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HomeMy WebLinkAboutMiscellaneous - 32 ROSEDALE AVENUE 4/30/2018 32 ROSEDALE AVENUE f I 210/060.0-0019-0000.0 I 1 I r /o Date. . �%` . 95x7 NORTH 3r��,, •'„•.',�oo� TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,SSAC14USS This certifies thatg'r". . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . t / plumbing in the buildings,nof . . . . . .C.O S.cq. . . . . . . . . . . . . . . . . . . at . . . . 2 . . 6P . . . . . . . . . . . . .. North Andover, Mass. Fee.,5.5.°x. .Lic. No..lQ3Q. . . dti/',1 t / PLUMBING PECTOR F Check ,7 V/D i Date. /� 2.. .. . ... .. HOft TM OF ,6 ° OL TOWN OF NORTH ANDOVER FO 9 41 • PERMIT FOR GAS INSTALLATION SACMUSES�y A This certifies that . . .// . . l . . // has permission for gas installation . in the buildings offs. . . . eoSCU . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . .I`.°S. .. . . . . . . . . . . . . . . ., North d vers. 00 Fee. `36.'. . . Lic. No../o3vl. . C / .. . GAS INSPECTOR Check# �f�o j 8291 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK r� V CITY 4. MA DATE 6 ( PERMIT# t JOBSITE ADDRESS Z, aS �}1 OWNER'S NAME " _..—._,_ / OWNER ADDRESS ._ ._. .. -__ 4.- , _ _- TEL ^ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL E] EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW:[ RENOVATION:0 REPLACEMENT:Or PLANS SUBMITTED: YES 0 NO Q APPLIANCES 1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER �.. ! J BOOSTER CONVERSION BURNER ! J hT-_I _ ! __-_-I _ COOK STOVE DIRECT VENT HEATER DRYER FIREPLACES FRYOLATOR FURNACE - GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER —,J ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MOL.Ch.142 YES ]NO �_I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERA BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY,.. G 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. rlk� OWN © AG 1 SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this applic on are true and accu to e e t of m k wl dge and that all plumbing work and installations performed under the permit issued for this application will bk. compliance wi ali .e in t rovisio t Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME f LICENSE# _�3ci l._ SIGNAT E MPAMGF ] JP DJ JGF F- LPGI CORPORATION er[ �PARTNERSHIP E3# ( LLC[3# COMPANY NA "ry �lr `c- _�ADDRESS CITY ` ✓ . i STATE®ZIP TEL FAX CE17 �._ yG '7 MAIL -- -- (, -- --� �-- ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes A. THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES r .l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Uf 600 Washington Street Boston,MA.02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information , Please Print Legibly Name(Business/Organization/individual) l Address: ��- City/State/Zip: U ' Phone#: Are ou n employer?Check the appropriate box: Type of project(required): 1am a employer with 4. El am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance, g, r]Building addition [No workers'comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11,(Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.[J Roof repairs insurance required.]t employees. [No workers' ' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:. P Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to and/or one-year imprisonment,a as civil penalties in the form of a STOP WORK ORDER and a fine of up t 250.00 a da ainst t violator. Be7ad '�(ed ata y of this statement may be forwarded to the Office of Invest ations of the DIA for' ance coverar' c 'on. X do here cert under 'ns- nd pena i f per that the information provided above is true and correct. Si atur8-------"- Date: Phone#: � t