOR HEALTH DATE APPROVED DATE REJECTED COMMENTS �C�� PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE HOIV81SINIV40V 09810 VW 9NIOV30ij" IS ANISM 101 AONVI 'f NHOr NO11AISNOO AQNV1 t/98TO VW 9NIOV3d N is 1nN1S3H:D TOT OO/ZO/CO UOTIOIT03 XONV-1 "f NHOE MSMIM - 9dAI NOnom16NO3 .GNV-1 t9jSZ1 UOTIP11ST688 dIHS83N1dVd — 9dX1 00/Z0/60 UOT'4e-LTdx-A V8ZSZT UOT4eJ4ST6G8 HOiDVdINOO 1N3W3110ddWI 3WOH 80TZO sqq9snqoesseW luoqsog 'COOT wOO8 — GOeTd uoqjnqqsv auo SpNOIIO-leMle�JI-4SI938 S6013$ PUe GUOT-4V�3iNOO IN'1?Tn6a�j 6UTP Tng l o ID A e o I NOH Restricted To: 00 80564 DEPARTHENT Of PUBLIC 'k?"Y 00 None CORSTRUCTIOI SUPERVISOR LICENSE Birthdate, IR HasOnly only pumper: Expires: IG - I & 2 Family Homes 1199g 01,0711951 CS 04�01� 01101 failure to possess a current edition Of the Restricted To: 00 Hassachusetts State Bujilding code is cause for revocation Of this license, JOHNj LRNDY j 39 RIDGE Why BOO "a PiPmRST, M 01866 v - it V � �1 Q €3 rnk- r V � �1 v V.F 1NJ �- V► w VL w`� V P ri i/'�•1 1 A. V r" � r All M �������� Q A����I Z ��a�,�� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 77771, BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 2Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning Dii-rict Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided —+ 1.7 Water Supply M.G.L.C.40. 34) 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 '' ' �- l i ; ` ti'ri Ct: 2.1 Owner of Record L v A, (' 1hac� ame (Print) Address for Service Signature Telephone 2.2 Owner of Recor : Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address _ Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature_ Telephone 00 M z O 0 z M 90 0 aaaa r r SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 2! Workers Compensation Insurance affidavit must be completed and submitted in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... 0 SECTION 5 Description of Proposed Work cheel[ ad applicable) New Construction ❑ Existing Building 0 Repair(s) 0 A this application. Failure to provide this affidavit will result Alterations(s) 0 1 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: 7 Coo ltr* (p, lu h� �q ���tiliIu I SECTION 6 - F.STTMATF.n CnNSTRTrrTTnN rnRTC I Item Estimated Cost (Dollar) to be Completed by pennit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 . Fire Protection 6 Total 1+2+3+4+5 Check Number .JEA, l l Vll r a V TV ll li t1 V L -naxGH l llJ1, 1 V ISLE 1, VTVJ rLE 1 Ev W HAf4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2 ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Zoning Bylaw Denial Town Of North Andover Building Department ......A ,, 400 Osgood St. North Andover, MA. 01845 Phone 878488-8546 Fax 978488.1542 Street / PAR(C MaplLot: 3 \3 8 Applicant :K> A u Request A VK t R-'0 wt �- 5 �-� J+t 6 ti s Data: 3- r) - 5" � w■... v.d AwwlirsfiAA i4 Please be advised VW after review of your AWWataan area rmw YMa Y -- DENIED for the following Zoning Bylaw reasons: ■ Zoning /1-1 Variance Site Plan Review Special Permit c - Setback Variance Access other than Frontage Special Permit Parldrig Varsance kern Notes Common DrMmw Dr'Speriai Permit stere Notes A Lot Area Special Permits Zoning Board F Frontage Large Estate Condo Special Permit 1 Lot area Insufficient Speciel Permit Use not Listed but Similar 1 Insufficient R-6 Density Spedai Permit 2 Lot Area Preexisting e S 2 -Frontage Frontacie Complies 3 Lot Area Complies 3 Preexisting5 4 Insufficient Information 4 Insufficient Information B use S No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required VW s 3 Preexists CBA �+e 5 Insufficient Information 4 Insufficient Information C Setback H Building Height All setbacks comply1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 r51 Left Side Insufficient 3 Preexists Height `� 4 Right Side Insufficient