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Miscellaneous - 22 PERIWINKLE WAY 4/30/2018
Q,a/PERIWINKLE WAY 210/038.0-0280-0000.0 North Andover Board of Assessors Public Ac ' cess Page 1 of 1 ,JORTh North..Andover Board of Assessors Ot t•�ao•a,~O SSS"`"j5� Sroperty Record Card Click Seal To Return Parcel ID :210/038.0-0280-0000.0 FY:2012 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels " '` Search for Sales �. { Summary t M1 k Residence pc Detached Structure y ,. Condo 22 PERIWINKLE WAY Commercial Location: 22 PERIWINKLE WAY Owner Name: FUCHS,ELI FUCHS,TRACY ANNE,TNTS ENTIRETY Owner Address: 22 PERIWINKLE WAY City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 10-10 Land Area: 0.60 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3729 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 793,400 793,400 Building Value: 500,300 500,300 Land Value: 293,100 293,100 Market Land Value: 293,100 Chapter Land Value: LATEST SALE Sale Price: 763,000 Sale Date: 12/21/2010 Arms Length Sale Code: Y-YES-VALID Grantor: DERRING Cert Doc: Book: 12342 Page: 0042 http://csc-ma.us/PROPAPP/display.do?linkld=1889945&town=NandoverPubAcc 5/17/2012 Residential Property Record Card PARCEL ID:210/038.0-0280-0000.0 MAP:038.0 BLOCK:0280 LOT:0000.0 PARCEL ADDRESS:22 PERIWINKLE WAY FY:2012 PARCEL INFORMATION Use-Code:. 101 Sale-'Pnce 763,000 Book:_ 4 12342 Road Type4i T_ _ Ins-pectLLDate 10/23/2009; Tax Class: T Sale Date: 12/21/10 Page 0042 Rd Condition: P Meas Date 03/24/2008 Owner: ' —__ z: 4 Tot Fin Area 3729 Sale T e_ P Cert/Doc: Traffic M Entrance X FUCHS, ELI Tot Land Area 0.60 Sale Valid: Y Water " "Collect Id SGC FUCHS,TRACY ANNE,TNTS ENTIRETY --- - - Address: Grantor DERRfNG Sewer Inspect Reas M 22 PERIWINKLE WAY Exempt-B/L% / Resid-B/L% 100/100 Comm-13/11/6 Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms:` 10 Main Fn Area: 1765 Attic NBHD CODE 10 NBHD CLASS: 10 ZONE: R3 �. _ _ _._ ai Story Height: 2.00 Bedrooms: _ 4 Up Fn Area: 1964 Bsmt Area: 1737 9_ ._ YRQ Code Method S Ft Acres Influ Y/N Value Class Se T e Roof. H Fuli.BathS " 3 Add n Area: ' Fn Bsmt Area: 800 1 P 101 S 25949 0.600 m 293,053 Ext Wall. FB Half Baths: 1_. Unfin Area Bsmt Grade G A Mason Tnm "" Ext Bath Fiz -„1Tot Fin'Asea: 3729 VALUATION INFORMATION ry_, T M Current Total: 793,400 Bldg: 500,300 Land: 293,100 MktLnd: 293,100 Foundation CN Bath Qual: M RCNLD: 500310 Prior Total: 793,400 Bldg: 500,300 Land: 293,100 MktLnd: 293,100 .. __ _ ____ __ 4 ' Kitch Qual: MEff Yr'Built: 2001 Mkt Adj: � Heat Type:� FA Ext Kitch: Year Built 2001 Sound Value Fuel Type. G4T Grade: V'� Cost Bldg: 500,300µi Fireplace: 2 Bsmt Gar Cap:'2re - Condition:' MVE 'Att Str Val1: _-_ _ - . . ., _ �� .. K _ _ . Central AC: Y' BsmtGarSF: Pct'Complete: AttWGar SF: %Good P/F/E/R. 100///100 Porch Type Porch Area Porch Grade Factor W 264 SKETCH PHOTO 22 12 264 Sq.Ft 12 FM/B EB Y 351 Sq-Ft w s Ss ' 17 17 FU/FM/B a { � q1824 , 11945 •R FU/FM/B 30 8 192 Sq.R B 33 24 * 2 Q 24 q.Ft 3 564Sq:R s- Sim $ ��' �•"', „�4e��t�,� �.'.a�3 � tea•e` �„R'�L" '`�4`� ,��i`�"'��,..,. . 3*, 5 . 22 PERIWINKLE WAY :. Parcel ID:210/038.0-0280-0000.0 as of 5/17/12 Page 1 of 1 Liberty Mutual® Liberty Mutual Insurance New England Region Central Property Unit INSURANCE 75 Sylvan Street Danvers,MA 01923 Tel: (800)566-0323 April 8,2014 Town of North Andover Attn:Building Inspector 120 Main Street North Andover,MA 01845 Re: Property Address: 22 Periwinkle Way,North Andover,Ma 01845 Policy Number: H3S21850137640 Underwriting Company: LM General Insurance Company Claim Number: 029210565-0001 Date of Loss: 2/23/2014 Attn: Town/City Official Pursuant to M.G.L. c. 139, 5 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. .143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, 599, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, 5 3A &B, or Mass. General Laws, Ch. 143, 5 9, or Mass. General Laws,Ch. 111, § 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number,claim number, and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Location /,4 l t d P-PrtW t-v K /C LUA I/ No. Date J~��' °�0 NORTh TOWN OF NORTH ANDOVER F? • • OA 9 + , . Certificate of Occupancy $ sAc►,us�' Building/Frame Permit Fee $ �5 r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / Building Inspector /Jocisrir4-.vSr--ewe-W \3-c;k4-(S)vo / �c. n6� OF �p` ISI E TLrI0 D 'rrPL,- 173.95 2�.2 Av m m s � • r IMUDYMY !1O ria 00. A0G>o,/EQ PLOT PLAN gi;m.POPI, mr ria rpro, IS Loam OR IN ria Lor AS SHOW AND rBAr 1T DOES Cox"" wrri ria-rowr�ar W, AK1 r-bler-,;8oxrxa R WUffoMS 8ar8A N G Rali/RDINO " FROM S PJRVS t Lor LW S• • I Ir MMM WRMT WAV res 1'D'T1J, !S xor LOCIM N l718' F RAL FLOOD iAZW AM AS DRAI W FOR SHOW 0111 F PAWL f Z,v�09 t, ,� 21Ip, o`Z Pe ri wink le, R.L.S. DAIT 8o xor FOR MRA MACK RMCINMUNC SERV MS rim. aommamr 1xFORIf mw rA1Cdx a Rscoms. e6 PARK SrRA'ar IIAMVRA YASSACHUSRrrS 01810 Location 01*2?aA,)K,,,, W y No. '39 Date Q` k`Dco NORTh TOWN OF NORTH ANDOVER O s Certificate of Occupancy $ yes'•^°'E<� cNBuilding/Frame Permit Fee $ s� us Foundation Permit Fee $ Other Permit Fee $ TOTAL $ SQ r.