CO Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: Information and instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: Tho Coxt monwoalth of Mossachusetts Department of Industrial.A,ccidonts Office of Investigations 600 Washington Street Boston,MA,02111 Tel,#617-727.4900 oxt 406 or 1-877�,M'ASSAFB Revised 5-26-05 Fax#617-727-7749 www.Mass.govfdia MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK Imp CITY _ I MA DATE ! Z�+�1 PERMIT#. ��� JOBSITE ADDRESS 3 2 "� Q —� OWNER'S NAMEF_____ - — � -- POWNER ADDRESS k TEL - FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ( EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: # RENOVATION: REPLACEMENTS PLANS SUBMITTED: YES® NO FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN ___f _--_.-._.} ____ 1 --------- FOOD .___._FOOD DISPOSER FLOOR/AREA DRAIN ! 1 M f J _ ( s J .-..__ J __......_- -__--I ._ _I INTERCEPTOR(INTERIOR) i i .____I KITCHEN SINK i I } _....__. l _._..__J ! { ._^� _.._..__J I 6 I _ J l _ _ LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL -- WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING I i OTHER ,J --JI . I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES F�J NOD IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. C NL SIGNATURE OF OWNER OR AGENT Y: OWNER 0 GT J0 { hereby certify that all of the details and information I have submitted or entered regarding this applic ion are true and.acc ahe be o y owledge and that all plumbing work and installations performed under the permit issued for this application will in complia ee wit a inent i 'o f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'SNA (.-�w jA- _ LICENSE# 0-7 C?t SIG TURE MP, JP P CORPORATION =PARTNERSHIP 0# LLC U COMPANY NA k,7 , ; ADDRESS CITY __ STATE w ZIP n( —� TEL - od'�- FA6rL E CELL �j-'._ '�EMAIL - - i ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY r FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 1 r NXThe Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual). ¢' Address:. City/State/Zip: Phone#:_ 1C� 0 t— c�-33 U Are you an employer?Check the appropriate box: Type oject(required): lam a employer with 4. ❑ I am a general contractor and I ' 6, ew construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] employees. [No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. fil TV Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250 against the 'olator. Be ise that a copy of this statement may be forwarded to the Office of Investig 'ons of the D for ins nce cover ge ve i on. Ido her certfy un r the 7a pe I' of erjury that the information provided above is true and correct Signature. Date �fl, � 2G Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: f 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-_4900 ext 406 or 1-877rMASSAFB Revised 5-26-05 Fax#617-727-7749 wwwanass.govldia i N° / % Date..........I..�'....19..... NORT►{ TOWN OF NORTH ANDOVER p PERMIT FOR WIRING o �7'TSAcmU This certifies that'..� ���'L'` ......................................................... has permission to perform,., �'? --(� '"'�� .. ...................................................Q; wiring in the building of at.... ............ ............................................................ ,North Andover,Mass.►. .... .... Lic.No:�'�.�.��. ....... :...I ..... ....... ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer 2'�(J9M1QNWE4LTH0FM4SSQaK1 7S Office Use only n DEPARTMFNf OFPUBUCS4FETY I Ifl Perrrut No. BO*OF ME PREVEY77ON REGUL4 770AS 5.7 C34R 12.00 Occupancy&Fees Checked ... APPLICATIW§GEiCaElPEIZ.