The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 30 ELM STREET 4/30/2018 (2)I I I \ Dute~ � ' TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING [ \� 'This certifies �[ } ��`/� ��_��~—~' —--- ----'--- -� -' r------' permissionhas iso at �o�b �o� --_---------------------------. '_---�--, . Feo_��.q ..... Lic.No. i.-X*9.j . --------------------------. PLUMBING INSPECTOR Chook# ^ �'y I , k - I IIIIIIIIIIIIIIIMMMM =�====l SHOWER STALL SERVICE I MOP SINK WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability nsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 9Z YE&ONO 0 IF YOtJ CHECKED YES. PLEASE INDICATE THE TYP OVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY E770THER TYPE OF INDEMNITY 0 BOND [I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [] AGENT SIGNATURE OF OWNER OR AGENT - () I I hereby certify that all of the details and information I have submitted at entered regarding this applicali rueandac r lothebe o[rTyyknovAedge be and that all plumbing work and installations performed under the permit issued for this applicali;�� inc lian ertinent provision of the Massachusetts State Plumb* Code and Chapter 142 of the General Laws. PLUMBER*S E7�1 IC 1'71!e"4 9NATURE L jP MP JP CORPORATION 01# PARTNERSHIP LLCE1 # -W -- COMPANY NAME t4ft-" (::I 4—f- ADDRESS F'Dri-� TEL CITY STATE ZIP —71tL ' LJ 15, Lt'Z- 4 FAXJ3� '2" CELL q-7'?�) EMAIL W'5'r , , /. 4A V� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK P TYPE OR PRINT CLEARLY CITY MA JOBSITEADDRESS OWNER ADDRESS OCCUIPANCYTYPE COMMERCIAL 0 I NEW: RENOVATIO14: REPLACEMENT - DATE PERMIT # (a OWNER'S NAME TEL'Tn 'IA) ZZV�� FAX EDUCATIONAL C1 RESIDENTIAL PLANS SUBMITTED: YES NO[] FIXTURES I FLOOR- 2 3 4 5 6 7 a 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEN DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIORJSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR (INTERIOR) I , k - I IIIIIIIIIIIIIIIMMMM =�====l SHOWER STALL SERVICE I MOP SINK WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability nsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 9Z YE&ONO 0 IF YOtJ CHECKED YES. PLEASE INDICATE THE TYP OVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY E770THER TYPE OF INDEMNITY 0 BOND [I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [] AGENT SIGNATURE OF OWNER OR AGENT - () I I hereby certify that all of the details and information I have submitted at entered regarding this applicali rueandac r lothebe o[rTyyknovAedge be and that all plumbing work and installations performed under the permit issued for this applicali;�� inc lian ertinent provision of the Massachusetts State Plumb* Code and Chapter 142 of the General Laws. PLUMBER*S E7�1 IC 1'71!e"4 9NATURE L jP MP JP CORPORATION 01# PARTNERSHIP LLCE1 # -W -- COMPANY NAME t4ft-" (::I 4—f- ADDRESS F'Dri-� TEL CITY STATE ZIP —71tL ' LJ 15, Lt'Z- 4 FAXJ3� '2" CELL q-7'?�) EMAIL W'5'r , , /. 4A V� This certifies that ... Date ..... ::� . ........ ..... ( . ..................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION r .......................................................................... has permission for gas installation ..... .............. . ............................................... k '17 - in the buildings of ......... ............................. . ... .... ... ... I .................................................... at .......... ...... North Andover, Mass. .............................................. : ...................... . Fee...-.. . ..... Lic. No. ....................................... GASINSPECTOR Check # I ��'j \1 7 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITr MA DATE PERMIT # JOBSITE ADDRESS OWNEKSNAMiISZ'g�'��- GOWNERADDRES's 5—Lt FAX VfYPE OR PRINT OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RESIDENTIAL CLEARLY NEW. RENOVATION: Ct!R:EP� �CEMENT PLANS SUBMITTED: YES NO APPLIANCES I FLOORS— BSM 1 2 3 4 5 6 7 8.. 9 10 11 12 13 1 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER LINVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. NO I IF YOU CHECKED YES, PLEASE INDICATETHE,1Y_PE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICi) OTHER TYPE INDEMNITY BOND! OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142* of the Massachusetts General Laws, and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are tru e t of my knowledge are t e kn t of my =g' and that all plumbing work and installations performed under the permit issued for this application vvill be in plia *th all t prov4ision of the Massachusetts State Plumbing Code and Chapt, 42 f e General Laws. 5 PLUMBER-GASFITTER LICENSE # k17�0L� A URE MG� jP JGF LPGI ��R P 0 R�A ��Tl 0 N -PARTNERSHIP # LLC # COMPANY NAME: 'kA"4 ADDRESS 6. -� __E� - f5q�A�_� CITY S IP -0 G SCI I—LI TEL Ln T:4 FAX CELLeO7 '24 -Z,-t EMAIL Ary ��'j \1 7 T.h8 Commonwealth of MassoAusells Department OfIndustriodAceidents I Congress Street, Suite 100 Boston, 11YA 02114-2 017 t www.mass.govIdla Compensationfusuran,ce Affidavit: Builders'Coutra To Br,, rIff-EID WITH T" 2EPMUTTING ATJT)'OPJTY' Name, (Bisillesslorganizailonftdi-vidual):. Aftess: city/statelzip: . I. 1 .11 . ek the appropriate box; Are you a mPlOYer? 