-- Check # 14 4 0 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING q,o f'% .33 F "Y x 1 S '`r'2 c ,y� d .x.ti• `F.,3 p - mt.. vR,.mxa xSS., - V a BUILDING PERMIT NUMBER: DATE ISSUED: �� Q 317X SIGNATURE: Building Commissionerff for of Buildings Date Z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: N, I e- LJ 0,y 3 $ aL FO Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 423 Sinclfe- Familw Al 9119 1 �u5b0D ZoningDistrict Proposed Use Lot Area s Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Required I Provided Required Provided 0 91e-'t3D ,p 8' Q 1 i0cy r 1.5. Flood Zone Information: 1.8 Sewa Disposal System:Rater 34) Public L .40 vteCD Zone Outside Flood On Site Disposal System D SECTION 2-PROPERTY OWNERSHMAUTHORIZED AGENT M 2.1 Owner of Record \ ;N�am�qpnnj) Address for Service: -73 7ignature Telephone 2.2 Owner of Record: Name Print Address for Service: Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ fAj; IIcC>m /3arr Licensed Construction Supervisor: ('55 a a L41 O License Number Addre - `� P -71 Expiration Date ) i n re Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name m Registration Number Address r z Expiration Date Q Signature Telephone Y/ f -• I, 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.......❑ SECTION 5 Descriptiq_jwrof Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. 0 Demolition ❑ Other 0 Specify Brief Description of Proposed Work: y y U U. I G omi I ! , SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be N OWL, IISE ONLY. Completed by permit applicant 1. Building (a) Building Permit Fee t . [� LS a Multi lier 2 Electrical (b) Estimated Total Cost of ?i 00to Construction 3 Plumbin - ( Building Permit fee tBl X (b) 4 Mechanical HVAC 12,hyo o 1q33 5 Fire Protection ,1J 6 Total 1+2+3+4+5 } 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, w, i+ i r ,as Owner/Authorized Agent of subject property Herebydeclare that the statements and information on on the foregoing application are true and accurate,to the best of my knowledge and belief Print me A J� IoI Agi o caner/A ent Date NO.OF STORIES SIZE 37to -F — BASEMENT OR SLAB 5 SIZE OF FLOOR TIMBERS 1 X ib 2NU-9 .106 3 SPAN 114 0 DIMENSIONS OF SILLS +4 X la DIMENSIONS OF POSTS .1r DIMENSIONS OF GIRDERS L4 — 3L ` HEIGHT OF FOUNDATION 3 THICKNESS ( ®` SIZE OF FOOTING 1 oil 'koLf'' X MATERIAL OF CHIMNEY /-(C/v IS BUILDING ON SOLID OR FILLED LAND (j IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. / PHONE ��Z. r.2 3 ZO APPLICANT ��f ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION 02r LOT NUMBER STREET STREET NUMBER OFFI IAL USE ONLY ........................................................................... RECOMMENDATIONS OF TOWN AGENTS mill DATE APPROVED5f- _i� b d COWSERVATION ADMINISTRATOR DATE REJECTED ^ (� /� COMMENTS C U - C 1/d"0 ) z- DATE APPROVED TOWN R DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED ff DATE APPROVED SEPTICS ECTOR-HEALTH ^� DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS �G 6 DRIVEWAY6 P �~ �? 3�✓/ACX al /clue/ C�cte 'S-, l �� DATE APPROVED FIRE DEPARTMi✓NT DATE REJECTED CON INffiNTS RECEIVED BY BUILDING INSPECTOR DATE EPC I; of ,I WAY RA W P"' I46 r SLL T 7t4 lip Z i FM. 17 t / i I�laDl�i E D �i TE p1.A� H OF wt LoT q Ab�pf�/IL,I.AGE � DANIEL m KORAVOS s 4p ' CIVIL CA No.37752 MAScheckYCOMPLIANCE REPORT Massachusetts Energy Code Permit # ; MAScheck Software Version 2 . 0 Checked by/Date CITY: Lawrence STATE : Massachusetts HDD: 6235 CONSTRUCTION TYPE : 1 or 2 family, detached HEATING SYSTEM TYPE : Other (Non-Electric Resistance) DATE : 11-15-2000 DATE OF PLANS: 11/5/00 TITLE : 22 Periwinkle Way PROJECT INFORMATION: Abbott Village COMPANY INFORMATION: William Barrett Homes COMPLIANCE : PASSES Required UA = 775 Your Home = 696 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA -- ------------------------------- ---- - ----- - ---------------- -- CEILINGS 2446 30 0 0 0 86 WALLS : Wood Frame, 16" O.C. 3450 13 . 0 3 . 0 246 GLAZING: Windows or Doors 600 0. 350 210 DOORS 74 0 . 350 26 FLOORS: Over Unconditioned Space 2446 19.0 116 BSMT: 8. 0 ' ht/6. 0 ' bg/2 .0 ' insul . 80 15 .0 12 HVAC EFFICIENCY: Furnace, 86. 0 AFUE ------------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans , specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Date Builder/Designer 4r i GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. Permit Applicant - Property address Map lin' �c��. A1, , b Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 ofthe Growth Management Bylaw.I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit.Further I understand that my interpretation ofthe exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building permit application and associated attachments,complies with one or more ofthe following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration or reconstruction of a dwelling in existence as ofthe effective date of this bylaw,provided that no additional residential unit is created ---1f The lot(s)was/were created prior to May 6,1996 and are exempt from the provisions of section 8.7 ofthe Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT ISG OUNDS FOR REFUSAL BY LDING DEPARTMENT TO ISSUE A BUILDING PERMIT. G , P ICANT S SIGNATURE \! DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT•APPLICATION Town of North AndoverNORTH ,y o ti Building Department r° 27 Charles Street North Andover Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 '-`°"'=''• �` S$ACHUSE i i i I DEBRIS DISPOSAL FORM i 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 a properly.licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: Facility location i Signature of Applicant Date i NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. I i I I i,. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . Boston, Mass. 02911 Workers'Compensation Insurance Affidavit 6 Please Print Name: Location: City Phone 0 am a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity �am an employer providing workers' compensation for my employees working on this job. Company name:-.Co I onkcxA U'i1ka-g, neo. Ccrp 068 - 19b)7)o'tr Qeo C:Dro Address1��ti�� I u;-n�,1~ e City: A),,) /,X- Phone#: (y a1- n Insurance Co. (- crec t ! m c'r•�`c'��� Policy# P C ( g I a S a a Company name: Address City: Phone* Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and Pena ' s of pe 'uqF� lthe irrlo ation provided above is true and correct. Signature — Date G Zt3 �J Print namePhone 7- Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is requked Building Dept p Licensing Board p Selectman's Office Contact person: Phone#: ❑ Health Department O Other FORM WORKMAN'S COMPENSATION I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 052241 Birthdate: 10/10/1952 Expires: 10/10/2001 Tr.no: 7876 Restricted To: 00 WILLIAM K BARRETT. 1049 TURNPIKE ST ( ......� i� N ANDOVER, MA 01845 Administrator ............. . ... - The .Commornvealth of Massachusetts C Department of Industrial Accidents Office of Investigations �c\ j Boston, glass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # aI am a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity U I am an employer providing workers' compensation for my employees working on this job. Company name: A, Address i L: y G r� ✓:- ` .� City: A;O r'-i n r�,• Ir'.� (��� Phone Insurance Co. C �� -_ I� /11�,�, c; Policv# Company name: Address City: Phone#' Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby cerrify under the/pain and penalties of perju a information provided above is true and ccrrect. Signature., -11=1 �i �� 'i ,,_.. G - Date_� ,�Qj__ Print name 1, (I a t ft Phone# (. J ;Z -.I Official use only do not write in this area to be completed by city or tcwn official' City or Town Permit/Licensing � ❑Check d Building Dept immediate response is required C3 Licensing Board C] Selectman's Office Contact perscn. Phone n Health Department O Other II ) REQUIREMENTS FOR BULDING PERMIT SIGNOFFS BY BOARD OF HEALTH To be filled out by the annlicant and submitted with tht- RililrNng Permit aPPhc= 1. What is the proposed project? Deck pool addition (new other 2. Are plans attached? Yes No (For additions and'new houses on septic systems, complete floor plans of proposed construction and any existing house must be submitted. For pools and decks, a site plan with location of pool or deck is required. Dimensions of deck are needed.) 3. Is municipal sewer available at this location? es ; No 4. If sewer is available and a house already exists, is it tied in to the sewer? Yes No 5• Is the location served by private well? Yes No 6. If this project is an addition and the house is served by a septic system, has there been a Title 5 inspection done recently on the septic system? Yes No 7. If,yes, is the inspection report on file at the 130H? Yes No A) I Town of North Andovero< NORT4 OFFICE OF 3? a`� e tiOOL COMMUNITY DEVELOPMENT AND SERVICES ° x 27 Charles Street �° ,>•' i North Andover;Massachusetts 01845 �9 =°•''thy WILLIAM J. SCOTT SSACHUS� Director (978)688-9531. Fax(978)688-9542 IIi CHIMNEY APPLICATION AND PERMIT DATE 3�0I', PERMIT # i LOCATION a Ike r i t CX v OWNER'S NAME BUILDER'S NAME g v►, 0. MASON'S NAME -T- MASON'S ADDRESS-- ` W e S+ 114 y er S+- �1 h MASON'S TELEPHONE (n 1 1,, - O!f i4.9 MATERIAL OF CHIMNEY t?) CLC INTERIOR CHIMNEY EXTERIOR CHIMNEY NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH a. Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: y e S s DATE SIGNATURE OF MASON .� - 4t,4-,, CONTR. LIC. # 05 ,/17 l EST. CONSTRUCTION COST/CON CT PRICE -54IOOb PERMIT GRANTED FEE ` i ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 N2 3855 Date ............ogwiaft .. ................. o TOWN OF NORTH ANDOVER t RECEIPT SSgCHU j This certifies that..... I &,k ............( ill t.' .........a- ............................................. has paid............. (z)() /...................................................... l® - �. for......t�' ,w)c-r .................C..ber i;w ....... ....... Received by.............................. Department.................. L C........wo ..... ........ ........... WHITE: Applicant CANARY:Department PINK:Treasurer 14 TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)685-0950 DIRECTOR Fax(978)688-9573 F AORTh 1 ��OSEO 1694 OL O I- A ' � QAarE De aYp"(J 9SSACMUSE� DRIVEWAY PERMIT a� DATE ?loco LOCATION �`� )�Ie�rj t W ,.q.O Q BUILDER phone OWNER �rG(re��( le- phone " 2 �U THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. � e526 APPLICATION FOR SEWER SERVICE CONNECTION o I c�' North Andover, Mass. Application by the undersigned is hereby made to connect with the town sewer main in �'�tt St, subject to the rules and regulations of the Division of Public Works. The premises are known as No. or subdivision lot no. t 1*4 f:�L bet,Vire-� 64? tq P 6� Owner Address Contractor Addr jo�m Applicant's Signature PERMIT TO CONNECT WITH SEWEER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at e� t t ��` 4e a Street subject to the rules and regulations of the Division of Public Works.. ision of Public Works By Inspected by Date See back for rules and regulations i 'No a 9 ; : . . � .:,` i 3;A"�' APPLIC , Na'FOR WA TER4SERVICEaCONNECTi'ON ` ` ° if t - O � ,, w' I#! t t � ar.a g 1-}f3rt'�{ #'� i'e. 