�ORM LLECRICAL WORK ALL WORK TO BE PERN ACCORDANASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 / (PLEASE PR-EN"T IN INK OR TYPE ALL INFORMATION) ate �` 4 - MAP__ � D Town of North Andover To the Inspector of wires: The undersigned applies for a permit to perform the electrical work described bel PARCEL do/ Location (Street &Number) 12 ��� 1 /4 j Owne-or Tenant �p�jj��-�- cn o Owner's Address Is this permit in conjunction with a building permit: Yes No F7 (Check Appropriate Box) Purpose of Building t L o �Q S fd-/o Utility Authorization No. �3 "- Existing Service /04 Amps Ido volts Overhead F-1 Underground No. of Meters Ne%%#Service J0Q _ ,Amps 06 /.?Y&olts Overhead underground No. of deters Number of Feeders and Ampaciry I Lot!ation and Nature of Proposed Electrical Work ae M 0A e- No.of Lighting Outlets c No.of Hot Tubs No.of Transformers Total KVA No ofLighnrg Fixtures 40* Swimming Pool Above Below Generators KVA and eround No.of Reccptacte Outlets /0 No.of Oil Burners No.of Emergency Lighting Battery Units NO 01$wttCn Outlets �/ No.of Gas Burners No of Ranges No.of Air Cord. TotalFIRE ALARMS No.of Zones Tons No of Disposals / No�of Heat Total Total No.or Detection and f Pumas Tons KW Initiating Devices No of Dishwashers � Space Area Healing KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No avrDryers HeatingDevices KW Local Municipal Other J I Connections No �f Wale:Heaters KW No.of No.of i Sins Ballasts No .cro.Massage Tuos I No.of Motors Total HP OTHER Um ralx�Com Ptasuarx�the rt�tmana�ts cx C>a�r-al Laws I have a asra�t Liitity frrnsance PdiLy Sze C xe,P Caea� its nal YES NO I ha`e abnMEd�and pmfofsarne to the Off=YES If}l u hate cteciced YES,phase trichcm the type cfby wig the wqxmbac NSURA,NCE a BOND ?ease Specify) f ) Espirnocrt D, tD=R d Rah ` 1 cC�,Estr l Valu l Wak S wt�i;>�sr�t r . �J Signed U-ijeim Pz its cf'pa tay: FIRM NANE L.6--2seNa li ge IrJG`� L,-rise No 35-N) Bt.6yes Tel.No. pery1 O W\E-R'S L\aRA a WAIVER;I am m4tll -r I &,,)l rxt the a rarc�:m,,�cr-s ail areal egsvaiertas ret--�ai hn via s Cam La vs and tint my 9�2sMx--cn this p=m ac ip c=W wanes ttrs ted s?art�sx (Please check one) Owncr Agent Telephone No. PERMTT FES S 7177 No I / / Date...... ... Ot 11�T�. 3: O� TOWN OF NORTH ANDOVER 00t 0,000 PERMIT FOR WIRING Y O ♦ i ^ i cc �SSAcHus� 8 This certifies that .......T1..�., e.sJ.!......!=....r... ..!2.s... ............................... has permission to perform ..... ..�.....cti:� .! !..`' ...................................... Kr wiring in the building of...-l:.!//��.0 .... .......................................M gat..................................S... r An SA Fee--"V:.0.. Lic.No. ............. ............. .......... .. ..........�.... . G ECTRICAL SPECTOR O G `rx r + WHITE:Applicant CANARY: Building Dept. PINK:Treasurer M WARD Office Use Only l') 1C� �II�iritIInlUPtt . Permit No. flepar'tment of PubUr ftafEtg Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE- ALL INFORMATION)) Date City or Town of To the Ins actor of Wires: The udersigned applies for a permit to perform the electrical work described below. FPA AP____ _ Location (Street & Number) 502Owner or Tenant 4o RCEL Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building 5//y im 4— J7 /26 J ' ��grncl horization No. Existing Service Amps / Volts Overhead ❑ No. of Meters New Service Amps .J Volts Overhead ❑ Undgrnd ❑ No. of Meters umber of Feeders and Ampacity ,Location and Nature of Proposed Electrical Work I No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- _ grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals .No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained p No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑ []Other Connection No. of