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Miscellaneous - 315 MASSACHUSETTS AVENUE 4/30/2018
315 MASSACHUSETTS AVENUE �S 1 2101016.0-0053-0000.0 i 1 1 Date... �1 ........................ NORTIi pF �.a° 7ti ioTOWN OF NORTH ANDOVER ""= PERMIT FOR GAS INSTALLATION gg'�CHUg� This certifies that . �. ....... : .�. ...................... h M me'. o .. ........................................... has permission for gas installation A + s�i+�?- in the buildings of..... e ...�... at.....�,�1. ...HOSS.Ac .1 S... North Andover,Mass. Fee.. eqN`..... Lic. No. �9: �. ...... .......................................................... r GAS INSPECTOR Check# ; 370 `gam MASSACHUSETTS UNIFORMPA94MACATION FOR A PERMIT TO PERFORM GAS FITTING WORK V I IL CITY I North Andover MA DATELOVON PERMIT# �1 JOBSITE ADDRESS ' h S OWNER'S NAME GOWNER ADDRESS Same TELL— =FAXI 71 TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW: RENOVATION:El REPLACEMENT:® PLANS SUBMITTED: YES❑ NO[j APPLIANCES Z 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 MAKEUP AIR UNIT OVEN POOL HEATER ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER Replace 1 as Meter x and Pi inci as Needed INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES E]NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ 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 true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be i mpliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Joseph Marino LICENSE# 8736 SIG ATURE MP 0 MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION[3# 3285C PAR SHIP❑#�LLC❑#0 COMPANY NAME: RH White Construction Co ADDRESS 41 Central St CITY I Auburn I STATE MA ZIP 01501 TEL 508)832-3295 FAX508-926-4347 1 CELL 508-832-4614 1EMAILI JMarino@RHWhite.com ACORD -6--" CERTIFICATE OF LIABILITY INSURANCE page 1 of z 08/2/2oi3 THIS a%MTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SU 13ROGATION Is WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). PROOVGER t-M101CT of Maeaachusette, Inc. NE c/o a6 Century Blvd. 877-945.7378 PAX P. 0. Box 305191AL _Nog 866-46_77-2378 Xhmhva11e, TN 37230-5191 DnS55s ce �.ficateaC�w•illis.co INSURER(S)AFFORDINGCOVERAGE NAICrt INSURED INSURERA!The cbAa:ter Oak riro Zneurancq Company 25615-001 R. N' White Construction Company, rnc, INSURERS:TreLvQlA S property Casualty coagpany oQ 7m 25674-003 41 Cassa ox Street INSURER C:Natio)aal. Union Piro Insuranca Company o£ 19445-001 P. 0. Box 257 Auburn, MA 01501 INSURER D;Travelers Ind=nity Company 25658-001 INSURER F; INSURER F; COVERAGES CERTIFICATE NUMBER.20287680 REVISION NUMBER, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T094- JJJL TYPE4FIN8URANCE DD' SU6 POLICY NUMBER POLICY EFF POLICY EXP A GENl7iALLIABILITY LIMITS VTC2000 9771K9949-13 9/7./2013 *9/1/2014 EACH OCCURRENCE h 2,000,000 X COMMFRCIALGENERAL LIABII.ITY DDqq TORENTEp PR N3(E eunmocl _� 300_ppp CLAIMS-MADE OCCUR MED EXP(Any one ereon 10,000 PERSONAL&ADV INJURY 5 2 QDO,000 GENERALAGGFEGATE S 4�Qp0 000 4BAUTOMOBILE GGREGATE LIM17APPLIES PER; OLICY PRO LOG PRODUCTS-COMPIOPAGO $ �QQO 000 uaealrrVTJCAP 977 9/1/2013 OMgINEDSINGLELIMIT $ /1/20x3 9/1/2014 accdeD X ANYgUTO 21000,000 ALI.OWNED SCHF,DULED BODILY INJURY(Perpereon) & AUTI NON OWNED Toe BODILY INJURY(Peraccidsn!} ;S X HIRED AUTOS X NON X Co Dad X Cv11 Ded AUTOS -P ry erRccldent s C; UMBRELLA LIAR OCCUR $ $36766140 /1/2a13 9/1/2014 EACH OCCURRENCE $ 51000,000 X EXCESS LIAR CLAIMS-MADE DED }; RETENTIONS jp,000 AGGREGATE $ $,000,000 D WOR COMPENSATION VTRXUB 820.6A105-13 9/1/207.3 9/1/207,4 $ O - $ EMPLOY AND EMPLOYERS'LIABILITY TDf�Y LI D ANYCERIMEM]3r;R EXCLUDED? NfA VTC2KTJB A209A7yA-13 9/1/2013 9/1/2014 E.L.E ACHACCIDENT 1,000,000 OFFICERrMEMBEREXCLUDED7 LJ fMyyerl;des flbban E.L.DI2EA9E-EAEMPLOYEE 5 1,000,000 UE�VKeII61 UN W OF F.RATIONS balow E,L,DISEAsr.POLICY LIMIT S 1,000,000 )ESC RIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(AataCla Acord 101,Addlionpl Remarks sehvdula,If more ep sen la rsequirad) 'ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �:VidO(1ce Of InM=Ance AUTHORILLDREPRESENTATIVE coll,-4197604 Tp1:1694012 Cert:20287680 ©1988-2010ACORD CORPORATION.All rights reserved, CORD 25(2090105) The ACORD name and logo are registered marks of ACORD OENOoT��aO Town of North Andover r � 1600 Osgood Street ; Bldg.20,Suite 2-36 CHU North Andover,MA 01845 SwcNus Phone: 978-688-9545 Fax: 978-688-9542 Gerry Brown,Inspector of Buildings September 28, 2010 Ocwen Financial Corp. Ocwen Loan Servicing P.O.Box 785 055 Orlando, Florida 328755-5055 Regarding: 315 Mass Avenue,North Andover, MA 01845 Mortgage#03105639 To whom it may concern: Please be advised that upon a visual inspection of the structure at 315 Mass Ave. on September 28, 2010 it has been,deemed that the structure is in an unsafe condition which may result in injury to abutters or abutter's property, local children or anybody utilizing the structure for its intended use. Please accept this letter as an official notice under the Mass State Building code(780 CMR) section 5121.1-5121.6 Unsafe Structure which states in part"The building official immediately upon being informed by report or otherwise that a building or other structure or anything attached thereto or connected therewith is dangerous to life or limb or that any building in that city or town is unused uninhabited or abandoned,and open to the weather, shall inspect the same; and he shall forthwith in writing notify the owner to remove it or make it safe if it appears to him to be dangerous, or to make it secure if it is unused, uninhabited or abandoned and open to the weather." The State code also has serious penalties for failure to make a structure safe section 118 states in part"Whoever violates any provision of 780 CMR., except any specialized code referenced herein, shall be punishable by a fine of not more than $1000 or be imprisonment for not more than one year, or both for each violation as per section 5118.4. Each day that a violation exists shall constitute a separate offense. Please contact me so that we may begin the process to remedy this in a timely fashion, I may be reached between the hours of 8:30— 10:00 AM at 978-688-9545. Respectfa ly, AA AE Gerald Brown, Inspqftor0of Buildings Cc: Mark Rees Curt Bellavance 7V, , .0-j i07 Z- PL NORW4 F—m4,1 TH O;tt�ao ►i�'60 Town of North Andover : ! N 1600 Osgood Street " *., -�•,'� �` Bldg.20,Suite 2-36 ' ra,�,�s North Andover,MA 01845 Phone: 978-688-9545 Fax: 978-688-9542 Gerry Brown,Inspector of Buildings September 28, 2010 Ocwen Financial Corp. Ocwen Loan Servicing P.O. Box 785 055 Orlando, Florida 328755-5055 Regarding: 315 Mass Avenue,North Andover, MA 01845 Mortgage#03105639 To whom it may concern: Please be advised that upon a visual inspection of the structure at 315 Mass Ave. on September 28, 2010 it has been deemed that the structure is in an unsafe condition which may result in injury to abutters or abutter's property, local children or anybody utilizing the structure for its intended use. Please accept this letter as an official notice under the Mass State Building code(780 CMR) section 5121.1-5121.6 Unsafe Structure which states in part"The building official immediately upon being informed by report or otherwise that a building or other structure or anything attached thereto or connected therewith is dangerous to life or limb or that any building in that city or town is unused, uninhabited or abandoned, and open to the weather, shall inspect the same; and he shall forthwith in writing notify the owner to remove it or make it safe if it appears to him to be dangerous, or to make it secure if it is unused, uninhabited or abandoned and open to the weather." The State code also has serious penalties for failure to make a structure safe section 118 states in part"Whoever violates any provision of 780 CMR, except any specialized code referenced herein, shall be punishable by a fine of not more than$1000 or be imprisonment for not more than one year, or both for each violation as per section 5118.4. Each day that a violation exists shall constitute a separate offense. Please contact me so that we may begin the process to remedy this in a timely fashion, I may be reached between the hours of 8:30— 10:00 AM at 978-688-9545. Respectfu ly, Gerald Brown, Insp o of Buildings Cc: Mark Rees Curt Bellavance X31 b��'�. �a�� � 5 ��d 315 �� 5 *Mailing Addresses Page 1 of 1 Home:Site Slap:Help:Contact search this site ''Customer Service Center I Customer Promise I News 3 Views I Educational Materials I Company Info] ,(' ('1✓� + Understanding Mortgage Servicing a.!t► us—tomer StTVice .enter Mone4466f(tEL X — Makin!tAve4 Mbinferlmation UnderriRIGM969M Score Contact Usked _Questions Financial Difficulties ►Contact Us To complete our Customer Survey,please call(866)513-2954 i Insurance,Warranties and or to participate in our Web Survey please log in to your account. —More Please address all correspondence to Ocwen Loan Servicing,LLC and be sure to include your Ocwen account number. PAYMENTS: TAX: P.O.Box 6440 P.O.Box 961260 Carol Stream,IL 60197-6440 Ft.Worth,TX 76161-0260 Telephone:(888)656-3672 Fax: (817)826-1728 INSURANCE: INSURANCE CLAIMS: P.O.Box 6723 Regular Mail: Overnight Mail: Springfield,OH 45501-6723 P.O.Box 6501 One Assurant Way Springfield,OH 45501 Springfield,OH 45505 Telephone:(866)825-9265 Fax: (937)324-6796 Telephone:(866)825-9266 Fax: (937)324-6797 GENERAL INFORMATION: ; COMPLAINT: P.O.Box 785057 P.O.Box 785055 Orlando,FL 32878-5057 Orlando,FL 32878-5055 Telephone:(800)746-2936 What do I need to do if I have a complaint? mail: Click Here REO for Sale Properties: Corporation Service Company: Residential: For serving Ocwen with legal process,please View Properties for Sale send to our registered agent: Email:residentialREO()ocwen.com 2711 Centerville Road,Suite 400 Commercial: Wilmington,DE 19808 View Commercial Properties for Sale Email:William.Stolbero(cDocwen.com Telephone:(877)226-2936 t To protect your privacy and to better service you,we require that you submit your full name and loan number on all correspondence. Equal Housinp Lender. ©Ocwen Financial Corporation.All Rights Reserved. Return to Ocwen Homepage(web Terms and Conditions http://www.ocwencustomers.com/ci_contact.cfin 9/28/2010 Bellavance, Curt From: Rees, Mark Sent: Wednesday, August 25, 2010 10:04 AM To: Bellavance, Curt Cc: Brown, Gerald; Stanley, Richard Subject: RE: 315 Mass Ave Thanks Curt for the update. This is a priority so please move forward asap with tracking down the mortgage company and putting pressure on them to clean up the property. Bring Tom Urbelis in if necessary. Mark Town Manager Town of North Andover 120 Main Street North Andover, MA 01845 email: mrees@townofnorthandover.com Phone#: 978-688-9510 Fax#978-688-9556 From: Bellavance, Curt Sent: Wednesday, August 25, 2010 9:21 AM To: Rees, Mark Cc: Brown, Gerald; Stanley, Richard Subject: 315 Mass Ave Mark: I asked Jerry to take another look at the#315 Mass Ave property. He determined that the house/condo unit is in good condition except for tall grass and shrubs. The house/unit is secure. A mortgage company owns the unit and we are working on getting an address or someone to contact in regards to cutting the grass and possibly trimming the shrubs. The neighbor that lives in the attached unit does not want to be involved and said they think the owner is in California. We'll keep you updated when we get more information. Curt. Curt T.Bellavance,AICP Director I Community Development Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover,MA o1845 1 --- ----� C���� � �.,�� / ��� � I � �a�� �_ Y 1Q Bk 11933 Pa 129 3024 U2-03-2010 d 08 c 33ct ASSIGNMENT Taylor Bean and Whitaker Mor AnCoro. y holder of mortgage from 4 Yinglin Han and Xiao Liu to Poli Mortgage Q=,Inc. `O dated March 26, 2004 recorded with Essex County(Northern District)Registry of Deeds in Book 8664,Page 295 assigns said mortgage and the note and claim secured thereby to Ocwen Loan Servicing LLL. W 1417 North Magnolia Ave..Ocala.FL 34475 In witness whereof the said Taylor.Bean and WhitakerMoi gage Coro. Has caused its corporate seal to be hereto affixed and these presents to be signed, in its name and behalf by Erla Carter-Shaw its Executive Vice-President Taylor, 'takTortgage Corp. B Erla Carter-Shaw M Jandar`y'A ; ?A10 STATE OF Florida -k COUNTY OF Marion <. On this 11th day of January,2010,before me, the undersigned notary public,personally appeared Erla Carter-Shaw as Executive Vice-President,of Taylor,Bean& Whitaker Mortgage Corp., who I have personal knowledge of identity,to be the person whose name is signed on the Bk 11933 Pg130 #3020 proceeding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. anya-J o My Commission Expires: Ju y 12, 2010 File No. 465.0938M,�,..„.M..»...� TANYA J.JOR73�3 ; Return to: E J.-•A" ` �$ c Orlans Moran PLLC � �;?r= 7f1?12010 s pbrida Nolan �c P.O.Box 5041 ................N....NH.....�H Troy,MI 48007-5041 r J y 't win AGY2000S.BD024.DO72110.T132815.TXT Notepad File Edit Format View Help /AGENCY/CUSTOMER/FA—TAXID TAX PAYMENT REPORT RUN DATE: 07/21/10 RUN TIME:,iz--IZ 1-5 , AGENCY.. : 200050024 NORTH ANDOVER TOWN , 120 MAI STREET, NORTH ANDOVER MA01845 Go (978)688-9550 INSTALLMENT: 1 CUSTOMER: 0010300 OCWEN LOAN SERVICING, LLC v " TPA: r:k TAX IDENTIFI TION BILL NUMBER CONTRACT SUP J, SUP LOAN NUMBER OWNER NAME SITUS ADDRESS LEGAL -------------------------------------------------------------------------------------------- r ---------------------------------------- r . 