HomeMy WebLinkAboutMiscellaneous - 323 MIDDLESEX STREET 4/30/2018 323 MIDDLESEX STREET
210/005.0-0034-0000.0
1
Date............ .....................
,40RTH
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
4L
0 0
,SS
ACHUS
This certifies that
...........................................................................................
has permission to perform,-. -t-----,- -
................... .......................................
wiring in the building of...
................................................................................
ate—, .'-i.........71-7 ................. ............. .North Andover,Mass.
...... Y:� 14- V�t.-A 0`0(11061
Feee��. ........ Lic.No. .... ........ .... .....................................................
ELECTRICAL INSPECTOR
Check 0
5211
THE COMMONWEALTHOFMASSACHUSEM Office Use only
DEPARTNRMTOFPUBLICWHY permit No. �Ll�
BOARDOFFIREPRLVEN170NREGUTATIONS527CMRI2:00 HJT
Occupancy&Fees Checked
APPLICATTONFOR PERMIT TOPE ORMELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAC USSTS ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work desc ;beI below.
Location(Street&Number) C),C1kcj,
trY
Owner or Tenant
Owner's Address �� SCOW--e�
Is this permit in conjunction with a building permit: Yes No M (Check Appropriate Box)
Purpose of Building p` � Utility Authorization No.
Existing Service Amps �Volts Overhead Underground No. of Meters
New Service a,��1= Amps )o L2olts Overhead ®Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
round ground F1 4
No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. Total C FIRE ALARMS No.of Zones
Tons J
I No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW Nq..XSounding Devices
2 Noi,oESelf Contained
Detoction/Sounding Devices
No.of Dryers /f Heating Devices KW Local Municipal Other
v [7 Connections
No.of WaterHeaters KW No.of No.of
T Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
>THER
all= Pwsuant to mgmemcnts ofNL%sachilseusCuie lLaws
>aveacuuerltliabi7ityltouar=PolicymchxngComplete Covaageoritssulsan>ialecguvalait YES NO M
>avesubmitledvalidptoofof tothe0 YES ff}ouhavechecl®BYES,please indica�thetypeofooby
eding the _
TR ANCE BOND OTIIER (Plea9eSpecify) \Ae\.a \X la-- �
EvitidonDale
x Estimated Value of Eled�CaI Woik$
oiktosait kqectionDaleRaluesled Rough Final
cedund �ieFelalties o
ZMNAME r�� �.�LC � Ct��.lsF�e t� --Ze7)C L=-N,'No. 11 N3 4
Signahue LA LiemscNo
BusinessTelNo. (s.\-7-34s I —SCo r)
Alt Tel.No.
V1\.�'S INSURANCE WAIVER;I am awðat dr-Lice does not have the insucaixe coverage or its substantial egtuvalent as teguiied by Massachi>etts Geneial Laws
that my sipahue on this pe n it application waives this req*e-fm
ease check one) Owner ® Agent
Telephone No. PERMIT FEE
ignature ot Uwner or Tgenf
u The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers'Compensation insurance Afdavit
Name Please Print
Name:
Location:
Citi Phone #
I am a homeowner performing all work myself.
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. Policv#
Company name:
Address '
{ I
City Phone#: f'
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 iof-a_STOP WORK_ORDER..and_a fine.of.(.$1.0.0..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.
1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature Date
Print name Ph.one.#
Official use only do not write in this area to becompleted by city or town official'
i
City or Town Permit/Licensing
I] Building Dept
❑Check if immediate response is required Licensing Board
Selectman's Office
Contact person: Phone Health Department
Other
I
LocatioaA.-
f
Mo. Date _p
i
TOWN OF NORTH ANDOVER
S
a0,
Certificate of Occupancy $
ACMUS c�' Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check #
t/
17164
/� -Building Inspecto
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
x I „µt
BUILDING PERMIT NUMBER: DATE ISSUED: J -31- 0 V X
�
SIGNATURE: ic
Building Commissioner/Inspector of Buildings Date z
SECTION 1-SITE INFORMATION O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
9` a y;VA t �
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zane Information: 1.8 Sewerage Disposal System:
Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
C'/�/mss• 1/���c.-� �--� � �� /�• �
Name(Print) _ Addressor Service:
,Z c2 ..o2
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Tele hone
SECTIONS-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor:
ter. J`��� /' ` License Number mn
Address X`
Expiration Dat
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑ v
Company Name
Registration Number 1,12M
Address
Expiration Date ^^
Si nature 1011- � Telephone V
ael w..