'B ,.t'f�' � i f 'rc` , k -.se-"l`xla�S �n dh 'i�'! sI'll x"78 ^:i, �o E ¢x ' - `� t:i "#'i if � i 1 ,F,',x x tl,!zq x - fi Y t �.Ay t a a ss�,x; ' L.Northf Andover, Ma 1 Y pp tt s g e r v s; y F f 91t € v L i r a r"r xx z 1I 11! i�, �7% �F�t ��(� �� 1 ti r t om. A hcatlon b` the undersl npd is hereb made to connect vulth the'2own water main In subtect,to�the'rules and regulations of t-erU vislon�of Publie�Work's; s F 2n '` "�t r. �, ,w a ifT 4 f$fic in ' i S 3' Y'z 3 k�l Et?.V� :� '1� u �1 h' rt ` x 4 s"�,, ��':i ?mss �tx�Y,t¢ k�,, � , fhe p'.remises'::are knownr. a`s No11�,11 x" _r_ 6 C}�L ,` '' 11 � - Street z # ,,.1, e d '� 1.c?3 " ,,'. k W 0 ' fix:«I g t. ,`k, i I ,..{E�" ��# -2-t 3r.}# t>" � `"T ' '` k, k _11 or subdivision lot no : �` F ;;> 1 1� DG t x i rH 'i V.W ,(�`: '.7 t",:.Y/�+� (,,... e q`/r� j } _j, ;` t4t r LC '�E,}( .i?ft',sof 3 .�rq* � - r.J' .n� ,� 1 _:. If i �3..sz� Y�tl•rL'— ,,, W�` '� �1,f �x s' s `x' pG� +� l_.:; 4 �."'l. j f ax i [,4 6 1. x t OWnerry ri '#,. n-s �'. e a y ;5 ,+, a e r s w ^'�'2i (S ,z a y a '� .x 3 � r 11 r a } , y Address t l #. L e E E 11 - "." Y � _i ��}€ a,p sx }'^x5 ., �� "J tz �t x #, } 4 } ,. r �a lw � ,xR xv�€��V #a z i�' 's � - + 3 a-._t.Y x 4 1 r a-�{A i' .+. L .,-<' r. "'"€ 4r'q'A -, *.. 11' �, ,� Contractor � £ z fiI � � +€ ' s > kp§^�`.,I .1 ! % r, �?,r. �, j Add ss r b s.... .r# � ,, 4. 1. w .:J'ir K 4,s �.p _. i �tA egg zrr. t r Y µr°�# z.'{r w r �E� 'Ys a -s.+*.. _y ��M1 l l,rex vs z Y ,�I N 1 - fl+�.. .: .r i j� f §{ ?t3 1 e3 fix e # g_ $ jn z F_ � x7 (a r a� i ! ,` ° •x'' 's:� fipp.iv.°: " r,�•!d z.i�.� - ,�:,, F' r ,- °'`" Applicants Signature'. arf Ac n r .. w '� t 39 Sy,�t ' i r•.- ky k 6 e ,3 :r R , , o I 'Y�^�d'I["` re :r 3��,�t.y7 ,.a s. d � s t,. 7 .0 x l `; < , a a §g `1; k ,rY. #y .t 9 .Flx i x n r 1'r €# +� ,a Tr �" Y ..', f`�yt l `4-�.a t p $ J r i '• +) €.tq - ! `'` -_ P- a Y j I i ay ` t is �x e,tF x " r i t, '`}; e t r xt� = � 7, .s r :. �"y+ y 3 z !, -_. z 'i,a a }faS'"sl l C"` i',x:,} 1, o w7 w V + �' �%V I , A 'x€ i a , �r.� {``� � :1 a '.d �, t+ `a" � �g.. % # � .r«,'tt li -€k s x - s r a1°` ,. z rcr C ,, , r+w', tr e i t,s�, '.w t r1. f k xt k t Y �� r..; `t ;rr slh+'n-r r i' a� ,X' *a, . a $-.'a -,.S l�,s� 't.-: - . r 5 5 x„ „1. , i �,� 'F it rs !v ams �j { { � rF `J�f... r R. .. r ��.�!/ ,: . } ''r l h� y s ,� ,s.�t C. k " , a c v ,; M 5+ �� .�qg P Ili 1r `yy r A44 't -`.. 1-i p rtt. t war ! ,�.�, F A. i�,, ' r'r�'� �," a ���III n P s ar> x , � 7 e 1 w a* 'i s +' 1 4 t W k 1' �Y. .ql. 1'` t(': 1� I. -Y `. "4' " Y -�w$'-,,i ^3 1 ke f ke3 F `a. II$'"` d x ar�„r,r cx '_ , 's4er �. r t 4 A.}`., , :-' i .r A sd ar I s. , �'M t} n�,k { t' x s .. 11. I_ .! SY 1. e,r A.. jA.s. , ,ti.. �irs• _ r' �' �a- ¢ z x I $,f ,, "aa ,a v r, '�7 0= 'u 1"'Er;'.- s a ° - 9 ;3 ,dh -. �*' x S w. t A. „1 _ k S ,, y u v ! 1 asf 't rr �}.' sr s 4 r x, ,r ,t } + - a r '. If k�,�, r. �,re#r, s # .,.5x F .tee Sk y2: +� ta< . ' v }a x c i ` t rx > xr{ €; ! a ° iii * ' g "' k ^ y 1. s+es = c,;. x} :" x. .` ,}' 7 a.� ,s •Ya e A S p>i ° a,y 3 a r #` + t : r ryv'i s r . fi r ti x :_ :. ,."Al T Tx NNE A M ' . ERMI -CO CT.'WIT . W TER IN p ,- The Board o'f PubhcxWprks�hereby grants permission to ,- s��CZ�iI _,,w r� F M �, a t s ,�_. 3 a s zt aF �f S ` .., ` ` i``, - n t.,' T t i , i to make'a connection with the water main , a I- � 42 � � s '�I . �, 1. �.., ,{.• � Street h : sub�ect;to the"rules and regulailons of the Division of Public'Works. - 'r:: 1 . 3, a. � ,,� ,5�k A 11 4" � Board of P' lic Works k ,, 4 `` ' , . " °. r � By e`/f � ,:t r s Inspected,by 4 F ',.Date t 1 F. {� A __P L } ,' . Fy, L .k 5 .. k �, 2 - I 'f I See back for rules and regulations i. ... 1 a.. :q . . _ I :% - 4:} � d r �. - y c ., - '1. .., - - ..? . ,.:: ::.r. :,:.. _ e, _ _ - - .- ." .,..KLA,.. 1,L .., - r 1. -. 1, ! _ _ F.. - NORTH Town of Andover 0 No. i i - 1 / C, �C O over, Mass., 09& 010 3 - COC MIC ME WICK V ADRATE D P �Cy S 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....Ah.b.o '.. ................ �.�..........Copp. ... N��..... Foundation has permission to erect................. ................... buildings on of.. ... .. iti K.�e....WA Rough to be occupied as19.rM. Q 1..a*jr...T54 1...01... 0 oil. . C ' ....��.... ...FAM• Chimney provided that the person accepting this permit shall in every respect conform to the terms of the tip !cation on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M as Pa so PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STAR ELECTRICAL INSPECTOR Rough ............. ........ .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town o �- 10 n over 0 No. 41L T ndover, Mass., . 0 CPO 0 CAKE COC E *1. 0 HEWICK 0RATED PR C) SSAC HUS FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ....Alip ...... V' .............................................................. has permission to excavate and pour foundation at .1 ...C/ I Y 10 1A 0 k PAL ...............................................I...................... .... 