2100090000700000 3868 19476416 001 001 -' BANDLE MELVIN F INST-1 1,146.38 INST-2 0.00 69 UNION ST, NORTH ANDOVER MA 01845 INST-3 0.00 INST-4 0.00 AMOUNT PAID= 1146.38 LIAB LTD TO AGY/TID PROV ------------------------------------------------------------------------------------------- - — ----------------------------- `r' 2100140004800010 9890 47322384 001 r 3�` 001 `1c SHEEHY,BRENDAN INST-1 707.19 INST-2 �{ 1 0.00 J a Type:Text Document Date Modified:7/2212010 1:42 PM Size:2.68 MB <.R ��j a. I'�JJ..hI�' `' .. =3911�Ih,...Jd�.".:� 4'77-701.�' _ StarC o e a r TO Goyern For windows .. '10 DA �,Pi AGY20005.80024 D07... 9:16 AM Tuesday,Aug 03,2010 09:16 AM C ' G 50 r r r 1 29 Y y R _ MIT XX�'..y s.�. t . : i 1 1.1 - yr✓ - alLrrd4s-c: Mb X1. ' ! File Edit Format View Help . ---------------------------------------- 2100090000700000 3868 19476416 001, ; U r;001 a R sf BANDLE MELVIN F INST-1 1,146.38 INST-2 0.00 Go 69 UNION ST, NORTH ANDOVER MA 01845 INST-3 0.00 INST-4 0.00 AMOUNT PAID= 1146.38 t LIAB LTD TO AGY/TID PROV r,i - - i ----------------------- ---------------------------------------- 2100140004800010 9890 47322384 001 001 SHEEHY,BRENDAN INST-1 707.19 INST-2 _ 0.00 144 WAVERLY, NORTH ANDOVER MA 018453508 INST-3 0.00 INST-4 0.00 AMOUNT PAID= 707.19 LIAB LTD TO TID PROV ------------------------------- _ ----------------------------------- 2100160 0010 � �;,-/�, 5591 0 105639 001 0 ��P 'rwrtisT _s. HAN,YINGLIN D INST-1 ® INST-2 315 MASSACHUSETTS AVENUE, NORTH ANDOVER MA 01845 INST-3 0.00 INST-4 0.00 AMOUNT PAID= 934.17 LIAB LTD TO TID PROV r r ,•. -------------------------------------------------------------------------------------------- a 2100180001500000 2980 81144676 001 • 001 t y■ Or Type:Text Document Date Modified:7/2212010 1:42 PM Size:2.68 MB A! S g`. .4a { -'-7;,e !l -;f°� �§'�1G -- ': -vs7ici.itmm"I!1(I°- 3 7711t.iF lAl' �Je g ;.•i.m f°I �ia?.m�. l� 11 Start ,fL2 la W [(; ro Govern For Windows .., 1 D:l AGY200M.B0024.D07 a; ® ®`p � �t 9:i5 AM Tuesday,Aug 03,2010 09:15 AM i floo Gni 0, 31s000, ua .6' D� Ile if Loll- Z /s 4�� I N W N fgrio of ' + N N i 5'l E+6%04tt r� i immBY cmmy ro mr uo,A o�av Ea. PLOT PLAN s Ltz.- Dc Pr• rxtr rat 0IJ eu,. Is Locirm oX IN TIM Lor AS MO►N AND raer Ir DOGS comm" VIM In-I''owi l OF foo.Ak)xwvg"omxo itsomnoms ARGARMNO HIMen FROM SMZVS ! Lor LINRS.' I FtMrECR CUM7 MAV rMS -r%jELL. IS Nor LOCAND IN rM FBDRRA FLOOD ILSdRD AMU AS DRAWN FOR BROWN ON f 250090 0003G Falb;. _ PINBL PAT'�P C E as rip 141 sraPt Ls. Lug - Nor BouNtuRY lJdx. eoumwr wwwmw J/RRRWCK RNGINRR UNG SRRNICRS rIKRN FROM Rrrsrlwo MMUS. 88 PARK STRRRr 11"DOMR, YASSACXUSMS 01810 Location 3 IS VA to 5,S Ay --,- No. Date Q%( v NORTq TOWN OF NORTH ANDOVER p + s Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s,KMuSE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 100y 175 1 2 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 111b Sethi for Use 0 , rn BUILDING PERMIT NUMBER: Q a DATE ISSUED: /S �a 0 / X ic SIGNATURE: �..+ Building Comnidsioner/12EeEtor of Buildings Date Z SECTION 1-SITE INFORMATION • 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 31C Ha-5 5 AJC 112 53 3 ,6 '.slap Number Parcel Kumber (� .J 1C 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lct Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yazd Side Yard Rear Yard Required Provide RcqWred Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: ' Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT «11C, ' Lr' L. YU3 V M 2.1 Owner of Record `1 Name(1`44 T Address for Service 1 • S' re Telephone o 2.2 Owner of Record: Name Print Address for Service: • Z a 171 Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ . �4 Company Name M -)9 Registration Number r Address r Z Expiration Date /) Signature Telephone V� r SECTION 4-WORKERS COMPENSATION(XG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Signed affidavit Attached Yes.......0 No.......C SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �►S-I f I 1 t/u IM�oc;JS 7�- 1�� (ADO 1 0 o D S- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee �Dt Multiplier 2 Electrical (b) Estimated Total Cost of p�0 Construction 3 Plumbing Building Permit fee(a) x!I, 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR tCONTRACTOR APPLIES FOR BUILDING PERMIT I, '7 i In 4 l t t-� a t' as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION I> As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TDaERS iST2ND3RD SPAN DIN ENSIONS OF SILLS DIN ENSIONS OF POSTS DINIENSIONS OF GIRDERS , HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i t NORTk Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 S�cr+use D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATIONS 5 5 b S Number Street Address Map/lot ..HOMEOWNER �C-iy1 ��g—bg7.'l d 93 �I �T3 —og b Name Horpe Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homedwners"was extended to include owner-occupied dwellings of two 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 108.3.5.1) s DEFINITION OF HOMEWOWNER: 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 or two family dwelling,attached or detached structures ac- cessory 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. 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 No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE_ `S APPROVAL OF BUILDING OFFICIAL ' 4 G The Commonwealth of Massachusetts t d Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 M sy• Workers'Compensation Insurance Affidavit Name Please Print Name: -: A e ��h M n a Location: G i c M 4 e>S hcJ City p1=[ -tir�r���p f Phone # R 7 g-6 9 ® I am a homeowner performing all work myself. F-1 I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone- Insurance Co. hone Insurance_Co. Policv# Company name: Address City: Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment_as_well_as_civil_penaltiesinTheftirmdaSTOP WORK ORDER_and..afine.of.($1.00..00)_aAaysgainst.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of pedury that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept []Check if immediate response is required ❑ Licensing Board ❑ Selectman's Once Contact person: Phone A- ❑ Health Department ❑ Other iE Brc 69" P&.310 AMADC MMM 1W67Mr OF DMPO MOM,DIMS&ONO 7AKAW W AMMIOR MAX U44U& 06*AkAOghvvr&As PP-Pmr PLCM rorAL 4wlr AREA I.Wff/-1600 da (EhrA=IW*6ARAaRl AMWIMV fl A4aEPSVr oAavevr imr //07 Sa Pr Am-SAOS ip Atr.Wr apt9o.4A 6EMENr FLOOR PLAN AMWMr caerPy mAr rAm P"N wAFORm6 TO ME RaM AND R""WNS OP AE RS"7MO OF DMV6. lFmrAmcmiwrn"rrAMP"NRZLrAND ACAMMA7ELr 4o-aux r aom PLAN oF Do-cm r-a!p/r kex-A w.