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--MASSACHUSETTS UNIFORM APPLICATION
MIT -TO bO "PLUM
BING
(Type or Print)
at '-f Nn
NORTH ANDOVER mass. D �e:'�'-
Permit
Building Location 9W A le K
Owners Name
New Renovation Replacement Plans Submitted
FI TURES
(Print or Type)
Installing Company
Name of Licensed
Check one: Certificate
Name Corp.
Partner.
Firm/Co.
lumber:
Insurance Coverag Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy jr,,��Njl Other type of indemnity Bond F-1
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 coverages..
Signature of owner/agent of property Owner Agenf�-,,..
I hcccby cettify that all of die dcl2ils and informalion I have submiticd (ot enicied) in abcowc applicalio ia(c to the bell of say
n ace leue and Ar.
knowledge and (hat all plumbing wotk and insullations lierfatnicd undcr Irccoosit i-sucd (of this 21111lication will be in comptiance with all pcClinept
vUiOAS of the Massachusetts State Plumbing Codc and chapicc 142 of lite (knegal LAWL
By
Title
City/Town:
APPROVED TOFFICE USE ONLY)
Signature of Licensed Plumber
Tvpe of Plumbing License
11 Master PI
License Number Lai
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2ND FLOOR
3RDFLOOR
4TH FLOOR
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6TH FLOOR
7TKFLOOR
STH FLOOR
(Print or Type)
Installing Company
Name of Licensed
Check one: Certificate
Name Corp.
Partner.
Firm/Co.
lumber:
Insurance Coverag Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy jr,,��Njl Other type of indemnity Bond F-1
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 coverages..
Signature of owner/agent of property Owner Agenf�-,,..
I hcccby cettify that all of die dcl2ils and informalion I have submiticd (ot enicied) in abcowc applicalio ia(c to the bell of say
n ace leue and Ar.
knowledge and (hat all plumbing wotk and insullations lierfatnicd undcr Irccoosit i-sucd (of this 21111lication will be in comptiance with all pcClinept
vUiOAS of the Massachusetts State Plumbing Codc and chapicc 142 of lite (knegal LAWL
By
Title
City/Town:
APPROVED TOFFICE USE ONLY)
Signature of Licensed Plumber
Tvpe of Plumbing License
11 Master PI
License Number Lai
Date.? -
N2 3490
TOW N OF NORTH ANDOVER
I
---PERMIT FOR PLUMBING
cz
M
This certifies that
has permission to perform
ru
...........
plumbing in the buildings of .....
at,::M'F . - -,4? ....... North Andover, Mass.
FwA). - Lic No IZ-,'26
...... . .......... ...............
/'?, 0/�/ PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Location
NO. Date
TN
TOWN OF NORTH ANDOVER
0
41
Certificate of Occupancy $
Building/Frame Permit Fee $
-is CHUS
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
54
31-00 PAID
Div. Public Works
Location
No. Date
ZOO' T
TOWN OF NORTH ANDOVER
Building Inspector
%2 061'09/98 08:54 31.00 PRID Div. Public Works
Certificate of Occupancy
$
Building/Frame Permit Fee
$
CHU
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
Building Inspector
%2 061'09/98 08:54 31.00 PRID Div. Public Works
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WnJ1,kM 1. SCOTT
Director
Town of North Andover
OMCE OF
COMMUNITY DEVELOPMENT AND SERVICES
146 Main Street
North Andover, Massachusetts 0 1845
In accordance with the provisions ofMGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be disposed of in a
properly licensed solid waste disposal facility as defined by N/fGL c I 11, S 150A.
The debris will be disposed of ill'
c —k 9 (1,--19 , /I& Yz
(Location oF Facility)
Signit-ure—RIUrmit Applicant
bate
NOTE: Demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
I
BOARD OF APPEALS 699-9541 BUILDING 699-9545 CONSERVATION 689-9530 BEALTH 699-9540 PLANNING 688-9535
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-74
11
Locat ion
No.� Date 10
I
8542
TOWN OF NORTH ANDOVE
Certificate of Occupancy $ Ui
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
Building Inspector
Div. Public Works
PERMIT NO. O-Slr- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE I
MAP +40.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK :PAGE
ZON E
SUB DIV. LOT NO.