6e . Phone, 0: wifh fun and/or part-time).4' .m rop pl,y,r _. __eMpjoyes( I am . a sole proprietor or Palherhip and have no employcesNorking formoia any capacity. Foworkers'comp- iusuraucc reauired.] -1surau quired.] 1 am ahomeo-wrier doing allwOrkmyselt [NO workere jcomp.ir cc le 4. 1 am a homeo-,Amer and -will be hiring contractors to conduct all work onmy property. 1 -will e ,nsure that all contractors cither have workere compensation insurance or are sole 5.E] I am a general contractor and I have hired1he sub-coiitractors listed ontho attached sheet. these s�b-contractorAg�e 0�plqyo�s and have w�rkerscomy. iasuranco� -exemption perMGL c. 6.E] We area corporation and its qff jqRrs have exercised their right o"ua,,,, reqiind.] I comp. ins 15% IM, an� -we have PT6 workers rA731 L I 1- 7 5 —5) -LA 'Z' Type of project d): .T�qwre -1. V1 New construction 8. EIRemodelffig 9. El Demolition 10 Buff(yng addition 11.0 Electrical repairs or additions 13. E] Roof i0pairg 14. El Other_____� tion below showing theirwOrkers'00roPenset'on Policy iofonn.atlon� *AMY applicant that checks lioxill, must also 0- outthem hire outside contractors must sijbinit a new affidavit indicating such. t Romeowners'Who stbaf Ws a&avit indicating they are doing all work and then jjott�ose entities have tContra-ctojs that check this box must -attached an additional sheet showing the, name of the sub -contractors and state whether Or comp. policy number. employees. lfthesub-cbfilrad&slia�� es, &� ifillit pro -vide, their workers ,ion insuraycefor my em quensa Vj6yee8r., BeJOW jS t1lepolley andjoh site eftj pidvidlhg -Taman 'ployertfiatis vork�rsl com information. insurance Company tr — � 'r , , F,xpiration Date: roncy if or S e Cit�lfttelZip: 6214S fob Site Address: sation policy declaration page (showingthe Policy number and, expiration date). Attach a copy of the Workers' c�OMPOVL - - violation punishable by a fino up to $1,500-00 Fail -are to secure coverage as required under MUL a. 152, §25A is a criminal and/or one-year imprisonment, as well as civil p enalties ja the form, of a STOP WORK ORDER and a ffie, of up to $2,5 0. 0 0 a day against the violator. A copy of this statement may be fonvarded to the Offtca of Investigati6ns oftbe DIA for insurance coverageverw�unuu,u� � _1 VMWUnUL),U -rect t the informationpropided abov istr andcoi ,ee _h lf=d=o hergh afy derthe andp Phone #- -221( q__�j Official use onbi. Do not-w1ite in this area, to be completed by city ol'town Official City or Town: Permit/License issuing AuthoritY (eircle One): i clerk 4. Electrical inspector 5.13jumbing Inspector 1. Board of Ifealth 2. Building Department 3. Cityffown 6. Other Contact Person' Phone COMMONWEALtH 6F AC7- S M IMACHU ETTS... Date .... i.7� - [ 0 -�P ........................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ...................................... has permission to perform ..... .............................. wiring in the building of ...... A at ..... 1�50 CC I Pk .......................................................................... . North Andover, Mass. H Lj . - . J ...... Fee .... ......... Lic. No. A( -.!J... t ..... . . . ELECTRICAL INSP� R---*-*-*'* Check # t I I � ?;71E eM&X07M5,4Z7;?1 09 2VW5SXeW455?7S VO -4-4 4 Poe& S*r# BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Offi i I U e Only Permit No. Occupancy & Fee Ch "ge I APPLICATION FOR PERMI'I 11 U PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod7e527 MR 12:00 1 12 .2 (Please Print in ink or type all information) Date // 3 / To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number 30 E�zm S4 -- Owner or Tenant 7TOLV\ 5 C A,343 ntq C4 V_ r Owners 5,ym e Is this permit in conjunction with a building permit Yes 0 Purpose of No k ---(Check Appropriate Box) Existing Service Amps_________________�VoitS . Overhead 0 New Service Amps Voits Number of Feeders and Ampac Location and Nature of Proposed Electrical Work Overhead 0 Utility Authorization No. Undgmd 0 No. of Meters Undgmd 0 No. of Meters OTHER: S4n im P6 _3 i / &r - INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted val proof of same to the Office YES = NO - If;puhave checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE =ND - OTHER - (Please Specify). t,2 If (Expiration Date) Estimated Value ofElectrical ork$ Work to Start— I V I TLC) -I Inspection Date Resquested —Rough —Final Signed uncleWh 4ena S of perjury: FIRM NAME 4r Ar7 S�rviww LIC. NO._J/70 All� e_V9, C License &1 0 ^A !a f Signature LIC. NOo2 G 13 - Bus Tel No. 66 3d,31 lvff,7 Address 15 o /yo 41-1. 