No.of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage 7Ubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Mass usetts general Laws 1 have a current Liabilit Insurance Policy Including Complet Operations Coverage or its substantial equivalent. YES a"-NO O 1 have submitted valid oof of same to the Office. YES NO O If you have checked YES, please indicate the type of coverage by checking the app riate box. INSURANCE BOND O OTHER O (Please Specify) 7 Estimated Value of Electrical Work S (Expiration Dat Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of duty: FIRM NAME CO' LIC. NO. .Z9 Licensee S Signature 5{&LIC. NO. ems-3U �� Bus. Tel. No. Address Alt.Tel. No. c �Y OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not h the Insurance coverage or Its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permitapplication waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE$ (Signature of Owner or Agent) • x6565 Office UnLy Permit No. Occupancy & Fee Checke 3/90 (leave blank) Ward Area APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 rn (PLEASE PRINT IN INK 9q T PE 4L INFORMATION) Date r''at �1 1 0 City or Town of I17-V&J(')0U0 r--- To the Inspector of Wires: -n The undersigned applies for a per to perform the electrical work described below. m Location (Street & Number) o �. Floor 0 Owner or Tenant LOIS Tel. No. Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building Uti/litV Authorization No. 7 Existing Service (0 0 Amps _!/ Volts Overhead LJ Undgrnd ❑ No. of Meters 1 New Service /OC) Amps 1490 / a7y Volts Overhead Undgrnd ❑ No. of Meters W p ri (.,2 /Gtr��,P 5 m Number of Feeders and Am aci n O Location and Nature of Proposed Electrical Work � n Total O No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting Z No. of Receptacle Outlets No. of Oil Burners Battery Units D No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones I< I of Detection and No. of Ranges No. of Air Cond. Total No. Z tons Initiating Devices Cn a Heat Total Total m No. of Disposals No. ofPumps Tons KW No. of Sounding Devices O No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 No. of Dryers Heating Devices KVA' Local ❑ Municipal ❑Connection Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring O No. Hydro Massage Tubs No. of Motors Total HP r— OTHER: 15&U I C-_c V{FJCn CZ��.l�)C� m r m n INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy includ- M ing Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ 1 have submitted valid proof of same to the Office. 0 YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. Z INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) C 1 O Estimated Value of Electrical Work$ � Work to StartStart— �' 2(0 ]c Inspection Date Requested: Rough Final Signed under the P alties of Perjry: FIRM NAME LIC. NO. _ Licensee r— Signature LIC. NO. 6e;; Bus. Te. No. Address Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivale as re- quired by Massac efts General Laws_*'6d that my signature on this permit application waives this requirement. Owner Ager�t1 (Please check G8-) Telephone No. �/� PERMIT FEE $ (Signature of Owner or Agent) Notify Inspector for rough and/or final inspection. Permit must be obtained before commencing any, and all work in compliance with G.L.C. 141 &all applica- ble laws&ordinances is required and understood. X-6796 s PL, _MIT NO. �� APPLICATION FOR PERMIT TO I3U1LI)********NORTH ANDOVER, MA hi\1'NO. LOh.NI), 1. HECORU OF O\1'NlRSllll' DATE al7nhPACES f63 7(IhE 3 SUIT DIV. LOTNO. �O 1.0(:A I ION 32 ��- llt)R"t:()F 13011 DING OWNER'S NAME I � LT LG�S�p NO.