PERMIT GRANTED
c /.z r, 9
/
LOCATION
PURPOSE OF BUILDING
OWNER'S NAME rnCLC,\�j
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER*S NAME
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
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 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
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS 1 3
PAGE 2 FILL OUT SECTIONS 1 12
INSTRUCTIONS 3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED %A" -
SIGNATUFM OF OWNER OR AUTHORIZED AGENT
�4 06
F E E 001,5—. 00
i
PERMIT GRANTED
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OWNER TEL. #
CONTR. TEL. #
CONTR. LIC. #
H.I.C. # -444n
- W-7
NA
BUILDING RECORD
OCCUPANCY 12
SINGLE FAMILY
SiORIES I—
MULTI. FAMILY
OFFICES
APARTMENTS I
I
CONSTRUCTION
2 FOUNDATION
—
8 INTERIOR FINISH
CONCRETE
PINE
a
2 13
—
CONCRETE BL'K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
_dNFIN
3 BASEMENT
AREA FULL
FIN. B M T AREA
14 1/2 1/1
FIN. ATTIC AREA
t!O 8 M T
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
4 WALLS
9 FLOORS
CLAPBOARDS
B
1
2
3
DROP SIDING
WOOD SHINGLFS—
CONCRETE
CARTH
ASPHALT SIDING
ASBESTOS SIDING
_�ARD",VD
COM/AGN
ASPH. TILE
VERT. SIDING
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIO! t0OR
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH Q FIX.)
GAMBREL
11
MANSARD
TOILET RM. (2 FIX.)
FLAT
_iillil)
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
HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER EMS. & 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
AS
OIL
I
B'M'T 2nd
Ist I 3rd I
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.
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office use Only
01 4t Lfammumm4 of 14fluz-admiffs Permit No.,
leputmfut af �Puhilr Omfetv O=pancy A Fee Checked
BOARD OF FIRE PREVEN'nON REGUUMONS 5V MR 12:00 3W 0eave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:07
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
(%*or Town of NORTH ANDO R To the Inspec or of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant Rm�.,
Owner's Address
1� �";_ ermit in coniunction with a building mer it: Ye s No (Chleck. Appropriate Box)
Purcose of Buildina 5111 /10 Ac? 441 Utility Authorization No
Existing Service Amps I-Voits Overhead Undgrnd
New Service Amps Overhead Unag.-na
Numcer of Feeders ana Ampacity
Locaticn anc Nature of Proposed E!ec-,,;cai 'NCrK
No. of Meters
No. of Meters
total
No. of Lighting Outlets No. z' '�c* '%-cs No. of 7ransformers KVA
No. at Lighting Fixtures
Atcve—
Swimming Pcci - 0. —
in -
gma.
Generators KVA
No. of Emergency Lighting
No. of Recectac:e Cutlets
No. at Oil Surners
Sartery Units
.No. of switch outlets
No. --at Gass Surners
FIRE ALARMS No. of Zones
"Ibiat
No. of Leection and
No. at Ranges
No. c4 Air Cana.
initiating Oevices
No. of Discosais
��ea, 7cai
No.ct P a s 7ans
"Ibiat
K -W
No. ct Sounding Devices
No. at Seit Containec
No. at Dishwashers
ScacetArea �Jeanna
K16V
Oetec*;ontSouncing Devices
No. of Orvers
Heatinc; Oev:ces
KW
Municoal Other
Locai Connec-ion
No. at '140. z:;ir
Low Voltage
No. of Water Heaters KW
Signs Baflasts
Winng
No. Hvcro Massace 7u0S No. at %lCtCfS -,ota: HP
0 TI -1 E F'�: c� d
INSURANCE COVERAGE. Pursuant -,0 the recutternents w %assacnL;s8-,s ;enefal Laws vaient. YES = NO
I have a current Uaoiiity insurance policy incuc:ng Ccr.-=eEec Cceraticris Ccverage or 'Its sucs*,antial equi
have suomittea vand proof of same 10 the Office. YES = NO :: It you have cnecxeci YES. please indicate trie type of coverage cy
checking Me aoprocinate cox.