1-14,14 5 Ai � H � Att*Tel. No. w1ci 3.2 1 JZ 5 OWNER'S INSURANCE WAIVER: I am aware that the Licensesdoes; not the insurance coverage or its substantial equivalent as required by Massachusel General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE s---,2 (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In 0 No. of Lighting Fixtures Swimming Pool _gmd 9 gmd 9 Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners BattM Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices NoJ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal a Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Si ns; Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER: S4n im P6 _3 i / &r - INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted val proof of same to the Office YES = NO - If;puhave checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE =ND - OTHER - (Please Specify). t,2 If (Expiration Date) Estimated Value ofElectrical ork$ Work to Start— I V I TLC) -I Inspection Date Resquested —Rough —Final Signed uncleWh 4ena S of perjury: FIRM NAME 4r Ar7 S�rviww LIC. NO._J/70 All� e_V9, C License &1 0 ^A !a f Signature LIC. NOo2 G 13 - Bus Tel No. 66 3d,31 lvff,7 Address 15 o /yo 41-1. 1-14,14 5 Ai � H � Att*Tel. No. w1ci 3.2 1 JZ 5 OWNER'S INSURANCE WAIVER: I am aware that the Licensesdoes; not the insurance coverage or its substantial equivalent as required by Massachusel General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE s---,2 (Signature of Owner or Agent) The Commonwealth of Massachusetts Department of Industdal Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensabon Insurance Affidavit Location: C i1y Phone #6'03 ?,31.7V I am a homeowner performing all work myself I am a sole proprietor and have no one mrldng inany capacity' F—] I am an employer providing vmrkers! compensation for rrry employees worldng on this jOb. Comppey name: Address city: PhonL-#;. insurance. Co- Policv# G omra name: A_-ddregs, MOM* Failure to secure coverage as required under Section 25A or MGL 152 can lead tordie krVosWmG'f crkninal Penwbm afine*wt andlor one years' I ' . Understand ttu-4 a copy of Ws statement may be forwarded to the Office of Investigations of dw DA for cevegagewificatih. J do h"-aby cert* ander &)a painq and penalbes oifpMW bW Me MarnmPban provided abom is km aw wrr&Tt Print -0 a�, 2�j --Tq� ? I Officiat use only do not write in this area to be completed by city or town afficiar CRY or Town ------------ [JC7)eck if kmnedkde response is requked Ba"179 0 Lkensin E] Se/echn, Contact person. Phone, E] Health E Other Zoning Bylaw Denial Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 Phone 979,-1688-9545 Fax 97i468-9542 --Street: 3- - - .. E, I rn Map/Lot: -Variance Setback Variance Applicant: Request: Lj&,cta A� S 6 CA I Z; f I. l -a- C.-_1 ft U S V_ S Date: Lot Area � 019-- "%-- QUV1;MWV- MCILCRILUF Ut2VIeW OT your Application and Plans that your Application is DENIED for the fotlowing.,Zoning Bylaw -reasons: Zoning �P, - 4 , Remedy for the above is checkAd hPInw Item # Special Permits Planning Board 1-Itern Notes -Variance Setback Variance Access other than rrontage Special Permit— Notes A Lot Area Common 13&2�Spe�cial, Permit F , Frontage anance for Sign I Lot area Insufficient _�_7rontage insufficient 2 -3 4 Lot Area Preexisting Lot Area Complies Insufficient Information Lie 2 �-3, 4 Frontage Complies Preexisting -frontage— Insufficient Information LI e- 5 B use No access.over Frontage -1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting—. Lj 2 Complies 4 5 Special Permit Required 1 nsufficient� Information �-j e� S 3 4 Preexisting CBA Insufficient information Ll e- -S C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 4 Left Side Insufficient Right Side Insufficient r" 3 Preexisting Height lnsufficiein�t information -5 R ar Insufficient Building Coverage -6 7 D I Preexisting se-t-back(s) (s 1 Insufficient Informationj— Watershed Not in Watershed Ll C 5 5 1 3 7- Coverage exceeds maximum Coverage Complies coverage Preexisti—ng Insufficie nt Information Ll 2 3 In Watershed Lot prior to 10/24/94 j 1 Sign Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking I 2 3 In District review required Not in district Insufficient Info ation -5 1 2 3 More Parking Re—ouired Parking Complies 1 