SECTION 4-WORKERS COMPENSATION(MG.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must completed
in the denial of the issuance of the building permit.
and submitted with this application. Failure to provide this affidavit will result
Si ned affidavit Attached Yes... No.
SECTION 5 Descri tion of Pro osed Work check all a licable
New Construction ❑ Existing Building ❑ Re S) ❑ Alterations(s) W Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
l ;
hcJ �, sf
9
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be
Com leted b ennit a licant
L Building i
(a) Building Permit Fee
J� p
2 Electrical Multi lier
(b) Estimated Total Cost of
3 Plumbin Construction
4 Mechanical HVAC U Building Permit fee tel X (b)
5 Fire Protection
6 Total 1+2+3+4+5
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED cWHENber
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
He authorize �,�7�.�,z,,
My behalf,in all matters relative to work authorized by this buildinto act on
g penmt application.
Sij ature of Owner -, rn Y
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION Date
property as Owner/Authorized Agent of subject `
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief /
Print N
K Si afore of Owne ent -�,2...,
Date '
NO. OF STORIES
BASEMENT OR SLAB SIZE
SIZE OF FLOOR TIMBERS 1
SPAN 2 3 RD
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION
SIZE OF FOOTING THICKNESS
MATERIAL OF CHIl�INEY X
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED 10 NATURAL GAS LINE
® of.30,i- ,6i Andover
�-G0
No. 3 __
�. Z- O , dover, Mass.,
LAKE
COCHICHE.C:.
ORATED
U BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THATC. A.RleS !/*Ov co... ....... ............... .................
....................................................................................
Foundation
pe /�odt /
has permission to erect...I� ............... buildings on ..... 3...... .�. .�M.S 1�...... 1 Rough
, I
to be occupied as........... 0.�......0?.....�A.*9 1 �.y.......�!!�.He*....../PO.....tFw4*nto#%.... ./.......fw4tney
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, Afteration and Construction of
Buildings in the Town of North Andover. /3 y 3 D
� PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN6 MONTHS ELECTRICAL INSPECTOR
UNLESS V LESS CONS 1 L�'U C i I®N ST TS t w Rough
......................... �T.... 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
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER. DATE ISSUED: —31—
SIGNATURE:
3 /_SIGNATURE:
BuilTn—g Commissioner/Inspector of Buildings Date
SECTION 1-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
/D Cyt Map Number Parcel Number G
1.3 Zoning Information: 1.4 Property Dimensions:
W .
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
R red Provide Required Provided Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ 1. Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
C14�?2k-c l��yl o
Name(Print) Address or Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: .) 26-2 6
// �,(—/ License Number
Address G _/
W �//Y/, /
;7' % Y Expiration Dat
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑ c®
Company Name
/U
r ��/ • / Registration Number
l'Ll G� � l
Address
&�17 aal a2 Expiration Date
Signature Telephone
i
a �
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 permit.
Signed affidavit Attached Yes....... No.......❑
SECTION 5 Descri tion of Proposed Work check all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑
Accessory Bldg. 0 Demolition ❑ Other 0 Specify
Brief Description of Proposed Work:
"CJ 0
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY
Completed by permit applicant
1. Building (a) Building Permit Fee
OOC.). Multiplier
2 Electrical (b)(b) Estimated Total Cost of
OL
-ll Construction
3 Plumbing Cj Building Permit fee(a)X (b) ^ 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 CONTRACTOR APPLIES FOR BUILDING PERMIT
K
I, 1� ('� 2;Au'9.'�� ,as Owner/Authorized Agent of subject property
Hereby authorize��'!5iZ 7 to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7/b OW/ INER/AUTHORIZED AGENT DECLARATION
I, �/ / ��h��� 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 N
X
Signature of Owne ent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TRVIBERS 1 2 ND 3RD
SPAN
DINIENSIONS OF SILLS
DIN ENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHI10NEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
_ w The Commonwealth of Massachusetts
Department of Industrial Accidents
�Y
Office of Investigations
Boston, Mass. 02111
s
sy Workers Compensation:Insurance Affidavit
Name Please Print
Name:
Location: J 12 3 -F7
City 1/0- 4W 0Y- h Phone # 'c-20/-
Iama '
homeowner performing.all work myself.
1 am a sole proprietor and have no one worldng in any capaaty' .
EI am an employer providing wxkers'compensation for my employees working off t1ft job.
comnam name: V ( � J2. ,1A �U
Address
QW,
Insurance Co.X& / Poll :#
Company name: �
Addrts:
PhomInsurance Co. Policv.#.
