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Miscellaneous - 225 OLD CART WAY 4/30/2018 (2)
i 4� G\ Q �� rDate.......... ........... IL t.% ,apRT" TOWN OF NORTH ANDOVER ,a.6 0 a `p PERMIT FOR GAS INSTALLATION ACHUSES This certifies that . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . North Andover, Mass. Fee. . . . . . . Lic.t :.: . . . . . . .�. . . . . :. 0��'= 14:22 1 GAS if PECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING —� (Print or Type) ' /VUR �(/t�.���r�j� , Mass. Date ell 19 Permit # Building Location o< �' C L,J�S/_Owner's Name_,S7-0 GCS✓J 2 Type of Occupancy /�% ✓�� �� ? New Renovation p Replacement p Plans Submitted: Yesp No N a N W N 1C Y OG in N N U N rr rn X O N Z W F- W a O U Q7 t x n J N W 0 C x O W 4 a rt O n o 4 m rn F- W W O a r b `t �J W W W 1 = pC .a W Cr O W N Y N a CC 'wZ z '' s a ~ W►- mz o o> O W o O W U W O a ytoy txO- d l.rNzow x i SUB-8SMT. ,GAS EMEINT IST FLOOR 2bFLOOR 3 D FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTHFLOOR EH FLOOR Installing Company Name Yankpp Gag F, n; i Check one: Certificate # Address 140 SO . Main Street Corporation 103c Middleton Ma . 01949 [] Partnership -i— Business Telephone gpg_7741 760 Firm/Co. Name of Ucensed Plumber or Gas Fitter William RHarris - INSURANCE COVERAGE: I have a current liability Insurance policy or Us substantial-equivalent which meets the requirements of MGL Ch. 142. Yes 12 No D If you have checked Yes, please Indicate the type coverage by checking the appropriate box. A Ilablltty Insurance policy ® Other type of Indemnity O Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does riot have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. - Check one: Owner[] Agent ❑ Signature of Owner or Owner's Agent ' I hereby certify that all of the details and Information 1 have submitted for entered)in above application aro true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the Permit Issued for this ap icalion wi71 -complianoe,vvith all perUnent provislons of the Massachusetts Slate Gas Code and Cffapler 142 of the Gee I laws. x,11 BY To of license: Plumber Signalu-- rsLcan 'so um er or Gas l=itter Titl© Gasliltor h uw Master License Number 3785 AJ+1 Tow s O Journeyman �. NORT#q Town of4 over 0 i - /l-rel - on O LA o dover, Mass., COCMICHEWICK 7�ADRATED S H BOARD OF HEALTH PERMI T T D Food/Kitchen Septic System 18" BUILDING INSPECTOR THIS CERTIFIES THAT.. ... �...........................................................V50........................ ....... ......... ..........:............. Foundation has permission to erect....FN 1 5h...t.... b 'Idings on ...�. ..O....... ....0........"... ............................................... Rough to be occupied as 1.3.0m � S ........ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspect'o Alteration and Construction of Buildings in the Town of North Andover. #7 A /0 14y, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC ON faTS ELECTRICAL INSPECTOR Rough ................................................................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. action at Entry & BathSection at Bath & Entry 1'0' 114 3 5 Al2 Al2 1 2 A7 i i Al2 " EJ FulD ;;Lv aoo � I 2 � i I ��❑ � action at Furnace Room & Bedroom4 Section at Sitting Room, Bath, & Pump Rc =r-o" ,/4"=1'-0" 1 A11 D ❑ ❑ ❑ C❑ ❑ ❑ ��� ❑ ODD �a ction at Entry, Hall, & Sitting Room 6 Section at Sitting Room, Hall, & Entry 114 su Section at Bedroom & Sitting Room El El JA 2 Section at Sitting Room & Bedroom Location CJ(3-5- C�� '4P/ y y No. Dated -/9ad MORTIy TOWN OF NORTH ANDOVER i y ' + Certificate of Occupancy $ C �- cMustta� Building/Frame Permit Fee $ a1a Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building Inspector `r. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ar BUILDING PERMIT NUMBER. DATE ISSUED: SIGNATURE: AA,-- Building Commissioner/12gwor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record 2o *i cQ Seo 0-s a� al Lvkr Name(Print) Address for Service Signature Telephone Q 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ �No,a - , V1, Licensed Construction Supervisor: ® �0-3 © O 2 VO License Number aan Address l D 1 "M 14/, YO Expiratio DatJ imim S'Devl ure Telephone '... . , -�A 91g 464 �-7 d 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn 1 V-3 —a tbl ' m (k) -kUj Registration umber r Address 7) /9 7 /� r6 n11A;V� q4 - ajA --Q- 6<�?,-6 3 (� Expiration Date Si nature Tel hone f Y♦ n SECTION 4-WORKERS COMPENSATION(ALG.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 au a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Ls SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OI+'FICIAI USE(?NLY ',. Completed by permit a licant :r „ 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 a / 5 Fire Protection X 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZAT ON 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 Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name " Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIv1ENSIONS 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 �1t0 L 697't97t09t1!/ESCI(lI 0��.�!