insufficient information �xisting Parking Ll e 5 Remedy for the above is checkAd hPInw Item # Special Permits Planning Board Item# Site Plan Review Special Permit -Variance Setback Variance Access other than rrontage Special Permit— Parking Variance Frontage Exception Lot Special Permit Lot Area Variance Common 13&2�Spe�cial, Permit Height Variance Congregate Housing Special Permit anance for Sign Continuing Care Retirement Special Permit Independent Elderly Housing Special Permit Large Estate Condo Special Permit Planned Development District Special Permit Planned Residential Special Permit Tt��_E�pecial Permit Watershed Special Permit Snecial Permits Zoning Board Special Permit Non -Conforming Use ZBA Earth Removal Special Permit ZBA Special Permit -Use not Listed but Similar Special Permit for Sign SDecial Permit Preexisting nonconforming The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this view to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative' sharlel be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. You must file a new building permit application form and begin the permitting process. 1361ding Department Official Signature Denial Sent: Application Received Application Denied If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explami the reasons for denial for the applicatiW permit for the property indicated on the reverse side: Referred To: — Tl*-r—e— F5'o—lice -d-o—nservation Board :11anning L -d ariment ot Public Works Othei liss�ionll , 0 7e- & OU - PHONE ( :!� ARE -A COUL MESSAGE 1� I M. .DA&(.a -6-6<1ME -M. PHONED RETURNED YOUR CALL PLEASE CALL WILL CALL AGAIN A j I- LCAIVIETQ JOHN SCHOONMAKER NORTH ANDOVER STATION MANAGER ---a UNITED STATES jioSTAL SERVICE 131 MAIN STREET N ANDOVER MA 0 1845-9998 978-683-2890 FAx: 978-688-1293 WWW.USPS.COM LOT �C� 9,7 ZZ GT I �_k ob E L M STK E -E -T TO: A N DO V E rZ BAN - 7 -0 7We ;-171--- 1,VS6,W0W4,,V o r lol�,z 41v 7-0 /� eoe-,4;-�,o 0.41 N o. A 7- t< 6HdWAI 0// CeA4,t,, IAUA14-44- '900 C) !-A H 0 0 N MA KT_ R_ 4772�7 1 30 C cl-7. 199&l. tL /-I 17� 54 N2 Date ..... I/ ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that J .............. ....... .. .......... . ............................... has permission to perform ... ................. ........................................ wiring in the building of ............... ................... 7, .. ........ .......... .............. at ................................... I ............................................ . North Andover, Mass. Fee..,.u,., ...... ........ Lic. . ..................... ;� . ..... ........ 1 .................... Check # / j / , - I . /,,,, 1 - ELECT'RICAL INSPEcrOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer If= L1U1y1MUjyJ;,yr�4LI11 UP ALAX"wUlell 13' uttice use only DEPARTMEATOFPUBLIC&IFETY Permit No. BOARD OFFfflEPREVLAW0NRWUL4T10AS5270fR 12.D0 Occupancy & Fees Checked 4P)APPLICATION FOR PERAff TO PERFORM ELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 cmR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perfbrm the electrical work described below. Location (Street & Number) 11Z � I rl� � � Owner or Tenant 0-0 Owner's Address 1-:1-A Is this permit in conjunction With a building permit: Yes No (Check Appropriate Box) Purpose of Building R44 % _V, W -1 -Vo �A Utility Authorization No. Existing Service Amps Volts Overhead 0 Undergro und No. of Meters New Service Amps Volts Overhead r7 Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Elecffical Work Ze-Qtz 07 No. ofLighting Outlets No. ofHot Tubs No. ofTransformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground El ground No. ofReceptacle Outlets No. ofOil Burners No. of Emergency Lighting Battery Units No. ofSwitch Outlets -5 No. of Gas Burners FIRE ALARMS No. ofZones No. of Ranges No. ofAir Cond. Total ons No. of Detecti on and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal M Other No. of Dryers Heating Devices KW Connections F1 No. of Water Heaters KW No. of No. of Signs Bailasis No. �ydro Massage Tubs No. of Motors 11 — Total HP On ddle Tan , (1) Exhowst424 FAA, WUkIDSt%t '+12-01ZWO 1nspectionD*FzpesWd SigrWLMdXTrRn,hiesofPE,jury. V0 Ive FIRMNAME Lic.w!�44e �Z&,rr S Sigralre I EVrdfimD* EstirrgkdV"dEkdricalWatk Ra# Final A/ &,96 -3 1416 5 6 3 Meth M4,1 Bmixss Tel. Nh - 31, Alt. Tel. Nu(�� OWNER'S INSURANCE WAIVER, I amawareth1thel dmrirght�y Mq1ffedbyNbmdmeM Card 1mvs aid (Pleas�%k ne) ner Agent 0 Telephone No. l�U- 777� IT FEE E27n PERM Location a No. I Date 4 ,40RT" TOWN OF NORTH ANDOVER 6 0 Certificate of Occupancy $ +�i& Building/Frame Permit Fee $ ACHU Foundation Permit Fee $ Other Permit Fee $ SeWer Connection Fee $ Water Connection Fee $ JOTAL $ Building Inspector Div. Public Works PM -311T NO.,-? 