S 4 Insufficient Information Rear Insufficient i Building Coverage 6 Preexisti setbacks e 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting y S 1 Not in Watershed 3 4 Insufficient Information 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district 2 Parki Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-exisfing Parking Remedy for the above is checked below. Item a Special Permits Planning Board Ilan • Variance Site Plan Review Special Permit c - Setback Variance Access other than Frontage Special Permit Parldrig Varsance FTfte Exception Lot Special Permit Lot Area Variance Common DrMmw Dr'Speriai Permit Height Variance COngregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent EkWy Housing Special Permit Special Permit Non -Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Specigi Permit Speciel Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Sign R-6 Density Spedai Permit Special Permit prewdsting nonconformin Watershed Special Permit The above rayiew and attached eWandn of such is based an th pima ant W mMm submitted. No definitive review and or advice dW be based an verbal eoglarnatiorns by fta~ nor shall such verbal er;larnadorns by the applicant acne to prowls ddi*m answers to the above reaeans for DENIAL. Any inaccuacies, nAdeadkng kNamation, or o#w ukeaquw t changers to the knfarnow su11ed by the applicant shy be grounds for this review to be voided at the discratim of the ButdkV Daman t. The d{ached Wurwrt Ned 111m Raviaiw Na mbW shall be dlachd lorato and knoorp 1 1 1 herein by rehrum- The t> Aft depattrront M ref.h err Plam ant docnrrrnernddon for the about+ fie. You must fie a now b Adkng POM* OPP11000m fano and begin the prtr IM Pnxi uilding Department Official Signature ,31-71a3_ -3 -'Y jppksfioh Received Application Denied Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the application/ r permit for the property indicated on the reverse side: Refanad To! Fire IIiMr1111 Police r�— r/Y) a/- a Historical Commission Other p/J CDN P r /N S C- jV©(\9 Vk,) vii ve o /s /PP 2c)Av( ,� 02%�� m4ppeA Is ��C'7/vti a% �'- v.4 /SIA,vC ce- j0ok— side - lde-✓V A,7 C) DS 'G iv !S /�w ✓/��o `4c- c�Ia A % / `e- oZ . Refanad To! Fire Heelth Police Zoning Board _ Con88fV8tgn rtment of Public Works Planning Historical Commission Other BUILDING DEPT a PLAN OF LAND IN NORTH ANDOVER, MASS. OWNED BY DAVID P. AND KAREN J. PERRY SCALE. V'= 20' DATE. 811812004 U V 2/14/2005 U V 3 iv 0' 20' 40' 60' 01 e S 3 a 5� a Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road NOTE:SUBJECT PROPERTY IS SHOWN ON North Andover, Mass, ASSESSORS MAP 33 AS PARCEL38. k t^'rr. TI./r MIC"rMif"r 10 MA NORTH ANDOVERe4'4' 0' F� 3 BOARD OF APPEALS s DATE OF FILING: DATE OF HEARING: DATE OF APPROVAL: =0111-901 ::i RIGHT ELEVATION NO SCALE 25' D rS+ 4N Location �f No. / r Date �d ",. TOWN OF NORTH ANDOVER F 9 i Certificate of Occupancy $ Building/Frame /Frame Permit Fee $ s+cMuse 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 17623 ;"'—Building Inspect r ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR; RENOVATY OR DEMOLISH A ONE OR TWO FAMILY DWELLING '777 71 BUILDING PERMIT NUMBER:/ DATE ISSUED: SIGNATURE: -- - �• •(0010w--- Building Commissioner/I or of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Q Name (Print) M umber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Address for Service: Front Yard Side Yard Signature Telephone Rear Yard Required Provide Required Provided Required Provided 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SF,CTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record edress Name (Print) for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1, Lic a onstruct upervisor: sy� License ul umber� A ress 04 04 lr/I ROO Expiration ate re Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (NLG.