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HomeMy WebLinkAboutMiscellaneous - 222 BRIDGES LANE 4/30/2018 (2) / 222 BRIDGES LANE 210/104.D-0087-0000.0 a 1< 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 ofongoing construction activity,and may be.deemed.by thelnspector-of_Wires abandoned.and-invalidlflre—__. ._ 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. ❑ 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 i puipose 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. Xuje 8—Permit/Date Closed: ��- /' *'k*Note:Reapply for new perm'• 0 Permit Extension Act—Permit/Date Closed: Date....... ,&ORTN 0 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING A mU ............ This certifies that .......e;iit:::LVtr...........AL......................................... 0' has permission to perform ..C:7j" ..................................... wiiing in the building ...................................... .. ....North Andover,Mass. dt� o'- Fee .............. Lic.No. ............ "A -PLZII� Check # 93 <tS e/ �j Official Use Only C'ommonweaR olcc/ am"Lelti a(Je arEment o `77/lire�ervicea Permit No. i� P 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 INFORMATION) Date: el l�110 City or Town of: ' t9-1 l�jex 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) 9," IBJ'gt'a ,&j la ', e Owner or Tenant R05t 04 a 11 nag cokray Telephone Nod r-a—f'G-alj/p Owner's Address �y Is this permit in conjunction with a building permit? Yes ❑ No U (Check Appropriate Box) Purpose of Building 4111:4 9 Utility Authorization No. Existing Service doo Amps //10 / 4 & Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W t A t;,j 2 t�5 41t Ce -*4 S Completion of the followingtable M be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeilSusp.(Paddle)Fans No.of Total : Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires 41 Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets 3 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. ons TotNo.of Alerting Devices No.of Waste Dis posers Heat Pump Number Tons J.KW- No.of Self-Contained P Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other P g Connection No.of Dryers Heating Appliances KW Security ystems: rY 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 Tel No of Equivalent No.of Devices or E uivalent OTHER: Com?, rA✓) L t 3hT LJN r'T S Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electr'caI Work: /Q co,00 (When required by municipal policy.) Work to Start: f/-.7 0 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 cover a is in force,and has exhibited proof of same to the permit issuing o e. / CHECK ONE: INSURANCE YBOND F] OTHER F1 (Specify:)(j.Pp4/p/ T iT'IO�GYK s/ I certify,under the pains and penalties of perjury,that the information on this application is true and co lett^ FIRM NAME: 136PItilve A"c- LIC.NO.: / S-7 Licensee: 1411 C6ta-e/ C Signature LIC.NO.: �• \ (If applicable, �erepItL"in�f l�liVcen7te number line.) T Bus.Tel.No.: - Address: s0 t. e. o. �•� *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 squired by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. ;Goner/Agent PERMIT FEE: $ /signature Telephone No. DD,, j Official Use Only (/�ommoruvealth of Maodaclwelb cc� Permit No. �%�6 1 c� 4L Jevartment o/Sire Seruieed Occupancy and Fee Checked • : i 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)V,57 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �I City or Town of: 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) g2a? /3/t r'01q -,3 104 N 'C Owner or Tenant , 05-e a,I?y ncadenao Telephone NoWpl-a' '6-alj/p Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No L!J (Check Appropriate Box) Purpose of Building Dell kl i Utility Authorization No. Existing Service :;2j20. Amps /0 / d,40 Volts Overhead [Er 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: Gtr 2 t�5Cc,4`,6WJv" S Completion of the followingtable maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: r Susp.(Paddle)Fans o Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA hove In- o.of Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units r No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating.Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Dis osers eat Pump Num ,er ons o.of a f-Contamed P Totals:I Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ umctpal ❑ Other P g Connection No.of Dryer Heating Appliances kW Security Systems:* ry No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDeviesor Equivalent No.of Devices or E uivalent OTHER: CP) FGA Ltg�iT UNr'TS Attach additional detail if desired,or as required by the Inspector of Wires. 1 Estimated Value of Electr'cal Work: /&160. 00 (When required by municipal policy.) Work to Start: D 0 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 cover a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:)(5,ewo/6l' T I certify,under the pains and penalties ofperjury,that the information on this application is true and co lete FIRM NAME: 01 LIC.NO.: Licensee: /V1 r C A A,°s/ Signature LIC:NO.: (If applicable,per "ex pt"to �e license,�,,njy'�mber line.) Bus.Tel.No.: I� Address: ttAOL "G sT /��t�Iy�K-4 Alt.Tel. *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 agent. Owner/AgentZY PERMIT FEE: $ Signature Telephone No. i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations tj 600 Washington Street P Boston,MA 02111 . `+ www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /0/v / [,� Please Print Lepiblv Maine (Business/Organization/Individual): /10/] / /vL' F1 CC Address: AO IL Al O0 ),Mlcy w( -I JI City/State/Zip: tVe Phone#: V a APi"aim! a oan employer? Check the appropriate box: Type of project(required): 1. employer with_ 4. ❑ I am a general contractor and I employees (full and/or part-time). * have hired the sub-contractors 6 El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, �-Demolition working for me in any capacity. employees and have workers' 9. E] Building addition [No workers' comp.insurance comp.insurance. 5. [] We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 11. Plumbing repairs or additions 3.El I am�a homeowner doing all work. g p ' myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Horleowners 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. X am an employer that is providing worlrets'compensation insurance far my employees. Below is the policy and job site information. Insurance Company Name: N / Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 949v2- /.31?/'&jI Z'3 IC-,i H to City/State/Zip: /(J . /9`1 t7✓Cl/t°A 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Invdstigations of the DIA for insurance coverage verification. I da hereby certify under the pains and penalties of perjury that the information provided above is it a and correct. ' Date: Signature- Phone Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Date. °f,H`°°TM,tiO TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ♦ � a • o� a ,SSACMUSE� This certifies that . . !�r. �. . . . �.. �. r. . . . . . . . . . . . . . has permission to perform . . . . . ..`. .`. . . . . . . . . . . . . . plumbing in the buildings of . . .C:.0.c`. P '/1 .... . . . . . . . . . . . . . . at . . . . lam. . . . . . . . . . ., North Andover, Mass. c Fee. 5'�- Lie. No..'5..31. z". . . . . . . . .!�►_. . . -,.: ` PLUMBING INSPECTOR Check # l ld �t 8567 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: M •CLy\AuGr , MA. Date: Permit# i�I^G 7 r Building Location: 222 irA4 -s Lahs- Owners Name: G OLDca r2Q_LL Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential g New: ❑ Alteration: ❑ Renovation: © Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES z z N 0 Y V W J 2 H W N J V W z a z �- z z Q Q W z z 3 y = U) 9 a W I— W Z c~n Y 0 a x W W a g a z W R 9 W z w y z 0 a rL w V 0 N V z Q � c. Y z c= W w a m m o o u. i Y _1LL W °� ai n 3 0 SUB BSMT. BASEMENT PT FLOOR 2 WFLOOR 3 FLOOR 4 TH FLOOR 5 FLOOR 6 -FLOOR 7 FLOOR 8 TH FLOOR ' # Installing Company Name: B.F. Murphy Plumbing & Heating Inc. Check One Only Certificate ®Corporation 2903C Address: 72 Holten Street City/Town: Danvers state: MA ❑ Partnership Business Tel: 978-774-3174 Fax: 978-774-8709 ❑ Firm/Company Name of Licensed Plumber: Brian F. Murphy INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes g No❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy EA 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's 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 Knowledge 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. By Type of License: - Title F'1 Plumber Signature of Licensfid Plu r Citylrown ® Master APPROVED OFFICE USE ONLY [:]journeymanLicense Number: 9325 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street k9 Boston,Mass. 