Faye to sect con�ass requln order Section 25A or NIGL 1S2 eaR teaittwthe teripos ion oicrw matpenaltim tri a fne u�tto '!;:
anwar orae
years' lbefioima���7DP fioec€
(slaocM a asalnd"e
understand that a copy of this statement may be forwarded to the Otfiae"of Investigations of the M/1 forcoverage verulcmeiri.
db heseby rertyfy'r//xkr dieMOWanatpenneThes ofl J�X tAst fhe"u�lam�atlar provA*d above is true and correct
Si nature
Ike a if"U
.
Print name 2L Phone. 7 v zj
Official use only do not write in this area 6 be completed by city or town dfiaar
Cify of Town - P'eotr�llicensirg
pcheck it immediate response is regured tling
EW
.p Ei Ba
p Selectowes
Contact person. Phone# l] Heafth Depar
Other
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
t disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11, S150A.
The debris will be disposed of in:
(Location of Facility)
"�z
Signature of Permit Applicant
1�2�Zd
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
thisj
roect through,the Office of the Building p g 9 Inspector
II
MORTGAGE INSPECTION PLAN
NO. 323 MIDDLESEX STREET
IN
NORTH ANDOVER* MASS.
MIDDLESEX SURVEY INC. LAND SURVEYORS
131 PARK STREET NORTH READING, MA. 01864
SCALE.- 1"= 30' . DA 7E.- MAR. 8, 2004
CERTIFIED TO. PAUL A. DELORY, ESQ. & SCD REALTY TRUST
50' -�
PART OF
LOT 130
o
� N
(2 1/2)
STY.j
W/F
NO. 323
POR.
50' 1
MIDDLESEX STREET
i
NOTES: �P�SH OF MAS
1. OFFSETS ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES. � SE cti�
2. LOT LINES ARE COMPILED INFORMATION. o
3. THIS CERTIFICATION IS LIMITED TO THE STRUCTURES SHOWN ON U
THIS PLAN, FENCES, LANDSCAPING, ETC. ARE OUTSIDE THE SCOPE
OF THIS CERTIFICATION. ,
REGISTRY OF DEEDS ( ESSEX ) DEED BOOK 6314, PAGE 278 OVAL�A 0
1 HEREBY CERTIFY BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF THAT THE
STRUCTURES ON THIS PLAN ARE LOCATED ON THE GROUND APPROXIMATELY AS
SHOWN AND CONFORMS WITH THE TOWN OF NORTH ANDOVER ZONING SETBACK REQUIREMENTS
AT THE TIME OF CONSTRUCTION OR FALLS UNDER M.G.L. CH. 40A SEC. 7
AND THE PARCEL IS NOT IN A FLOOD HAZARD AREA AS SHOWN ON F.E.M.A. MAP
COMMUNITY NO. 250098C ZONE: X EFFECTIVE DATE: 6/2/93
P12805
xAORTH
Town ® 6 Andover
0
Z- A K E O ` lover, Mass.,
COCMICMEWICK
ORATED F"'F 5
U BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
%
BUILDING INSPEC'T'OR
THIS CERTIFIES THAT �.....14.•e...........5..........P..........yeti.CO................o
......................................................................... ..... Foundation
peModt /
has permission to erect...I+. ................................. buildings on .....�.43......�.1, ��.S.�,1�...,,..,, ... ..1 Rough
to be occupied as...............� r O? i0 rM 1...y........P I&V /Vo ewt AIOh A � O;w444vj,..e,
....................... .......... .......................................................... ... ............
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. *5 /3 Y / 3 q D
PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
�
PEy l V RMU EX MEpST TIN 6 M�TONTHS ELECTRICAL INSPECTOR
UNLESS V LESS COS 1 L\V�Ol V ST` TS ` w Rough
.. 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.
x Date. . .
HOR,M TOWN OF NORTH ANDOVER
o PERMIT FOR PLUMBING
SACHUS
This certifies that
` has permission to perform /�
T-3- 5),
�r
� plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . .
at r- : . . . . . . . . P-.: . . . .14: . . . . . . . North Andover, Mass.
`�
Fee �� Lic. . . `. . . . . . . . . . . . . .
PLA 41NG NSPECTOR
Check
6015
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBI
(Type or print).
NORTH ANDOVER,MASSACHUSETTS
Date
f
Building Location i Owners Name � � - � Permit# 0/ 1
.t'
Amount �
I
Type of Occupancy
New Renovation Replacement Plans Sub 'tted Yes ❑ No
FIIKTURES
Cr
Elf
V ICA
SZBBM
R4SR*W
Za FYaR / l
�1�IDCR
41HIUM
UM
5II3)HIDCI<i
6M HfM
7M FIOM
S1H)HIDQt
(Print or type) Check one:.