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 ....... ❑ SECTION 5 Description of Proposed Work check as applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work I SECTION 6 - ESTIMATED CONSTRUCTION COSTS 1 Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) U -v 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number NtUllu1N 7a Vw1VER AU IHORILA'1'lUr4 TO BE COMPLETED WHEN OWNERS AGENT OR CONDUCTOR APPLIES FOR BUILDING PERMIT as 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 Authorized Agent o subject property 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 * _ Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3Ku 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 +�✓�e �anz�nza�zure¢ll�. of 4i��ixiaar�u6el�a+ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 034049 1 Birthdate: 12/08/1923 u. Expires: 12/08/2005 Tr. no: 12443 Restricted: 00 MARIO T CASTRICONE 31 COURT ST�,r N ANDOVER, MA 01845 Administrator � �..` ✓ire T�amUaza�zu�ea,� o�✓����veti16 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 103317 Expiration: 794004 Type: DBA / CASTRICONE ROOFING & SIDIN Mano Castricone 31 Court St. N. Andover,'MA 01845. . . .!,-R`ftrftiziiSEratot " � �� , 2'fu {'c�amof:u+�aftfe of �lauacFtu,�sas M 090"Unt of hiduotrlialA=idmu Qfija of l 600'Wa sf*WM STflW (BOJW ,.W 02111 watirots' C4i4pm► I===u Affsdavit Localion: City 0 1 am a homeowner perfaaming all work myself Telephone #: _ i am sole proprietor and have no one working in my clachy C) I am, an employer providing wodoers' comPe�t my empioyees working an this job Company Name:,,{ Address: y3,�.� City: - —kz 04 insurance compeay: Telephone* ...._� Posy. L,l 7 X18 46-A 9.3 9 :Q G I am (circle one) sole proprietor, general contractor or homeowner and have hired -he contracters :L-Ved, below Who tiave due following workers' compensation policies: Company Name: Address: _ City: Insurance Comp,my: Company Name.. Address: City: insurance Compsny: Telephone M Poiicy s+: Tc:ephonc M: -- Policy #: Attach additional sheet if necessary 'railurt to secure coverage as required undet Section 25A of MGL 15B can lead to the tmFasitim of f.Timinal penalties of a fine ull to S1,500.:1U an&or ore years' imprisontnent as well as civil penalties in the form of a STOP WORE. ORDER and a fine of 5100.00 a dad against me. I undersund that a copy of this statement may be forwarded to the Office of Invea5gations of the DIA for coverage verification. 1 do hereby certify under the pains and P41!PSWO of Ptrjury that the information above is true and correct Srgnattre: Data: _ Print Narsr. QV lQ1 (' t1 S k L D d Phone OlLetat Use ONLY - Do not write 1s this are C Building Deportment I Clry or T ; , n: PermMicense M c Limning Board { o Seiectlnea a Of ze G tiealth deurtirneni 0 Check it immatliate response is requirea o Ott er _ i w O Q y �o W O y C V C3 CL w 000-0 >1 E Q m E a f Q° y _ `NG caO 10 ts cm Ma mm � O �y y � 3 ._-. co go - y :Z C C y O O :EoCon cm � :=Z O CLQ c O y o m •:��a o m 2 coo Canc Q y CD c0 = m m� 3 0 ~ O m.0.~ m .-• _ W Ca CO C c •- �`� •N O.Z W O C Z 7 • ui E omCO QQQ O CO)CL m '� = CL aO dISm cm i O.— m = y O O CD O O i M: ca ca o =� c R �o CL 0 CD claC z ts CD CL V y O C C C c y a C o0 U m wp°G a u. a W o°G ii a 094 w I~ cA o V)V) o y �o W O y C V C3 CL w 000-0 >1 E Q m E a f Q° y _ `NG caO 10 ts cm Ma mm � O �y y � 3 ._-. co go - y :Z C C y O O :EoCon cm � :=Z O CLQ c O y o m •:��a o m 2 coo Canc Q y CD c0 = m m� 3 0 ~ O m.0.~ m .-• _ W Ca CO C c •- �`� •N O.Z W O C Z 7 • ui E omCO QQQ O CO)CL m '� = CL aO dISm cm i O.