INSURANCE = BONO = OTHER = .(Please Siaec.!y) (Exciration Datei
Esurnatect Value of E!ec*ncai Work S Final
Work 'a Start Inwelanon Date Racueszec: Rougn
Signeci unaer me Penatties op p
Zj_/_1 LIC. NO.
FIRM NAME Z Xwer, o Wn 1?/Z LIC. NO.
L,censee Signature
Bus. 7et. No.
Alt. lei. No.
Address tantiak ecuivalent as re -
OWNER'S INSURANCE WAIVER: I am aware triat the --;censee coes nat have the insurance coverage or its suos Agent
quirea t)y Massacnusetm Generaj Laws. ancl :hat mry szgnature an :!-as =ermit aootication waives trus recuirement. Owner
(Please check onel PERMITFEES
(�J� C�� 79teonone No.(Z�
�1) (Signature at Owner or Agent) 5
Date ......... .......
ORT
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
Ui
'�SACHUS
This certifies that
... ....... ............... ..................................
has permission to perform ....... ...... - 1, /1 � ,
........................ i .......................
wiring in the building of .......... . ....... ....................................................... :�A
North Andover, Mass.
at ........................... AX ..... ......... , . .........
1�1' - v
Fee.... ........ Lic. ................................................
ELECTRICAL INSPECTOR
C t "�-dO -�
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
.JII; -,""
!C-,\ offlo Use
of 4t Crommonwalth of Musadpmlm Permit No.
flepartmclat Eff public *afq O=pancy A Fee Chocked
"o Penn blank)
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOA1
All work to be performed in accordance with the Massacnusetts Electrical Code, S27 12.00
(PLEASE PRINT IN. INK OR TYPE ALL INFORMATION) Date
T& or Town of ORTH MOVER To the inspector of Wiree
The uder3igned applies for a permit to perform tMEt, electrical work described below.
Location (Street & Number)
Owner or Tenant
Owner's Address L
Is this permit in conjunction with. a building permit: Ye s No El (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service /0 6' Amps —12�n ";Lyo Volts Overhead El" Undgrnd No. of Motors
tiew _Service — Amps —Votts Overhead Unagrno No. of Motors
Numuer of Feeders ano Ampacity
Location and Nature of Proposed Electrical Work
(-, 4 , k''; - , '. , /
No. of Lighting Outlets No. of Hot 7.r -s No. of Transformers Total
I KVA
No. of Lighting Fixtures Swimming Pcoi Abcve— in- r—.
grr.c. — grnc. Generators KVA
No. of Emergency Lighting,
No. of Receotacie Outlets No. at Oil Eurners Battery Units
No. at Switch outlets
No. at Ranges
I
No. of 0isoosa13
No. of Dishwashers
No. of Dryers
No. of Water Heaters
No. Hyaro Massace Tubs
OTHER;
I kl� - y- - = .
INo. ct Air C-,r.c.
IqM.-A- .4---
I Heatino 0evices
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Sell Contained
09tection/Sounoing Devices
Local Municipal 7 Other
Connection �..
Low Voltage
Wiring
INSURANCE COVERAGE� Pursuant to the reautrements of M assacn. users general Laws
I have a current Liability Insurance Policy incluoing C�mz;:eiec Ocerations Coverage or its substantial eouivaient. YES =Z"NO
have suornittea valid proof of Same to the Office. YES NO Z It you nave CMOCKOC YES. pleas* indicate the type of coverage oy
checking the appropriate Cox.
INSURANCE -7;--80NO = OTHER Z (Please Scec:�?)
.1/ � A�6iratian Defeo
Estimated Value of E!sctncal Work S P6.6i //
-'� 3 Insbecnon Date Aacues:ec: Rough Final
Work to Stan - 42 , —,197
Signoo uncer Me Penalties of perjury:
FIRM NAME A- : -,,,74 UC. NO.
Licensee Ala Y-1 IC11-11sa I-, Sigra:-.;re UC. NO.