Certificate
InstallingCompany Name Vf-4 �t1%
� rP
r
Address
Y Partner.
Business Telephone — S' El Firm/Co.
Name of Licensed Plumber: .lasd/�H /a 5o D! JZ
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
r Liability insurance policy Other type of indemnity ® Bond ❑
l 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 El 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
I` 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 setts Sta Pl mN' g C e d Chapter l42 of the General Laws.
BY igna e o cense um er
ype of Plumbing License
Title a?66 W
City/Town License iwmber Master a Journeyman
APPROVED(OFFICE USE ONLY
I
it
Date:!�7. . . . . . . . .
TOWN OF NORTH ANDOVER
0
PERMIT FOR PLUMBING
SACHUS
This certifies that
has permission to performs,!( --z,,,r- . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . .
at 3 . . . . . . . . . . . North Andover, Mass.
OV
. . . . GIN
Fee,/I . . Lic. No., . .
.J . P INSPECTOR
C T- -R
Check # . . . . . . . .
JC PLUM , ' S 0
6016
MASSACHUSEM UNI DRM APPUCATON /PE.RNMffT TO DO GAS FI1r1'Il�tG
(Type or print) Date (�
NORTH ANDOVER,MASSACHUSETTS
Building Locations 0),3 �f /� f� Permit#
Amount$
O'ner'9�Name
New❑ Renovation Replacerne it ® Plans Submitted ❑
x w
oA � x H
W a w ;QH x a
z rz O H w
Fw+ FO O O W F
z o x
Ga z `W' 9 a a w . 9 w H W H x
Cw7 F z WWF z F. �w. �w vii w� z� O z O W
O x w A c7 a UO a> A a H O
SUB -BA SEM ENT
BASEM ENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
STH . FLOOR
(Print or type) Check one: Certificate Installing Company
Name 2 AGi4� �-e- -c—
Address �"�"`�- ,l ' �� ❑ Partner.
h
Business Telephone -- S'7,1- ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one: .
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑
If you have checked yes,please indicate 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
T compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
B y:
Signature of Licensed Plumber Or Gas Fitter
Title ❑ Plumber
City/Town ® Gas Fitter License Num5er
❑ Master
APPROVED(OFFICE USE ONLY) Journeyman
n
"sacus
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number S/0 L3 Date /a/,3 y
THIS CER S AT
THE BUILDING LOCATED ON c7, cj L� s Ne y
MAY BE OCCUPIED AS C� F;-' �C4-2
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING
CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.
Z / CERTIFICATE ISSUED TO Cdr/cS u��
Building Inspector
N F?^ T_'�
Town ® -e �� � Andover
No. �6Z3 y
}1 x, 10rth�i .Andover, Mass., 3 n3-/ ft-w?
y O LAKE �, T
COCC!EW-CK
\
�AD0'ATED PPS ���
BOARD OF HEALTH �
PERMIT T LD Food/Kitchen
Septic System
/t BUILDING INSPECTOR
THIS CERTIFIES THAT.....C...tiA.Rle.3...........v ^+ O
............................................ Foundation
has permission to erect...AF.�!'�o.Co*- ..... buildings on ..... 3......
V! .�r.S. ......... 1 Rough
Pe r '�/0 117 f �� 1M /✓� n l01" I ���
tobe occupied as................................................................y...................................................... ................... ........... y
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final / �,1� /6? /0
this office, and to the provisions of the Codes and By relating to the Inspection, Alteration and Construction of /✓✓��``
�il
Buildings in the Town of North Andover. �3 ef X 3 9, `�� PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 �MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STA_":kTS w Rough
1400.00,600 ....................�...;......................... Service
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building GAS INSPEC]r
RQlle'f S— L.r---C- `i
Display in a Conspicuous Place on the Premises — Do Not Remove F&W &1'1 i
No Lathing or Dry Wall To BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burners Z
Street No.
SEE REVERSE SIDE Smoke Det.`
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc. '
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip- Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min.22x30 w/3' headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have: ►
Natural light equal to 8%of floor area.
Y of required glazing shall be openable.
•' °" =s„< Bedrooms required min. 20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber- Finish
Smooth parging, clean joints, 8"solid @ combust. Surf.
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DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36” high, Baluster max space 5"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails. r
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee- $30.00(Be Ready).
Certificate of occupancy required prior to occupying structure.
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