1. for the purpose of Lrom.A.5'..exTh'A' b.. 11....ATI .6.4.....$4.1...?.....Rq The person accepting this permit must return to the office of the Building Inspector a cerfiffled plot plan show of building thereon before Foundation will be inspected. M3 (a Ob 4X a 0 VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. .............. BUILDING INSPECTOR i f I I I I i I II !, II , II I II li II I II II i II II ! ' II II II cn ,r -- - � 4 IJ -- -- -_--- j m -r I rnrn I I j LZl� 8 O I IHIM 211111d IL L II IEEE] 11 m II � PM: 9fff: II II II II II I II II _ II II II II II II II II II I I -- I I --- II II II II i II II I I I I I WILL 1 ,41-1 E3,4f;z,: fiRETT PEfRlWINKLE UJ Oat - g v8° ,-ra° 1/,2<=!�i�� n�WN[3Y, K�VISIONS; BUILDEIR OF FINE HOMES 9 HCCr111LC• FRONT ELEVATION • SII i I I I I i I I II II II I II (-I no II Om t. II II - _mo II I I II II II - II ii II - � II -m O II II II II II II I II I II II I, II II II I I ® Lo II E. - I � II I I I I I i I I i �I I W I L L 1 ,4 I wolcffllLF: PERIWINKLEWAY PACE SCAI.�; SUILDER or- SIN NOM�� LOT- 9 ,�8 = I -� �1�29�Ot s►r��T. SN��T TI1L�: [?PAWN PY; REAR ELEVATIONws1oNs: _ I i I ` I I I I i i I I jl i I I I i i II I I I I I I I I I I I I I j I I I I I I I I I I I I I I I j I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I I I I I j I I �lJ I I I i I rn I I I I f T1T I I � m I I I JillJill 0 I I I I _- " -f II II I I I I i I O I I I I II I II IIW.0 �I II II II ' II II i Il II II II IIoilNoIV / - II - II -I- - - --- I I I I I i I I I I I I I i I it I WILI PPOJECT T111 E: SCALA: 12AT: 5 fEf: LIAM E34RRE TT PERIWINKLE WAY LOT - 9 1/S"=1'-m' 1/29/01 D�WNt3Y: BUILDER OF FINE HOMES 5frT11TI.f;: RIGHT ELEVATION __ I i" I I I i it I I j i I i i I 1 _-NaI-I i 11111 Hill ca II II I I II II II II I I — II j II II II ' I I I ( II 0 I I o z I I I I II I I I I I I I � II II II I I II II I I I I I i II II I I ' IJ I I I i I i I i I ( I l E �o.�cr�ri�: PAT: WI I.I, IAM f�Al�l���i"ll" I'FplWNKI WAY OT- 9 �/8�'=�'-011 1129101 OF FINF— HOMVPMVMPY: PLV19ON5: LEFT UMON i I. j I , • 59'-a' � V ',0.. 0.. 12'-0 1 ------------ NECKAPOVE o ------- - `� 21'X 12' (� _ rn u t O 6"x b"z 2"Gp - z -------- -------------------------------- Pew Pkt --- :�AO a � l4" 1 -- — - -F1ush. �,ed L�,/L-Geam - -- ---- - - -- �-- ------ ----- ----- 10"CONCP%TE vv,K,./ 6-0"POUF<+/ ) - 10"VP X P-6"VV CONT.FOTING O = -- 0 cc 3-2 x 12 [61 Fr - 2, T_0„ 6' 6" b' b" b'-O" 6-0, I PK' ------ O GEAJ,PKT --------------- _ 31/2"nIA.LAI LYCOi„ o VO 30"52,X12"PPF001% ---------- -------'- - W/2 5 GABS EACH WAY 42 X 12 ---- - GUILfdP GEN 4 _-- GEAA1 PKf _ 4 i ----- 42X12 e �I _ --- �-- GUILf-LF MAM ------------- Cal -- _ ----I -- ---------- ----- 5 -5" L------- y-' v CO��C�fE FII.I.EC7 G:�I. \ = o FOD11NG5 FOP 5TE?5:-50vy --' m zz -------- FOUNPAION PLAN T — --------- 0 5ch.Eiia ----------- V i j I 1 I I i O r) N - --- o WnAMOV ft O o 77 O p O I - I -O"C.O. >'-O"C.O. 0 . I - CU U 1 I I NN� I = b .4 9-.Z -61 II II I O_ Ni- � b II II � b rn _ II rn ,II ..o-.9 II � \ b 71 ---------------L II 9-1 b — I lol I N I b (31 o I I II _ - I I II Q i - I 0'.6 I 9 It 0-.OZ f _C— O Molcr ME: 5C&F: WI 1,L_ IAM 13AI�I���fi PFrIWiNU WAY Of- 9 1/8''-I'-0'' 19ATE: 1128101 �r: 13UIL-[2F-I? OF FINF- HOMF-S 9T-rf 11L�: MVVwPY: FIt?5T FLOOr PLAN I I I.-Oil 3'-b,. 3'-p.. b'-0�� I b,_p„ O2"xbii b � z o h I 3' .O /°' i I FA:,LY ROOM _ 9' 9 15' 11 1/2" "Moo 13�1!Xoom #4 N W W " PEROOM 2 d r AMCQN ACCE55 O O a - ° - ---- FLLISNf3,'-AMAL3 OV� ----- I \ a O � WALK-IN N-------- m N OPEN t0 FO`EI? PMSTEt? - �EXOOM ! '� PEROOM #3 ------ ---------- b O I51tT M6 room - v C3 FLU5H CREAM ------- -- -------- -- - - - —- --- --- - ----- ---- - I/2'NALL M.3A- b 4272 N 0 5ECONP FL000 PLAN Z 2'-6"2'-O' S'-O" '-O" 5,-b.. b'-0.. b�,p�� 9'-0.. 9.,p.. 1L. 2-7'-0" 12'-0" 2X IO At 16" O.C. 2xIOPf Peck Jal @ 16" O.c, 13-I /,q" x 19" CD N . flush gamed \ — J L L L L J L J l J L J L J L J L J L J r�rrr�r�rrrrr�r�r�n r n 11 IDLING CC) } \ n Q r � z IDLING � O z o >r » - — o � n � S z FII?5T FLOOI? FLAMING PLAN �- Q � i i r I I i i i I I I I I I n I C) O X X -- 7C5 I I r I o�0O `a N W I _- .- -J I I � _ I �I Q pp 21V4" 9112" -7 k/ 7 AE/ ------------ CD-7N -0 o� I I 1 i I I I I I I I WI I, IAM SCALAPATE: 5f F1: WW I/29/of 13UUPF-P, OF FINF- HOMF-5 s1 Crnn�; n�AwNaY: i A-9 PIr?51'PI.00P PLAN I I � I i I ' I I I I I I I I j I i i I I i i I I I I I i j I I � � i I --- - - I r�—'7:777777777-7N I = 0 �N n- I N cR y I - - -- I I I I I I I I I I 1 o � � z � Q d � I I I i Pwlcr 11TU: sc��: nnr� WIL IAM r3 p�TT MkIWINK.E WAY Loo- 9 ve al'-0„ 1129101 sFar: [3UIL1��12 Oi" �IN� HOMF—S Crrin�; Arl1C FMM�NCA PLM nPn4vr�r�Y; vlsloNs: Ar�O I - I -------------- o D O r -p rn � B � b z i I � I i I i I I � I r I I` W I L. L. ( AM B,4RP�E TT PERIWINKLE WAY LOT-9 5CA-E 1/21 /Vol ;N��t t111�: MWN PY: — BUILIDER OF FINE NOMES ROOF FRAMING PLAN I I i j I i I, I �I I I I i 41 Oo Cly - r m i � I i — I I i\ � F � � N Q I � I I I i j I j rPOJrCrnnF: WIL-L- IAM �Al�l���f"rt" AeriWimv_1e �� 9 scnie: nnr�: �r: 17176100 Or- FINE HOMF-S sra Cr nn c: 13UII.I2ING 5FCT10N '^'�`��Y: vis�oNs: /� 12I N° 2664 Date..... f �10RT11 1 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SS�CMUSEt This certifies that .......7-k!ev.......!.1.�`�.'°`f ..../.�1... G...................... has permission to perform lv� w �f v�?