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): I.C- fbu f hU 5 I'MkIna a �f-dJL ' (nc 1 Address: 12al-itvn . City/State/Zip: 1`�Inytf S• M A N92.1 Phone#: C1I1k'114- '311 L(- Are you an employer?Check the appropriate box: Type of project(required): 1. fid'I am an employer with 3 4. ❑ I am a general contractor and I 6.❑New construction employees(full and/or part time).* have hired the sub-contractors ?. ❑Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached'sheet. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.# required] 5.0 We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work officers have exercised their 11. 5(Plumbing repairs or additions F myself [No workers'comp. right of exemption perm MGL insurance required]t c.152,§ 1(4),and we have no 12. ❑ Roof repairs employees.[no workers' 13. ❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that Is providing workers'compensation insurance for my employees.Below Is the policy and job site information. Insurance Comp any Name: Li llL Dec-- Lin (hC.• Policy#or Self-ins.Lic.#: CIL-A-5G1D1aDFS Expiration Date: L©I Job Site Address: --ZZ ,ZA"a Lqr�a City/State/Zip: M•QRAMx . MA b1$4.5 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 MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify Zunder the pains and penalties of perjury that the information provided above is true and correct. Si ature Date: / Print NamePhone#: ZZY- 3 Oficial use only Do not write in this area to be completed by city or town official City or Town: Permittlicense#: Issuing Authority(circle one): 1.11oard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: i Date. . � . . .l a. . �... HpRTM Of .ao ti0 aj °� TOWN OF NORTH ANDOVER PowN A • PERMIT FOR GAS INSTALLATION SSACHustt This certifies that . . ! . :. .`.'. . . . . . . . . . .:�f y has permission for gas installation :. . 'r1 Q. . .! '. . . . . . . . . . . in the buildings of . . . .��. ` L: �, -�u-r.�. . . . . . . . . . . at : . '. . . . - North Andover, Mass. pt ?1 Fee.��. . . . . Lic. No.. . . . . . . . . . 1: rr. �-'. . . . . . . . . GAS INSPECtOR � G Check# f- 4. 565 Massachusetts Uniform Application For Permit to do Gasfitting (print or type) / �J• An4llel-M ass ach usetts Date: %—/D 20o3 At: Location: ;t ri ' V Permit Owner: (sbUdleaa- �Type of Occupancy: 1 New Renovation ❑ Replacement ❑ V Plans Submitted Yes ❑ � No 9,/ (' 0 U m E ` 01 y a) a: °� m n > 0 a) o c m ami a °3 d O o d> V = y .. a> t_ tY 2 O = u_ o 0 3 U > 6 o° H O Sub-Bsmt Basement 15.floor 2 floor 3 -floor- 4 floor 5 floor ' 6 floor 7 floor 8 floor (Print or Type) Check one Cert.# ff < Installing Company Name:_ ► ( ems t�� /iJC Corporation C� Address: l � 6y�c/ro7 1 QST. ❑ Partnership City/ State/Zip: V4 ot &U ❑ Firm/Company. Business Tel. #: - F,9 PRINT Name of Licensed'Plumber: Insurance Coverage: I have current liability insurance policyyoor its substantial equivalent,which meets the requirements of M.G.L.Ch.142. Yes 2 No ❑ i If you have checked,yes_,please indicate the type of coverage by checking the appropriate box. y 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. General Laws Check One Signature of Owner or Owner's Agent Owner❑ 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 Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts-State Gas Code and Chapter 142 of the General Laws. By Type License Title ❑ Plumber Signature of licensed plumber/,gasfitter City/Town ❑ Gasfitter Approved ❑ Master �4L5 0 Journeyman License Number Location No. I Date - /c,- HORTM TOWN OF NORTH ANDOVER 0 amis gidkp Certificate of Occupancy $ Building Frame Permit Fee $ ` Foundation Permit Fee $ J YOt ie -PeVee $ 1 Sewer Connection Fee $ AgeConnection Fee $ A10, hdOlf&TOTAL 1,01jertor _ Building kis'rector Div. Public Works PAGE 1 NORTH ANDOVER, MASS. BOOK ;PAGE DATE APPLICATION POR PERMIT TO BUILD — I a o 8 I Ol Y� RECORD OF OWNERSHIP i �-I pERMIT NO- b LOT NO. ' MAP9o✓iriaN SUB . LOT O•-_ PURPOSE OF BUILDING SIZE ZONE / NO. OF STORIES LOCATION 9y �2�dG�Sh �c �. GN�n� BASEMENT OR SLAB 3RD OWNER'S N `ME TI /�O(/�,2 SIZE OF FLOOR MBERS 1ST 2ND OWNER' , ADDRESS?lt1„64f0G•� �� --- .