— m = y O O CD O O i M: ca ca o =� c R �o CL 0 CD claC z ts CD CL V y O C C C c y Castricone Roofing & Siding REPAIRS FREE ESTIMATES b Telephone (978) 682-4266 MARIO CASTRICONE 31 Court Street, North Andover, Mass. 01845 I/we, the owner (s) of the premises mentioned below, hereby contract with and authorize you as contractor, to furnish all necessary materials, labor and workmanship, to install, construct and place the improvements according to the following specifications, terms and conditions, on premises below described - Owner's Name..... ..... Job Address....... f../.•.• ...... ...... ..... .. ...........�...............................city....��., .................... State , .. .....�c.11:t-.....�G.�c-�..,.. r...-... SPECIFICATIONS ! FA ' I I I I 017-30''p, ' .A►, n.l G�......�: ...........�L....�, ...��C �..-....:...... ?....��'�.� 1 ........................ �..( ....................... ., r^.^:. . ....... .......'1.�rL................. I........... .......................................................................................................................................................... .......................................................... Materials and labor to cost Payable on and balance in............ .............. y......................................................................... monthly installments of $.......... . ..................each, payable on ........................................day of each and every month thereafter until paid in full (..............% charge per year is o be added to above cost of labor and materials and is included in monthly payments.) Contractor will do all of said work in a good workmanlike manner. Upon completion of above work, all undersigned agree to execute and deliver to contractor, their joint note in accordance with his (their) above obligation and a completion as requested by the contractor. Upon refusal to do so, contractor`may at its option declare the entire contract price or so much as then remains unpaid immediately due and payable. It is agreed that if permitted by law contractor shall be paid by the owner(s), all reasonable costs, attorney fees and expenses, in addition to the amount due and unpaid, that shall be incurred in enforcing the terms and conditions of this contract and/or any lien in connection therewith. It is further agreed that this contract may be assigned by contractor; and also that the obligations hereof shall bind and apply to their heirs, successors or estates of the parties. The undersigned warrant(s) that he is (they are) the owner(s) of the above mentioned premises and that legal title thereto stands of record in his (their) name(s). PROVISO: This contract shall be void and of no effort if credit approved of owner(s) is refused. There are no representations, guaranties or warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is this contract dependent upon or subject to any conditions not herein stated. Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. Cover attic storage cleaning not included. Receipt of a copy of this contract is hereby acknowledged, and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. Owner or Owners are not responsible for Property Damage or Liability while job is in operation. (� IN WITNESS WHEREOF, the parties have hereunto signed their names this ................�. ...... day .......L............., fa...G....� Accepted: / Signed... .... .......... ..........................................�..,,/ 0 (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) Signed...................................................................................... Per........... '..... ............................. Repr entative Owner Signed...................................................................................... 0 f � Location No. Date 'f Check # 14 ', : 7 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL / `"'`Building Inspecto6r'F TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING e BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Bui din Cofnmissio for of Buildin Date - ValL' al�l'vl\L�it1 A. av1\ 1 1.1 Property Address: 21 1.2 Assessors Map and Parcel 33 Map Number Number: s? Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: P . Lok Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided t 1.7 Water Supply M.G.1-C.40. 54) Public Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1%U�wdner of Record/1 ? �} Name rint) Address for Service: 2.2 Owner of Record: Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed onstruction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: IAddress Signature Telephone 3.2 Registered Home Improvement Contractor Company Name Address License Number Expiration Date Not Aoalicable ❑ Registration Number Expiration Date SECTION 4 - WORKERS COMPENSATION (MG.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 ....... SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ ExistinVuildinf ❑ 1 Repair(s) �L Alterations(s) .. ❑ Addition ❑ Accessory Bldg. ❑ Demolition ' ❑ Other ❑ Specify Brief Description of Proposed Work: I SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollarto be Completed by permit applicant I . Building (a) Building Permit Fee ` o Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) `.e ��5 4 Mechanical(HVAC)e'v Fire Protection 6 Total 1+2+3+4+5 a 00 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property r Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Narnu- Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS in 2ND 3RD SPAN DIN ENSIONS 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 0 0/'� as x w cn cz w° C2 G U w O H w a a ao' w O w w w v ci w a0 ; w W W4I. CQ z cn v o cn ERS O IN04 C G O ` C y O C 'r O CJ C.3 r C Cc to m C `oN- CO E -a r C7 CD C. N C • m CO2 yO+ OM CD C H A 4D v o m �3: C J C_ � • C m A 0 H m = O r.O COQ :O.CZ A : v y O A Z O Q D = 0 ma yZ„ C 0 O H 4 - EE EE G MIS U.•VJ dt O C � r W .E � .m V 0 0.0 _ m .5 x CC41a � a 0 �— w cam. m cm �91' 6 O Ico Ccm O■� y Q co.� y � � .E cc m co cm co CL♦■■� CD cm CDca L CL �Q C •� Cc Q co C Z 15 V y � C C C 23 0 U) U) Ir W W U) Town ®f North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM NO RTp.f 20 6 Y yy, as O 01 p'pe cecw�ic. A% 4'r o PP_4 In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit-# the debris resulting from the work shall .be disposed of in aproperly licensed solid waste disposal facility as defined by MGL c11, sI50a. The debris will be disposed of in /at: Facility location Signature of Applica� ------------- Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. a Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax Please print DATE 2 3 ` 0 JOB LOCATION 2 Number "HOMEOWNER �fl ✓t PC's tz- Name PRESENT MAILING ADDRESS HOMEOWNER LICENSE EXEMPTION `MZ- K&tZ - 5 -r Street Address . 6'fY '%ofS e Phone 2 i (C C rt 57 ,7- o °L # 2 Y sAckuse� Map / lot Work Phone Y ✓i- Iv 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 j DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory. to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not beconsidered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by4aws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. _ HOMEOWNER'S SIGNATURE ,19lU19_, APPROVAL OF BUILDING OFFICIAL it N° 1612 .......1.. .. .... Date... ....3 l TOWN OF NORTH ANDOVER G. PERMIT FOR WIRING u This certifies that ........... //"C has permission to perform "' wiring in the building of...�,... ................................................................. at ........................... ................................... — ,North Andover, Mass. Fee ..... (7/10 .... Lic. No .............. . ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only Permit/W5 eM=0W9,4Z7,?1 69 X455,46MV5577-5 No 100-r-4 4 p601- S*# 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) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number -2- i ,k K F P S-1-1, Owner or Tenant '/i% k_ D �4,LtSS A -r )J -)k 7 Owner's Address 4 1��- Date To the Inspector of Wires: Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) Purpose of Building -keS f b IV 4 i Utility Authorization No. Existing Service jQo Amps o�o�n Voits Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity (` Location and Nature of Proposed Electrical Work f1r/7�G- 1 f i �I� 6( ROM 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 Workb Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME 1 -,,_% L LIC. NO. l a ,P AL�rC1>!C` r1J Signature LIC. NO. Bus. Tel No. �/✓ P Alt Tel. No. RANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantia equivalent as required by Massachusetts Laws. d thaty signal on 's permit application waives this mquirement. Owner Agent(PleaseCheck one)+6,49 `/�//,(�� ( Telephone No.*e e l Y PERMIT FEE $ — of Owner or Total No. of Light8nq Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets 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. of Ranges U No of Air Cond Tons Initiating Devices . Heat Total Total No. of Di al No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers S ace/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of D rs Heatinq Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring d No. Hydro Massage Tuds 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 Workb Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME 1 -,,_% L LIC. NO. l a ,P AL�rC1>!C` r1J Signature LIC. NO. Bus. Tel No. �/✓ P Alt Tel. No. RANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantia equivalent as required by Massachusetts Laws. d thaty signal on 's permit application waives this mquirement. Owner Agent(PleaseCheck one)+6,49 `/�//,(�� ( Telephone No.*e e l Y PERMIT FEE $ — of Owner or Location No. I Date NORTH TOWN OF NORTH ANDOVER n Certificate of Occupancy $ Building/Frame Permit Fee $ sus',"°''th s�CMUSE Foundation Permit Fee $ t7 Other Permit Fee $ Sewer Connection Fee $_ $ Water Connection Fee $ TOTAL $ � Nrs" 12.267 Building Inspector Div. Public Works N N !d d W i O z t x ag a Z I O J IS O H F 09 W d Z 0 P u IL IL W } J J w LU V a 3 o o O V V _ Y � p m U) m W � O W I � I Y Z V)Q W 7 Z p Z x J _ N N O W W J z z ; 0 0 < Z y� Z 4 0 0 0 0m Z m m j F m W p Z 0 H Z 0 O J O F U O H U O 1- U 0 J f m d 0 O Z N z Z Z m W CLL 0 p Z UO 4 0 U U U U 0 W N 0 m W Z W J L 4 z 0 (n 4 0 F 0 4 4 J Z O Z O Z O Z O 8 C 0 m W Z < W f W/- N m m m m N d Z mN 0 N O I m f m m m � 1 W 1�2 W Z 0 r 0 z z f O J ; O 1 W W ' ' z H 0 o mZ :)q4` �-J U ° o� m < J 0~ AW M W i _ JIr I- �'� 60 Q Z 0 z 0 F f � z o r - 1 W m W I Z W R < Z N i 0 J f ; W 0 cO F J U 0 tq < W Z 0 I < Z O O < m < Z m 0 0 m 0 LL 0 J z z < z < O Z 0 J n < p, O T W ` „ C m W F K W U z U Z U Z 4 O O J 0 J O J > m 0 O IL Z N U J Z 0 Z 0< U J m N N N W i m m m m �^ J < m 0 0 0 A ; U Ir L A N Z 0 F U D N Z } C 0z 0 C Q 0 0 m U U L K < J J L m m V W W e a N N mm O 0 u u W W N W N F ~ W > p O 0 J J_ F L 4 0 N m W W W U 0 W < < U) . L L cry. a :- } J J w LU V 3 o o O V V _ cry. a :- 80MIsININOV I 69810 dH 9NIOd30.i 1S InN1S3H) 101 AONVI 'f NHOf NOI13ndISN00 AONVI 00/ZO/EO u0r;e1rdx3 0 dINS83NIdVd - edAI _ r telSZi uoraeaasr6aa _ �98TO VW JNIC]V3�J '11 IS I(1NIS3HO TOT AGNV-1 "f NHOf NOIIUn8iSN00 AGNV'l dTHSa 3N.121Vd adXj 00/ZO/UO U0T-1 1Tdx c uOT ai STOa b8L,ZT .4 4 . a 8OIJV�JINOO INAW]1A08dWY :MOH 80TZO S4qast1y0asseW ° UOqSO8 TOET wOOd - aOeTd L104jnggsV auU I spi'eppua-4 ppu'� SUOTJ n6a 6UTp Tr8 O pa o NOT1�1d1.M38 SWIOVdiNOO INAW /1U�3dL I �WUH - r ��� -(r.a rrrrrrl�rrnvrr�/1 r l.rrr�uc rrr.