(N:STORIES SIZE OWNER'S ADDRESS 3 2 � E € BASE?,IWr OR SLAB ST ND RD AK('1111 E(-I'S NAME OF FI.00R TIMBERS I 2 3 lit III DER'S NAME SPAN DIS'IANCETONEARESI BUILDING; DIMENSIONS OfSILLS DIS FANCL FROM S 1 REE I' DIMENSIONS 01:POS IS DIS I ANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE I IEIGI IT OF FOUNDATION THICKNESS I S dl)II.DI NCi NEW SI'LE'OF (X)IING a X IS BUILDING ADDI I ION MATERIA).OF CI H MNE Y IS BUILDING ALTERATION IS BUILDING ON SOLID ORTII.LED LAND WILL BUILDING CONFORM TO REQt 11REMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY - 0crl 6 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECI ED TO NATURAL GAS LINE INST11('TIONS 3. PROPERTI'INFORMATION LAND COST EST. BLDG.COST �© PAGE I FILL Ot 11'SECTIONS 1-3 EST. BLDG.COST PER SQ. FT. EST. BI.IXi.COS'1 PURR(X)ti EI ECFRIC METERS MUST BE ON OUTSIDE(N=BUILDING Stil'FIC PERMIT NO, AI'1ACHED GARAGES MUST C(NJFORMTOSTATEFIRE RE(RHATI NNS a. APPROVED BY: PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR B .DING INSPECTOR DATEIIl.1.1) �i y OWNERS'IEL#.', — 2��CO C(NITR A E I.N 17 - o Cc NJl"R.l.l C'N SIGNA I I1RL(N OWNLR t)R A1,1 D 1ORIZI:D AGENT I I F I'IHMI1GRAN IID l� FORM U - LOT -RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICA-NT FILLS OUT THIS SECTION*********************** APPLICANT o,�je 2 1 Jac' S co PHONE LOCATION: Assessor's Map Number c PARCEL SUBDIVISION LOT (S) STREET o� e�3�e �y-e- ST. NUMBER **************************O F F IC IAL USE ONLY"********************************* RECOMMENDATIONS OFT WN GENTS: CONSERVATION ADMINISTRATOR DATE APPROVED -3 9 DATE REJECTED I COMMENTS (� =gin bf TOWN PLANNER i DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS - rr PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm `a,O R T' Town of dover No. OeoO ti •tip � �.. C),j) COCHI E dover, Mass., ADRATED BOARD OF HEALTH PERMIT TFood/Kitchen Septic System b * m O L% N BUILDING INSPECTOR THIS CERTIFIES THAT.......8.0...40 ............. . 5 C a 4 .................................................. ....................... Foundation has permission to «pet... . . .. ......... buildings on ..........c3..o........ 0 ,oR. .�.! ......�4u�► Rough to be occupied as.. O G i r s.a .... . .. ....................................................................................... 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 PERMIT EX L J� PIRES IN 6 MONTHS Final R 7 ELECTRICAL INSPECTOR 30 �s vNl�Ess cO�STRL�cTIO. S T Rough ............ ... .... .. ........................ ..................... Service BETTED SPECTOR Final Occupancy Per-mit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. 1, J• 'A SEE REVERSE SIDE Smoke Det. N° i Li c. J Date:":.......:..................... f pORTN, TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSAcmUS� This certifies that ... ............................................. f............................ has permission to performs ` ..................... ...... ...... :�?............... wiring in the building of...1:..... ... �. .......................................... at.................................... ..:.......................... ,North Andover,Mases I e-61 Fee—�4 ..... + . Lic.No.,.:. / .......... ,..r j� �� ELECTRICAL INSPECTOR o ti WHITE: Applicant CANARY: Building Dept. PINK:Treasurer a Location z--� v { No. C, Date NORM TOWN OF NORTH ANDOVER �? • • OOR A Certificate of Occupancy $ . , • ; ; , Building lFrame Permit Fee $ C71)-� sA�MUs Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ ' r Water Connection Fee $ /y! TOTAL $I // / (_ -- jj Building Inspector `LOVA/4 08:42 25.00 PAID Div. Public Works Location �3a 2aSFIC)I- A U--c No. .