%wr NO,Apoomwalow MAW 6MEMW CONDOMINIUM 5 A1 - uAtIr / 31-4 MAMACAWEMS AVS 102 AACMEU -.ORA-WAU RLS DATE Ni ANOOVM OF OCALEs 110'- /L0 MARC44 5, 2002 ANDREW yG ENCHMARK &WVE*r 40 ELM S7?qfiFr C. SrOMS4AM, MASS, BRAMHAU. (70V 279-9/09 No 33177 OP 3 SUS�y�Q MA AMW RM, MW RM. AWL4 BED RM - ---------- REAR yr OUNfiR OF RECORD FRONT cqBe4RP E IA cm AM 6319 P.G. 310 RMEW NORTH REGISTRY OF DAWO NOTE•PIMEN610" UACM TO ------------- INTERIOR PLA67MeM WALLS NO. 30 BB MAASMW&AAS AFFIRSr FLOOR MASA404�16 AVE TOTAL umlr ARz4 ft VVINO RM, UNIT 1600 54 FT, a wr i-1600 sa Fr FF /01,76 4DeC4W1XCv GARAGE/MASEMEM KjrcHov /4MMY CERTIFY THAT PLAN CONFORMS TO rAE AWLM AND REGULATIONS OF ME RWIS MW OF DEWS /FiNnam awiFy THAT m/6 PLAN Riir AND Ac4a#e4 ra r DEP/CM THF jArrVr ,Le,--4770K IJNM NO,AND DIMENSIONS OF M7,00f 4.Al BUILT. FAMILY RM. 5j2,bjfjZ- PF -VI-39 A ge C. ANUMMAU P40 P, AA Of ANDREW C. NO 33177 UNIT'I �brESSN nV0 CAR SUR vol GARAGE 4M Sa Fn AS-Mli-r FLOOR PLAN OF MAW aRa-WE CONDOMINIUM uNIr / .35 MAMACAWE7T8 AVE MARCH 200? BENCHMARK SURVEY 410 ELM anefiLcr ------- SrON64AM MAW. eo7fiV 279-9A09 SMEEr I OF 2 O 5 AO a SCALE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL 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 MGL c11, S150A. The debris will be disposed of in: LL (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector �.1O R TH TOwn of -o oLAKE ver, Mass., f 7 1 0A 0 0 O COCMIC ME WICK 7� ORATED S V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System r BUILDING INSPECTOR THIS CERTIFIES THAT......... ............... ...... A►.N............................................ ........................................ Foundation has permission towt...W.Qt..0)......... buildings on . 5 M A .�........,A F............... Rough ........ ................... ............ ......... to A M N� N 0 w F NI '� Chimney to be occupied as............................... ..........................................W............................ .... ... ........ .. ........��............ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 1(0 ) S 3 4 so ... O (- m AS!aArfti t PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Ree R O o V%0% Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough .. .. ......................... ..................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location 3/, 7XA SS A No. YQq Date NOR,h TOWN OF NORTH ANDOVER 3? 60 /1 Certificate of Occupancy $ .J bis' Building/Frame Permit Fee $ G s�cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 0 Check # ata AIR 5 u 4. 2 Building Inspector i i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT i APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .. 0-30 � �. �r BUILDING PERMIT NUMBER: DATE ISSUED. 07 SIGNATURE: Building Commissioner/IRt for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: r--- 16� Map Number Parcel Number \\ V 1.3 Zoning Information: 1.4 Property Dimensions: -`I I 85 -7 ! z -7, Ll -7 Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required I Provided Required I Provided > >- 'R a 1 tz I -�- 7 d 1 -,� L i 1.7 Water Supply M.GLC.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 a SECTION 2-PROPERTY OWNERSE IP/AUTHORIZED AGENT r 2.1 Owner of Record \Q Name(Print) Address for Service 2�L�— Si/gAt6re Telephone 2.2 Owner of Record: Name Print Address for Service: r Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3. icensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: jl�� — t�Z ,{,I ✓� License Number /v a resh)z 1A Expiration/ te/ (� ignature Telephone r ee 3.2 Registered Home Im vement Contractor Not Applicable ❑ V1- C We,) , Z,- Company Name -=c Reg tion Number Ad re // // �e / � 3V,� Q f/ o �5 Expiration ate S' ature Telephone i 1 SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.... No.......❑ SECTION 5 Description of Proposed Work check all applicable New Construction ❑ Existing Building ❑ Repair(s) ❑ Aherations(s) ❑ Addition Lh—I Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: z'( 06/7/0,00 o2 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFI le AL Ory - Completed b permit applicant 1. Building 6 C-) U o C7 (a) Building Permit Fee O K t $O,C�163— Multiplier 63Multi lier 2 Electrical _ (b) Estimated Total Cost of v U Construction / 00 0 015 j 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical(HVAC) O 5 Fire Protection 6 Total 1+2+3+4+5 D Check Number SECTION 7a OWNER AUTHORIZATION O BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of(honer Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, r 9 '� C� �' e I C " t 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 / (S --e C `� Print e 0 11 9-19 -o ature of O er/A ent Date NORIES SIZE / (BASEMENT R SLAB SIZE OF FLOOR TIMBERS 1 -2 X/0 2 16 3 RD SPAN / DIlMENSIONS OF SILLS ,2 DIMENSIONS OF POSTS L L L DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING O X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE p, �( X 3 to r- FORM U LOT RELEASE FORM aW DW�((� r 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT_ PHONE /�C� - � �a�v LOCATION: Assessor's Map Number PARCEL SUBDIVISION� C� LOT(S) /� �/I I STREET A SJ A � � ST. NUMBER *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS 17n DRIVE Y PERMIT 0� }Z6 J FIRE DEPARTMENT \ 6 d RECEIVED BY BUILDING INSPEC R DATE Revised 9\97 jm TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)655-0956= DIRECTOR Fax(978)688-9573 f I10RTk " q S�O1" ibfb�O - Or L 16- ,n y o f IL i • �9SSAcwuSEs�y DRIVEWAY PERMIT DATE Zpc LOCATION BUILDER phone OWNER � = ,� hone -92-L6-5 THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENTS OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. E x r Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: e, Location: 11,E PLA A S S A 0 �-- City P , L Phone 7 _ �� S 7 / am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. �1 � Company name: ( -e f °1 Y� 0z P aZ 42r, Address /A 1 il--M /iU 5 7- City: �P QA r ti 9 CA Phone#: Z?