(-Q33CZlYt[lacN4 BOARD OF BUILDING REGULATIONS `. License:'CONSTRUCTION SUPERVISOR Number: CS 040360 yt 'Birthdate: 10/11/1945 Expires: 10/11/2002 Tr.no: 4509 Restricted To: 00 DAVID J FULLER r 15 LORIN OR �, !� WILMINGTON, MA 01887 Administrator 1 � ,:7— Board of Building Regulatidns and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: I Registration: 109287 Board of Building Regulations and Standards One Ashburton Place Rm'1301 Expiration: 09/09/2002 Boston,Ma.02108 Type: PRIVATE CORPORATION ; DAVID J. FULLER&SONS DEV.C David Fuller 15 Lorin Or -�� ,moi Wilmington,MA 01887 Administrator Not valid wit o sign ture Town of North Andover of r►ORTH . 0 Building Department o 27 Charles Street North Andover Massachusetts 01845 1 .^ �► (978) 688-9545 Fax (978) 688-9542 l 1 \ / oq P? of r •STlO ( S9C HU5� II III DEBRIS DISPOSAL FORM 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: Facil' y loca on I Signature of A Wlicant 60 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Masi. 62111 Workers'Compensation Insurance Affidavit p da tt Please Print Name- / 11,/0 Location: 15—kop � ~- Citv tf�`` /,)g --m 1 o /. Phone am a homeowner performing all v6ork myself. am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address city: Phone#: Insurance Co. Policv# 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 o h of Investigations ement ma be forwarded t t e Officeof the DIA for coverage verification understand that a copy of this stat yg I do herby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date / / o Print name Phone# ?S' Oficial � use only do not write in this area to be completed by city or town official' E Building Dept ❑Check if immediate response is required Building Dept E3 Licensing Board E] Selectman's Office Contact person:_ Phone A- Health Department 0 Other FORM WORKMAN'S COMPENSATION FORM - U - LOQ' RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/pen-,nits from Boards and Departments having jurisdiction have been.obtained. This does not relieve the applicant and or landowner from compliance with any applicable requiiements. ar■■■■■■wrmrw�■wmw■r■wwmww�■■wwwwwwm■r■■■■■�■■rm�mm■rr�■■■nr■o■rrrrr■■■■wwr■ APPLICANT To .k)9,47 soil,P/ PHONE ASSESSORS MAP NUMBER LOT NUMBER SUBDM910N LOT NUIN4BER STREET STREET NUMBER lZ �rrr�ar■■rrr■z ■■■■■■ ■■■■■■■■■■r■■ ■■■■■■rr■'■■rrewa■sr■ ■■■er■•■■■r■■■■r■■■ OFFIC USE ONLY �rrrrrr■■■■■■■■■■■■■■■■■■■■r■rr■■rr■■■■■r ■■ m■ ■ ■■ ■■■m■r■■■ RECOMAffiNDATIONS OF TOWN AGENTS ■rr■rrr■r■ ■•r■•rr■■■er■■■■■■■.■■■■■■■■■■■■.■■■■■■■•e■ ■■■■rrw�m■w■■■■r■■■rrr'■rrr■r■■■rr _ DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED I COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED ZI ZZ 5 xy /1 SEPTIC SP R- TIi— t/ DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVE3VAY PERMIT / � DATE APPROVED FIRE DEPAR DATE REJECTED_ COMMENTS RECEIVED BY BUILDING INSPECTOR DATE 3; 1 . 15400 PLUMBING FIXTURES&FITTINGS Scope of Work Fixtures and fittings for bathroom and bar. g Related Work in Tile: Section 09300 Other Sections Base cabinets: Section 11455 Materials Bathroom sink:Kohler K-2098-8 Invitation self-rimming vitreous china lavatory,8"centers, white 1 Bathroom faucet:Chicago Faucets 795-317,widespread lavatory faucet with metal blade handles,chrome Bathtub:Kohler K-516 Dynametric 5.5'Bath,outlet at right;enameled cast iron,color white Bathtub drain:Kohler K-7160-TF Tub and shower unit: Symmons#S-25-600-B30-VBR: • Temptro12000 pressure-balancing mixing valve with integral diverter and volume control,black trim,round handle tops • Levertrol 4458 diverter with integral volume control • Clear-Flo shower head with arm and flange • Tub spout • Wall/hand shower with flexible metal hose,in-line vacuum breaker,wall connection and flange,and 30"slide bar for mounting hand shower. Toilet:Kohler K-3445 Folio Highline,color white Bar sink:Elkay ELU-1418 Single Bowl 18-ga.stainless steel undermount sink, 14"x16"x7- { 7/8"deep bowl } Drain fitting:Elkay LK-35 standard stainless steel strainer with stopper Bar faucet:Moen 7385C One-Touch single control kitchen pullout faucet,chrome plated with chrome spout;use round escutcheon for single-hole mounting 15500 HVAC 15500 HEATING EQUIPMENT `. Combustion air supply for existing furnace and hot water heater:Tjemlund Model PAI-1 with Model MAC-3 Multi-Appliance Accessory Controller,wall-mounted intake hood.Follow manufacturer's instructions for mounting motor unit and intake hood., 15800 AIR DISTRIBUTION i Related Work in Framing: Section 06100 Other Sections Gypsum lath&veneer plaster: Section 09210. Thermostats: Section 16400. 5 i ( 7Date......v ... .. `. Q . NORTI{ °`t"'°:•�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� ........... ... This certifies that ......................:....�....�..�.. y...........................Pl�� has permission to perform ........ae. '.�.. .C ...... ......................... wiring in the building of............�J.C .L. ............................................ at....�aS �..6.. ' .... !Q ,North Andover,Mass. .. ......... G 00 Fee..Z©.......... Lic.No. ... .� �/�.............. . ELECTRICAL INSPECTOR v Check # b ti 8191 ` ' SN_ Con~nweafik o/Ma.46ac1U44et Official Use Only cc�� Permit No, i 2apartm.eni ol.-�`cc��ire Serviced 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: G�Y�„ZErQ 1 City or Town of: /"el /-�z�o%2 _ To the lnspector of Wires: 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 ,4) "9"zls Telephone NdF&EI�L,5-7-,G SC C Owner's Address Is this permit in conjunction mith a building permit? Yes ❑ No �' (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts OverheadE]. Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed.Eiectrical Work: zr- �/i!L z ti Com letion of the following table may be waived by the Inspector of Wires. Y No.of Recessed Luminaires No.of Cel.-SusP'(Paddle)Fans o.of 1 otal Transformers KVA No, of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above .❑ In- ❑ o.o mergency. ig ng g nd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners IFIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of etect�on and Initiating Devices No.of Ranges No.of Air Cond. otal iNo.,of Alerting Devices Tons No.of Waste Disposers eat Pump umber ons o.o e f-Contained Totals: - Detection/Alerting,Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑.ther Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.o atero.of o. of Data Wiring: Heaters KWSi ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP elecommunications iring: No.of Devices.or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires, Estimated Value of Electrical Work.:'S pQ, .Q (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent, The undersigned certifies that such coverage is in force,and has exhibited proof of same to.the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) L�6cr-�7y RJB 104 I certify, under the pains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME: ,,,,,� �> LIC. NO.: 1011 � - CGve�- igatureLicensee: LIC.NO.: (If applicable,enter "exempt"in the license num er linq.), I Bus.Tel.No.:-7%-jam 2600 Address: LAve__ 0\13C>7', Alt.Tel.No.: *Per M.G.L.c. 147,s.57-6.1, security work requires De entyof 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/Agent Signature Telephone No. PERMIT FEE: $62<1_ :APPLICATION FOR ELECTRIC WORK PEHMIT : 1130 NOT FILL Ouy THIS'FOLDI ; f JI Itaard — is— REPORT OF IXSrf"OR OF WINES � A 97 '2- 22 Date...............................P NORT" o TOWN OF NORTH ANDOVER PERMIT FOR WIRING SA Thiscertifies that ............................................................................................. has permission to perform .... .. ............ ..... . .. ......... 7...................9 ............ wiring in th55e building of............... . ... 4 .4..................................... at...........a .........NRrth Andover,Mass. Fee..... Lic.No. ................ ... ..... . ....... .... IC AL A L INSPE R Check # 42 �.� av►nrrQvei�rc�aQaQQ aan Q91f6Q.9�SQl4�000d�t�66� Permit No. Department of Fire services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM�ELECTRICAL ORK All work to be performed in accordance with theo 527 CUR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: /a 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. Mian. Location(Street&Number) S 0/0/ C��7- _ Telephone No.9 6566 Owner or Tenant /io N a/e+/ .S e'L e/S 4®r ter Owner's Address Check Appropriate Box) Is this permit in conjunction with a building permit? Ye ❑ N0 R1 ( ppro p Utility Authorization No. Purpose of Building Volts Overhead❑ Undgrd❑ No.of Meters Existing Serviced?Gv Amps ______ New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: go an ec/ �� "TG on �' ��S l e! �o T4 Completion of the following table may be waived by the Inspector of Wires. No.of Total , No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Transformers KVA Fans �A Tubs No.of Hot Tus Generators No.of Luminaire Outlets o.o mergency ig ng Above In- No.of Luminaires Swimming Pool rnd. ❑ rnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No. of Switches No.of Gas Burners Initiating Devices Total No.of Alerting Devices No.of Ranges No.of Air Cond• Tons He!Tpout mp Number Tons KW.......... No.of Self-Contained No. of Waste Disposers als: Detection/Alerting Devices Municipal Other No. of Dishwashers Space/Area Heating KW Local❑ Connection Security Systems -• : No. of Dryers Heating Appliances KW No.of Devices or Equivalent No. of Water No.of No.of Data Wiring: KW Ballasts No.of Devices or Equivalent Heaters Si ns Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 6`p? ©m 0 (When required by municipal policy.) Work to Start: /G-,2� -/o 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 4 BOND ❑ OTHER ❑ (Specify:) .I certify, under the pains and penalties of perjury,that the information on this application is true L Cctnolete. FIRM NAME: signature LIC.NO.:i�/��6 Licensee: fj e 6�r p- /Y �t'i Z 2 a<o u g Bus.Tel.No.•9T4 yo 7S�T F3 (If applicable,enter "exempt"in the license number line.) Alt.Tel.No.'lx SLk-Y-1-123 Address: *Per M.G.L c.147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 ' Owner/Agent Telephone No. PERMIT FEE: $ S Signature �l �� .1 � �, l//? ," 4 The Commonwealth of Massachusetts 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 Print m ibl Applicant Information - Name(Business/Organization/Individual): 0 6"er /`r "''`Zz°4 Address: /os� a 4/Q7 City/State/Zip: Ir4 -0 r1/S3 Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees full and/or part-time).* have hired the sub-contractors j # 7. ❑Remodeling i 2,� I am a sole proprietor or partner- listed on the attached sheet. l ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.L-/Nlectrical repairs or additions required.] officers have exercised their of exemption per MGL 11.❑Plumbing repairs or additions 3.❑ 1 am a homeowner doing all work e right 52,§1(4),and we have no myself. [No workers comp. 12.E]Roof repairs insurance required.]t 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. t 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 is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct. Si ature:i4�'e`'�' . Date: Zo ' �—V Phone#: 12B Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Date./--�7.- No 465 h TOWN OF NORTH ANDOVER 3? .� 0 ° p PERMIT FOR PLUMBING s � •"a ,SSACMUs c� This certifies that . . . . . . . . .. . • • • • . has permission to perform . . • • • • • plumbing in the buildings of .'!':':;. -s . . . . . . . . . . . • • • • • • • . at . �. !-< . ��� . dA-n—�w.1$-.41. . • ., North Andover, Mass. Fee.4.0 Ltc. No.. . . . . . . . . PLUMBING INS �T'OR Check # 3�`� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICAT10: FOR PER 3T TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date It--27-0 nn Building Location �A5 C�� C�l�/�G HOwners Name �") � �L s Permit# Amour>'��� Type of Occupancy New Renovation ReplacementED Plans Submitted Yes No El FIXTURES T z d W Lz z a [- Cr Cr Cr Cr Cr x E- Q d Fes, W Ha zCn F aEna A a d FCnQ x r SL$)(S�K M 2-D M RO/� r1..1.J�R 4M r�uaipn - 7M M�3 lF��.).-.J 9Mlr• FifM (Print or type) �� /fC� Tl� Check one: Certificate Installing Company Name �` ■ Corp. Ad I %�';25 / D Partner. Ol � F-1-Fim�/Co. Business Telephone 7 — '72— 7 Name of.Licensed Plumber. � ✓/� �� � �' Insurance Coverage: Indicate the of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity M Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner r-1 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 installation5loefflormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa chu to Plumbin a and 12 of the General Laws. z By: 7gna ot Licenseaum er Type of Plumbing License Title oe7 � City/Town tcense M um e—�— Master � Journeyman � - APPROVED(OFFICE USE ONLY Location 0k-o CA2T 4 No.' S Z t Date � 0 N°"T" TOWN OF NORTH ANDOVER k 3?��,,..� , 0, p Certificate of Occupancy $ S . r Building/Frame Permit Fee $ -7i;b � 'sswc14 Foundation Permit Fee $ p Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ �_ TOTAL $ S� o Building Inspector 7678 Div. Public Works Location 2,Z�9- Ql) 4A QT WA No. Date W 191 q4- II I j M°"T"`A TOWN OF NORTH ANDOVER 8 p Certificate of Occupancy $ S�b Building/Frame Permit Fee $ r 'SSAGNFoundation Permit Fee $ t OV i Other Permit Fee $ Sewer Connection Fee $ I Water Connection Fee $ TOTAL $ l5� Building Inspector 7677. i.» PATS? Div. Public Works Location 275 / / .,/�'" amu, i 40t- No. ` C1 ` Cf NOauTy1ti� TOWN OF NORTH ANDOVER O A Certificate of Occupancy $ ` Building/Frame Permit Fee $ Ss�cMuFoundation Permit Fee $ stt ' Other Permit Fee $ l � Sewer Connection Fee $ s �9401 Water Connection Fee $ /077.r7d TOTAL $ Builds g In ector { 1.07 .250 PAtn T + 8423 Div.#u is Works I ' itlT NO. 15ZAAPPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE1 MAP i4O. .Q LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE ZONE I SUB DIV. LOT NO.� LOCATION f /'+ '� PURPOSE OF BUILDING OWNER'S NAME K- 1. 1 / NO. OF STORIES SIZE CP -OWNER'S ADDRESS T 1'C- �C.-7' BASEMENT OR SLAB �' P 4.. V ARCHITECT'S NAME kf lA SIZE OF FLOOR TIMBERS 1ST2f y /f� 2ND .. 77V P 3RD A BUILDER'S NAME n ISE" �ff� �f L�C j� SPAN /!O i DISTANCE TO NEAREST BUILDING " � L DIMENSIONS OF SiLLS --- DISTANCE FROM STREET l POSTS DISTANCE FROM LOT LINES-SID ..50 !T01 REAR .� GIRDERS AREA OF LOT Cie, FRONTAGE HEIGHT OF FOUNDATION I- THICKNESS / 0 IS BUILDING NEW W SIZE OF FOOTING �"1 d X o l IS BUILDING ADDITION MATERIAL OF CHIMNEY l0 O IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND ''OW ILL BUILDING CONFORM TO REQUIREMENTS OF CODE ♦ /,,�% IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY y IS BUILDING CONNECTED TO TOWN SEWER -�+ IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS PERMIT FOR FOUNDATION ONLY 3 PROPERTY INFORMATION SEE BOTH SIDES REGULATED BY PARA. 114.8-S. B.C. LAND COST 00�d o o EST. BLDG. COST PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. � PAGE 2 FILL OUT SECTIONS I - 12 DATE FEE PAID T. BLDG. COST PER ROOM SEPTIC PERMIT NO. Z QJ ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED Y ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULAPENNIIT FOR FRAMUBUILDIN - PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR ,DATE ILE — DATE: FEE PAnf7t�� ID• MUILDIN OPECTOR SIG T• N OR AUTHO I ED AGEN FEE ©� L3j� -- -�$, '�� f� �QIvIIT OWNER TEL.# � s� 3 a o�� 40 5A�6 PERMIT GRANTED ��' _ CONTR.TEL.# ci t BLm PERM F� � _' CONTR.UC.#. LESS FDA EEE H.I.C.# 1 02 DUE FRAME PERMIT= 3 1994 j BUILDING RECORD 1 OCCU ANCY 12 SINGLE FAMILY s;0 't THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT. LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- _ APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES,PLOT PLAN. CONSTRUCTION 2 FOUNDATION JS INTERIOR FINISH • CONCRETE- 1:; 2 I= CONCRETE BL K. PINE BRICK OR STONE HARDW D _ PIERS PLASTER _ _ DRY WALL _ UNFIN 3 BASEMENT AREA FULL FIN. B'M'T AREA 'h V2 °/. FINS ATTIC AREA s NO B M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 - WALLS FLOORS CLAPBOARDS B e 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD"d'D 790I�_ AS SIDING COMGN --I VERT.. SIDING MDING ASPH. TILE t STUCCO ON MASONRY - STUNCCO ON MFRAME - BRICK OASONRY ATTIC STRS. 8 FLOOR AN BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING - - STONE ON FRAME oe_ SUPERIOR POOR ADEQUATE I ONE 5 RO 10 PLUMBING GABLE I IP BATH (3 FIX.) v GAMBQEL MANSARD TOILET RM. (2 FIX.) _ FLAT SHE ATER CLOSET/ 3: ASPHALT SHINGLES -LAVATORY WOOD SHINGES KITCHEN SINK '- SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING ,i 1. HEATING WOOD JOIST PIPE LESS FURNACE ,JdRCED HOT AIR FURN. TIMBER BMS.41-QA& TEAM ' STEEL BMi/6.COLS. T WT'R OR VAPOR ' 'y - WOOD RAFTERS AIR CONDITIONING "'"'" R[:F1 l,} ba t, RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS ...• ..-....�� (�ia . ! . ' cif'; ILf 1� B'M'T -—1 ?-1 _ ELECTRIC 3rd 1st I NO HEATING S)L �z.x z9� X38 Z�K3lo �3<0 22xZ-�a S-9Z aA -4 3b4 � �or o" or Vsi_ -JAIALto V C'r 76 No. 5 1 3 r nrth yy dover, Mass., 199,4 LAKE �� T C 0C H.0 HE wiC N BOARD OF HEALTH :• Food/Kitchen MSeptic System PER IT BUILDING INSPECTOR ...... ^� THIS CERTIFIES THAT Gei4Rb......1l�£t,.c ............................................................ ... Foundation has permission to erect.0 ....F.M.041L buildings on 22S ©1�......C�icr..lA•�`�......... . �t Rough g T t0 be OCCup18d 8S S�K6t..Z.;..��llX1l�.• • • 1� •� Chimney ..................................... provided that the person accepting this permit shall in eve resp ct conform to the terms of the application on file in Final is f: 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. tPERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR REGULATED BY PARA. 1143-& B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough fiT FEE PAID Final PERIVI I I1 EXF2� _F 6 1V OI1 _IC ELECTRICAL INSPECTOR UNLESS CON1 yi' ` Se f , . .h ; Rough ..................... �- BUILD G INSPECTOR al .�; AQP►` GAS INSPECTOR Occupancy Permit Re aired to Occi.i{' Bitil in. _.t'y -�' ��� Q Qugh Display in a Conspicuous Place on the Premises — Do Not Rei Final r_ . No Lathing or Dr Wall To Be Done Dry 4 .•j;:�,3 - FIRE DEPARTMENT -w Until Inspected and Approved by the Building Inspector o�C; Burner Street No. :Y;. PLANNING FINAL CONSERVATION FINAL .: Smoke Det. SEWER WATER FINAL DRIVEWAY ENTRY PERMIT ��• Z M 1 �& � «�f y ��« ~� � »/ �> . ' . ��� ���* ���� �»» .�/� f�/� `�\ �� �� ��. �� .�_. � . � ��{�, ' `�� 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 local or state law, regulations or requirements. ****************Applicant fil�l/s� out this section***************** APPLICANT: APPLICANT: � � (1y U' Phone LOCATION: Assessor' s Map Number lo '7 Parcel �; Subdivision 1�66A2 LO&al Lots) ZZ Street r)2- cr W A Y St. Number z� ************************Official Use Only************************ RECO NDATI S OF TOWN AGENTS: i Date Approved Co se tion istrator Date Rejected (� Comme Ml� ' zed Date Approved Town Planner Date Rejected Comments _�2 'fit �V1 C<<Y5�-I�t� "C 1b inn Geaco Date Approved Food Inspector-Health Date Rejected � � ) Date Approved Z/ Septic Inspector- ealth Date Rejected Comments -,56-1 ��2E•9 • z - CV/3T�.e Gl�� T6 �� Gr/S`���� �E��� �i�F/� . Public Works - sewer/water connections - driveway permit �. Fire Department Received by Building Inspector Date Nov s r Town of North Andover, Massachusetts Fpr»#Am 2 BOARD OF HEALTH ` a i i j ` DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant ���r� A w Test No - Site Location t a-T ` —i4.J Reference Plans and Specs`��.rvt�-�'�f ENGINEER DESIGU DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee �� Site System Permit No. 7 1 / f M "� �.±E'a�1°-4.� A"+S'�'•�.�s�,.v.-.aij..x'S>y ...:1...'- � ... .. - 'r6r•J��"' �,rr � Failurtoposss.. COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY e a• OF ONE ASHBORTON PLACE �llsss iscau aforrowpos loo 3 Codelscaasaforrarecaila�s MASSACHUSETTSO�'j tjfj BOSTON,MA 02108 EXPIRATION DATE aftho L; r� j CAUTION =.;.- CONSTR. 3IJPF7 2V7 n� ' r l)�`/1 /1 �' EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB 7''`4 PRINT IN APPROPRIATE r p BOX ON LICENSE. N C I R C L i_ =cl, BLASTING OPERATORS -,, ;', ,y .;;=,- $S > 034-42-5569 n AND!}VER SIH GIRIC i MUST INCLUDE PHOTO. / S - PHOTO(BLASTING OPR ONLY) FEE: 10 0. of) I NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: I STAMPED-OR-SIGNATURE OF THE COMMISSIONED DOB: C'4/13/195r2�4p6iTHIS DOCUMENT MUST BE � � � SIGN NA " "'•" CARRIED ON THE PERSON OF I V SIGNATURE OF LICENSEE lIN FULL ABQVE SIGNATURE LINE) li THE HOLDER WHEN EN- f OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION, I NER I� / o*~ V. K;hL Re�istratior: i 02ii TYC2 U i EXPi'iatlJii THE U RPE COMPANY G[RARD 't. lJt C!i ADMIN!'TRATOR M AMOGVLR I'iti =r e r/' +�G, A� '• A4'F r� I+ r tk, , ?at3.►moi.�.F� �'+. I ..4 v� I I ;� `` 4 15 6 - oration 018Fi /50816A-A910 _ ---- -� Ty -_k";� Georgia - MA PaCLia Carp, 250 al ,ardval'e St. /y,Y�lmi ngtar. _:'E1 G�� A9T eam (c) 1990.4 GEORGIA-FACIE T.C; IC�pxPhRRIION Locat-.i.C)n F.,KI 11 Uriit}s `"ll po�ect VEY Descript.a.on I3FAM SpaCg 0 �d+t Mark = Floor(Beam) Rep.Strs • ?240 'N�? Usage L/ 00 TL = L/ .,9 0 MaX Def . LL 1 j T 6�--0 C i. r , r i 3 3 .5D . .�o r i A , . (Spa21 is lltjl di c nsior= th r19- 2- Q to ae��n{ te�'l�i,r iee) 1 i vroiect ti4a 4n Loader Flour, Live- 40.00 poE. S�cad• 10.00 a?Eaetol• •'` ( a, r .` 1� L1viT i��ad(L) DO1'` s Live•Dead I,oadtl't �F�?3ff Sta ' , a,e. {� a^ ar�nd Qil�:•.�.._--_.__.._—,--• Qi O J ,'�ll,00,• l!, f 4 0.0 put f a u,0 p•.s. '" �� i ; Span Ca ried { one teed, measured trom left essd when ararip ie 0, h'hr2^n}+/C:, iz'c;r,n leftxpecltlOA span is i "Dlmenai n + �y Genet at d Loa 1' 14 li G . J Load Span © 1 2 pattern x Imo` Group Combinations + PatteZrt yj 3 Support 62E35 215661096 Max Rn (lbs) - 4GE n (lbs) 1257 - Min R' 3 .SQ pori, 55Q p Min 'erg inch) 1 . 50 si. } Grrni Allow Rati.� Valum Sparl# x i ( DV (I 3212 2 0-11 1 F3094 0 .40 C V (1b ) 6920 7- 4 ;3 1.7982. 0 .38_20 ,• 1. G M {i ti lbs) 2 0 . 15 I,/2420 i 1 3- 0 U . 30 0 . 11 Y,/27.8$ p-I+T {3 ah) -0 .03 3- 0 I,/S72 J D-TL(i Ch) • 03 2 6- 6 :; 0 . 32 0 .71 , D-LIa(i Ch) 0 .23 2 3 0 . 65 0 .44 L/5144 ` D-TL(i ch) 0. 29 : .25 ( 75x 9 . 2 5ij 3 plDesdepth tocced bl ue�rl k i 'I. USE: d MPLANK2 2 .0 ; i McCausey T�ucnl� - .C .- M ster Plank L , 4 .,Re{.pal4h R Iica.blc A¢parova . •. d a } NOTES ecificatio�e for xood Conetn•�ticn ori gr )•;� dor II �. ;a.signed !n accord ae vicA National Peaign Sp ; rt at the iRnal o lecseire 'f r6f""est ee f end OP the member. COntitlu•:uB ]ateYa aup 1 Z. Psov4dO ptersi suppe .t'. ,I ill 11 crnpread on edge. I otRorali ' r uaq only. sL ca scst.y erau ba verified ttr.t � )•'.,. 3. LtlaLgn v+4did h dry m:itari It supl>exc nett!:s �+ I 4. ROari»Q Ygeh weed oaa:dsalgaa ji?.:.�•::; 1"Dr9yr-d vy}ife lrcaieta a at mufpertm with negative ieseeiot+e. 1 p7COride �t�d of top ori et�vally from L-c',kh eillee. 4i y �Cdt. ,i, •�' 6. 1't+rSfY C t lo>d is app ,lo> top ane tx,etom Qclges. Nail from 1. bail pli a t63ethor bi, i nails a <a o/c es xeterenced art tradc�Mrkq �'r sch"'tare`s traBemAxks of t:,siv resp peive r t. Cot any. , rod�tc 1 iF * TOTFA tib . •{.,�' !, l , / "!+ L�/���0� se r�.w• r.'•....+.— `� ,. - �,,'•• , , �1 , • ,� - Z% Vie, . . ' ' - . - �<., •. 04 001, Jill vv 0-1 11 ol 41 • 'S'nF'ti � I / � , � A' ��r ,, + rl, �� '� ;i'+} )..t3. Y�' t+r •/ a I YYf��q'T� �� � ti -� ;`� . '� .� 1..% j �� nv • Iv J�AI > ,1 �it � , � � ' ,- , r..;. ,f , . ,.,;.. ,,� • 1 •w / / I / • L /��/J/�/ y ed l . �„�/.1 r ,�t •• ♦ � / ///i1/�/�/ J . . f� r.,h.�,n �, ` n 1, r��n• 1 II + :I !e`� jii>. �, C ;y,J �• n /�+I.� /1"-'r— 'i,.�l r ;:� ,q"�t V`�� ft"• �""'•j41 •-•r •! ra. 1 { .. t � #.rf, ��. �.f � ... " / i _ • •-� �M���S'' •,1.:.�'A , � 1• /. .1 n S�'t.., j^. f.. - t ��x t Y{ . �,•x�i. ._y� F r • ,-1 ° /� w "Jill ,J�� r N .{� Ld'• .i4�. �>•+n Y�• � r rp`'-.xA 3•r 1.� ��F'�1/�'��.�'1�{+Id��?L��'�.�,r��1.�',Y+' �I'��� C�•i�••�5���,`+ . r � F '��t '�l • � pi. ' "f�'fF' �"'S - 1` I �''t,: h �' 'S -I,„ _ }t ,St r7�' i. ,1���1�,f�,hT�_t MIri• '' �� t` ,t j• ,` •/t•� V •� t ` , , t 1 a1, . +1• ' f 1�1 ' ” s)4,1 �.. �'�+ f, ,xf.P'• I. '1 ..' � '� i . N .. ' S, � +`t . • si�� � 1 L F._r. -F 1 i � r Q i �• t.• � � 4 /?1.1 •T yl, ``• r*,1.'rti ` /k 4� ,. � � fiv �/7�. ' i ' }t ,, Y, # JY,:�, •Ll� T• -.{ ���})�j•Myir?�r�..l l�j,�>.t��'M1•�1 "�{ S; .l ,� ,' '�^ , �� Z - �� `i • _ ol/ . it Fr). ,,_ ,ll :1 Iii "''".I CY{lM.�`.6`N r�,, ♦I .w..t'_4r• •'r' O� � 2 � J 3�•5 J � s� t ,`` 99s Fs- G0.2.FfCp. 0 W 0 V 0 O G./Sopa Y S NE.PEBY CE.�T/FY TO Ts�E T/TGE/NSU,PO.P ANO I�L 45) or •TQ THE BAN.('T.S�iQT T.s�E O/►'ELL./•uG/S GOCATEO O•t/ TiS/E LaT AS S.�i1►4V ANO T//AT/T ORES CONFOPgI //V IY/T/1 >�E T'ow'er� OF.vo.A.✓o o vc 2 ZON/NG ,�EGv[AT/D,l/.S ,PEG.4.eo/.✓G .SETeGIC.rS F�O�s1 ST•PEET.S E LOT U�✓ES."' �1� F/j,�T,yE,P cE.rT/FY T//.4T Tif/S�irG-GL/N6 /S�vOT � Y Q• �iv��'�E� GOG4TE0/.{/ T.YE FEOE.PAIs 00 .5'AZAPO APER. O.e.4*5.V FO.P �Syawn!O/t/FfMA' CO �. ,4NGL ZSoo96 �1 I s �L� ,� � � •'�'� /:� (00 � .9o.2/G /495" Bo�.vo.ves�/.v.�o.Q.r�- �E.P.P/�f1.9C.�E.(iGidEE,P/.1/6 SE.PIi/lEs AT/o v rarE.y F,Po� E�rsr�vc ��Co,Po s, 6� �A•P� .ST,PEET ' A'i/ODYE.P, �1ASS,gC,%//SETTS o/8/O � i F 94 BRADFORD BRADFORD ENGINEERING COMPANY,3 WASHINGTON SQUARE, P.O. BOX 1244.HAVERHILL, MASSACHUSETTS 01831. TEL.(508)373-2396 FAX: (508)373-8021 REGISTERED CIVIL ENGINEERS AND LAND SURVEYORS February 22, 1995 Gerald Welch Re: Foundation Inspection Let 11 Old Cart Way North Andover, MA Dear Mr. Welch: As requested by you, Peter D. Mauritz, a structurai engineer with Bradford Engineering Company, visited and inspected the above referenced property for the purpose of assessing the installation of the foundation footing. The topography of the lot in question is steeply sloped from front to back with exposed ledge in the area of the foundation. This required the footing to be stepped and keyed into the existing exposed ledge. The right side of the foundation consists of four steps. The top step is twelve feet long and twenty two inches wide with a minimum depth of 9 inches and a maximum depth of 24 inches. At the rear of the step, two reinforcing bars are doweled into the rock. Two#4 reinforcing bars are placed horizontal. The second step is 3'-8" long, there is one dowel installed into the rock and the #4 reinforcing steel is placed horizontally.The third step is 2'-6" long and is anchored to the rock with three reinforcing bars. The bottom piece measures 2'-9" long and is anchored to the rock with three reinforcing bars. The #4 reinforcing bars run continuously from top to bottom. The three bottom steps are more steeply sloped than the top step. Hence the shorter length and additional dowel steel. The left side of the foundation is not as sloped as the right side, allowing the steps to be longer and not as steep. The footing is keyed into the ledge. There are no anchors into the rock. The rear footing is on crushed stone at the right rear corner for approximately eight feet. The next eight feet adjacent to the chimney is on ledge and is anchored to the rock with dowels at 24" on center. There is also horizontal reinforcing running continuously along the back wall. !`, ten inch wide and tvvelve inch Nide fOL-rdation wall have been installed atop the footing. The 'inside of the foundation has been installed with a clean sand while-the exterior of the foundation has been-backfilled with backfill material. Both the interior and exterior fills should be properly compacted. Adequate steps have been taken to properly support and anchor the foundation into the sloped ledge and the footing should properly function in supporting the foundation. I hope the above information is of use to you in assessing the integrity of the foundation. Should you have any questions or require any additional information, pleas do not hesitate to call. Very truly yours, Of 4,4 Peter D. Mauritz P.E. Bradford Engineering Company L) �i OT Rh Town of E - Andover . 0 - 1� Aw 19CKrt�i dower, Mass., Or. �j. Aok P�\ J IT 'SIS `o BOARD OF HEALTH 'PERM A Food/Kitchen � �� e Septic S st m aAA BUILDING INSPECTOR THIS CERTIFIES THAT Geadab WF t.�.vi Foundation n has permission to erect. ..... !4.!S1 ►r buildings on ..! +Q. q ......... .......1l O Ro °N � i'1� 1 ^� te 1. to be occupied as.5AI*L....�7�11�1U.. ..b. ( . .......4 2.(4.4_...! AR&4L....................................... Chil„ney ro Ided that the person accepting this p rmit shall In envb resplct conform to the terms of the application on file in P Y P of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 'L this office, and to the provisions Y 9 P Buildings In the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING IN PECTOR REGULATED BY PARA 114.8-S. B.G. �- VIOLATION of the Zoning or Building Regulations Voids this Permit. Itou O�(S �. << FEE PAID ` PERMIT EXP ZS-16 MONJV� ELECTRI ALUNLESS CON TT ou PERMIT FOR FRAME/BUILDING :. .. ....................... BUILDI G INSPECTOR � Final DATE: FEE PAID Occupancy Perm' it Required to Occupy Building Gas INSPECTOR -- - , a /s Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner ,-- PLANNING � - JAL CONSERVATION M �51FINAL Street No. Smoke Det. /0 SEWER/WATER i�� FINAL DRIVEWAY ENTRY PERMIT 6' �-00&) e- -- -Z3-95_ -- - - _ - - - c 7- ti CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date d V 6+ z4 , Lasa' THIS CERTIFIES THAT THE BUILDING LOCATED ON ZZ V CUD C.AfZrr W! —( MAY BE OCCUPIED ASQW;&X 4t� 1lEJ..1.W �Z� N ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. o ,"..°"'".1�o CERTIFICATE ISSUED TO ggERAQI wA G` p ADD �''4cl4us B ild ng Inspector r 4 a WDate.................................. ,40RTN TOWN OF NORTH ANDOVER PERMIT FOR WIRING ACHU Thiscertifies that ............................................................................................. has permission to perform ............................................................................... wiring in the building of........................I......... .. ................................................... at. ........ . .....................................................................,North Andover,Mass. Fee... ................. Lic.No.........:;;:.. ............................................................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer \ 7HL'CXAMU,'VWL'ALJHUI'MAN-"(,HUJ'L'1I-Y winceuseonly DEPARTAiEW 0FPUBLICS•4FM Permit No. BOARD 0FFIREPREVENI70NRWM4TI0NS527CMR120 Occupancy&Fees Checked APPUCATTONFOR PERMlT TO PIMORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date L _ �( i Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Lp CPc Q,"T �J M 0 Owner or Tenant�`l ALS S2Y� R_l_C (� Owner's AddressM, P, Is this permit in conjunction with a building permit: Yes o (Check Appropriate Box) I Purpose of Building �N�S�{�`�? rn�'� Utility Authorization No. Existing Service Amps, / Volts Overhead a Underground No.of Meters New Service Amps`/ Volts Overhead Underground � No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No_of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.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 Alo.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis o.Hydro Massage Tubs No.of Motors Total HP OT TER. n eu►ark-- G 1'1 wet r1� — P—A-,1 e�e_ hsiraroeCo Ptastrstttoihem4zu rlatsdMasmdxsmGamWLaws Ihaveaa=tLikkhtstrar=piDbcynidmcmvi le * Coorits�>valetgmalett YES NO a Iha%e%hnkedva1idptoofofsanetotheOffie YES �er If}puha%edradredYES,pimenha*tttetAxofwmawbyd=kirgthe BOND OH-&R ma y) EVxi'attrn Date E4r0WdVahrectlE6 ' $ 5' IJU• OZ7 WorktrStxt {.�sctev� r+ 6kM hgvcdcnDWeRe*xsted Rota, Fara) SigneduAa&Pavlksofiajta� FIRMNAME 4LioaseNa I;oa>9ae re-(�1�Yl�, Q. rte', Sigr>�nE lioaseNo 59 3 ,,���� ���� Business Tel.Na Ad ���.Z ..S.�..:.. '�'�'r" 2.� h/L�Q- d l 3 AiTel.No. OWNER'S INSURANCE WAIVER;I.gnaw.aethattheLaoased=nut cereal Laws anddratmysiglmh cnthispm-nittppficadotr ftre4wit ent. (Please check one) Owner M Agent `i Telephone No. PERMIT FEE 30 Date......( ... ...�... ..../�J NORTF� TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACHUSEt This certifies that ... ;1 ..{�/t7 r :<' .. 6-r C......... has permission to perform ........ x.`.J........1 t/. .'::!.....I C.: ....... wiring in the buildin of.....?�/ ....... at... ,T....: .. ....... ,t ..k�/. '�.!' ,North Andover,Mass. Lic.Noj1� ............................................................ ELECTRICAL INSPECTOR C ��• � 1 13 06/06!95 14:29 255.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File '--vQe"e dee o-theh bide e 5� t>fiee u..o�ty / / 771e Commonwealth 0f Massachusetts v..,,,ls No. A5 Department of Public Safety i/o����� p«�dt.akl 80ARU OF t=1RE PREVENTION REGULATIONS 527 CMR 1200 `�A ! APPLICATION FOR PERMIT TO PERF=ORM ELECTRICAL WORK NI work to be performed In accordance udth the Massachusetts Electrical Code. 527 C1,111 12:00 (PLEASE PRINT IN TIM OR TYPE ALL IliFORHA-TION) Date l, �f i City or Tovn of Al" To the Inspector of Wires- The undersigned applies for a permit to perform the electrical Work described below. Location (Street & Humber) OZOf ,4,49 C/ A7fi1e Z G- f Owner or Ienant Owner,* Address f'� G/ d1`a�t „��egi r A/G /fN��✓J�!/ ��ii jf G/��� Is this permit in conjunction With a building permit: Yes ® No ❑ (Check A 1cn Utility Authorization It Purpose of Building / /vt�j tY Existing Service• limps / Volts Overhead. ❑• Undgrd❑ Ito. of Heters Ifew aervice,t_ . ,r ce�Amps��� /�rf� Volts Overhead ❑. Undgrc'® , Ho. of Nete:s`� • Number of Feeders and /.-parity• Location and Hature of Proposed Electrical Work iv//.Jl/C-/- /{Z I-- A�7/-F Ito. of Lighting Outlets No. of Hot Tubs Ito. of Transformers Tota KVA '(J No. ong Swimming Lighting Fixtures Pool Above In- Gb g grnd. ❑grnd. ❑ Generators KYA l� O Ito. of Oil Burners No, of Emergency Lighting No. of Receptacle Outlets ,J (� l� Batte_ry Units No. of Switch Outlets k1 q Ito. of Gas Burners FIRE AIAMS No. of Zones ® / No. of Ranges Total Ito. of Detection and 8 f Ito. of Air Cond.d'(% tons Initiating Devices a No. of Disposals Ho. of Heats Tions tal ToKtal Ito. of Sounding Devices 2 No. of Dishwashers S ace/Area Heating KW No, of Sel; Contained a P g Detection Sounding Devices No. of Dryers !fearing Devices KW Local❑Hunicipal Connection❑Other No, of Water Hearers KW Nos of o. o Low Voltage Signs Ballasts Wiring >I No. Hydro Hassage Tubs Ito. of Hotors Total HP OTHER: IIISURANCE COVERAGE: Pursuant to the requirements of Hassachusetts General Laws I have a current Liabil11 Insurance Policy including Completed Operations Coverage or its substantial e99uivalent. YESJJ HO[� I have submitted valid proof of same to this office. YES• , NO ❑ Yf you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LA BOND ❑ OTHER❑ (Please Specify) (Expiration atej' Estimated Value of Electrical Work S Work to Star! S �`/� Inspection Date Requested: Rough inal Signed under the penalties of perjury: FIRH HAIfE1i�lc>✓✓dl� /3Gf�aT/'/`G j.�� LIC. 11�•� � Licensee Signature�jrr��i? LIC. NO. AddressA 4/�`/ AAi lti ��—��-`r�✓�!G /y/�f1 /yfy Bus. Tel. Ho. Alt. Tel. No. . OIMER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub. .-I Stantial equivalent as required by Ilassachusetts General Laws, an that my signature on this pe Lt applieption waives this requirement. Owner Agent (Please check one) r /^ G 1. Telephone Ho. PER11I1 FEE (f Signature of Owner or Agent 3 5 6 4 alterations to the basement of the A4 A4 A4 A4 ' Searls Residence 225 Old Cart Way 16'-0" North Andover,MA O 92" (V 84 Of — � 1 1 A14 .' N A5 A5 _ OEn BEDROOM SITTING ROOM x 3 ^ 5 1\ / 3 Ala � A5 fn'�,Vnlf o J I above- below UP rr3 above below A13 A13 A14 A14 \ A14 2 0 1'-8Z" 5'-1y' 10 2 A5 N N 2 / �� �O' 4 @13 bar counter 8A13 _ _\ A9 cabinets:see Barry Zevin,Architect O / — — O t � 1 67 Hampshire Street furnace / A13 — /1 / SIM. ' / - - - Cambridge,MA 02139 CLOSET 1 O ----- ----------- A10 (617)492 3921 a (;A3 CLOSET LINEN O CLOSET 2" HALL 1 5'-10" F_ 0 BATH A4 4 vanity: 5-6 2 see A6 --- --0 -- En A4 FURNACE ROOM COAT CLOSET a O O 0 o' 12 3.2Zg " UP 2 ENTRY 2g" 2" heater A11 A13 J 1 15 July 2000 N sewage A4 in O O A9 2 tall cabinets:see _ 4)1 N � A4 _ � t PUMP ROOM GARAGE called N / q _ 1 . 3.634 32, 0 2 4 feet i FLOOR PLAN 3 5 6 4 A4 A4J A4 A4 A2/