`J Date 3 1 1 c r1 �aRTM TOWN OF NORTH ANDOVER A Certificate of Occupancy $ it �: Building/Frame Permit Fee $ ? L` �,'b"•• E��' Foundation Permit Fee $ .7 CMUS I Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ L/ TOTAL $ 7 / Building Inspector 03/c�2199 15:54Div. Public Works X67,00 Pp?n r PERMIT NO. _APPLICATION FOI2 I)LIZMIT TO I3UILI)******** RT11 ANDOVER, MA %I,No . lir 1.0I.NO. 4w / Z. RECUNUOFON'NLRSIIII' DATE�` BOOK4S PACE 3c{3 /ONE 6?3 SUB DIV. LOT NO. / Q P(1RPOSE OF BIM DING CjaTcl L(OCAIION 3� ✓�4S�G��/CF �� /fou-SF m Igor a ) )u)J ze .. i)SVNER'S NAt tE r N0.Of:S TORIES Iwo SIZE Z/oo SO>=i /20(��2 r 1�9 LoSc o OW2 ,(05P qq BASEMENT OR SLAB ( NER'S ADDRESS cYJ�SC 2 .v• �vo+rw NAME RD i'I Ill'EC"I*'S NAM SIZE OF FLOOR I IMBop ERS I xST 2 NU 3 lit III DL•R'S NAME SPAN DISI ANC E*IO NEARESI BUILDING 3�K DIMENSIONS(�SII.I.S (%14.1 J LV//—! DIS I ANCL'I-ROM S TREE I' 25 � DIMENSIONS(X POS C�,rr;N G /v DISTANCE FROM 1.0T LINES-SIDES (SFT REAR �o�c DIMENSIONS OF GIRDERS 67xOsr'N6- AREA OF LOT IMI sci F( FRONTAGE '7 1FF 11EIGIII OF FOl1NDATICNI ;xl T14ICKNESS CxoT Ne IS BUILDING NEW SIZE OF_I(XII f T(X)I— X ou IS BUILDING Al)DI TION MATERIA).OF CHIMNEY nNN 6, p/o✓� � of �p/w ES ry / G IS BUILDING ALTERATION C IS BUILDING ON SOLID Ciall.LED LAND �JG /���� Wil.I.BUILDING CONFORM TOREQ( IREMENISOFCODE nISBlIII.DINGCCXJNECFED'fOTOWN WATER OARD OF APPEALS ACTION, IF ANY IS BUILDING CCN4NECI ED TO TOWN SEWER y�S Vftj/m( 61fPQvll�j f J�� p�a(l rt/ort? IS BUILDING CONNECTED TO NA RURAL GAS LINE Yc_5 INSTIWTIONS 3. PROPERTY INFORAlA1'l0N LANUCOSI' ESI'. Bl.1Xi.COSI r OGS P...GE 1 FII.L Ol TI SECIIONS 1-3 EST,BLDG. COS I PER SQ. FT. Sl. B1.1xi.C(nT PER R(X)ti EI EL-TRIC METERS MUST BE ON OUTSIDE OF BUILDING Q Jam. y SEPIIC PERMIT NO. ATI ACIIE11)GARAGES MUST C014FORM TO STATE FIRE REGULAiI/NJS `iY('#7 / 6� 4. API-ROVED BY: PLANS MUST BE FILED AND APPROVED BY IIIIILDING INSPECTOR LBIIII.DING INSPECTOR DAFIIEI) ��/ OWNERS'TE1N.' G�/� r���� l r r S L� \J' �h CON IRA EI.b I t 91 ccNITR.LICN > � _ SI(:NA II IRI:OT UWNIN()R AtI I I IORIYI:D Al)I:NT I l'II _, L'E PI RnRT(MAN ILU //� 19 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICA-NT FILLS OUT THIS SECTION*********************** pp (1 o�NoC a`�mor �� IdJ APPLICANT —gob ee� Kb5c 0 PHONE 2- 5P} LOCATION: Assessor's Map Number 0 c PARCEL A p prOUA(S SUBDIVISION (( LOT (S) STREET �o� e�3l� v-e_ ST. NUMBER **** * ***************************OFFICIAL USE ONLY********************* RECOMMENDATIONS OF T WN GENTS: CONSERVATION ADMINISTRATOR DATE APPROVED 3 9 DATE REJECTED COMMENTS 12 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 DRIVEWAY PERMIT /FIRE DEPARTMENT RECEIVED BY BUJLDING INSPECTOR SATE Revised 9197 jm TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: ZNnFIo�� �ria� 4i;oi1cf4 iso F/a�„� Est. Cost oo� Address of Work gas-E0 et C- AV Owner Name: QogC2i �oseo Date of Permit Application:_ 3� 55 I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date Building not owner-occupied _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 FIND LINER 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: , Da a Owner Name e Registry of Deeds Northern District of Essex County Lawrence, MA 0184 12/08/98 AN L N ROBERT LOSCO O A N 88 Rev Type PLAN 10.00 inst 42198 Copies 1.-00-10 N 89 tt^^ec: Type O 10.00 in: v 42199 Postage 0.32 r-� -r-2 Total. 21a3 Register of Deeds NORTHTown . F � r of over , No. D�' ~ "= moi _ h � 1 q o COC H- � Q dover, Mass., A- C � E V 7 AORATED BOARD OF HEALTH Food/Kitchen PERMIT T Septic System Leje OSc O BUILDING INSPECTOR THIS CERTIFIES THAT.734F�... Foundation kildings .......... .....................................a...... .............L has permission to erect.. .. on ....... .................................... ` V`� ....................... Rough A. c t0 b8 occupied ..................................... 