/I C .......................... . ................................................ t wiring intheb—uilding of......... .y�j..f..P. ......... ............................. _ q�.., ... 1°/1 �`/,h l` ...�a�._ (North Andover, !lug' F'e3.. ,.��Lic.No.�" . G'/�..D........ r r� ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer THE00iWONWF.4UTIOFI�IAMCFIU E77 Office u my DEPARTNIENT0FPUBLICS4FE1'Y Permit No. BOARD OFMEPREVEMONPSGMTIOAS527CMR 12*0 Occupancy&Fees Checked RAPPUCATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat (� Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical wor64scribed below. Location(Street&Number) 4Dr-1— ` 1)111,; _ � ������.(�/�C /�1-1 Owner or Tenant w I VOW>+7 .�u i_�r if,4 M fXT— Owner's Address 67 (/.0_w d ap L �q Is this permit in conjunction with a building permit: Yes® No a (Check Appropriate Box) Purpose of Building ,It A/GGi- 61M/LSA �GU�GL1 AJ6 Utility Authorization No607gliq Existing Service Amps / Volts Overhead E3 Underground No.of Meters New Service 0,) Amps / / V( Volts Overhead r7 Underground No.of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work �':T til7ftcc 1',(Jl,(IAb h11...l A ,, J/Ax6Iloif 10,0, No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA N¢.of Lighting Fixtures Swimming Pool Above Below Generators KVA _ ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No,of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections INo.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER Ir>StrnroeCov�age R�tprttbtheragt rrartsafTvlas d GaiaalLam Iha%eacumrtLiability bwaxePoliyffddmgComplete Caaageaits sutm>trale4ivala# YES F NO ❑I I haw ahnittadvalidptoofofsarretDftOffi=YES FJ NO M If} uhawdtac WYES,pkmird'r*th NxofwvwWbydtadmlgthe WS[1RAN x F—1 BOND oTHR F-1 (PkaseSpeffy) Expi�Dr►Date E0rgkdVahr dHedncal Work$ Wotk6DStxt hWaciicnD*Ra4xsted Ra# Fatal Signed underlie Penalties ofperjtay. FIRM NAME {z�L1/tJ I [,g i t y £6 772 lG Lic seNa L=isee 1 rk tP tq) 1' 1) f{%� -- Sigriatute Lioa�seNo 1" t BtsimTdNa � l Aa)oL co>-r Rbtu ��f�PVL� AILTdtsh L-2 2 _ OWNER'SiNSURANCEWAIV ;Ia+nawar dut cLkmdmtd theie wmx a-9s loWwala>tasregtmWbyMm tCs(a l[aws andthatmysigt�tuernlhisptm� wai�esthisreguaemad. � (Please check one) Owner M Agent F7 /J Telephone No. PERMIT FEE$ k' " Date... �.�........... tORTM 1 ° t"'° '• "° TOWN OF NORTH ANDOVER PERMIT FOR WIRING SA US y I� This certifies that . ... Y U l 44�'............ .................... has permission to perform ... jj��� 1� �.............................................. wiring in the building of.................. /K! ........................................ at............ ..... ! � ... jY...... ,North Andover,Mass. 6 r� Fce_....n.. "'... Lic.No.333 7 ......... �1 . . ......... �ELEMIC INSPECTOR Check # 8454 �. Commonwealth of Massachusetts official Use only 19 Department of Fire Services Permit No, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked — [Rev.1/07J (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 ININK OR TYPE ALL INFORMATION) Date: j� 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) 2 f ✓1 l�el�, ( t� .t,I Owner or Tenant os Telephone h one No. Owner's Address a Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters _ New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: completion of the followin table may be ivaived b the Inspector o Wires. No.of Recessed Luminaires -2d No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVI, No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,i No.of Luminaires 7,— Swimming Pool Above ❑ In- o.o mergency ig g P-rnd. rnd. ❑ BattM 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 Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: _............_._........................._. ........... ....... Detection/Alerting Devices No.of Dishwashers Space/Area Heatin KW Municipal g Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or E uival�-nt No.of No.of Heaters I signs Ballasts . DatNo of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalcnt OTHER: Attach additional detail if desired,or as required by the Inspect or of Wires. 1 Estimated Value of Electrics Work: (When required by municipal policy.) Work to Start: //!3- d Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless ess waived by the owner,noermit for the p performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"covers or its substantial a uivaleat. The undersigned certifies that such cov ge is m force,and has exhibited proof of same to ermit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Spec' :) I certify,under the pains and penalties of perjury,that the informa 'o on is ati on is true and complete. FIRM NAME: ` LIC.NO.: Licensee: JV G 1/ Signature LIC.NO.: 4,3 ,�� (If applicable, enter-exemat'IV the license mber linoJ Bus.Tel.No.: Address: �� <. kAJ e, j Z7 1�i 2 3 Alt.Tel.No.:–/-7F-', = *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 ❑owne:•'s agent. Owner/Agent -� Signature Telephone No. PERMIT FEE:$ F J Imo`^ L . The Commonwealth of Massachusetts ka ! Department of Industrial Accidents Office of Investigations 600 Washington Street � Boston, MA 02111. www.mass.gov/dia . Workers' Compensation Insurance Affidavit.- Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeQibl Name (Business/Qrganiza6on/individual): Address: City/State/Zip: Phone#: . �� Are you an employer?Check the appropriate box: Type of project(required): 1.[] am a employer with 4. ❑ I am a general contractor and I 6 Nev,construction 1 employees(full and/or part-time).* have hired the sub-contractors 214 I am a.sole proprietor or partner- listed an the attached sheet t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition working for mein any capacity, workers' comp.insurance. 9 Building addition [No workers'comp. insurance 5A7 We are a corporation and its required.] officers have exercised their 10.F7 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LED Plumbing repairs or additions myself.[No•workers'comp. c. 1.52, §1(4),and we have no 12.E] Roof repair; insurance required.]t employees. [No workers' comp. insurance required.] 13.[].Other "Any applicant that checks boz#l must also fill out the section below showing their workers'bompensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding:workerscompensation insuranceformy employees. Belo information. w is the policy and job.site 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 Section 25A of GL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.04ancd/ neyear impri ent,as we civil penalties in the form of a STOP WORK ORDER and a fine of up to$25, a st the viola a advis ata copy of this statement may be forwarded to the Office of investigations of thins v rage of n. 1 I do herebyce fy u /r r ns p s e y that the information provided above is true and correct. Signature: / Date: Phare Official use only. Do not write in this area,to be completed by city or town 01 aL City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Departmeut 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 employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of 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 theforegoing 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 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-contractor(s)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 workerscompensation 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 for 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,notthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation 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 ofthe 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 Tel.#617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia Date- . . . . .G". . `. . z 4 .0 PT:�� TOWN OF NORTH ANDOVER . o PERMIT FOR PLUMBING '4 '°,,r,°.•x'`15 ,SSAcwUSE� This certifies that !. . . . . . . . . . . . . . . . . has permission to perform.. ."``. . . . . . . . . . . . . . . . . plumbing in'the buildings of "'O. . . . . . . . . . . . . . . at c-. � . ' .. . . . . . . . . . . .. North Andover, Mass. U ;; Fee:/ .-. . ". .Lic. No.. �. . . �;_._.. . PL'�-�-:!�'14 fi ~.,. . . . . . . . . . . . /G 3y v L NSPECTOR Check # 7912 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) . ,Mass. Date 20 Permit# Building Location ��- lc�W"�� ``t Owner's Name P l'c.;2k (M 6, Owner Tel# Type of Occupancy. New 0,,-' Renovation ❑ Replacement .❑ Plan Submitted: Yes ❑ No ❑ FIXTURES z V) z H �, o z ¢ W x x N 0 z z z H o wLO y v w �, o a 3 x Z H F w ¢ A Q tx F z. Q A a w Iv H U > H O = a a `n E~ z O O v, z H O U x !� Q F 3 w o a 3 x' H in w t7 a Q S a o SUB-BSMT BASEMENT , I ls`FLOOR 2ND FLOOR 3"D FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR iL I.F7T"FLOOR TM Installing Company Name 4 fin_ A zl; Check one: Certificate Address (9 /J x � ❑Corporation Cl Partnership Business Telephone# V —0 7 V3 ❑Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: I have a current liabbi't insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 01"' No ❑ If you have checked Les,please indicate the type coverage by checking the appropriate box. A liability insurance policy 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. Goneral Laws,and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this ap lication will be in compliance with all, pertinent provisions of the Massachusetts.State Plumbing Code and Chapter 142 of the Ge eral La By Signature— Lt erased Plumber Title / Type of License:Master Journeyman ❑ City/Town APPROVED(OFFICE USE ONLY) License Number C� i Town of US r. NORTH ANDOVER �rs,cC BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: ��-S�C-l'�i�/�11�/ —IW09&0 DATE: UNIT NO.: FLOOR: WING: BUILDING NO.: a 0 9' / REMARKS: Excavation-depth and soil conditions Framing- Other: Date: — ©'- Date: y 1(:9'—C-' Date: Inspector//�� �`"" Inspector_xmW Inspector Footings and foundations and drains- Insulation- Other: Date: Date: ' © Date: Inspector /a� `' Inspector 12' Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: &—`/ 0 Date: o / Date: Inspector Inspector Inspector JdV Electrical-final Plumbing and/or gas-final Other: Date: Date: C9 `� Date: Inspector Inspector Inspector Fire Dept- oil burner,tank,stove,smoke detectors Final inspection Certificitte of Use and Occupancy Date: 8`� —D� Date: l C of O M Inspector Inspector za'k � Inspe for Form#995 Action Press,685-700 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number V Date (♦3/�aeao/ THIS CERTIFIES THAT THE BUILDING LOCATED ON �l �� MAY BE OCCUPIED AS N q � � —IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDINGCODE A SJUCR OTHER REGULATIONS AS MAYAPPLY. 