�r ' Restricted To: 00 DBPARTHBNT OF PUBLIC SAPBTY 00 - None i� CONSTRUCTION SUPERVISOR LICENSB x Expires: Birthdate: ]A - Nasonry only w Number; 1 & 2 Family Rome$ 04,016 0110111998 0110111951 1G CS Failure to possess a current edition of the Restricted To: 00 Massachusetts State Buiilding Code a is cause for revocation of this license - JOHN J LANDY 39 RIDGE WAY AVE BOg 118 PINEMURST, MA 01966 80564 i - ainleu6ig U) = 0 w N FY ❑ W J Ln M ch F -CL r400 `V MZ C Ln �� • O 1 Q Q} � cow O z z w V Q o LL ❑w U Z❑ � Z ❑ f O W Q F- ❑ OC ix 0 J • GC Q w Ln o 1 Q W (nn N W cq cn u)fY • EQ O� z3 ? ❑ CLW w ❑ z ,c 00 1� in s W W d j 0 H W w Q co N U v F- %T o j in � 3 �y M x Continuous Soft Rock (617) 542-0241 • Fax (617) 542-5809 7 a 4 a \ ® � � k 2 _ / w � 6 � � £ � � 2 � q « � U � q � � P2 q k � < « rA W �¢ E a v 0 A 6 v .0 C w a w � w w w cq' V)cnui ul 0 w w a CO O z O U Cf) O m a CD O E C Z o Q. O y G C O OM CO) O-0 CD CO) O •FE m m CD CD _� = O� O O L M:0 v�aC o •-- 0 CL Cc CD ca C Z CD V y O C C CL CO2 G 6 z m C ul 0 w w a CO O z O U Cf) O m a CD O E C Z o Q. O y G C O OM CO) O-0 CD CO) O •FE m m CD CD _� = O� O O L M:0 v�aC o •-- 0 CL Cc CD ca C Z CD V y O C C CL CO2 G m C O C 'r O V V CL O ea m C r.+ 10 V O m �; Alce 4e Ea c JCD O d SEE t Y 1 .2 m W me E CL= H AIE mm C \' N CD co `m 3 C m 2 _ � y O O O m O cm c�a c o,t mom m V g Z �v > O c � o � c H _ O p N y as O N� W ea Z m � � C w •Z,,, OC *4•tyA oc �E nz`°c v 4 .y Z o ui F=� g C#* CL _ a` y O a:Em� ul 0 w w a CO O z O U Cf) O m a CD O E C Z o Q. O y G C O OM CO) O-0 CD CO) O •FE m m CD CD _� = O� O O L M:0 v�aC o •-- 0 CL Cc CD ca C Z CD V y O C C CL CO2 G ►SSACHUSETTS unwow APPLICATION.:.FOR.PERMIT.-TO:DO'PLUM6ING (Type or Print) NORTH ANDOVER ,Massa Date. �1. Building Location oma,, Permit # "'' "' � . _ Owners Nam New Renovation Replacement 0 Plans Submitted ❑ , FlXTl1RFS tY�• (Print or Type) Check one: Certificate Installing Company Name Corp.- orp.Address Address— /� E�Gr//�,2j�S� Partner. G✓U�S'C/i�/✓ ��+ - Cj Firm/Co. Z Telephone_ 7 '- a7 �r-ltc � Name of Licensed Plumber: t�jc'�f6/ ,(5r%Ii?!booc 9 _ ¢ N ¢ Ol O Z 1.. > O F. a W art Y Q 4. < X Jj ¢ o ¢ v=i ¢ �-.. < t- 0 _ ¢ a- C Z Q a O w O O Q 03 O ¢ z Q W Y a" Q CC t- J Q >r Q W a -1. X W u¢s t- z � r� F' O = a 2. N Z Q• O a 0 _Z Z Q W t IG O U 1. Z 3 Y J In 93110 o J = F- H U. sus-8sMT. BASEMENT 41 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TNFLOOR STN FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR tY�• (Print or Type) Check one: Certificate Installing Company Name Corp.- orp.Address Address— /� E�Gr//�,2j�S� Partner. G✓U�S'C/i�/✓ ��+ - Cj Firm/Co. Business Telephone_ 7 '- a7 �r-ltc � Name of Licensed Plumber: t�jc'�f6/ ,(5r%Ii?!booc 9 Insurance Coverage: Indicate -the type of insurance coverage by checking the appropriate box: Liability insurance policy M Other type of indemnity 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 three insuronce coverages. Signature of owner/agent of property OwnerAgene\o ;. hereby certify that all of die details and information 1 have w4,nittcd (or en(ctcd) in aMt•e application ate True mail V -tate to die best of my -• - knowledge sad that all plunibinC work and installations lictformcd undct rcnnit i-sucd for this application will be in compliance with all palincnt pro... rt:ions of the Massachusetts State Plumbing Code and Chiptes 142 of the Gcnerat taws. By Title. City/Town: APPROVED ZOFFICE USE ONLY) Sign t e of Licensed Plumber Tv a of Plumbing License License Number ❑ Master EN- Journeyman This certifies that Date �-<! TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING has permission to perform .... . ................. . plumbing in the buildings of .,4. 4I;c. (P s Ft r. S�/A(............. at . d..►. /.�!'a!�'1 �.!1.. S� --................ . North Andover, Mass. Fee. ��, - .. Lic. No.. :�- w 2 4 ............................. . PLUMBING INSPECTOR 04/02/98 09:16 45.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer