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Home My WebLink AboutMiscellaneous - 28 JERAD PLACE 4/30/2018 (2)rc-v J4�nl VTZ VY') ,-1 ��P�t 7NW 6 V-tl4j J\�taj N�hw h aile Commonwealth of Massachusetts City/Town of System Pumping Record OCT 'I g1011 Form 4 TOWN OF: NORTH ANDOVER DEP has provided this form for use by local Boards of Health. Other forr4s-W information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left front of hou , right fir rear of house, right rear of house, left si e c ��-e-- Ac. City/Town 2. System Owner: Name Address (if different from location) CityfTown ft side of house, right side of house, Left State Telephone Number Zip Code C -D B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: El Cesspool(s) D-S'eptic Tank 0 Tight Tank F1 Other (describe): 4. Effluent Tee Filter present? Ej Yes 0-K-0 5. Condition of System: P , -f - '�� ('j��) 6. System Pumped By: Neil J. Bateson Name Bateson EnterDrises Inc. Company 7. Loc i I .L.S.D Signature t5form4.doc- 06/03 contents were disposed: If yes, was it cleaned? [:] Yes F� No F5821 Vehicle License Number Date 6,2— [a - t ( System Pumping Record - Page 1 of I 11 0000 SAWAX200 j;vriffl P. I FAM ILY POOL AND PATIO INC. MORTGAGE- PLOT PLAN 92 So. Broadway LawrOnCO, Massachusefts 0 1843 EK SURVEY PhOnS: (508) 688-8307 17 ROYAL STREET, LAWRENCE, MA. 01841 Tel. 508-975-1413 M MOOTC OOTGAGOR —Aaeal5f- OECD REF. — 3 9'0-'r — PG. ADORESS OF PRINCIPLE BUILDING PLAN REF. am Arp, DAlt OF INSPECTON —aZ& io r /-4 %2?54�4,v IA1250 � ��Ap 'I'\'- I 546 P(7vi 5f -as: IC to,, x 7 Location-�� No. Date TOWN OF NORTH ANDOVER 0 0 Certificate of Occupancy s Building/Frame Permit Fee $ 4". CHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Aliq Water Connection Fee s TOTAL $ ins tor WWorks Div. Public Location LIT -3,-4kqp puk—,5-- K— 1--,, No. 7— Date TOWN OF NORTH VE,R T7, o Certif cate of Occup cy jo;ae Buil n me Perm! Fee $ Fou dat on Pe it Fe $ P 1 R 'I e Cith r P rmit F $ Se er C nne ion Fee $ w er Connection Fee $ $ TAL 0 L Building lnsp�ecto, 5278 Div. Public Works PERMIT NO.-Zt/-'5 APPLICATION FOR PERMIT TO BUILD * NORTH ANDOVER, MASS. I i /AGE I MAP 4.40. hYm, A LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. F - LOCATION c� �d, PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES SIZE' OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME BUILDER'S NAME A �l SIZE OF FLOOR TIMBERS IST 2ND a)( jo 3RD,;,px SPAN loof DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDE S REAR / .58 -* GIRDERS AREA OF LOT Y,31617/ FRONT��,S-() HEIGHT 0 FOUNDATION TH ItKNESS IS BUILDING NEW SIZE OF FAOTING X/ IS BUILDING ADDITION MATER:AL V CHIMNEY / IS BUILDING ALTERATION Is BUILDIN� ON SOLID OR FILJED LAND &nzi�z WILL BUILDING CONFORM TO REQUIR MENTS OF COPE IS BUILDIN CONNECTED TO TtWN WAT�� _Vj- BOARD OF APPE)u ACTION. IF ANY Is BUILDIN CONNECTED TO TJWN :,EyfER is BUILDINA CONNECTED TO Njp0fAL GAS LI - NE ,ye,5 INS RUCTION SEE BOTH SIDES mmo ony PAGE I FILL OUT SECTIO S 1 3 PAGE 2 FILL OUT SECTIONS 12 ELECTRIC METEPS MUST BE 0 OUTSIDEJTF BUILDIIVAYE ....... _ FR PAID ATTACHED GARAGES MUST CONF M TO ATE FIRE REGULATIONS A P\ PLANS MUST BE FILED AND PRO D 8 BUILDING INSPECTOR DATE FILED f- - Ld - SIGNATURE,QE OWNER ORIVJTHP&IZFD AGENT F E E PERMIT E 2-49 9 Z-- fT E- e- r� PERINI;, � - i, FRAMEMBUILDING DATI LE- FEE l0nla I D: LESS FDA FEE— DUE FRAME 3 PROPERTY INFORMATION LAND COST ZZ sw EST. SLOG. COST �� EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 15-07, 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BUILDING RECORD OCCUPANCY 12 �.INGLE FAMILY S'ORIES 'IC MULTI. FAMILY rOiFF E S APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE — - a 11 2 13 CONCRETE BUK. PINE BRICK OR STONE HARDW 0 PIERS PLASTER DRY WALL UWFIN 3 BASEMENT AREA FULL 1/1 1/2 1/1 t!O 8 M T HEAD ROOM FI . B'M T AREA FIN. ATTIC AREA FIRE PLACES MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B 1 2 3 CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR CONC.OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR ;q POOR �DEQUATE NONE 5 ROOF 10 PLUMBING GABLE I BATH (3 FIX.) GAMBQEL] -dip MANSARD TOILET RM. f2 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES_ KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DAIDO 6 FRAMING WOOD JOIST 11 HEATING PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & �OLS. STEAM STEEL EMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS As 7 NO. OF ROOMS i—m—T T.—t 3,d ELiCTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. FORM U - LOT REIXASE 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 applicantand/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: <,RnF Phone LOCATION: Assessor's Map Number )n Parcel A Subdivision Lot (s) L Street o-7 St. Number ************************Official Use only************************ RECammENDp,.-,-[oNS OF TOWN AGENTS: 1, AJ � - Date Approved (2=nservation AdmiATstrator Date Rejected Comments Comments Health Ag Comments Date Approved Date Rejected Public Works - -SP-kuaw*water connections - driveway permit ad Fire Department Y41-141'1'At J1-V[t1eC�re-C-Td1'J Pgo,,�VLQ &4, J �15t 0 Xecelte,-* eA �2, 0 A4 -f-v AV 0 A "UiQ -10� �,Iu � 01 ell ,f -- 6--1J1-1P12- Received by*Building Inspector Date N Nj N9 119 APPLICATION FOR WATER SERVICE CONNECTION 1-- Q7 Nnrth Andovp.r. Mass. C-/ .--,i qlt— Application by the undersigned is hereby made to connect with the town water main in fif-slye� subject to the rules and regulations of the Board of Public Work -j. 11 �,- L 2-8- 1 0- "'T rs -*tFP44w- I e prem ses are nown oz. u. or subdivision lot no. U0 Owner Contractor --76 PAe /, A�- 6) Address V �Ad d res Applicant's Signature PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permissi to make a connection with the water main at J 11-9�ctl r10 subject to the rules and regulations of the Board of Public Works. nspected by Date 'FDA 1 11, MW71M,"M�94 3 � See back for rules and regulations RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES 1. No person shall tap or in any way tamper with water mains which are part of the distribution system of the Town of North Andover without a valid permit from the Board of Public Works. 2. All water services shall be installed a minimum of five feet below the finish grade. 3. No water services shall be backfilled without inspection by a representative of the B.P.W. — Telephone 687-7964. 4. Service connections shall be 1" type k copper tubing. 5. All fittings shall be brass flange type Mueller or equal H 15202 Corporations H 15212 Curb stops H 15402 Three part unions H 8185 stop and waste valves 6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 41/2 foot rod and brass plug type cover. Ir uj .-J. I= U. z Z -4 to to Cd kind PM cr- w CL >- cr- z Lu <LU 3: w > cam cc Ao Old cc ci z CPR Q 4ft jai �i C- C z LAJ LLJ LLS Z V) ZD :) r -L V) z V) LH ui V CkC c C3 I go -! E- 0 "M .0 7 C6 LLI 0 0 0 cc 0 06 W) z z MA 0 z LU z z 09 L6 cl LLI -1 z CD 0 > m z �i c - 0 0 !E 0 0 0 S a: o iT. rr U- cc co iT- Ir I � PM cr- w CL >- cr- z Lu <LU 3: w > cam cc Ao Old cc ci z CPR Q 4ft jai �i C- C z LAJ LLJ LLS Z V) ZD :) r -L V) z V) LH ui V CkC c C3 I go -! E- 0 "M .0 7 C6 LLI J) 5 J. LLS CL C:9 c M C ag c Izu C z c A c = c Cc r cc CL w c cc . '. .-I . - Location 7P3 Zt;,RA-b 20�E No. Date -<zIq Of V40RTN I TOWN OF NORTH ANDOVER Certificate of Occup ancy-,$ 9; a > r) LT Building/Frame Permit Fee $ A= Foundation Permit Fee TO Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 3-4 (:!6� \J Building Inspector Div. Public Works PEWMIT NO. 1-�q APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. 4 PAGE I MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO LOCATION PURPOSE OF BUILDING OWNER'S NAME t)' JCho j 0 lic I NO. OF STORIES SIZE <I'x' le. OWNER'S ADDRESS as Q75? ct BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Gev-:5�-5 Prot-,, SPAN 1A I DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS 4 POSTS DISTANCE FROM STREET DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING /off X 4,81/ IS BUILDING ADDITION -5 MATER:AL OF CHIMNEY IS BUILDING ALTERATION I /-,-(-> IS BUILDING ON SOLID OR FILLED LAND 60 Ird WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 3 PAGE 2 FILL OUT SECTIONS 1 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR JDAT9,1`41-ED OF F E I- ^slqlau IZED AGENT PERMIT GRANTED 19 1 S 3 PROPERTY INFORMATION LAND COST EST. BLDG. I COSTf 66W EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # 'f - CONTR.TEL.# �33 CONTR. LIC. # o �' H.I.C. # P4&" A BUILDING RECORD OCCUPANCY 12 �JINGLE FAMILY I ;ORIES MULTI. FAMILY APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE ___ PINE 3 1 2 13 CONCRETE BL'K. BRICK OR STONE HARDW D PIERS �LASTER 151RY -VJALL UNFIN. 3 BASEMENT AREA FULL FIN. B M T AREA 1/1 1/2 FIN. ATTIC AREA NO BMT FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 3 DROP SIDING WOOD SHINGLES ASPHALT SIDIiTG ASBESTOS SIDING VERT. SIDING CONCRETE EARTH HARDW D COMMCN ��SPH TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STIRS. LFLOOR CONIC OR CINDER ELK. WIRING STONE ON MASONRY STONE ON F-RAME SUPERIO� POOR ADEQUATE NONI 10 PLUMBING 5 ROOF HIP BATH J3 FIX.) GAMBRELj_j MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING 11 MODERN FIXIURtb TILE FLOOR TILE DADO 6 FRAMING HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER EMS. i COILS. STEAM STEEL BMS. & COILS. HOT W*T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T*G UNIT HEATERS 7 NO. OF ROOMS I AS 1 OIL B'M'T 1-22 d l.t 3,d ELECTRIC NO HEATING THIS'SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA. . ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. -,q i I�md C* VO4 W rA co CD C=, ci C-2 CL cc m co C2 M P-. : E C:) CF C3 C) CL. C's 0 ca CD cm :mi CIO m 40: ca. cc c=a ca 4D 75 icD cm 4D cm ^u CD's Go. Ca ca a- cl CD CL S, — =- L,_ =, OD 4=0 -a LU 4D . O'l COL is co :10 CD E C3 CD co C3 CA @ C3 P10) �4 co CO2 co 6 u cm ca cm w CL co G3 CL ca C3 Cc C.3 CL. CD CO3 ts -Q4 = CD CD CL C-3 CA 0 , . ca - CL. CIO cc LU U) m C) c_.:) CIN 90 0 Cid z UD 0 co 00 Ei tm -a w ci o t :3 tw cis r. 0 V) LE C2 u x V) E V) CD C=, ci C-2 CL cc m co C2 M P-. : E C:) CF C3 C) CL. C's 0 ca CD cm :mi CIO m 40: ca. cc c=a ca 4D 75 icD cm 4D cm ^u CD's Go. Ca ca a- cl CD CL S, — =- L,_ =, OD 4=0 -a LU 4D . O'l COL is co :10 CD E C3 CD co C3 CA @ C3 P10) �4 co CO2 co 6 u cm ca cm w CL co G3 CL ca C3 Cc C.3 CL. CD CO3 ts -Q4 = CD CD CL C-3 CA 0 , . ca - CL. CIO cc LU U) m C) c_.:) CIN 90 -A(3n-ioNi Isn-114 - Ti. Cl -�* w wci, -IOH 3H' N-3�jM U30 .:jO,M8l3VUNOC13'd'fVo ias isnn JN3WWC S'Hl :.LHE)13H 3.LVG I 7 7-: -A(3n-ioNi Isn-114 - Ti. Cl -�* w wci, -IOH 3H' N-3�jM U30 .:jO,M8l3VUNOC13'd'fVo ias isnn JN3WWC S'Hl :.LHE)13H 3.LVG 7� T 7 C 7'. - - . . �? ' ' 7' E? C) 77 :1 Z: 7 C 7 '77 Z 'Z 7, 7 7 .7 E? 3 IU 7. r 7 C: 7 2'0-,7 7 C� ILI 7) 7 77� C L: 7 3 T n @U� C)_; U:20"! P UO '_L77�).�70 7 a U P, 0 a JI!,3 Ll L::) n aaumo�),_,,Oq, psaap7suc.) 9c, :cu U Ll -L �?ulolj auo uleq-) Z:lotu OUM L'C= ID11L, =_ Sn C- C� D@DUZ;nUT 37 :10 37 S7=',�- S o quo r 9 V S C) S 3 G :4 a S 9TL; ,:�-Lulv UO D'i o s u DO-) 2 U- D-1 7 ng -0 1 L a a r. s 3 p s& C 7 7 1-1 C) 0 J s u s -)-[I E? Es�)Ssod �ou sa:)T) cum al- 07 3 UOMS 2",077P Cl pUp SSaT :0 S-.-LUrl X-rS :ro S-:77m:-.:� 0 Pn L, -1 C. -1 p,�_DUD�XE) S?m 7?:! tl� 50 9 u 0 ,;,: ---. .1 OP., 0 Ll 0 7 aucli L :1 1-7 77�_ uoj�CjU!@XZ BSU@OTq aaUMOaUJOH 10RIUM DNIQUOS aaAOPUV t1130N 90 UmOl- 76 b I b uoj�CjU!@XZ BSU@OTq aaUMOaUJOH 10RIUM DNIQUOS aaAOPUV t1130N 90 UmOl- . . . . . . . . . . . - ........... 17 IF Mw- te*. I'luz gp?"isl ZI �107 011Tuq -d Dpuno j jo ol 7 =-or -- Avow, 107 747 Dpunol. AV , "Li UA w7- ZT TF- -77= ALT 7- 4 , - L7/// T.; ;E;., �I�z `77 31 -I--, z 7 77 . . . . . . . . . . - - - - - - - - - - fAl c ...... ...... jV ik c 777 MEET . . . . . . . . . . n_77 71 .77A T I" 71 4 1 . Location C t�— No. ' /(, Date 0 4 71,-3 jr� ,,839 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee T�L $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works c 0 PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP 4-40,10C. A LOT NO. ()Ooq 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. LOCATION 7 PURPOSE OF BUILDING OWNER'S NAME�- ,cliprf"o t NO. OF STORIES SIZE Is x OWNER'S ADDRESSfg jr,,, _(, BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS tST 2ND 3RD BUILDER'S NAME !FAM,,,( tpkTi. SPAN DISTANCE TO NEAREST BUILDING ef 41 DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES 11 REAR MCI GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW Yeq c5;w,mm,-j(, (7,V) SIZE OF FOOTING x 19 BUILDING ADDITION MATER:AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE YES IS BUILDING CONNECTED TO TOWN WATER 401ARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 1 3 PROPERTY INFORMATION SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 3 PAGE 2 FILL OUT SECTIONS 1 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR /IATE FILED MkIL0,1f of SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 19 MAR 2 6 1997 LAND COST EST. BLDG. COST lot -<Do EST. BLDG. COST PER 6Q. FT. iLay. ul-ou. GOUT PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY 'e'l BUILDING IN111111PIECTOR (:� 91? — OWNER TEL. # v � 11747 CONTR. TELJ z- CONTR. LIC. # If!:7 le -S s 0 # --20 �z 76 7-:5 I OCCUPANCY SINGLE FAMILY I ls�ORIES BATH 13 FIX.) TOILET RM. 12 FIX.) MULTI. FAMILY 1-1 i—LA—T1 SHE D WATER CLOSET APARTMENTS ASPHALT SHINGLES LAVATORY CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 3 1 2 13 PINE CONCRETE — CONCRETE BL'K. BRICK OR STONE No PLUMBING '�TALL —SHOWER HARDW D TAR & GRAVEL RADIANT H*T'G PIERS PLASTER 7 NO. OF ROOMS !CIL _6_RY _VJALL 5-NFIN 3 BASEMENT AREA FULL FIN. B'M*T AREA 114 1/1 FIN. ATTIC AREA t!O 8 M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES TA -RT H_ ASPHALT SIDING HARDW'D ASBESTOS SIDING COM/,AC;N VERT. SIDING _�SPH TILE STUCCO ON MTS-ONRY STUCCO ON WIRING 5 ROOF 10 PLUMBING GABLE I HIP GAMBREL MANSARD I BATH 13 FIX.) TOILET RM. 12 FIX.) i—LA—T1 SHE D WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE No PLUMBING '�TALL —SHOWER TAR & GRAVEL RADIANT H*T'G 6 F ING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H*T'G UNIT HEATERS GAS 7 NO. OF ROOMS !CIL B*M'T d EEC4'C_ 'nd NO �ETTI�G BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 13 le -GM m V-4 wiff- 7am :CIE 0 go ;L4 0 L U CL. C u U) 00 u x iz cl x 0 z U) wiff- 7am cf) 0 c/) CL4 F4 U) z 0 0 �D z 0 u U) U) 2 WE I v b-4) I m 4ftA a) E CD CL CA CM CIO CD CD CD Q CL. Cc 0 CL. ZE cmcc cc CL 0 CD Z CL cc cc CL W3 :CIE go 0 L U CL. C cl COL r= s MCD .0 C.3 t; ch lj- 39 lo: ca 0 ch CL.C.3 I.: 0 ja a 20'. .00 CD r 0 V C3.m 0 Z 0 to co LD 0 =ID CLOW COD Eg =0 mo 'col m C E CL= O:a CL con cf) 0 c/) CL4 F4 U) z 0 0 �D z 0 u U) U) 2 WE I v b-4) I m 4ftA a) E CD CL CA CM CIO CD CD CD Q CL. Cc 0 CL. ZE cmcc cc CL 0 CD Z CL cc cc CL W3 Y - FORM U - VERIFICATION FORM A INSTRUCTIONS: This form is used to verify that all necessary Approvals/permits from Boards and Departments'havinq jurisdiction have been obtained. This does not r4�lieve the applicant and/or landowner from c6mpliance with any applicable local or state law, regulations or requirements. *********.*******Applicant fills out this section***************** APPLICANT: Phone LOCATION: Assessor's Map Number Subdivision Street 3 -CxXA63 kog-E Parcel Lot (s) St. Number 'Z'9 *Official use only************************ RECOMMENDAT ONS 0 AGENTS: 61 Date Approve -- -/, "' Conservation Administrator nAi-= DMAMe-+-�At - Comments Date Approved Town Planner Date Rejected Comments Food Ins ctor-Health _-----I�!!�!�:ii,,IE!:Pejlc-Inspector-Health Comments I � 0 Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected M 2 61997 Date q .L p 0 5 e-a4e- L o t IS ,,�,--Edge of - I i) m. 440 1 (117ofS 00,-, "L- o t -16-, , ;of-, J(J -,;res ry ........ .............................. . . ... , -RIM=l � . IM/ (/ 2 15C INV, /Ak= 153.5 9 162 qj 0. & AV q) 40 164 ....... ....... 82.001 RO&M�7Q WO11 ge Of Fovement a e -R f3o' Wide) / C) � 17 L .,, I m Jul. -25 194 12:11 0000 SAWPX200 series MORTGAGE PLOT PLAN EK SURVEY 17 ROYAL STREET, LAWRENCE, MA. 01841 Tel. 505-975-1413 MOOTGAGOR - - - - dQ(dM6t ' DEED REF. PG - ADDRESS OF PRINCIPLE BUILDINO PLAN REF. AB DAlt OF INSPECTION dy, /3 F. vo P. I 0.4r-c-aik S17 -r- ? V-0 I t'.S ' kS )e:S 6 %7Y4�4p mAR 2 6 1997 *I 'j--ju Oki I ul I I ..1 11 '(10 L)" , I , 10 z ...... BRANCH DAlf V_ 12 S&PrING AI)ORF.5 "-)& o P.c. It P ME _:EAmt��_?m t -j VREET '65 ciry/STATE BRANCH C) 0 A 001 Pro VIA Ef f ective -3126/9rb Pliwa: 0 ig,Z?, k'2h'7 --Z;P Q'IR43- commor4 CARRIFR 0 A;R FRi ICI;l CAYI WZY COMPLETE AND WARLE 0111-NTiTY ORDERS VALL BE PW-XCW-0 VAPK opvcrEo 0 I - R N N AER PR'I\'T: C)SQUARE 0 DIAGONAL RADIUS 0 rl A; ) 01 OVERAP . WAI.L: 2 0 G A U F7 27 CAW-!_ [_j -61 u 6 011ACONAL I RADIUS 9 9,-1 o.w. 20 OXXF 0 0 0 -1 T OM ElFsT.O."ce (INclocs) 17 CAL14 1-1 YiHiT;' S-,;�A: ��7 Fj (INCHES) 1 17 W, F N RECTAN LE r. r MAGONALS SHOJ.).J) BE TAKLIN FROW, A 90 .0 "t.STEPS L. 1.1 STEP LENGTH . 1-1POLYMER fli)(jr-tr USTEEL'� i.- RADIUS� ri OT HER STR "'HT u T L j LOCATION: 1-.121TER OF SHN-LOW END n 00TINER (VAAW I-OrATION) K C4 T D 40 E 40 F I C K L m I qmrK"l w p E R I M IET E R —7, �_j A — Isl –=—I sil r,7 -T. DIAG I - R — L) �,TINND!N% .1 'i.,M SIW.10W EN" �p W10111-1 ONLY if reclangulur CORNER Z J Dim; -mn UKN L R wlv,!�R 4 N, 7 x As, v I lu - vt Irl. JA PRO rrom N". Of r 7 1 c� 7 f qr�n) P. 1 Ju"',. 25 '94 12: 11 0000 SAWAX200 series FAMILY POOL AND PATIO INC. MORTGAGE PLOT PLAN 92 So. Broadway LOWrOn0e, Massachusetts 01843 EK SURVEY Phone: (508) 688-8307 17 ROYAL STREET, LAWRENCE, MA. 01841 Tel. 508-975-1413 MOOTGAGOR 01406t ' DEED REK PG. A'3 ADDRESS OF PRINCIPLE BUILDINO PLAN REF. -igr & JrrJp DAlt OF INspEc-nON 9M M4. li�y- /5- ........................... PDP� 7�' MAR 2 6 1997 Pot "I'lu 44vto L", tt, MAR 2 6 1997 "ROME IMPROVEMENT CONTRACTOR Rigistration 118204 jype - PRIVATE CORPORATION I; Expiration, 02/12/99 FAMILY POOLS & PATIOS INC IILLIAM C. GIANOPOULOS BROADWAY AD MINISTRATOR LAWRENCE MA 01843 DEpARTIVET OF P!jBL7c SAFETY CONSITUCTIO1 SUPERVISOR LTr sSE luiter. ZIX%4res: hirthdate: CS 0 0 3 3 0 07,11911997 01/19i1960 Restricted To: 00 WllLnq C POULOS 92 3 BROADWAY LAW30CS, FA 01843 0 r, Location (241,� No. -,0v Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ ACHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ Check# 5 5 5 Building Inspe TOWN OF NORTH ANDOVER BUILDING DEPARTMENT Number: Zjo C) Parcel Number APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING e5M 661y� 220 1.3 Zoning Information: Zoning Di ct Proposed Use BUELDIN FE ISSUED: 1.4 Property Dimensions: Lot Area (sf) Frontage (R) 1.6 BUILDING SETBACKS (ft) SIGNATURE: 2.2 Owner of Record: Building Commissioner/IREeL)Ctor of Buildings Date Side Yard I SECTION I- SITE INFORMATION I 1. 1 Property Address: 1.2 Assessors Map and Parcel Map Number Number: Zjo C) Parcel Number A"t zz 2) e5M 661y� 220 1.3 Zoning Information: Zoning Di ct Proposed Use Address for Service : 1.4 Property Dimensions: Lot Area (sf) Frontage (R) 1.6 BUILDING SETBACKS (ft) 2.2 Owner of Record: Front Yard Side Yard Z_ Rear Yard RegWred Provide ReqWred ProvicW ReqWred Provided SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Su rvisor: 2�/ A/ . T(,/7Z/ 1.7 Water Supply M.G.L.C.40. 54) lie 0 Private 0 1.5. Flood Zone Jmformation: zone Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSEEIPIAUTHORIZED AGENT 2.1 Owner of Record A"t zz 2) e5M 661y� 220 Name (Print) Address for Service : ,iz 41,iG,411 /V. Signature Telephone 2.2 Owner of Record: ")i- X Z_ game Print Address for Service: -,�z 1414&o-6 . . . Al, Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Su rvisor: 2�/ A/ . T(,/7Z/ Not Applicable 0 /��,OA / 10 � Licensed Construction S -I,- /5f SA.4A,7777isor: I - License Number . . Address Expiration Date ignature TOephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Signature Telephone Expiration Date T z 0 I SECTION 4 - WORKERS COMPENSATION (AG.L. C 152 & 25c(6) —1 Workers Compensation Insurance affidavit must be completed and submitted vAth this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... V No ....... 0 SECTION5 Descriptiono Proposed Work (check applicable) New Construction 0 Existing Building 0 Repair(s) 0 Aherations(s) Accessory Bldg. 0 INTY Won 11 �Other 11 Specify Brief Description of Proposed Wob-0 56 , )c 6,6 1 1 a A Z SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant 1. Building MF 19-1.9 C _WOW (a) Building Permit Fee Multiplier 12 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1 +2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WBEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT �/4, as Owner/Authorized Agent of subject property Hereby authorize My ,?ehalf, i1i all rn�fters relative to work a/uthorized by Owner building permit application Date' I SECTION 7b OWNER(AUTTIORIZED AGENT DECLARATION T_ to act on ��1-21?JdAd /'M-T,� ZiElVrZ-1L, l'ue-, 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 JWYA,4 Print Name I � Z2— � - 4: A_� - �: - � — Signaturrof Owner/Agent — Date NO. OF STORIES s1zE 36 e. o BASEMENT OR SLAB SIZE OF FLOOR TIrVMERS I ST 2 ND 3M SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS -HEIGHT OF FOUNDATION THICKNESS -SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND [IS BUILDING CONNECTED TO NATURAL GAS LINE 05/22/02 10:06 FAX 17812462016 ECG MGMT CONSULTkWS qep-11—gi 99:15 AM a K QUQVG:y 978469704& E K SURVEY INC # KAVILRHILL, MA 9 Phone MAW I ON * Fst 979-460-71�M MAGOR id"15i "411,01 ZAV Vio DEED REF. 4m PG 11499 Or PRINCIPLE OUILDING' -PLAN REr g It& IMAM -AL- - DATE OF INS—PECTION IkLAA10. .4 WALE: I's 001 tv Pw1a 0002 P. 132 T. RVIDEL CERTIFIt%T ION rQ: 14c. 36W wc The loCallor' Of ft Pfl"iplt StlUeIVIC/6 his MG4iqGQM,1wG_,$hm aspre" ea��rfflzmyfot mwwar; w"s rid it is not Intendca or repirtcanted j DI I PM *,ty Tint rimm'd survey. TNI, Plan is no( la be ugm wkri mc for -a[ zwmg WWR In 0f_*c7wh6n _cQn*,,Ctcd WIIKI� 4fTy of thi? prop" unm (cor any owmae. 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CD = cn< cc C13 ts co CL CO) w 0 U) w U) In w w cr- w w U) 0 �2 U) 0 go: r. �2 x 0 F4 C2 x 0-4 U) X bo —cu ZW r 90 6 V) Qj 0 co C:j CIS C2 C2 C.3 CL cc co E MCC CF CS CD CL CM 0 3 Q cm mi ce s CA cm CD zip Cc C42 z Cc C2 0 0 cm CLU C/) C/) LA CD C2 cm CD's OF) cc Cc C =CM 0 CL CD CO3 LLI. ::"o CA CD C., CD M CO3 0' u C3 cm CD cm CD 0.41 w J- !9 ts I co C* E co C) 1= ca co ca E co L— CL G3 CO) CO2 cc CL CO2 co CL. CO) CM Q co cc C3 CD CL. CD = cn< cc C13 ts co CL CO) w 0 U) w U) In w w cr- w w U) VAORT11 0 I- SS CH S Date ........................... Le". TOWN OF NORTH ANDOVER PERMIT FOR WIRING // I I ), ;. .,/ This certifies that ........ ;r ...... e .... . ......... ...................................... -1 ' - has permission to perform ......... .......... 1� ....... ........................................ wiring in the building of ............. :.,e� .... / ... ......................................... at ........ ............................... ............. �i—z ..................... . North Andover, Mass. Feelr..� .... �.::. /—b Lic. No,.'.'.. ELECTRICAL INSPECTOR WHITE: Applicant �ARY: Building Dept. PINK: Treasurer GOLD: File ft office use Only k1l y 'ked Um On'* of 4Z CrOMMUMMIt4 of funz-arffim2tts Permit No. legm-tMfut af Vuhift E-ifiau occupancy Fee Checked BOARD OF FIRE PREVENTION REGIJUTIONS 5527 C%M 12:00 1 3190 peav"s blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK All work to be performed in accordance with the Massactiusetts Electrical Code, 527 C 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) saz. QK or Town of NORTH ANnOVF-R To the inspector of Wires: The udersigned applies for a permit to perf e electrical work described below Location (Street & Number) Owner or Tena Owner's Address Is ',his permit in conjunction with a building permit: Yes N a Ell (Check Appropriate Box) Puracse of Buiidina Utility Authorization No. Existing Service Amps I Vdits Overhead '--j Uncgrnd Eli No. of Meters New Service Amps I --210its CverheaC Unag.-na No. of Meters Numcer of Feeders and Ampacity af� Location anc Nat, --re of Pr000sed E!eclncal V1JCrK I�Jl lee ZI No. of Liqnting Outlets No. of Lighting Fixtures No. of Recec-ac:e Cutlets No. at Switc-i Outlets No. of Ranges No. at Oisoosais No. of Dishwashers No. of Dryers No. of Water Heaters No. Hycro Massage 1ubs OT HER: No. of �ct -�--=s Atove— in- r7 Swimming Pcci - grin.a. — gmc. No. of Cil Burners No. of Gas Eurners No. of Air C--nc. Hea, 7cai No.at P-urncs 7ans totai No. of '7ransformers KVA Generators KVA No. at Emergency Lighting Bar*ery Units FIRE ALARMS No. of Zones iotai No. of Cetection and initiating Cavices 'crts I iotai i'ON ScaceiArea �Jeanna K101 Heatina Oevtces KW No. =t of KW Sicns Sailasm dial HP No. of %lotcrs No. at Scuncing Devices No. at Seit Contained De,ec*:ontSouncing Devices Local — Munlc�oal !-7 Connecuon Low Voltage Winric INSURANCE CCVERAGE. Pursuant ZO the recuirements ot *Aassac.-.%.;ser:s general Laws I have a current Liaodity Insurance Policy inCucing Ccr-=etec Cceravions Coverage or its sucs*.antial equivaient. YES = NO Z I have suarninea vafid proot at same to the Ottice- YES = NO = it you nave cheCKeo YES. ;:lease indicate the type at coverage --y crieciting !me acprooriate oax. INSURANCE = BONO Z OTHER = (Please Scec:fy) (Exoiration Date) E-stirnatea value of S�eczncai Work S Want *a Start Insclecuon Daze ;;acL;es-.er-: Rougn Final Signed under -.Me Penalties at perjury: FIRM NAME C LIC. NO. U-censee —S;Gna,%;.,e _UC. NO. I Zrj��-,t nor- /W Bus. 7el. No. Addre Alt. 7el. No. z OWNER'S INSURANCE WAIVES: I am aware trial trie a censee aces nave the insurance coverage of its suosTantiai ecuivalent as ouirea by Massachusetts Generai Laws. and mat -ly S:qnarure on tras =ermit application waives this reouirement. Owner Agent (Please cnecx one) '79tecincine No. PERMIT FEE S (Signature ot O%vner or Agent) Date.. 666 '40 40 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ...... -Z./j . ................................... has permission to perform ....... ...................... IQ wiring in the building of ........ ............................................ ..... ).,7.&.- (zac( (OL at ...... .......................................................... . North Andover, Mass.8 Fee... 3.5..'A) Lic. No.��Wk ............................................................ ELECTRICAL INSPECTOR CU WHITE: Applicant CANARY: Building Dept. PINK: Treasurer The Commonwealth of Massachusetts 01iicc Usc,Gnly Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVEN11ON REGULAnONS S27 CMR 12:00 3/90 (le"e blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INTORHATION) Date 12 — J/ — City or Town of & /,�# To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 2k - Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes [2rNo n (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service ______�mps Volts OverheadEl UndgrdE] No. of Meters New Service —Amps Volts Overhead El Undgrd 11 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Z5�lral,"to Q",o Z,4//" Jt11;1e0Z1,yP V"�eoz_ No. of Lighting Outlets No. of Hot Tubs Total No. of Transformers KVA No. of Lighting Fixtures Above r-1 In - Swimming Pool grnd. L_J gr-nd. Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local 0 Municipal Other ConnectionD No. of Ranges Total No. of Air Cond. tons No. of Disposals Heat Total Total No. Of Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No , of No. of signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current _�i�ility Insurance Policy including Completed Operations Coverage or it-esubstantial equivalent. YES ff NO E] --I have submitted valid proof of same to this office. YES 01' NO 0 If you have ch k d YES lease indicate the type of coverage by checking the appropriate box. , /nc e "p INSURANCE Ei, BOND 11 OTHER E] (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Ivh �_/ — Inspection Date Requested: Rough _ Final Signed under the penalties of perjury: FIRM NAME _LIC. NO. Licensee Signature- LIC. NO. Address Bus. Tel. No. —Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent, (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) z 0 p >1 c 0 u c t; 0 LU 0 LL. 6 z 6 Z E E 0 (7i iz a- u REMARKS BY ELECTRICIAN: 7- 7 2539 Date.. TOWN OF NORTH ANDOVER 0 PERMIT FOR GAS INSTALLATION8 lam* This certifies that ... ... .... s installation has permission for gas installation . . in the buildi of ................ ... a' gs I ........ North Andover, Mass. at. .... ..... ..... Fee. t� . Lic. No.. . .......................... Ck r7 03 GASINSPECTOR WHITE: AppIIcknrr'0--k CANARY: Building Dept. PINK: Treasurer GOLD: File MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER Mass. Date 7 tuilding Location Permit # cRS'347 A N Owners Name ijie (S New �-7 Renovation Replacement Mans Submitted -7, 1 10 =:z (Print or Type) Check one: Certificate Installing Company,.r4k 1h6e LIM � iVj� Corp. Address ('� 7 S�j L,.> L-)(- I/ Partner. FF-trm/Co. Business Telephone: SOY 4-15 Y �5 Name of Licensed -Plumber or Cas =itter e a Ou Y, 6 Insurancr- Coverage: Ind; e o` i-surance coverage by.che . __.k in g the c appropriate. box:, Liability insurance policy type of indemnity F.Bond Insurance Waiver: 1, the undersicne,_-�, have been made aware that -the licensee of this appiication -does not have any one of the above three insurance..coy�er:pges..__'_ Signature of owner/agent of proper:y Owner = -Agent I hc:c!3y ccrtiry that all of the dc(Ads and iaformation I have zuhraitted (or entezcd) in &Love x0plication are true and accurate to the best of mY IL"awtedge and Mat zU piumbing work and LnICALUtions -.crfor=zd undcr ftrrmit i==d roz this sprik:aticta viU be in cocapdance witft ad -rcrtLac=t Pcc�zioms or t1ho MAsuchusetts SU(c C4% C13de Zrtd C%22tcr 14-' C�C ::Lo Cen=zi I-Aws- GaSZEit�-_er Signature of Licerise� 'Masl�er Plumbe_- or Gasf-4tter C _';:o1_'=-1eYMar1 a3c�. is APPROVED (OFFICE USE ONLY] L.Lcen��7u_rnber 0 0 01 a% 14 0 z P W UZ C2 UA tu U11 C W — Ul I.- .2. 02 Us Ul ay Ut LU 0'- W U, ca U_ Uj 93 tu > = -< !i 0 CL Stia--3SMT. F-3ASEMEUT 1 1 _4 7� 7 I,% ST FLOoFr ZX0 FLOOR 3RO FLOOR _1 --T I 4TKFLOOR ST K FLO OR -1 1 -7- 15TH FLOOR 7-rK FLOOR aTH FLOOR (Print or Type) Check one: Certificate Installing Company,.r4k 1h6e LIM � iVj� Corp. Address ('� 7 S�j L,.> L-)(- I/ Partner. FF-trm/Co. Business Telephone: SOY 4-15 Y �5 Name of Licensed -Plumber or Cas =itter e a Ou Y, 6 Insurancr- Coverage: Ind; e o` i-surance coverage by.che . __.k in g the c appropriate. box:, Liability insurance policy type of indemnity F.Bond Insurance Waiver: 1, the undersicne,_-�, have been made aware that -the licensee of this appiication -does not have any one of the above three insurance..coy�er:pges..__'_ Signature of owner/agent of proper:y Owner = -Agent I hc:c!3y ccrtiry that all of the dc(Ads and iaformation I have zuhraitted (or entezcd) in &Love x0plication are true and accurate to the best of mY IL"awtedge and Mat zU piumbing work and LnICALUtions -.crfor=zd undcr ftrrmit i==d roz this sprik:aticta viU be in cocapdance witft ad -rcrtLac=t Pcc�zioms or t1ho MAsuchusetts SU(c C4% C13de Zrtd C%22tcr 14-' C�C ::Lo Cen=zi I-Aws- GaSZEit�-_er Signature of Licerise� 'Masl�er Plumbe_- or Gasf-4tter C _';:o1_'=-1eYMar1 a3c�. is APPROVED (OFFICE USE ONLY] L.Lcen��7u_rnber ( PHONE q8LL3 A.M. FO �:l 0 A T E S.': 1 M E _ P.M. A PHONED OF PHONF- RETURNED YOUR CALL PLEASE CALL AREA CODE MESSAG NUMBER E. WILL CALL AGAIN CAMETO SEE Y U WANTS TO Is-- I G N E 0 niversar 48003OU SEE YOU .ft OK CN r.-4 0 UmEd C -i t CD ca E ci cm CD cm ccc," Ca w —'s A CD K L co MY* cD . C* cm tv 2 s V— co wa 0 C'* CD C.3'F CD rm C.2 G3 C3 CD= CL*- 0 C) ..- ;; = I w MR, CD :5 = = MD cc M CL= CD E C, , LU &- C.) =.L2 ch C.3 a) C3 CD = C COO C2. a) :s ED ;a ca m No 40 C) CD cc 0 L- = *- CL.:�a- 5 q SZ) L J� Q) C/) 0 zi 0 U) C/) z 0 u C/) LAM C= ICA., LLJ C6 0 0 'S �21 ;t lzv 4--) .v� u ui LAJ Ll— a] t7c CA co > < 2-7 CD E LL- co Uj ZW C13 w Z'4 C3 CO) cla CIL A CO) co CD :5 Co CO Cc C'/) 2-7 CD a) C) —cri bo t* —co (U C/) 0 P. C2 u W. :3 '2 x z '2 U'-) Ll� 0 aze. Xr- C: w co U) U) C -i t CD ca E ci cm CD cm ccc," Ca w —'s A CD K L co MY* cD . C* cm tv 2 s V— co wa 0 C'* CD C.3'F CD rm C.2 G3 C3 CD= CL*- 0 C) ..- ;; = I w MR, CD :5 = = MD cc M CL= CD E C, , LU &- C.) =.L2 ch C.3 a) C3 CD = C COO C2. a) :s ED ;a ca m No 40 C) CD cc 0 L- = *- CL.:�a- 5 q SZ) L J� Q) C/) 0 zi 0 U) C/) z 0 u C/) LAM C= ICA., LLJ C6 0 0 'S �21 ;t lzv 4--) .v� u ui LAJ Ll— a] t7c CA co > < 2-7 CD E LL- co C13 C3 CO) co cm CO) co CD :5 Co CO Cc C'/) 2-7 CD a) C) co imp% CL-) co C.1) C* L - L- CL M CD CL CL CO3 cm Cc cc EL co) Q Co < Q co CL. ;z L.2 CO) cc cc CO2 7e L o c a t i o n No. Date 412-:--1-17—fe� 'A 7374 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ :=::::::Z Foun,dat!Qn Permit Fee $ -V I e641ze� Otfier Permi('Fe; s e.) D Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector Div. Public Works a A - Location Za No. Date --5,e TOWN OF NORTH ANDOVER, Certificate of Occupancy $ +A9 Building/Frame Permit Fee $ Foundation Permit Wee $ CH Othe r Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Xt Building Inspector M3 Div. Public Works J�Locatio&—' Led 16 - 4joc- No. '517 Date i TOWN OF NORTH ANDOVER Certificate of Occupancy, $ too )-/I- Building/Frame Permit Fee $ C;P yr, S ACHUS Foundation Perrhit Fee $ 1"y Other Permit Fee $ Sewer Connection Fee $ 30� Water Connection Fee $ ?i-) I TOTAL �44/29/94 16:16 7 f'. 8 6 $ Bui[ ctor 2,149.00 PAID Div. Public Works Location I No. Date A�-4 I " 7- : I � �-, 4CHU TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Aj, 1 17 2" W, Building Inspector Div. Public Works 7 �4 Location j' No. -.k;- -7 Date 4 TOWN OF NORTH ANDOVER Certificate of Occupancy s 7j Buildin'g/frame Permit Fee $ Foundation Perrnit*-ee,? s Otl�qr Permit Fee $ SelYeko!rytion Fee $ Waie? ConnectidV4 $ /,22, TOTAL S-, Bujlfdln�l sect r/. 1. 00U. 41110:44 5 U Div..,Oupfic Work� A 0 APPLICATION FOR PERMIT TO BUILD NORTH ANDOVER, MASS./��,",) Lill PAGE I MAP 4 -JO. ,ZONE INSTRUCTIONS SEE BOTH SIDES Aws POW FE Y f, 0 d PAGE I FILL OUT SECTIONS 1 3 LwFm 1: Z) C-111 1) 6) PAGE 2 FILL OUT SECTIONS 1 12 DUEFRAMElror'EnnMlT$4L/Z- I �00 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ',? — — — SIGNATURILOF OWNE U RIZED AqfNj ol '2 FEE (40r--e)Z �41- 0 C) C) PERMIT GRANT 0 a ly'41z- '1 19 Z —� V9V 2 1993 A, OWNIERTEL.#— CONTR, TEL. #—,o��3-4:� CONTR. Llr,', FV3 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 3 �C5 EST. BLDG. COST PER *Q.'rT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF OCLECTMIKN BUILDING IP LOT NO. 2 RECORD OF OWNERSHIP JDATE ISOOK !PAGE SUB DIV. LOT NO.Jr P/ f _4()O Ace 13) L01--ATY0 To".61 'o /C PURPOSE OF BUILDING :r/, !DWNER'S NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD ax /40 BUILDER'S NAME SPAN Iq DISTANCE TO NEAREST BUILDING 140" DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES 331 REAR GIRDERS AREA OF LOT FRONTAGE Z 4Cr-e HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x e, IS BUILDING ADDITION /V MATER:AL OF CHIMNEY IS BUILDING ALTERATION N ISBUILDING ON SOLID OR FILLED LAND 1,-d WILL BUILDING CONFORM TO REQUIREMENTS OF CODE y'e-5 IS BUILDING CONNECTED TO TOWN WATER V 0-� BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER Itlo IS BUILDING CONNECTED TO NATURAL GAS LINE MAP 4 -JO. ,ZONE INSTRUCTIONS SEE BOTH SIDES Aws POW FE Y f, 0 d PAGE I FILL OUT SECTIONS 1 3 LwFm 1: Z) C-111 1) 6) PAGE 2 FILL OUT SECTIONS 1 12 DUEFRAMElror'EnnMlT$4L/Z- I �00 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ',? — — — SIGNATURILOF OWNE U RIZED AqfNj ol '2 FEE (40r--e)Z �41- 0 C) C) PERMIT GRANT 0 a ly'41z- '1 19 Z —� V9V 2 1993 A, OWNIERTEL.#— CONTR, TEL. #—,o��3-4:� CONTR. Llr,', FV3 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 3 �C5 EST. BLDG. COST PER *Q.'rT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF OCLECTMIKN BUILDING IP BUILDING RECORD OCC�PANCY 12 TINGLE —FAMILY S'ORIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOFLOT AND DISTANCE FROM MULTI. FAMILY _[O'FFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - APARTMENTS I 7d RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 9 T, mavfm PAM Ain, Ilk It CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 2 3 CONCRETE BUK. PINE 1'�DRY BRICK OR STONE HARDW D PIERS T—LA—STER WALL . UNFIN. 74 3 BASEMENT I AREA FULL 14 1/2 1/1 11 F11 . B M'T* AREA FIN. ATTIC AREA t1O 8 M T FIRE PLACES HEAD ROOM MODERN KITCHEN_ 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING WOOD SHINGLES -EO-NCIZETE EARTH ASPHALT SIDING_ ASBESTOS SIDING VERT. SIDING HARDW'D COMMCN -;�SPI —TILE STUCCO ON MZO—NRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME CONC. OR CINDER BLK. ATTIC STRS. & FLOOR WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR POOR DEQUATE -NONE 10 PLUMBING 5 OF BL G LE L 4/ HIP BATH (3 FIX.1 -_j AMBREL MANSARD TOILET RM. (2 FIX.) LAT F T SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TIL DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER EMS. & COLS. STEAM STEEL BMS. & COLS. 'HOT W'T'R OR VAPOR WOOD RAFTERS �IR CONDITIONING RADIANT H*T'G UNIT HEATERS I A loll I El ECTRIC 7 NO. OF ROOMS B'M'T 2nd Ist 1-13d 11 NO HEATING 9 T, mavfm PAM Ain, Ilk It 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 fills ou this section*****"********** APPLICANT: T 2=if M`Q Phone 4Z7f q7S - F715 LOCATION: Assessor's Map Number Parcel Subdivision 2042? ]�c Lot (s) Street — St. Number -Zb— ************************Official Use Only************************ RECOMEENDATIoNS OF TOWN AGENTS: "'-�I � Conservat�ion �Admi�nist�rato�r Date Approved 14L Date Rejected Town Planner Date Approved Date Rejected Comments Date Approved He th Agen Date Rejected —4 Comments Public Works - sewer/water connections driveway permit 27 - Fire Department 4&1� V Al? Received by Building Inspector Date NOV 2 qo "'TION NO A 4A VIA is Oki - 4c LOT 17 lee 4L,7� .40- 01 84 - ftr E N'C_ Rim or _,F qqo too F-L-E:V- t 1<0 NN `rF-`$T1ON j 64 th, IOT 17 TA011- t-L- Aal -84 OF PA q� too (WFICE-S (A.: IWILDING (.()NSl:ltVA'1*1()N 0 1 V1 *11 A. N 1.) 0 Nr E I t I 11VINI, IN I IF I'LikNNING'. & AH CHIAINEY APPLICAHON ANO I'Ll"All I* ATE )CATION PK A-1 PERNI'l' :62-9 1:211 r,l;iii I, # 5-1. 7 — UNER'S NAME: '96c�— -,Tyq 1ILDERIS NAME: :kSON I S NAME: -Th 6��tzl /gy kSON'S AVORESS: Z,:gc At 9 63d6c) Al WN'S TELEPHONE: r K7 — 31 JERIAL OF CHIMNEY: (3 6oc /C-, ITERIOR Clfl&(NEY:—*' EXILRIOR CHIMNLV: IMBER ANO SIZE OF FLUES: IICK14ESS OF HEARTH: H �U civDiiney olL ()iaepCace con(loAm to 4he. U0 VLV- CO(h tUld 11(tVC AUIC-5 (Old .gutatiow beeii /LeceZved: .TE: GRA -ZilT GRANTEV:—i�ff IBERT NICETTA, 'ILVING INSPECTOR SPECTEV: -'AIARKS: r.. L E SOLLD BLOCK R EQ U I I I E'D THIS PERMIT MUSr GE VISPLAVLA) 014 IVE PUNIAS C�� 7e, I? / -, F OK x 0 0 E co u k Uv u kz CD 2) CO2 CD w CD LU U) C) E C:) L) 1.-0 u — C) >. CE) L- > C/) u 7J 0 1= cm M '5 > 6 Qj C: 8 0 Qj V) 0 0 1:4 u �c 0 0 1:4 Q) c . A �z "FL CO) 0 w :j - E cn ui 0 z C.21 cq co's co -ce It emu us 45 w 14. No k C� E= 2' �i C* LA ow C=n W CD C., JR lqw fA Cm dol'. Ca .5 CL cm 0'3 *40* C'a c LL- cc M CA CL= cc -@ = — Z� ; LU b- C3 = M cm oo CD = = CL C* CD co .0 Cos C13 L—:E CL* - Ki C) U [ ......... E L co CL 42 Cf) GO CA 5 .C, �j 0 M r C5 .5 ca co cm PQ CD U- 0 LCA -1 CD tal ral C6 ui ui CD 0 E co k CD CD 2) CO2 CD CO2 CD LU U) CD L- CL 0 CD I.— = C:) L) 1.-0 CD — C) >. CE) L- > co 1= cm M cm CL 2L CO) cc C.3 "FL CO) cz C.3 CD CL CO) cc CL (a CD ;M �E CERTIFICATE OF USE & OCCUPANCY j cvin, ci North Andover Building Permit Number 517 (1993) Date AUGUST 12, 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 28 JERAD PIACE ROAD (Lot #16) MAY BE OCCUPIED AS SINGLE FAMILY QWEKNG W/3 CAR GARAGE IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Robert Janusz 40 Sunset Rock rd. ADDRESS Andoye"_MA Building Inspector Date ... tl 41. ...... ORTk 0 A TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ISS CHUS 4 This certifies that ........................ has permission for gas installation 1-4-z- . . . .. . ... . . . . . in the buildings of . ................... at ........... North Andover, Mass. Fee��-� ..... Lic. No....."?.3-17 ............ ....... GASINSPECT00 Check # lie) 42 5868 n noun on mass on on on Now NUNN on- Wandu owns a MENEW 0 NOWN a on a MUSEUM NUNN UNION *=Nunn now I i""py C#rllty 1FW 0 of the "eil 4r,d 11`1&J 4111 P4UmojN won " Infl:wMallon I have 61,bmined (Of 4`4146(ed) in -,Ad In6tailal4na PQf10(M*d wndof Permit 4bo- ""60n We rue and Accurew AA&4'&"VWv S4410 Gas Code and Ch&M., 10 the D" of my kr0.%0,;, ha 142 of the G 1""'d 'of "I "iCA110frk *jN ve "'form" 11',e owner Or his age - 41 Laws. b* in Compiler" w1th AN Pertinent nt that I cio no, haye liab,111y inaUrance InCluding COmplet Ocl OP"�O'ns Coyerage ALL APPOINTMENTS F a— - — "" I I 1� ll�N 3� P7 E�—C7T 11 C N A R E -- #YlpA (3 Signature Of O`wner/AgeTI TF —8 E —M A� D6—E� �Y; L 1-1-1 I have a current liability. aO� insurance polic, inclu(je y to CoMP18ted OPerations co rage. C2/ n a We 01 Llcenm—d —pj—umb—,, �j z m r m 0 m 0 > < -4 v 0 m z 0 m "n 0 CID z r, z 0 z C) 0 a 0 "a z 0 m m 0 C) m rn Ln m n 2! z V m 0 z m -4 0 m W m m 0 0 m 0 c LA m 0 z r, — / 0 �' Date. . . . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING -x e 4" has permission to perform ............. e ...... plumbing in the buildings of ............................ atc': ............. I North Andover, Mass. Fee?A- ( r-y- o� ..... Lic. No ........... ...... PLUMBING C�TOR Check # 7238 IN�ANCE C6V�gp,,-. I r�aye a curr ent Hablitty insurance yes (2 N o C) P011cy or its substantW equivalent Which meets the YOU haye checke-dylj, ple_a3e Indicate the tYPo coverage by chocking requirements of m0l. Co. 1 4 2 A llabtf�y l,)3Ur-dnCe policy (3 Other typo Ot Memnfty C] thc'approPriate'boK OWNER'S Bond C 'NSURANCE WAJVER: I am aware that the Ilcenuo Chapter 142 Of the Mass, Generaj LaW3, And that MY signature P� Lay the Insurance cOyerage requirec �)y n this permn aPPllcatlon walves this requl 61 Or 1) Check one: er 3 ent Owner 0 Aoent 0 Q1, ail Of the d'Wls and lnlOmlatlon I hays subm)tW ail plumblng woA and 4-�3W,aUorv3 PqdQrTn0,d ptr�n BY 02 02 of Lhs M"uchuutL3 State Plumbing 41 0 rlu Wf ;gn7a f d) In aboye &pP Wn rmh L. us tNQ and accwato to the De 5 � 0! -7, 2 of U &PPIICAUon will bf) 1r) Compliance wim a:! I A -w 3. — (>Y/7own Type Of Ucensa: Mute( F �!!� , 11� b . journeyrw �3 1 11 R Ucen&e Number 011 MASSACHUSETTs UNIFORM APPI-Ic (Print Or TM) * ATION FOR PERMIT TO DO PLUMBING 4 7�e�la v�� Mesa. Date S7 Permit Building Location—A—,?--j7#)rrd. # -------- Owners Name New Renovation C3 TY of Occupanc�,,,—gZ2��. Replacement Plan3 SubrnMed: y e 3 C3 No' CD FIXTURES x 0 Z z 0 0 x z z z Q Vil x 0 cc W V11 x z — V) Z) 0 a Z Q. V D CC UJ 0 CC V1 W 0 0 z 0. j Q Q x > < -C . 0 x Z V) a. V3 4 0 Q V, ( ; W W SUB-83MIT, 0 -K Q < OA39MENT IST LOOR 2.40 FrLOOA ZRO FLOOR 4TH FLOOR 3THFLOOR OTH FLOOR 7TK FLOOR 8TH F-LOOR installing company Name, A L COMPAn INC. C y IN Ad�reS3 AVEO�M� 18 COVF AVVMWE Check one: BEVERLY, HA 01915 Cor;>oratlon 1 990C Business Telephone ---1zUj—j7 I — 4 9 0 -1 - 13 Partnership -------- Na.mc Of Ucensed Plumber _ AL BELL 0 FIrm/co. IN�ANCE C6V�gp,,-. I r�aye a curr ent Hablitty insurance yes (2 N o C) P011cy or its substantW equivalent Which meets the YOU haye checke-dylj, ple_a3e Indicate the tYPo coverage by chocking requirements of m0l. Co. 1 4 2 A llabtf�y l,)3Ur-dnCe policy (3 Other typo Ot Memnfty C] thc'approPriate'boK OWNER'S Bond C 'NSURANCE WAJVER: I am aware that the Ilcenuo Chapter 142 Of the Mass, Generaj LaW3, And that MY signature P� Lay the Insurance cOyerage requirec �)y n this permn aPPllcatlon walves this requl 61 Or 1) Check one: er 3 ent Owner 0 Aoent 0 Q1, ail Of the d'Wls and lnlOmlatlon I hays subm)tW ail plumblng woA and 4-�3W,aUorv3 PqdQrTn0,d ptr�n BY 02 02 of Lhs M"uchuutL3 State Plumbing 41 0 rlu Wf ;gn7a f d) In aboye &pP Wn rmh L. us tNQ and accwato to the De 5 � 0! -7, 2 of U &PPIICAUon will bf) 1r) Compliance wim a:! I A -w 3. — (>Y/7own Type Of Ucensa: Mute( F �!!� , 11� b . journeyrw �3 1 11 R Ucen&e Number 011 Ic z —4 m z r I V )10 M f" 0 V m c 0 *0 m 9 M > z V 0 0 c T z m 0 X 0 a 0 0 0 m rn M 0 —4 0 m rn r 0 0 m 0 a V) M z r -K Date ... ....... o4' TOWN OF NORTH ANDOVER PERMIT FOR -GAS INSTALLATION This certifies that Av cl has permission for gas installation ................... in the buildings of at North.Andover, Mass. Fee. Lic. No.. ... ....... .............. GASINSPECTOR Check # 1141�? MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY A DATE [2�-- U//-r��.