7-? 9 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. GXPAGE I MAP 4-40. 4� LOT NO. 2 RECORD OF OWNERSHIP jDATE BOOK 1 PAGE ZONE SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING OWNER'S NAME 7o A ,n dot 5 c- o o,,i iym fie NO. OF STORIES SIZE OWNER'S ADDRESS 2 --6 Zl^ 5 BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW Z) SIZE OF FOOTING x IS BUILDING ADDITION 'v 6 MATER:AL OF CHIMNEY IS BUILDING ALTERATION �-e5 IS BUILDING ON SOLID OR FILLED LAND 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 DATE FILED SIGNArkE OF OW . NER OR AUTHORIZED AGENT FEE 4vl-. dc) OWNER TEL. 0 4 y CONTR. TEL. #-- CONTR. LIC. # PERMIT GRANTED 19 df 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 200 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY S-ORIES MULTI. FAMILY APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 3 CONCRETE Bl. K. BRICk OR STONE —INE HARDW D PIERS PLASTER -FRY WALL _jNFIN 3 BASEMENT AREA FULL FI . B M*T AREA V, 1/2 114 FIN. ATTIC AREA �LO 8 M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS CONCRETE TART—H �ARDIIJ D COMMON MPH TILE B 1 2 3 DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT, SIDING STUCCO ON MZONRY STUCCO ON FRAME I BRICK ON MASUIN'RY ATTIC STIRS. & FLOOR BRICK ON FRAME CONC.OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR 0 R _'�_ __j NON DEQUATE I E 5 ROOF 10 PLUMBING GABLE GAMBIELI I I BATH (3 FIX.) -dip 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 MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN_ TIMBER BMS. & COLS. STEAM STEEL EMS. & COLS. HOT W T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS I AS I 'L B'M'T 2nd lo I 3rd ElLiCTRIC 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. I a I ft ao-ON LL L- C* Lu. - mi cc r z uu w lelft 6 z < 0 < 0 co 0 u 661 z z z 0 c E c 0 CL. vi z z CL. z 0) 0 0 CL. ;A .4 < w 6w 0 06 IA z z LU c 0 a: 0 cr U- cr co U- cc U- in co v w a.m cr- F- Z= w rA CID : CZ .0 W, z 0 0 E w bw 0. CL w E v C9 *M* 0 z 0 ao� one c D 0 in 0 17-17� CL cc C 'N. m 'k z OFFICES OF: APPEALS BUILDING CONSE-RVATION HEALI'H PLANNING Town of NORTH ANDOVER DIVISION OF PLANNING & COMMUNITY DEVELOPMENT KAREN NELSON. DIREC'FOR 120 Main Street Norih Andover, tyl; ISS; WI It ISCI IS 0 1 H45 (6 17) ( iH5-4775 In accordance with tile PrOvisiOrl-s of MGL c 40, S 54, a condition of Building Permit Number disposed of Ls that the debris resulting from this work shall be 150A. in a Properly licensed solid waste disposal facility as dcflncd by MGL c ill, S Tle debris will be disposed of in: � A ve r Re -5 c— o (Location of Facility) Si S nature Of Pcrn�lftApp�licaannt� ignatur Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Buildina Insnector- Suggested Affidavit for Home Improvement Contractor Permit Application For Oince Use Only NAME OF CITY'frOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition, or construction of an addition to.any pre-existing owner -occupied building containing at least one but not more than four dwelline units .... or to structures which are adiacent to such residence or building" be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: &.".A 0 /1' -on Est. Cost 0 2 A Z—/ Address of Work gy M �1 Owner Name: Ta�, 5c400nr.-uXer Date of Permit Application: k / a /I -t I hereby certify that: Registration is not required for the following reason(s): —Work excluded by law —Job under $1,000 —Building not owner -occupied _LZOwner pulling own permit —Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby, apm for a permit as the owner of the above property: Date Owner Name „Location No. Date ,AORT” TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ Building/Frame Permit Fee $ 'r ACHU Foundation Permit Fee $ Other�%ermj% Fee $ Sewer Connection Fee $ Wate(Connection Fee $ fOTAL $ 4 Building Inspector Div. Public Works 1. % PER31IT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. IXAGE I MAP 4-40. LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK !PAGE ZONE SUB DIV. LOT NO. LOCATION a't 611,q 5f PURPOSE OF BUILDING AIPW OWNER*S NAME 'T' 5 GAA -6 5--4 a o�;n� �cr NO. OF STORIES SIZIE fr&lt 51 lof OWNER'S ADDRESS 5f BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW c) SIZE OF FOOTING x IS BUILDING ADDITION 0 MATER:AL OF CHI NEY IS BUILDING ALTERATION Al'o IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER le 3 - BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER s -* IS BUILDING CONNECTED TO NATURAL GAS LINE )-,15 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 DATE FILED SIG ,rTURE OF OWNER OR AUTHORIZED AGENT FEE OWNER TEL. PERMIT GRANTED CONTR. TEL. # z'2 19 9,42?n GONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST l000 EST. BLDG. COST PlEh SQ. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING 130ARD BOARD OF SELECTMEN llel� 11uz4" & N&PECTOR BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY _jS'ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES. GA - APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. /V4r 11 11 rJ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 — 1 — 3 CONCRETE BL K. PINE BRICK ORSTONE HARDW D PIERS T -LAS T E R DRY WALL _�NFIN — — 3 BASEMENT AREA FULL FIN. B M'T AREA lh 1/2 1/1 FIN. ATTIC AREA L40 8 M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING WOOD SHINGLES CONCRETE TA`RTl ASPHALT SIDING ASBESTOS SIDING �_ARDVl D COMllAcN VERT. SIDING -iS-PH —TILE STUCCO ON MAi0_NRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR CONC.OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I I POOR ADEQUATE 17 N0NH_ 5 ROOF PLUMBING GABLE GAMBREL I 11 .10 BATH (3 FIX.) -dip 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 DERN FIXTURES TILE FLOOR TILE DADO 6 FR MING 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 7 NO. OF Itooms As I JOIL I B'M'T _Lnd 1 st 3rd ELECTRIC NO HEATING _4 /V4r 11 11 rJ z LL z 0 Z 0 LL. @own I 0 < 0 CID cc 0 6W 06 V) z u z r- 0 Cl Q) C E I z c U- ad 0 u LU C6 vi z v z —4 06 c 0) 3 0 cr leg '@ U- 0 u CL tA z < u u ua :3 0 a: L (D (o I c U. cc 0 w CL AA z C cm 3 0 a: I "@ U. I..: A. LU cl (D c in I 0 E Cd 16o V oil 0 INI CD IL z Lu uni LU > cim 4 k. * ZCJ C6 CL 40 CL. w 40 z 0 zj j Co 40 0 E 10 0 40 0 0 --"k Z k-, 0 z z ca E CL 0 --"k Z k-, j Location �0. Date 'A k0RTpj 14 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Sa %e Foundation Permit Fe $ Other Permit Fee 'Sevo-; Connection Fee 45 Kf- er Connection Fee C--� 'TOTAL Building Inspector Div. Public Works IWL 0 v;; 0 w IL U) It w z 0 U. 0 La 0 m 0 u w U) Z w o IL I 0 W 0 z m d� i z F - o 19 z 0 0 w 0 0 J LL IL 0 w U) W w z x u Z o w w z < Z 'D 3 Z U 0 0 P L, Q) 1, 0 0 z U. 0 2 0 U. -(j 0 2 W z 0 Z w w w I- < < L w z 0 z 0 0 IL z r iz w IL 0 m 0 u a z 0 0 J m w z z k. 0 0 I � E I (A w 13 0 w z < ci z u 0 Ix U. NP It w z Z 0 o . z w 0 w W w Ix 0 6 > z 0 Ir 0 IL z 0 U I < z w 1 < w z 2 0 J 1 0 o w z 4 w U o W CL U Z Ch 0 . X M 0 A a 0 L z a j L < LL u w �-WZZIZ0222MQ i w u w u w u w a a L 3 0 i u w a < < < < w m n m D m D m j j m < 0 < a < WO J m z 0 0 IL z r iz w IL 0 m 0 u a z 0 0 J m w z z k. 0 0 I � E I z 0 >- ci u 0 Z) It W w w L L 6 > z 0 0 o o (A IK V U L 2 0 L 6 d w w w a a L J J 06 w _u 0 WO J LL 0 w 0 w w m w w V) z 0 u Z) z 0 (A 0 z z 2 0 u u w w 06 w 0 0 WO J LL I-- 0 z m w w w w J L L a 0: -C 0 z z z a— C4 Nd 10 UJ Lj _j ct� uj C) CD c;l z W w I w 0 0 06 WO LL I-- 10 z w J L w w z 0 w 13 7A IL w L z W w I w 0 Z 0 F) z 0 > A �2 :E > > o 0 0 - > Z z < "I Z -L" 00, 0 m m 3: �� 0 > z L 3: 0 Z A w Ol>o:;<>O>— Q m �� I z Z 0 03: mr)m 3::2 X X 2 c 3: z a Or) 0 :E 1 -4 :E 14 0 1 3: 0 0 0 Z 0 0 0 CD () () m 0 0 > > 3: m c: > z 0 z , , n 0 0 r) > 0 0 r) z z A n n z m !4- 0000 0 > A �2 :E > > o 0 0 - > Z z < "I Z -L" 00, 0 m m 3: �� 0 > z L 3: 0 Z A w Ol>o:;<>O>— Q m �� I z Z 0 03: mr)m 3::2 X X 2 c 3: z a Or) 0 C, U. �� c - I c � > > o m m * 0 o 0' > 4 > Z 0 > (A) CD () () m 0 0 > 3: m c: > LA z z , , n r) z z A n n m !4- 0000 0 006 wo F, > M 0 c� 0 zmzzooa� L) z z E � T �E z am z 0 0 z 3: > > z > > 0 G) > - I > 0 . z 0 0 Z > 3: 0 Z (7) 0 0; i ?1 a z m m Z z 0 z 1 0 oz 0 o c > > r) 0 T > m r) 0 (D 3: T -2 T ;2 > jr >1 OD z o 0 > F) P1 3: 3: Z r) > z F) M Z z o z F) > > - > ;on 00 m > z z Timim- i I i i -F M ;a r —i >OX C) ZM m rn 0 (n Z C r, X c M (n X -1 i>w 'a 0 3: 0 0 0 U:E mim PMX -1 z > Xwo ii a -1 ;u z 0 MOK "U A M 0 0 M 0 Wsz -a r Soo Z"R z 0 M > 0 z m 00 �x 0 c z m n 0 z m IUL I dil.1- 0 $04 ;= d) 0 pv cc LJLJ a-0 ui Cf) a 6 z ICL ft IA to LU am am fA U-) 40 CL) lots C6 Ul) > LLJ a >< "a LLJ LLJ con F3 CL 4, ol C .0 — .2 is c CL, 40 40 A CL 02 z G z ZD CD u His'. 'F C4 Z) F�qq .0 E .0 c E W) cg o z c cc c 0 z 0 0 0 0 06 0.- 0. - kA u LL. z z 0 z LU z z 0 Cl* CID E CL 0 :E 0 0 S cc 0 U- a: cc cn cc U. to LU am am fA U-) 40 CL) lots C6 Ul) > LLJ a >< "a LLJ LLJ con F3 CL 4, ol C .0 — .2 is c CL, 40 40 A CL 02 z G z ZD CD u His'. 