2�. ��r"a�,� '� v PwA&I 116t A For S1md.!t FANS. w & Chimney .. . . .. . .................................................'............................ ......................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the 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 i2'e c'-01k, PERMIT EXPIRES IN 6 MONTHS Final 0 3 ELECTRICAL INSPECTOR Rough RAZ 1 -30001 3� UNLESS CONSTRUCTTO ST S` V a Iia 4`L I"'� Service �+ c 0 pok` }f•N . UILDING INSPECTOR Final Dec KOccupancy Permit Required to Occupy Building GAS INSPECTOR 0 N&.y 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 7 8 A *L O 3 6--9 8 Street No. 9161618 Smoke Det. SEE REVERSE SIDE Ot VkOl oTk 1 y r o ; JOYCE TOWN OLLtK " NORTN ANOOyER Ano ,SS�CHUSEt SEP I TOWN OF NORTH ANDOVER MASSACHUSETTS Any appeal shall be filed BOARD OF APPEALS within(201 days after the NOTICE OF DECISION date of filing of this Notice Property: 32 Rosedale Ave. In the Office of the Town Clerk. NAME: Robert&Theresa Losco DATE: 9/9/98 ADDRESS: 32 Rosedale Ave. PETITION: 036-98 North Andover, MA 01845 HEARING: 9/8/98 The Board of Appeals held a regular meeting on Tuesday evening, September 8, 1998, upon the application of Robert&Theresa Losco, 32 Rosedale Ave. North Andover, MA, requesting a V from the requirements of Section 7, Paragraph 7.1, 7.2 & 7.3, of Table 2, for relief of lot area, strl ° frontage, front setback, side setback, and rear setback, and for a Special Permit from Section 9, Paragraph 9.2, to construct a second floor level above the existing level for the addition of 3 bedrooms and a bath, on a non-conforming lot, within the R-3 Zoning District. The following members were present: William J. Sullivan, Walter F. Soule, Robert Ford, John Pallone and Ellen McIntyre. The hearing was advertised in the Lawrence Tribune on 8/25/98 & 9/1/98 all abutters were notified by regular mail. Upon a motion made by Walter F. Soule and seconded by John Pallone, the Board of Appeals voted to GRANT a Variance requested from the requirements of Section 7, Paragraph 7.1, 7.2 & 7.3 for relief of lot area of 15, 568 ft., street frontage of 50 ft., front setback of 1 foot, right side setback of 10 ft., house side setback of 4 ft., and rear side setback of 4 ft. and to GRANT a Special Permit from the requirements of Section 9, Paragraph 9.2 to allow the construction of a second floor level above the existing level for an addition of 3 bedrooms and a bath, on a non-conforming lot., with the condition that the existing garage be removed, in accordance with the plan of land dated 8/7/98, and prepared by Scott L. Giles, Registered Land Surveyor. Voting in favor. William J. Sullivan, Walter F. Soule, Raymond Vivenzio, Robert Ford, John Pallone, Ellen McIntyre. Y The petitioner has satisfied the provision of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a Building permit as the applicant must abide by all applicable local, state and federal and building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. BOARD OF William J. S Ilivan, Chairman /decoct/4 Zoning Boar of Appeals r FLAN OF LAND s NORTH ANDOVER Location BOARD OF APPEALSNORTH ANDOVER, MA � Drawn For ROBERT & THERESA LOSCO Map 60C, Parc. 50 SCALE: 1"= 20' DATE: 8/7/98 N/F 0' 20' 40' 60' Marilyn Hopping. D�0 �i�w�t� DATE OF FILING: 67 Longwood Ave. � Scott L. Giles, R.P.L.S. r DATE OF HEARING_ DATE OF APPROVAL: Frank Giles, CAD 50 Deermeadow Rd. THIS IS TO CERTIFY THAT 1 HAVE CONFORMED ( � ��Q�� �������� � 01845���� WITH THE RULES AND REGULATIONS OF THE Lot 2 (plan) \�7�� 683-2645REGISTERS OF DEEDS IN PREPARING THIS PLAN. L i ace. Assessors Map 