--IPERMIT 4 JOBSITEADDRESS W NER'S NAMEF- A 74— OWNERADDRESS TEL -7, TYPE OR PRINT OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RESIDENTIALM CLEARLY NEW: 0� RENOVATION:[] REPLACEMENT: PLANS SUBMITTED: YES No L�—N - 6�A APPLIANCES -1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS =7 zr n MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOFTOP UNIT 'TEST UNIT HEATER UNVENTED ROOM HEATER WKI-ER HEATER INSURANCE COVERAGE I have a current jjj�insurance policy or its substantial equivalent which meelsthe requirements of MGL. Ch. 142 YES -MO I IFYOU CHECKEDYES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 1 -\'*4 LIABILITY INSURANCE POLICY y'� OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER: I am aviare that the ficensee does not have the insurance coverage required by Chapter 142 of the Massachusetts.Generat Laws, and that my signature on this permit application waives this requirement. CHECKONEONLY: OWNER [_--01 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of thedetails and information I havesubmitted orenteTed regarding thisapplication aretrueand accuratetothe best of my knowledge and thatall plumbing work and installations performed under the permit issued for this application Will beinco nce Wtb all Pertinent proVision of the [Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTEIR NAME- (I MCENSEO/ SIGNATURE IMP MGF jp 1-LPGI CORPORATION ]LLC U�- �JGFI PARTNERSHIP COMPANY NAME:.If P ',4 �'ADDRESS 1'� P�� STATE V��-` 100' V-' C;ITY q71' FAX MAIL �'CELI-f 0 6i LU LL 'W'asu wromwed W #2111 ewliffmigitti , 0111-11figwo Awpf MOW= 3 Oarl molma comp. Insurancere'(110red.1, aw rllq&. -- ----- site Illittm. Althch'a COX" Polley wilrop Ilippsol tirtiplog W, ED AS* ,r, Cmv, Iss [dug, Antrwilry, (wrcjL-0jqr, bowfifred Ilmoh-etink.1ciam, lbsitralltv- eoumrdbrug aft iverk Wit oremawkson-oomm "WtfrfUID MOY&F.4 CoMp fimmuce mijokedjl' comp. Insurancere'(110red.1, aw rllq&. -- ----- site Illittm. Althch'a COX" Polley wilrop Ilippsol tirtiplog W, ED AS* ,r, Cmv, Iss [dug, Antrwilry, (wrcjL-0jqr, IRfOrMation itud, fustmit- pow, O"fM&eiEcmj*yees�- Ibm cri6lifflK, ore, ormfitttue- "AWPewn �Fp'le ismk-- Of Mwfficr, MR&Irmy,'contrad abft, A4k'j)tp/qjt,iis-de�uied as -a4 intliviatmi, co*mWon OwAvy ormd kyellfithaiisaws, `nOtluft ()n orb ffi&hou* 0 kWh, f producediweeptabre-,Cxjkknwor, romp' Mhueemlitli. fliefilsItFance, , I-SUT)Crwlbn 01""hto -1%18 At (RIC 14 *ozkex.0 cojupellsatiojI. afrgavit.tOMP&M.Y... byrke6kong Me-6mm-thatappli,; t(ovmr-situatibn m if .,,ec!Z99%suppIy, si&-conftacfo -f -cermcategof F T 0-1-u 11MICe.COVeYage. A�is#bvslire�tosig;i)and'dhfeflieaffid.-tvit. isbef DIV I -reqtrh— by, bi if)T*tl am d t(y, obt� iwa Ivorklere POOP* bu PbIiI-APTme call the*J�,.&Pprtinent' FWfIL-,nuntbee-lisWWmr— Seff-lnstwcd.compaftie�sftood enter thr C Itror TOW11 offlciw� b&-qire!fijat'ho aff- -t davit Sb 11 I)WID hLaMkDnjw.qpprhNmr fowmay, bmprwdm,fethe� fGtIktbmPeFJmI�.0F. Hbonsm, A ii"r; calf, y qmflb �jefqijjone and .MPatim- Ont of %dtTstfi%fAcdK'*6ts Office Of fiRmwon"alm 61DOf � Wa silihgton Sftet -Boston,, M& 02111. 617-727-49M-eXt406 or 1-8777-MAS&AM # 10691 4, 0 . 41 SS CH 5 Date ...... /P.- /../ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies thak ............................................................................................. has permission to perform .... . ........................... wiring in the building of ......... .................................... ,0 a J-,4g,.q.,6 .... i) at ............ .................... .6�F ........... . North Andover, Mass. Nwe ic. No.. 1--v, i� ...... /�-, . . ...... Fee .. .. L ............ ...... ECr AL INSPECTOR Check # -3> iK Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 11) 391 BOARD OF FIRE PREVENTION REGULATIONS [ Occupancy and Fee Checked — Rev. 1/071 - Q,ave 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 (PLEA SE PRINT 17V INK OR TYPE ALL INFORMA TION) Date:. io—ta— ( ( City or Town of- NORTH ANDOVER To the Inspector of Wires: By this application the undersigne ives notice of his or her Tn—tention to perform the electrical work described below. Location (Street& Number) P-4 N P1 Arr- Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Telephone No. q q �- Yes [] No Ell, (Check ADDronriate Box) Purpose of Building Utility Authorization No._ Existing Service Amps Volts New Service Amps Volts Overhead El Undgrd No. of Meters Overhead 0 Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: APSLAUAT100 OF 2DLW yFjjL-Vnp Aitach additional detail y desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: -!JQE2�L (When required by municipal policy.) Work to Start: 10-14-11 -- 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 Eg"' BONDEJ OTHER F� (Specify:) F -)(P 12--BJ-2-011 1 certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NA aJ04)(?A�l n eltt-4-r� C LIC. NO.: �E: Licensee . Ir�1t)r'll 65 Signature LIC. NO.: (1fapplicahl, enter 11 4 Z4�� Address: le exempt' in the licenLe num�r 1�e.l Bus. Tel. No.�Uk:f�614544q3 .4 - W L�I]I . Alt. Tel. No.: *Per M.G.L c. 147, 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) El owner 0 owner's 2&ent. Owner/Agent Signature Telephone No. PERMIT FEE. S C4 r"V't1-4- &IZAP -rl &0r,.1C11,PC7 �- 7 - X t on ol e luituw ravie mg ve waived by the of Wires. No. of Recessed Luminaires No. of Ceill.-Susp. (Paddle) Fans 1�ector No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above I Swimming Po i—n-, ol El 0 No. of Emergency Lighting ernd. Zrnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALAR of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump No. of Self -Contained Totals: ..... .. ....... Detection/Alertin2 Devices No. of Dishwashers Space/Area Heating KW Local 0 Municipal El Other Connection No. of Dryers Heating Appliances KW Security stems: No. of Water No .0 No. of No. of evices or Equivalent Heaters KW Signs Ballasts Data Wiring: — No. of Devices or Eguivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications W=. No. of Devices or Eq ent OTHER: Aitach additional detail y desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: -!JQE2�L (When required by municipal policy.) Work to Start: 10-14-11 -- 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 Eg"' BONDEJ OTHER F� (Specify:) F -)(P 12--BJ-2-011 1 certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NA aJ04)(?A�l n eltt-4-r� C LIC. NO.: �E: Licensee . Ir�1t)r'll 65 Signature LIC. NO.: (1fapplicahl, enter 11 4 Z4�� Address: le exempt' in the licenLe num�r 1�e.l Bus. Tel. No.�Uk:f�614544q3 .4 - W L�I]I . Alt. Tel. No.: *Per M.G.L c. 147, 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) El owner 0 owner's 2&ent. Owner/Agent Signature Telephone No. PERMIT FEE. S C4 r"V't1-4- &IZAP -rl &0r,.1C11,PC7 �- 7 - X )ve-vp 7 -f� -I � p4l