No. 69-1�LZ-7.-
Address Bus. To, -
Alt. Tel. No, --------- A—
OWNER'S INSURANCE WAIVER; I am aware [mat the t-:censee coes not-mave [he insurance coverage or its suostantial equivalent as r0-
quirea by MassacnU3@tts General Laws. ana that my signature an �!%i3 -ermit agpitcalion waives this reauirement. Ownh, Agent
(Please chocx oner 7eieonone No. PERMIT FEE 3 1pyo
(Signature of Ownor or Agentl X41563
Date...
1'1�-O' H86
-te —". '6 0 1
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... ....... ..............................
has permission to perform ......... . . ......... ......
wiring in the building of ......... ...................................................
at ............... �.�K ........ e.(Jf-1 North Andover, Mass.
Fee... �YA ........ Lic. NoPH/t ................................................................
ELECTRICAL INSPECTOR
C � t4 �a �0
WHITE: Applicant CANARY: Building Dept. I(Albsurer
09129/97 13'.20. 40.
Location
No.
f / w
Date
,4ORTpf TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CHU Foundation Permit Fee $
4rr (r)
Other. Permit Fee $
A
Jbi Mstm Connection Fee $
U jr ru
Water ChRROGOW ee $
$
!,.'rQfAL1qqj
"O-APA�er Collectoi-?o Building Inspector
Ir
Div. Public Works
Location
No.
Date /01
,&OR
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
Building/Frame Permit Fee
$
S- A
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
�QXZ,10—ohnBct
410.
*v4, ion Fee
$
1-ITp T A L
$
U11feli, Go/zeeefo.--
Building Inspector
Div. Public Works
il f I T N 0. 2
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
PAGE
MAP +40.
LOT NO.
12 RECORD OF OWNERSHIP IDATE
BOOK "PAGE
ZON E
SUB DIV. LOT NO.
F -
'LOCATION h.,ticidlesev
PURPOSE
be-vn-v 1,4-iol )--e ex- e u
OWNER'S NAME 5a."d,,ta, PLasv4-fr)
NO. OF STORIES SIZE
OWNER'S ADDRESS to -it 4
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 31,93 5 j. �±. . FRONTAGE
41
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW It
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 oej
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE \pes
INSTRUCTIONS 3 PROPERTY INFORMATION
SEE BOTH SIDES LAND COST
EST. BLDG. COST
4�t 040 0 - —
PAGE I FILL OUT SECTIONS I - 3 Q au - EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS I - 12 -7?, H, EST. BLDG. COST PER ROOM
0* , SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED -
01!!7 BOARD OF HEALTH
SIGNAT3U5J.0t:Z�"WER OR AUTHORklfd-AAEN
s Z -4p vy
F E E
PERMIT GRANTED
19
r
M AY 1 41991
a 4710-4 9�
OWNER TELA
CONTR. TEL. # ---------
CONTR. LIC. # ----------
PLANNING BOARD
RD OF SELECTMEN
,;)tl
BUILDING RECORD
I OCCUPANCY 12
SINGLE FAMILY
S , -OR , Es
MULTI. FAMILY
APARTMENTS
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
E
3
1
2
13
CONCRETE BL*K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
UNFIN.
3 BASEMEAT
AREA FULL
FIN. B M T AREA
7, 1/1 'j,
FIN. ATTIC AREA
NO BMT w
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
4 WALLS 9 FLOOR$
CLAPBOARDS
B
1
2
3
DROP SIDING
CONCRETE
WOOD SHINGLES
EARTH
ASPHALT SIDING
HARDW'D
ASBESTOS SIDING
COMMON
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
—
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STIRS.
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR �OOR
,�DEQUATE NONE
5 ROOF
10 PLUMBING
GABLE I
GAMBREL
�—LATIASHED
BATH (3 FIX.)
-dip
MANSARD
TOILET RM. (2 FIX.)
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES_
KITCHEN SINK
SLATE
_
NO PLUMBING
TAR & GRAVEL
LL 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
J IT HEATERS
7 NO. OF ROOMS
GAS
OIL
2 d
10 3rd
ELECTRIC
NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES. GA -
!AGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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