� SPAN �-- ARC ECT'S NAME �` - SEtG DIMENSIONS OF S�LL`� DER'S NAME r f --- POSTS DISTANCE TO NEAREST BUILDING r �oJ GIRDERS l0O THICKNESS DISTANCE FROM STREET / REAR .ZOO HEIGHT OF FOU T NDATION SIDES X DISTANCE FROM LOT LINES FRONTAGE SIZE OF FOOTING AREA OF LOT MATER.AL OF CHIMNEY IS BUILDING NEW IS BUILDING ON SOLID OR FILLED LAND IS BUILDING ADDITION TO TOWN WATER YDS IS BUILDING CONNECTED TOWN SEWER IS BUILDING ALTERATION CODE TED TO IS BUILDING CONNEC WILL BUILDING CONFORM TO REQUIREMENTS OF ` IS BUILDING CONNECTED TO NATURAL GAS LINE INFORMATION 3 PROPERTY I BOARD OF APPEALS ACTION. IF ANY LAND COST INSTRUCTIONSEST, BLDG. COST & Orjo. I EST. BLDG. COST PER$Q• FT' SEE BOTH SIDES EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. PAGE 1 FILL OUT SECTIONS 1 - 3 APPROVED BY PAGE 2 FILL OUT SECTIONS 1 - 12 4 N OUTSIDE OF BUILDING ELECTRIC METEPS MUST BE O ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BOARD OF HEAD DAT LED 5f�'TE/7BE 8d-16 SIC, URE F O R OR AUTHORIZED AGENT PLANNINGBO. CONTR.TEL.# .1,L • ls � CONTR.LIC. FEE PERMIT GRANTED _ BOARD OF SELECT BuILDING INSPI Ati .ASA 9V I.IV� FINAL1 - .! tl�Ei � 1 � r i avi#4Lc % ®:J Cli G �o� own of , _ 6Andover No: 381 ►- ,o iRIVEWAY ENTRY PERMIT - CY „� er, Mass.,_'5&7=T.''5 /0 19 49/ A �V WICK oPERMI LD R ?� SS BOARD OF HEALTH C115*Q.............. THIS CERTIFIES THAT...........�FP. ............. . ......................... .. •�� ,• �C ...! ► BUILDING INSPECTOR has permission to erect .... / .... '.. buildings on ..... Rough X �.� .. k Chimney tobe occupied as.... ... ........... ..... .1..................................................... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRUC • Service Final ...... ..... .. .... ... .... ... BUILDING INSPECTO GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in� a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke TarEET r Building Inspector Town of North Andover , BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE So, JOB LOCATION Number Street Address Section of town 'HOMEOWNER" Name Home Phone Work Phone 'PRESENT MAILING ADDRESS sg�yE C ' ity Town State Zip i code ''!The current exemption for "homeowners" was extended to include owner I-occupied dwellings of six 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 109 . 1 . 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 to six family dwell- ing , attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1 ) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . The undersigned "homeowner" certifies that he/she understailds the Town of North Andover Building Department minimum inspection procedures and 'requirements and that he/she will comply with said procedures and 'requirements . ONEOWNER ' S SIGNATURE APPROVAL OF BUILDING OFFICIAL Vote : Three family dwellings 35 , 000 cubic feet , or larger , will be fequired to comply with State Building Code Section 127 . 0 , Construction control . • 'r FORM U TOWN OF NORTH ANDOVER ' LOT RELEASE FORM i SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSIGNED BY D.P.W. "TREET r �20Z �IQ���rC' 1'mE GA'PLICANT /( l7pUO2L%c?J PHONE d'DATE OF APPLICATION Z() SA�—p f� TOWN USE BELOW THIS LINE PLANNING BOARD NI DATE APPROVED TOWN PLANNER DATE REJECTED Vil-�ONSERVATION . COr,1ISSION DATE APPROVED CONSE ATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PER11IT SEWER/WATER CONNECTIONS FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards , the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. //J/ ' � Y)x evv —v -7 7' Vk\ P. 02 Job No. L�z � vd�'EL G o T�5 i d3,'VW4 c n"',S'G � v o s r Ile V • N f OF C PAUL g J. .. mac^`_` -- (M4NE This plan was not prepared from an instrumpMORTGAGE LOAN INSPECTION survey. Offsets and distances shown should # LOCATION:-:20.2' be used to establish property lines. This plan is intended for mortgage.purposes �t5 only. SCALE:-A--2=c',4=> DATE: .x5--ctn I certify that the structure shown on this REGISTRY: Plan -in conformance with the zonin ,-?At'.HOZ 7 A-- • � 9 TITLE REFERENCE: ��• .a� setbacks in effect at the time of construction. PLAN REFERENCE: ��o� I certify that the parcel shown is located within a flood hazard area'as depicted COREY & DONAHUE. INC. on FEMA Flood Insurance Rate Maps for Engineers&Surveyors 040mmunity. No: 108 Cambridge Read,Waburr4 MA 01801 TnTGI P al>