7 Amo*S/ °7`'S HiQ i.75 ORTNCATE ISSUED TO l`/�/D P 114 e CERTIFICATE a .;2 96 6 OL 'I .' '* - � y p ADDRESS 71 IAnY 9SSACNIJy�t Building Inspector Town o. 4Andover J , V" No. X _ _ y / 31 �► 00 T �O _+__- LA O � dower, Mass. COCMICMEWICK 1 1 ADRATED o`? 5 S BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....Ahbo70 • .� v o P PERMIT .. ....................................... Foundation 3f. has permission to erect................. ................... buildings on j►� .. ... .... ..,.....�`1W�N�I� ��� J Rough1�24�( � _ 6 / .-C- to be occupied as .rQO 1..44...B.A ./... .. Oil...I I AC6A....Si.... ...FAM, I� c im111 provided that the person accepting this permit shall in every respect conform to the terms of the ap !cation on file in Final - / this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 0) a 8 pa 90 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Foha PERMIT EXPIRES IN 6 MONTHS 1� , ELECTITIC E UNLESS CONSTRUCTION STAR C ........... ....... ......�........... .................... ........................... Se / BUILDING INSPECTOR Fi Occupancy Permit Required to Occupy Building GAS INSPE TOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough i al No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North AndoverNORT1� 0�11► 0 Building Department 27 Charles Street o — North Andover, Massachusetts 01845 * '� (978) 688-9545 Fax (978) 688-9542 �•7 gO�n1TlD PPP,y(� SSACHUS�� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION i , ADDRESS 1"n r i -)i n V Z f,�.�o..�t LOT NUMBER Q SUBDIVISION h bo j DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING.DATE IS REQUIRED i ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLIC LE CODES. i SIGNATURE OFFICIAL USE ONLY II I ROUTING j CONSERVATION DATE i PLANNING 6 DATE � l G D.P.W. -WATER TER 0IZ- DATE (-VS FI?2Z—Q1 a( D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR INSPECTION REQUEST DATE. SIGNATURE/DAvAjTHoRffXTh6N i' N° 3108 Date...... !r. ............ NORTI{ "° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SAcHUS� This certifies that ..........l...t ►� 3..... � � Y2 t�!...................................... has permission to perform ....... ...... .......... .. .............................. wiring in the building of .P. ll at.. ... .� ...1.................�4 :: ........ orth Andover,.Mas S. Fee. ` . ...d........ Lic.No. ................ '' .SPE. .../, ...... LECTRICAL INSPECCOR Check # 7-3 WHITE:Applicant CANARY: Building Dept. PINK:Treasurer "�'�'� ItlCW1Yl1Y1V1Vi►"GHLlITVL'IYlf�.71,�C.LIUJClIJ ulll{:e USC ON DEPARTMENTOFPUBLICSAFETY Permit No. BOARD 0FFIREPREVEN170NRWMTI0A SR7CMR 120 �—"-'— Occupancy&Fees Checked UVPPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Data/,4 Town of North Andover To the In p or of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) .! PW w Wf t144--f J Owner or Tenant 4 -� Owner's Address `T-611 N,0i K t A Is this permit in conjunction with a building permit: Yes 0 No (Check Appropriate Box) Purpose of Building �f jV b LL 'tiM I LV �LuS i (,r tib Utility Authorization No. Existing Service Amps / volts Overhead r7 Underground Q No.of Meters New Service 16-6 Ampsa1J°.Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work' '�n/7't&,i i e Q 1 A,(n FQ1I�f T:AA4 i L4 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total K VA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of 9eceptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of v Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP ti OTHER hISIMXCCo�%YMtbthete"anat$c dhn&GmaWLam Iha%eaaalafLmbtldyhm =PcbcymdudigCm#Ate Co�cr9sak ttdapvalrt YES ® NO Iha%estbngcdmMprmf'ofsamiotheOfce.YES L2 NO r if mtmedteckedYFS,plme tttetypeo£oe'�bydakigthe II�IRANCE BOND 01HER (P>easeSpactfy) FsKm&d ValuedUecftxal Wade$ WakbStatt hWeMmD*Ragt>emtad Rough Final Sued utxJa$ie P�tltjes ofpajtay. FIRMNAME M vy I Lr,?fc L;cemee ��c,/y1 e P 6/7 71 y"ISigr� Lioa>seNo i J`5p�D-) Al BtsxssTdNo. L v ' t/I N AIt.TeLN6. —�7- '6 7 2"47 OWNER'Sl?,SU NCE WAIVER,IanawateflAd U=wdt�es_ notmelt theitarratao7magpa irssthlartiale: wiagasm#WbyNtGanal Laws and that my sgt>�aem dtis permit aPp)i�ott wain�tac�srterd. (Please check one) Owner Agent a Telephone No. PERMIT FEE$ 3 �� 60 Location or-J? No. S C Date /U-/3'Uy ,.ORTN TOWN OF NORTH ANDOVER 3 ' _ 0 F A ` • Certificate of Occupancy $ i � '�s'�•°•E<� Building/Frame Permit Fee $ Mus Foundation Permit Fee $ _ Other Permit Fee Ft4ce $ Q. TOTAL $ Check # I 14 ' 6 Building Inspector Town of North Andover0 AORTN { ,ti OFFICE OF 0 2 o OOT COMMUNITY DEVELOPMENT AND SERVICES H A 27 Charles Street :1 North Andover,Massachusetts 01845 �9SsacH 00, WMLL,kM, J. SCOTT Director (978)688-9531 Fax(978)688-9542 II �a - - i CHIMNEY APPLICATION AND PERMIT 1 DATE /0 f do PERMIT # C. 17),15 LOCATIONa a e V + � rl 1)�1 e wnXv OWNER'S NAME (-� b b �} ey e ( o✓�m erg`I- C d o `� BUILDER'S NAME MASON'S NAME MASON'S ADDRESS-149 W e- S+- Ay�er s' - fy ,e �y rj MASON'S TELEPHONE (,O !R MATERIAL OF CHIMNEY C(� INTERIOR CHIMNEY EXTERIOR CHIMNEY NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH I a. Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: y CS DATE s SIGNATURE OF MASON ;v CONTR. LIC. # 05a a y i � EST. CONSTRUCTION COST/t�O/NgCT PRICE �L/pQfj I PERMIT GRANTED FEE ROBERT NICETTA, BUILDING INSPECTOR i INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEAL'T'H 688-9540 PLANNING 688-9535