-T-) Insurance Co. 4-.2 f D A Policv# Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of I nvestigations of the DIA for coverage verification. I do herby cert' u d t ai a n ies of pe 'ury that the information provided above is true and correct Signature Date l —IZ fes/ Print name ( 7 P ct J`vl W I c. �1 Phone#9 Y r-?J >1� T Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept p Licensing Board [-1 Selectman's Office Contact person: Phone#: E] Health Department Other FORM WORKMAN'S COMPENSATION Building Department o < 27 Charles Street M North Andover, Massachusetts 01845 - (978) 688-9545 Fax. (978) 688-9542 0 AcHtis 1. ry yy� �� ceCri<ywKt 1\0 T 'QS OH'STED µP� �G, DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit-# the debris resulting from the work I of in a properly licensed solid waste disposal facility as defined by MGL cl 1,be-di posed The debris will be disposed of in/at: F rlity locati Signature ofApplic-nt Date NOTE: A demolition permit from the Town of North Andover must be obtain project through the Office of the Building Inspector. ed for this MFAMm C��F PSS? ti p SCfbAck r- N • r Awnpr =my m in u 10,A OP CIV 9!;z_ PLOT PLAN 01-16W , rs LOC m ON !N INC Lor AS SBOIN AND rBAr rr DorS comm Ilrlr fM-rsw`l or f4*-ANVVv9.aOM17 RB'GV UUONs PJGMM'; SB'MIM P80Y simrS & ,Lor LURE • r PUMM CnM7 nUF rMS r8 Nor LOCAUD 1N M PSDB' FLOOD EIZM AM AS DRAWN FOR SHORN ON P t PAMM E?,.50090 0003G C E 144,r2-p 1�1 Ems{ BI BP S. DAIIW _ Nor r+au4 YMUMCK RNCINRMUNC SRR�ICRS BOUNLtRY l�Jd1V. BOU11T17LRY 1NPORI[/liOX r/!l'RN PRou B7umm arcoROs. BB PARC SrRBRr I"DOYRR, MASS'ACHUSRrTS 01810 NORTH Tovm of � over z � q-ozS -o�oo/ 0 -Co� LA dover, Mass., �tC, v AD RATED P'P�`_\-J S H E BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... .r. ..!if �.............l ,t��...... ............................................................. Foundation x31 M.A.has permission to erect....d?. .......� ....... b 'Idings on ................... ............ Rough 0 to be occupied as,.....slot- ....... I foe �0 1r-... .r .. ...AAA A-VAC, 0 Chimney p y provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. D W ! 1' % iV 43 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. /&/d_ 3 Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ART ELECTRICAL INSPECTOR If ` Rough .. .... Service BUILD G INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Building Value Calculation - for Property at..... LOT# i ila 1� #. 2�raet � .. Room Length Width Sq.Ft. Cost per Sq.Ft. Total Cost Kitchen 14 10 140.00 65 $ 9,100.00 Brkfstnook - 65 $ - Dining Room 10 11.5 115.00 65 $ 7,475.00 Family Room - 65 $ - study/office - 65 $ - Living room 15.5 14 217.00 65 $ 14,105.00 Garage - 35 $ - Entry 10 9 90.00 65 $ 5,850.00 2nd floor foyer/sitting - 65 $ - Sunroom - 65 $ - mudroom - 65 $ - Walkin closet 10 8 80.00 65 $ 5,200.00 Basement Finished 65 $ - Balcony - 65 $ - Screened Porch 35 $ - laundry - 65 $ - Bedroom 1 12.5 9 112.50 65 $ 7,312.50 Bedroom 2 14 13.5 189.00 65 $ 12,285.00 Bedroom 3 14 14.5 203.00 65 $ 13,195.00 Bedroom 4 - 65 $ - Lav/Bar - 65 $ - Bathroom 6.5 10 65.00 65 $ 4,225.00 1/2 Bath - 65 $ - Bathroom 2 10 8 80.00 65 $ 5,200.00 Bathroom 10 9 90.00 65 $ 5,850.00. Balcony - 65 $ - k' � DEDUU{ WOFP[1B(xSAFEIY BaUDOFFIREPU VTMMMM2709 20 � Oexnpottey&Fees ClKcked APPLICATION FOR PERMU TO PERFORM ELECTRICAL WORK ALL woRK TO BE PERFORMED IN ACCORDANCE WTM THE MASSACHUSSrS ELECTRICAL CODE,527 CMA 12:00 (PLEASE PRINT IN INK OR TYPE ALL INIFORMATION) p D` Town of North Andover To the Inspector of wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) S 0 a1 -t-g Owner or Tenant q Owner's Address Z i C 11} a c c /tr%9 0— Is this permit in conjunction with a building permit; Yes® No (Check Appropriate Box) Purpose of Building 1A; y se Utility Authorization No. Existing Service Amps I Volts Ovedmead Underground No.of Meters New Service Ampt.../ .Volts Overhead Underground C No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical work Na of U#Ab B Outlet 4 No,Of 1W Tnbe Na otTnnehams Total No.of Ltgbthtg Fixtans Swimming Pool' AboveKVA Beiaeum"sKVA No.of Receptacle Outlet r No.of Oil Burners No.of Emaaeucp Li0tina Baum Units ` No.of Switch Outlet No.of err Burner No.of Ranges No.of Air Can& Told FIRE ALARMS No.of Zones Tool l�1 No.of Dispoule No.of Hat TOW Totd No,of Detection std Pa. Ton KW Initiating Devices No.of Dishwaher Space Ara Heating KW No.of Sounding Devices No.of Self C named arlsooWlng No.ofDryers Heating Devion KW Locd Municipel No.of Water Heston KW No.Of Na of Connections signs Blab" No.Hydro Musags Tube No.of Motor Tots!HP OTHER' hstmraeet7o�atsgt PlrstblrCtec}ierlmbcflNa�chB�Gmnesllxrts IhareaaaestLiehYYloaacsttiYrrludr;tbrs t or�s>bbr�Ia�ivaimt YM 13 NO Iiaresuart�dvaidpioafdsenebirct�oe YID ayauhtnedtadoedYKpkazindi*6e efc7-wVbp UXLESSEWmstU � ULM WM am BoWmDoie Twm� EgtrnabdVolacflloalwa k S WakbSw Rmz*d Rao Sigmedurmd,r Plzletlmafpajisy. Fmd FiRMNAME tiaelsseNa Bm�T111Na AMNa �1 OWI�R'sIIVS[JRANCEwANFR;Ianastwed�ettLeLicased�,g�hg�Qleirra�ao�a'�asbrinrridacfivalQtaerer}aedbYNt�ef><sdbCamaslLawa .� atdihetrrp�sig�serneispmr�appk+�®true¢t�t (Please check one) Owner Agent t. CO �O � cr� Telephone No. �•FEES ` w Date. .-' d.o cS °T•.'�coL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 'SSgCNUSE� i This certifies that „ . . . . . . J . . . . . . . A has permission to perform . . ."' � ' J� . . . . . . . . . . . . . . . plumbing in the buildings of . 0. . . . . .�I. "" . . . . . . . . . . . . . . . at -2/0” t . .2/0". "�''"� —�!` .!, . . . . . . ., Noah Andover, Mass. � . . . . . . . . . . . . . . . . . . . . . . +.Lic. No.Id. A. _ j PLUMBIN *V'ECTOR Check # 6667 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS _ S— _ / Date �0 Building Location /, J a^A-(4-hers Name / I/N MA dV Permit# Amount 3 a Type of Occupancy New 0 Renovation Replacement © Plans Submitted Yes No FIXTURES 3 9 REM BAg1MW 1 1S1:FIDQt 3�I1 FiOCR til FIDQt 4M FIM 5'IEi FIDCR 67H FI" 7M El" m fl" —ELL (Print or type) Check one: c er ificate Installing Company Name ` �� �3 Corp. _ Address �� / ��`�` 1 f Partner. Business usiness a ep one 3 Lt 10 firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy FT Other type of indemnity 0 Bond11 Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massac tts State PI bigg Fode and Chapter 142 of the General Laws. By: Sri' ul LI RS 'P ,IU Uel Type of Plumbing License Title 2A City/Town LICense INUM—WMaster Journeyman ❑ APPROVED(OFFICE USE ONLY Date.......... .j................. 4 f NORTH, "o0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUS� This certifies that ........./ i f->,- --................................................ ............ � has permission to perform ................ ...................... ........................................ w wiring in the building of............. .`.:'..................................................... at ..... ...... ........:....:........ .North Andover,Mass. - � Fee..................... Lic.No. ............. ............................ ...................::....... ELECTRICALINSPECTOR 1 Check # DF.PARZIMENTOMBUC AFE7Y Permit No. BQARDOFFIREPREV VMNRBiLWM517Cg,aioo Occupancy&Fees Checked APPUCATION FOR PERMIT TjO PERFORM ELEcnuCAL WORK ALL wORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INMRMATION) Date Town of Nor h Andover To the Ins for of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street tit Number) Owner or Tenant Gt Owner's Address is this permit in conjunction with a building permit: Yes® No [3 (Check Approgate Box) Purpose of Building IAg Utility Authorization No. Existing Service Ampa..L�: Volts Overhead Underground No.of Meters New Service Ampa...I.Volts OvedwW Underground No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlet rt M.of Hot Tube No.of?rnaftmers Total No.of Lighting Fixtures Swimming PodAbove BelowKVA �; KVA &wand 171 wtd No.of Outlet No.of Oil Burnet �P�b No.of Emergency Lighting Battery Unita No.of switch Outlet At No.ofGas Bonier No.of Ranges No.of Air Cad. Total FIRE ALARMS No.of Zones Tan No.of Disposals No.of Had Total Total No.of Defection end ' Pumps Ton KW Initiating Devices No.of Dishwasher Space Area Heating KW No.of Sounding Davina Na of Self CprhirtedDeteCtiorvIlountfing Device, Municipal No.of Dryer Heating Devices KW Local Mnoidpal � Others Connection No.of Water Heater KW No.d Na of Sim Boibib No.Hydra Massage Tubs No.of Motors Total HP OTHER' i ]naaaneCo�Plr®]entblheragtaerrasafMLt�edir�OCrlm�llawa Ih=acin39L ebdtYb=xaeFbicymck1kV M#* ariftakdr W143iVA" ygg 0 NO IhirwakmisadvaidpaidsanetoheOMM YID lfyouhnedodtedYlsS,pk�eixk*tetypeof wmmWby Sapp 3 BWD[:3 ORM [::] EstimandVafta•dEbckW Whk$ WhkioStst 1r onDalcF=reskid Rao p� SpBdFhVfdeaofpajirty. FIItMNAIv>E Li=Na *fie LiomaeNo &sk= dNa n�ttr�a OWT,WSIlV5f.1RAN EWAIVIIt;IamaweedaftLmw �i AItT�Na ardtMtrrrysigrll�emdreptsappicedonwr�i�fra `pa0� ffi���+ C,araalLawa (Please check one) Owner ® Agent ���� _3 f a �� zi�LTelephone No. ERS FEE� 5 a Date.. . . . .. . . . . ... .. OF .O oTM of /TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SAGMUSEt This certifies that . . !. : . :`.J. .�- . . . . . . has permission for gas installation in the buildings of . . . . . f . . . . . . . .. . . . . . . . . . . . . . . . . . . at �-�! ... . . . . . . . . , North Andover, Mass. Fee.- +4.�.: Lic. No..!-� . /{ r .. . . . . . . . GAS INS t& 1i 'l Check# 53t MASSACHUSEI'I'S UNIFORM APP`UCATON FOR PERMIT TO DO GAS FPITING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations l � Permit# ^30 Amount$ _33�tz5� Owner's Name 1 {� y✓ New❑ Renovation ❑ Replacement Plans Submitted ❑ U U mM Wa $ z O F W W F W OF p�, a E" 0 PGa 0 W - 9 1 . 0 SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR or type) t� �y,j� C��, Chic Certificge Installing y Name LA Corp. Address 1:1Partner. Ql Z usmess a ep one ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter T P 571-1-A-- INSURANCE 'r 1-1-A' INSURANCE COVERAGE Check o e: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked Les,please ' dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By. Signature of Licensed Plumber Or Gas Fitter Title Plumber 12-4 3 s� City/Town Gas Fitter License Number er Master PROVED(OFFICE USE ONLY) 0 Journeyman 6 MONTH Of.«sO s 'p swcwus CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Date ^d o THIS CERTIFIES THAT THE BUILDING LOCATED ONcJS l� v MAYBE OCCUPIED AS v �� r �-��f IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS TATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO tl.e N's,r //U C 1 Building Inspector N0RTH ED / f over Town - of prt...M.. o� CoC LA over, Mass., ORATED PS H BOARD OF HEALTH Food/Kitchen PERMIT T . D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ed ........................................................... r Foundation has permission to erect....0R. ..� ....... b 'Idings on ...... �... ...... .�g� ...... .. .... .......j Rough p Oh ��� �O . ...ISA' Chimney T tobe occupied as.. .... .........! . ........... ............................ ..... provided that the person accepting this permit shall in every respect conform tithe terms of the application on file in Final , this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 3 � Buildings in the Town of North Andover. rV!, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this. Permit. �� 3 �Q�• G °U / PERMIT EXPIRES IN 6r MONTHS UNLESS CONSTRUCTION ART Ic 'Iuvs cT ou v ....A ..... .. .. ................................ .. ... .... ! BUILD G INSPECTOR final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not. Remove No Lathing or Dry Wall To Be Done FARE EPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. _ Smoke Det. SEE REVERSE SIDE Location 3/ �ti�� r J ZJ No. V Date r J • j SORT,, TOWN OF NORTH ANDOVER Of „•c ,•1ti0 3? i • O F � P + ; . Certificate of Occupancy $ "CH�s Building/Frame Permit Fee $ Foundation Permit Fee $ ' Other Permit Fee P ,7 $ TOTAL $ Check # V wilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: SIGNATURE: Building Commissioner/19s for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Numb&: 315 ly455 A v t Map Number Parcel Number 1.3. Zoning Information: 1.4 Property Dimensions: Zontn District Proposed Use Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided —Required Provided 1.7 WaterSupp M.G.LC.40. 54) 1.3. Flood Zone lnf—tion: 1.8 Sewerage 1 System: Public ( Private ❑ Zone Outside Flood Zone $— Manicipat On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record /` Na a rmt) Address for Service 7 8 - 4 -7 a Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES RO 3.1 Licensed Constructi Supervisor: Not Applicable ❑ uvz", l v 4 Licensed Construction Supervisor: OCA 7i r ` L _ License Number mn 01 /v ( 17s /;Y& L l S / i ( �" 7Q tl/v Expiration ate S' na Telephone 3.2 Registered HoWiovementCon4actor Not Applicable ❑ Company Name /� 7 _ L ,y� 1� Registration Number Addres r�L�/ // � / 4, / v Expiration D to Si&a/ttKe L. Telephone SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check au a hcable New Construction ❑ Existing Building Q Repair(s) ❑ Alterations(s) ❑ Addition B-- f Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: �A z r (AK T o f E SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to bP ,(}FFICIALUSE ONLY Completed b permit a licant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNE/Rt/ THO(RI�Z(EJD AGE T DEC TION 1, (2 4 / l/ — -� ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the f egoing application are true and accurate,to the best of my knowledge and belief (2;. n w� Print Nam Si of Om;jrYlent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T ABERS 1 ST2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a c r �q �S 1.0 �Irr IV,ILwV rnN I E BY Can" ro in u o,A u Po v E a. PLOT PLAN • D�Prr�r ras v��eu.. LMM ON IN T" Lar As smo►N AND rair rr BOIS COX"" rffH f=-Mwf1Ole'14*--A►J VV9"0 INa BBOULAMMS RBGARMU SXMCn PRaY SrRSarS & LOr U nam r PUR777SR Ga8!'M MF 7711S Diel ELL. IS mor LOCAM IN 7718' PRMRtL PLOOD HAZM ARBA AS DRAWN POR SHOW ONPA •!7C NEL � ZSp" awl Qj Oo03G srRP a s. � "�" L ';� - Nor m MUMMY !!tlN BoUmwr INPOmffoN 1/RRRIJlACK RNCINRRRINC SRRVICRS rinX Pso�r Sxlsrtxa Racvms 88 PARK SrRRRr IlAnOVRP, YASSACXUSMS 