'F C4 Z) F�qq .0 E .0 c E W) cg o z c cc c 0 z OFFICES OF: APPEALS 111,11IX)ING CONSERVATION HEALI'H PLANNING Town of NORTH ANDOVER DIVISION OF PLANNING & COMMUNITY DEVELOPMENT KAREN 1-11'. NELSON, DIREM'011 12() Main Street North Andover, tY1i1SS;1ChtJSC1I-'; 0 184r; (6 17) 685-4775 ln accordance will, tile provisioll.s of MGL C 40, S 54, a condition Number of Building Permit is that the debris resulting from this work shall be disposed of in a Properly licensed solid waste disposal facility as defined by MGL c ill, S 150A. The debris will be disposed of in: 0 r q over � e-5 C -0 (Location of Facility) *ignaWtu0f�PCr111i1 -AApp1in., licanL 12,.2, Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Suggested Affidavit for Home Improvement Contractor Permit Application For Office. Use Only NAME OF CITY/TOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition. or construction of an addition to anv vre-existin2 owner-occUDied buildine containins! at least one but not more than four dwelling units or to structures which are adiacent to such residence or building" be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: &r6njJrVCJ ;L Vd/5 Jvrf' Vlj 4 114.'rj W4 Est. Cost Address of Work 3 0 Owner Name: ra A 5,r-4 0 onm6b Date of Permit Application: ? 4;� I hereby certify that: Registration is not required for the following reason(s): — Work excluded by law —Job under $1,000 —Building not owner -occupied t/Owner pulling own permit —Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: 7A Z/7 2 - Date I �/ Nv'ner Name Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/TOWN Permit No. /yo'-fA '4^iwer Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition, or construction of an addition to-anV pre-existing owner -occupied building containing at least one but not more than four dwelline units or to structures which are ad*acent to such residence or building" be done by registered contractors, with certain exceptions, along with other requirements. Type of Work: r—A Cg gvt tr Est. Cos IF Address of Work Z8 utA Owner Name: JoAA 5c1loon,,-i4ker Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): —Work excluded by law —Job under $1,000 Building not owner -occupied --TOwner pulling own permit —Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereb I for a permit as the owner of the above property: gfi / 7 ), - �w Date Owner Name Location No. Date TOWN OF NORTH ANDOVER ��N;j !?Wificate of Occupancy $ uilding/Frame Permit Fee $ - �MsNtikv� loundation Permit Fee $ Other Permit Fee $ Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works -AMIT NO.� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. I �, /PA G' E I MAP 4-40. y a, - LOT NO. I 2 RECORD OF OWNERSHIP IDATE I BOOK ;PAGE ZON E SUB DIV. LOT NO. ker 7 3117-z 1,7 S-0 1 I-ZO LOCATION )o 61M 61 PURPOSE OF BUILDING 1-io.-te /'t-Aogrfvfl4ilJ*c Yek OWNER'S NAME )Okr, 4, NO. OF STORIES 2. 412� OWNER'S ADDRESS A/o iqt\jove-r BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN /u� DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS 7prn le;c:�,*I&L-71�1—AAl-A /'^lL'> DISTANCE FROM STREET POSTS 1600,041Ateoi DISTANCE FROM LOT LINES SIDES REAR GIRDERS ke 4-t&e4eJ Ale eLifl-fs AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /V SIZE OF FOOTING x IS BUILDING ADDITION MATER:AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 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 �-e5 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 DATE FILED s / / ;�/ I ), SIGA ED AGENT F E E Y12" 4Z. 1� , 0 0 0 OWNER TEL. PERMIT GRANTED CONTR. TEL. 19 e2--- CONTR. LIC, T 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST - f -7,000 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF BELECTMEN INSPECTOR V7 BUILDING RECORD (2�:CUPANCY x 3�� . . 1 1 12 S I NG LV FAMI VY — S'ORtES -'z MULTI. FAMILY ��_�O�FFICE'S APARTMENTS CONSTRUCTION COINtRIETF CONCPETE BkIV. BRICk OR STONE" PIERS (8 INTERRk IN" , RFN a 1 2 13 .7 – i IZ �DD' 'AL S.M �STJE DRY WALL UNFIN 3 BASEMENT AREA FULL FIN. B M T AREA 14 1/7 1/1 FIN, ATTIC AREA tlO 8 M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 wALLs 9 FLOORS CLAPBOARDS B 1 3 DROP SIDING WOOD SHINGLEi CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING HARDVJ D COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME CONC.OR CINDER BLK. ATTIC STIRS. & FLOOR WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR 1_� POOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE GAMBqELI I I BATH (3 FIX.) -tip MANSARD TOILET RM. (2 FIX.) FLAT SHED ze WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES_ KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES_ TILE FLOOR TILE DADO 6 FRAMING 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 7 NO. OF ROOMS GAS ELM T �j 2 cl I st � / 3rd 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. f L�Q Y'A Q q- 0—i sect z OEM= LL LU LU .j LL. UJ W) z 0 Ck,2 IF - M a. z ft mow M ; N kttw. 40 S C6 as C6 C6 43 .0 C6 t 0 z c c 0 . C :pE rA "o 0(f) > LLJ rA c .so— >< LLJ Iz Ul) LIO LAA Cie 0 Cie 0 99 0 0 09 am E 0 c .0 o- w I.: 96 z z W E WAI 0 =0 W) W) ag c IL wl = ME z am cc z z z 09 cc < 0 ra V� M 0 D CID r- C j LU (D 0 :3 E uj 0) 3 c 0 0 c 0 S 