60C , Lot 19 Date: 9,432 S.f. See plan #2856 N.E.R.D. Zoning District R-S -- — t>� 3n 0miner : Applicant CD Min. Area= 25,000 s.f. ` � Min.. Frontage =125` r �' Role Losco 32 Rosedale Ave. Min. Front Setback= 30 North Andover, iVIA 01845 Min_ Side Setback= 29' ; 978- 681_097 Min. Rear Setback= 30` Existing 1,1/2 Sty. W . F e. o Map 60C, Parc. 18 Registry of Deeds use oni t�. Map 60C, Parc. 20 #32 _y y 3 N/F 16' sC5 NiF VVI Hazel Hart Michael Ranahan 7i 28 Rosedale Ave. 4€3 Rosedale Ave. Addition.to the second store only, all setbacks,remain the same. 75.0W° THE PROPERTY LINES SHOWN ARE THE. n' LINES DIVIDING EXISTING OWNERSHIPS, AND THE LINES OF STREETS AND WAYS SHOWN � Avenue ARE.THOSE OF PUBLIC OR PRIVATE STREETS Rosedalc� OR WAYS ALREADY ESTABLISHED, AND NO NEW LINES FOR DIVISION OF EXISTING: OWNERSHIP OR NEW WAYS ARE SHOWN. c:\artrdrk\blrana Location No. Date MORTp TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ s o• _ i '� b'�^•''<�' Foundation Permit Fee $ �ssACMust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ & B`ulldingInspector 0 ea n l7 J 2 Div. Public Works PER3IIT NO. APPLICATION I — PAGE 1 �. CATION FOR PERMIT TO BUILD NORTH ANDOVER, MASS. MAP +JO. /1 LOT NO. 2 RECORD OF OWNERSHIP ;DATE (BOOK ;PAGE — ZONE �s I SUB DIV. LOT_ NO. — LOCATION ///_ PURPOSE OF BUILDING OWNER'S NAME / NO. OF STORIES SIZE 614d z OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD f BUILDER'S NAME ( SPAN DISTANCE TO NEAR Bin 1PC. DIMENSIONS OF SILLS DISTANCE FROM STR ET POSTS 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 MATERIAL OF CHIMNEY IS BUILDING ALTERATIONQty Sp/ west' pl Q� , (�!/1�J IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE u ;l/ 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST a PAGE 1 FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT.^' PAGE 2 FILL OUT SECTIONS 1 - 12 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 R DATE FILED ��� 2 �p !!!///"' VVV �YILDIN INSP[CTOR SIGNATU E OF OWNER OR AU RI D AGE/R�T F E E 4 �-l' OWNER TEL.# ' PERMIT GRANTED CONTR.TEL.# zb 19 �— CONTR.LIC.# H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL K. PINE BRICK OR STONE P —_ — — PIERS PLASTER _N DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL N. B M'TAREA J- 114 1/2 l/. FIN. ATTIC AREA _ N_O B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B l 22 f 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD1!✓'D _ ASBESTOS SIDING COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 6 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.; FLAT I 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 BMS. 3 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING NOR'H Town of 0 OVe r O VIA No. 99 dover, Mass., 19 COCHICHEWIC C 0RATEI) P' I BOARD OF HEALTH Food/Kitchen PERMI D Septic System BUILDING INSPECTOR ... . ....................... ..................................... THIS CERTIFIES THAT.......................................... ... ......... Foundation has permission to erect ��4v. ... ... b I ingg .... .. .. .. . .................................... Rough tobe occupied as........................................... . . .......... . ... ...... .. . . ............................................................................................................................................................ Chimney provided that the person accepting this permit shall in e ry 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 VIOLAPON of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST ELECTRICAL INSPECTOR Rough ...................................... .. ..... Service LDING 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. Smoke Det.