01810 The Commonwealth of Massachusetts Department of Industrial Accidents Osco of Investigations Boston, Mass. 02119 Workers'Compensation Insurance Affidavit Please Print Name: G Q• C 1 Location: / S A gly Phone 7 — $ m a homeowner performing all work myself a1 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone# Insurance Co. Policy# Company name: Address City: _ Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby ce *fv u de the i n ' sof r'ury that the information provided above is true and correct. Signature Date Print name P G Phone# F-r 7 Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person. Phone#. Wealth Department Other FORM WORKMAN'S COMPENSATION I :.itie C?orrar�torxrue+a�i �l�%aasrur/xuaet�a �� ' �_ Board of Building Regulations and Standards t+ License or registration valid for individul use only � y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: i t Registration: 127552 Board of Building Regulations and Standards Expiration: 11/16/2002 One Ashburton Place Rin 1301 Type: INDIVIDUAL Boston,Ma.02108 GERARD E.WELCH GERARD WELCH 1213 MAIN ST � y READING, MA 01867 �✓�"� Administrator I Not valid without si star + �Te �ho�ramarrurz�� of;.1r[�rlu�•cl�rrvc�s V BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 007864 I . Birthdate: 04/18/1954 Expires: 04/18/2002 Tr.no: 22315 Restricted To: 00 GERARD E WELCH _ 1361 MAIN ST �,,,� ! READING, MA 01867 Administrator ` i Town of North Andover No�TH 0& r J_2 0 16 Building Department -x'� y�:'' "' '° °o O L • 27 Charles Street to North Andover, Massachusetts 01845 -k (978) 688-9545 Fax.(978) 688-9542 ^ 4 <" �.9 04Are o f?`~.�9 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit-# the debris resulting from the work shall.be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sI50a The debris will be disposed of in/at: a s' Facility location atu ofApplicant Date NOTE: A demolition permit from the Town of.North Andover must be obtained for this project through the Office of the Building Inspector. ,AORTH -Town of over v... : . , � 11% . . 7 �7_77 low o �y A dover, Mass. COCHIC 7,p ADRATE D PCO S 4 BOARD OF HEALTH PERMIT Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ��...`...�*....�..5.�...... .................... .......��.../.�.�...... ................................................. Foundation has permission to epeo..... .A... ... ... buildings on ...r3J's......... ...... / 5......, Rough to be occupied as.............�..&.Q................ .cq.v!!�.+...... ... -....�..1��V{..#....... .r.... .#Nt Chimney provided that the person accepting this permit shall in every pect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alter ion and Construction of Buildings in the Town of North Andover. C O M PLOA Awl CoL / PLUMBING INSPECTOR VIOLATION'of the Zoning or Building Regulations Voids this Permit. g XJ329 Rough 3 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARI ELECTRICAL INSPECTOR 4 Rough WOW Service BUILDING INSPECTOR Final Occupancy.Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover NORT,4 0 -1 Office of the Building Department 0� '�`'' Community Development and Services Division 27 Charles Street 4Tfo , North Andover,Massachusetts 01845 CHU D. Robert Nicetta Telephone(978)688-9545 ' Building Commissioner Fax(978)688-9542 i August 3, 2001 Re: 315 Massachusetts Avenue To Whom It May Concern: The property located at 315 Massachusetts Avenue will be permitted to obtain a Building Permit for the construction of an addition to convert the dwelling into a two (2) family dwelling, upon the completion of compliance with permit#74 issued on August 3, 2001 Very truly ours ! Michael McGuire, Building Inspector. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 N0 J P / J Date..././ f . ..�� HORT/{ °t� :•�"a TOWN OF NORTH ANDOVER PERMIT FOR WIRING ACMUS� This certifies that .........?. •I F 1 I.......1.................................................. ........... ....... has permission to perform ........... ...!.l.! ...........0 n�� 1.. .... ...................................... wiring in the building of E /C at.......r�1.�. ........�l.t n.:.:....�......e................../1 North Anddov/er,.Mass. Fee J(! Lic.Nod<...! . ........ .... +.. ,�/...Y...� '. ,.... rt / ELECTRICAL INSkCTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer - Official Use Only Permit No. ^� 7���Z7suYZl!/��,C'?�d3 SS�G�tSC�1S vopo a Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 �a ' � (Please Print in ink or type all information) Dat To the Inspector of Wires: Town of North And The undersigned applies for a permit to perform the electrical work described below. Location(Street&Numbbee�r Owner or Tenant1r5� rR�� �U�L Owner's Address �O��� IAI �"1` T��y Is this permit in conjunctionwith a building permit Yes ltd' No ❑ (Check Appropriate Box) Purpose of Building 12 #Aw I 4-,V- /b d Ublity Authorization No. l� /T Amps �'� Z�Ovoits Overhead gr-' Undgmd ❑ No.of Meters Existing Service • New Service 9004 Amps l 2 C�/V Wits Overhead Undgmd ❑ No.of Meters i Number of Feeders and Ampacity. 2' t �O " ©/YI (2,nNb6 bD/Tl0A- Location and Nature of Proposed E cal Work Total No.of Lighting Outlets57 No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets /c.J No.of Oil Burners Battery Units No.of Switch Outlets / No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges CS No of Air Cond Tons Initiating Devices Heat Total Total No.of Di osal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained " KW Detection/Sounding Devices No.of Dishwashers Space/Area Heating ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: 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 valid proof of same to the Office YES= NO = If you have checked YES please indicate coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) ,j (Expiration Date) Estimated Value of Electrical Works �T 0 Work to Start Inspection Date Resquested Rough 40 Final &V LC Signed under the Penalties ofperjury: LIC.NO. FIRM NAME^ Lkensee GJ � ( Signature 04/ G LIC.NO. 6 7 1 1 Aft Tel No. 3 3 O Address v� Alt Tel No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance co erage or its substantialqunralent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent) Date.f I "OR'N TOWN OF NORTH ANDOVER u 3? 4, .f - .0 9- .• OL PERMIT FOR PLUMBING 41 ,SSACMUS� This certifies that �. . . . . . . . . . . . . . . . . . has permission to perform . . . P 0.,. .c.�. .r.=. . .�.�: . . . . . . . , , , , plumbing in the buildings of . . . .� at. . .3. .1.1.41 s. . . .l. .-e . . . . . . ., North Andover, Mass. Fee.//. 6 ". .Lic. No.. J. : . . ... . . . . . . . . . �. :: .