0 (D c 0 c E d: L) d: U- CC co U. a: U. co ft mow M ; N kttw. 40 S C6 as C6 C6 43 .0 C6 t 0 z c c 0 . C :pE rA "o 0(f) > LLJ rA c .so— >< LLJ Iz Ul) LIO LAA am WIM am M Z 0 am E c .0 E w =0 W) W) ag c 0 = ME z am cc am WIM am M Z Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE_ /7 )QL,3 .j JOB LOCATION 3 0 //4 Number treet Address 6ection ot town "HOMEOWNER" -Faki 5,:�)00,4mjke" 5-0 t ( T- I Name Home Phone Wor PRESENT MAILING ADDRESS 3�� one /Vo r �� ql) a4/5'� City/Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code, Section 109.1.1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwell- ing, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Bulding Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of �North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. -HOMEOWNER'S SIGNATURE Z APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. 1i f . I Igg 7 O -j LL LU LU .j c%12 cc m LU IL z Ul .AftV.. t A At W 41 rA (A V) 0 c- > LLJ cL >< CL %-0 40IC6 (1) z .0 z Lf) z 0 Cil �z C9 cc me I 0 0 0 E CL CL. 4) < bm ac C < M C w bo 0 E (CA z z L6 0 z CL j CID v Q 0 MAI cc om >% z 0 z < w z WD (A < C *.Mc 0 j Lu j E 06 0) MJ 0 !E c 0 S 3 0 Ir 0 a: U- cc CO) cc U) .AftV.. t A At W 41 rA (A V) 0 c- > LLJ cL >< CL %-0 40IC6 (1) z .0 z Lf) z 0 Cil �z E CL CL. 4) < bm oz C M C w bo E (CA C C CL W, C CID Q cc om >% 0 WD (A C *.Mc z 4 LL, 0 LL, Iwo *cc LLI lu r:3 k E 2 z z 0 0 W z 0 ro rA rA LL LU I- 94 > 0 .j LA- I 0 0 0 uj 0 CAI co C5 z LU D. cr- 1�- z N ft C6 0 c 0 C C6 41 V T CL 4i rA V c E t 0 z C) b. 40 rA :R 0 U') > 'A c X .c LLJ !E z z .0 z CO ZD LO V) LO ::D t�r 1^4 am E 0 v .0 *MP c 0 SIM Il. am Ck. w c 0 u tv 7-;� am WER am I -Ml Ck. E c c c to cam .0 ow hin 0 WD c am CIO W 0 0 0 C6 CL CL z z Mi 96 U. z 96 0 0 CID 0 cick LU M M CID CL 0) j ... 0 CD > Cc 0 o cc 0 U- 0 cc o 4) Cc V) LL 0 cc U. 3 90 E (a N ft C6 0 c 0 C C6 41 V T CL 4i rA V c E t 0 z C) b. 40 rA :R 0 U') > 'A c X .c LLJ !E z z .0 z CO ZD LO V) LO ::D t�r 1^4 am E 0 v .0 *MP c 0 SIM Il. am Ck. w c 0 u tv 7-;� am WER am I -Ml Ck. E c c c to cam .0 ow hin 0 WD c am CIO LL. co U -L . at 0 mi 0 0 LU cc LU 3: ui U) CY) C5 z 16: c "C c i w cr. F - Z= w v 40 6w 06 gS U. 0 IA z WAI cr c ad 0 1-6 CID 06 LU 0) > -jo 0 0 cc co iTL 0 .5 cc LL 3 E co co 16: c "C c i w cr. F - Z= w v 40 c u 'For Ai rA 40 ao. > ro) 0 cw CL. lcm 6. CL. 40 45 .0 cc u E b. ww 40 E Gh A 40 C6 (0) IW ja - a M a "i 0 .2 2 'a. a. Am cz :C6 (1) z E w c c 0 A i�', (A em Z� 0 E(A r Iwo c 0 in v cc z c w c *M co Date..................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... //-, . ........................................ has permission for gas installation .... ......................... in the buildings of ... ................. ............. at ..... ...... ..................... North Andover, Mass. Fee. .-. . . . Lic. No.. .� Check # .......................... GASINSPECTOR MASSACMSEM UNIMRM APPUCATON FOR PFlZNW TO DO GAS FfITWG /� (Type or print) Date -7tj NORTH ANDOVER, MASSACHUSETTS I Building Locations - �3y C—(a4 s* Permit # Amount $ Owner's Name C7) New Renovation Replacement rCF' Plans Submitted El (Print or type) Address It 14, ( Check one: Certificate Installing Company , [] Corp. ElPartner. Business Telephone 11 Firm/Co. Name of Licensed Plumber or Gas Fitter '/ L INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes r] No[-] K If you have checked M, please �ipdlcate the type coverage by checking the appropriate box. Liability insurance policy El Other type of indemnity El Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent i nereby certity that aii ot tne aetaiis and intormation I nave submitted (or entered) m above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed und9ofermit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State GAW%fo-da4VQ[iaPter 142 of the General laws. ICity/Town I OVED(OFFICE USE ONLY) _,Signature of Licensed Plumber Or Gas Fitter 0 Plumber /01/o M Gas Fitter License ru ffmaster [:] Joumeyman MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING =3169 off@. Business Telephone 1;0 2, —LV Firm/Co. Name of Licensed Plumber: P4, cA( Insurance Coverage: Indicate the Wpe of insurance coverage by checking the appropriate box: E] Liability insurance policy a Other type of indemnity 1:1 Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 11 Agent [—] I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfoymed under Permit Issued for this application be wiH in compliance with all pertinent provisions of the Mas�� Code and Chapter 142 ofthe General Laws. By: signature ol Licensea Plumber Type of Plumbing License Title 1&0 lCity/Town License INUMDer Mast er a Journeyman 0 - ,APPROVED (OFFICE USE ONLY