`. .L � /. .. . . . . . . PLUMBING INSPECTOR Check # 5 -%.; b2 Ito MASSACHUSETTS UNIFORM APPLICATION.FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS L"'z Date f1U O_q_x b 1 Building Location.J u nt Owners Name ��po� CPermit Q6 Type of Occupancy C ^s _ Amount y ��• New VIT_ Renovation Replacement13 Plans Submitted Yes No FIXTURES z w a aCnw z Cnx x Cn 9 09 x a w -let CU ' w -let A x as SLRlM RASE" yr BE HIM M HDM 2 3MHfm Hl< M sIH ILOOR 6M HA" nfI HfM SIfIHAOM (Print or type) � Check one: Certificate Installing Company Name t`nt ��� Lr ❑ Corp. Address 5 mr-)tn Partner. (Y1CL c>t R>-) Business Te ep ones �Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy ,r� Other type of indemnity [:] Bond ❑ Insurance Waiver: I,the un-dersigned,have been made aware that the licensee of this application does not have any one of the above three insurance signature Owner ❑ 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 �Jnstaljans performed under Permit Issued for this application will be in compliance with all pertinent provisions of th aate in n Code and Chapter 142 of the General Laws. BY 'Signature Of icense um er Type of License Title City/Town License Numoer Master PWJourneyman El(OFFICE Use ONLY Date. .��.. %.�. .`. . �...... . NORTH � Of ..ao ,♦,ti0 o? '` TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION s a SACHUS This certifies that . J.�. . . . . . . .`. . . . . . . .{ has permission for gas installation . . . ! :S.'.-. . . . °:. '. . :. . . . . . . . . in the buildings of . . . . !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . .../. . . . . . .'.'. . . . .. . . . .. . . . . . . . . . .. North Andover, Mass. Fee. . . . . . . . . Lic. No.. . . . . . . . . . .. . . .' . . . . . . . . GAS INSPECTOR Check# 7 i 1 i J � r-- IN ASSACHUSETTS nt TFORM APPLICATON FOR PE,RNVITT TO DO GAS FITTING ��Type or print) _ Date Q , NORTH ANDOVER, MASSACHUSETTS Building Locations 3 l<,:� M095S Permit rt Amount S Owner's Name Ne Renovation ❑ Replacement ❑ Plans Submitted ❑ :n J ri In = z �_ " z _� = _ _ j,kSE .M ENT I I I I ST. F L 0 O R 2V D . F L 0 0 R 3 R D . F L 0 0 R .4"r if F L 0 Q R 5 r H F 1. 0 O R I 6T 11 . F L O O R 1 7T if F L 0 0 R 3T It F L O O R (Print or type - '^\Q o� Check one: Certificate Installin��Company Name i1T�11�I�.VJ t 1'f'• Corp.r Address `'�`�5 ��1� S� ❑ Partner. (cS bud Ma 01b?40 Business Telephone 1a,31(.Q iCo. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy r it's substantial equivalent. Yes No If you have checked yes, please indi e the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: l am aware that the licensee does not have the Insurance coverage required by Chapter 1=12 of the Mass. General Laws.and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agenr Owner ❑ Agent 1 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 per formed under Permit Issued for this application will be in compliance with all pertinent provisions of the:`vlassachusetts State Gas Code and Chapter 142 of the Gene,-al Laws. Bv: Signature of Licensed Plumber Or Gas Fitter Tide Flplumber Cn Citv/Town as Fitter en 1Ste, Journeyman APPRO�ED(OFFICE USE ONLY) ❑ Location '31s IPA S'S /Q U-el No. �� Date // J13 ?e t TOWN OF NORTH ANDOVER AL n Certificate of Occupancy $ �— + Building/Frame Permit Fee $ •'��' Foundation Permit Fee $ ,S�ACMUSE� Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ S 1JG� Building Inspector n r r 1,./13/98 13:32 45. RAT. • J 7,/ Div. Public Works t Location No. Date Np�TM TOWN OF NORTH ANDOVER A Certificate of Occupancy $ . Y . ; . Building/Frame Permit Fee $ sss CHus•'�t�' Foundation Permit Fee $ � e Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ t TOTAL $ ° Building Inspector Div. Public works 111?itM IT NO. APPLICATION FOR 1"U'R 11T TO BUILD"" -A*No IZ'1'11 AND0VF.R, (NA M%I'NO. --- -- I.OI.N(1. 2. it( ()111)DF DN"N1 ItSllllDA {•_ IlM)K /OnF SI113 hl\'. IDI NO. III 110,1lF(9:lit 111JIM(; /l/S%nlfiC �l/j�� p� ��roo ((\\NLI2 SIJ:\ML _2/ No . IN SIOMUS SIZE ()WNI:R'S AD)KESS �.� � 13ASLMLI4I'Oil SI AB --_--_ AR( IIII VVI'S N.ANil: SI'/3i Or Il(XN2 1Ih1BF.kS BDB OLR's NAME SPAN ------ - -- DIS IAN(F IONLARFSI BUILDING DI1 KIFNSIONS OF SII I S DISIANLLIRlNiS1HLEI' DILILNSItNJS(N POSTS DIS IANC LFROM It)I Lit JES-SIDES REAR DlhlliPJSIUIJS01 GIRDERS AREA 01 LOr 1ROM AGE IL-KllII OU IOtINDAIION THICKNESS - ---- ISB1)ILOINGNEW SI/I:OI I(X)IINGIS BUILDING ALI-ERATION IS BUILOINO ON SOLID OP FII 1 ED LAND \%:II 1.BUILDING CONFORM TO RI_QX II RP W NI S CA:CODE IS 111111 DING C(NJNECI E1) 10 TOWN WA I ER BOARDOF APPEAIS AC IICNJ, IF ANY IS IMILDINGC(NJNECII-I) It)TOWN SEWER IS HIM DINGC(NJNECIF:1)1ONAIURAL(,ASI.INE INS III( 'IIONS 3. PROPER IN' INFIIRI\IA'IION LAND COSI C /� EST. BLIXi.COS 1P41i1: I Fit I.(NII Sl:(.11(NJS 1-3 Ae ESI. BI I)(i. COSI PLR SQ. 1 1. ESI. BI D(i. COSI I'LltMXN.1 EI FC-I RIC ME I LPS KIM I BE ON(N II SIDE OF BUII DIN(; SEPI IC PLHNII I NO. AI'1ACIIEOGARA(&SMI)SI C(NJPOIZMTOSFAIEFIRERE(RILAII NJS 4. APPROVED BY: PLANS MI)SI BE FII ED AND APPROVED 13Y BI)ILDING INSPLC OR 111111.I)1NG INTI (C1011 OWNERS 11:1 DAM li 1 11 1.1) p ('(NJ I R.I L I I/ • Ct NJ IR.I It'd ' \LGN•\II 21�tN I?()I? lFlllt)12111:1)AIiINI / -- �' II.I l-.d ll7�i3t7 111 b 1'1 lth111 (MAN11.1)�/ {') �/ Town of North Andover t joRT1q OFFICE OF ��° „• •,,�o°c COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street • i ; i North Andover, Massachusetts 01845 �.''o*;;,;.�•`th WIIIJ"J. SCOTT �SSACHUStt Director In accordance with the provisions of MGL 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 MGL c I 11, S 150A. The debris will be disposed of in: (Location ofFacility) Signature of Per it Applicant Date NOTE Demolition permit from the Town of North Andover must be obtained for this project through the Once of the Building Inspector. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 OF3T ToANm of t , r over 0 affam���� z- No. 4.4v/ _ * Z dover, Mass.,— 199's D z LANE lb CO C H ICMEWICK �.Y'1` S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System N e ie'+, BUILDING INSPECTOR �''p...... .......... ....A....... ...... THIS CERTIFIES THAT........ ..ew........... . . .. .....3***"***"** ... .Foundation Ofo has permission to erectSrtr. ...Pbuildings on ........... �. . ......... .� ..... •� Rough t0 be occupied as O .o � �N • ••�• ••~•V `r'`t Chimney p .......".... ................ ...................... .. .............................. ......... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR _'VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final gic PERMIT EXPIRES IN 6 MO S ELECTRICAL INSPECTOR UNLESS CONSTRU T r Rough 1 ............... ...... .. ........... service BUILDIN INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough • No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. r Burner Street No. Smoke Det.