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Miscellaneous - 37 CHESTNUT STREET 4/30/2018
Date ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that V, C .............. . . ........ 'f. ...►�.......5.��a-- has permission to perforin........... ..... 6 .... As.�L wiring in the building of ........ C.......tj':�A e- t' 0 ............................................................................................ at ....... ........ N ....... ...prth Andover, Mass. Fee ........ ..... Lic. No. . . ...... to E ;MICAL INSPECTOR Check # ti t..ommonwaa& o f Mad9aclwet`.b 2,parfinen1 of g,ira Servicm BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No I71�5bI Occupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR Pr EJRMIT TQ PERFORM ELECTRICAL WORK All work to be performed in ac6rddnce with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION)` Date: 7�v��� City or Town of: „4J �!'If'Ql/�/2 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) J� ��t�1J>�y),Gt,T' Q Owner or Tenant eO5Z-2EZ149 Telephone No. V Owner's Address Is this permit in conjunction with a building permit? Purpose of Building Existing Service _ New Service Amps ! Volts Amps / Volts Number of Fecders and Ampacity Yes ❑ No Q (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead LJ Undgrd LJ No. of Meters No. of Meters Location and Nature of Proposed Electrical No. of Recessed Luminaires , No. of Ceil: Susp. (Paddle) Fans No. Total Transformers KVA Tran No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. El In- ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS TNo. of Zones No. o Detection an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices eat Pum umber Tons K No. oSelf-Contained Disposers No. of Waste Dis P Totals .............. Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Co n nate El other Connection No. of Dryers ry Heating Appliances Key Security Systems: No. of Devices or Equivalent No. of Water KW No. o No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs l HP T No. of Motors Total No. of Devices or Equi va)ent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: / / Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑✓ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the informatt n on this application is true and complete. FIRM NAME: Village Electric Inc A& LIC. NO.: 9163A Licensee: Anthony P. DelPapa Signature LIC. NO.:21861E (If applicable, enter "exempt” in the license number line.) Bus. Tel. No.- 978-256-4845 Address: PO Box 4044 Chelmsford, MA 01824 Alt. Tel. No.: "Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature _ Telephone No. k The Comn.�onweart a, fHassach.usetys , ` - . De�a�tment of Xnc��s�zccl.Accic�en�,� Office offnves igafeons 600 Washington. ,S'tr'eet -Holton, HA 0211 -www.MUSS90v1dia WprrkeX$9 Compensationfusnrance Affidavit: Buffderg/Codi°actors$)Electrxv iaaasqZumbUP J>>1 �-/ (t�-(,I� I ► nC-.-, .Areeotx axe eronplOyer? Cl ee the appropxiateYoo�: 1. L� f I a employer with. i 4 Z am a general contractor and 1 Type of project (required.): 6. yNow cbnstmeiiou am employees (falland/or pa -time) have Medthe gab -contractors listed on the attached sheet: 7. Remodeling 2. [] I am a sole proprietor or partner ship and`jiaveno.employees These sub -contractors have 8. ❑Demolition working forme in any capacity. comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its 9. Biffldffig addition AM'lectrical repairs or additions LNo workers' requixed.] Officers have exercised.their on ti of exemption light m or MGL p p • 1Q] Plumbiugxepairs or additions 3. [] Z am a homeowner ,oing all Work myself Lbworkers' comp. g c• 152, §1(4), andwehaveno 12.x] Roofreairs fiisuraucarequftefli employees. PTOworkem, 13.❑ Other comp. insurance required.] Any applicanttfiat checks box#I must also fill outthe section beldw showingtheir wbrkere compensat[on.polieyinformation. f Homeownerswho submitthisaWdavitindfcafttheyM;doingallworKandthen hire oufsidecontractors mustsubmafianew affidavit indicatingsirah. xCoirftacfors that checkthis boxmnst attached P additional sheet showing the name ofthe suh-contractors andthokworkers' comp. policy information. I am anexnproyeNtiiatiSprovidifigllloykeTs'eorftpellsationzns rar2eeforrayempoyees Bol'oty. sihepolieytcnuljollisite information. ) I 1. 1 PV Tnsuxance Company"r PoJic # or Selz ins. Lr ic. #: .I ExpiratloaDato: lob Site .Address 'J 1 � I lJ(� �i U ' v �� City/SiaieLZip: o A-Rach, a copy of the workers' comp ensation-pollicy cleclaration page (sh.owing•the policy nmnber and expiration crate). Failure, to secure coverage as requiredunder Section 25.A ofMGL a.152 can lead to the imposition of eriminalpenalties of a fine, up to $1,500.00 and/or one -pear imprisonment, as well -as civil penalties in the foam of a STOP WORD ORDER and a fin e ofup to $250.00 a day against the violator. Be, advised that a copy ofthis statement maybe forwardedto the Office of 7„vagHgaffoas.ofthe DIA for insurance coverage verification. X'do lies y r \ r ei liepains c nd venat'ties of verjury tliattrie information,proviciec� o a is true and eo�aeet.)A Official usa only. Vo notWPite in t%tic area, to be conwfeted bV city or 10M ©ficial. City or Town: BezmitlLiceuse # Issuing Authority (*cle One): 1. Baaxcl of Health 2. Building Department 3. CitylTowla Clank 4. Electrical Inspector 5. )dumbingInspector f. Others - - - Information aad Instructions Massachusetts General Laws chapter 152 requires alt employers to provide workers' compensation, for their em Pursuant to Phis statute, attemployee is defined as "...ever, person, iii the service of ployees. another under any coriiract o�hixe; express orimplied, oral ov written." .A.n. eraaPloye�r`ls defined as "an individual, partnexsbip, associafion, corporation or other regal entity, or any two Or mole of the Foregoing engaged in a joint enferpxise, and includingthe legalxepresentatives ofa'deceased employex,,ox the receiver ouir dstee of an individual, partnership, association or other legal entity, employing employees. Sowever the owner of a dwelling house, having notmore than three apartments encs and who resides therein[, or the occupant fi o ve dwelling house of another who employs persons to do maintenance, consfruction orrepair work on such dwelling house or onthe grounds orbuilding 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 eons€ Ga buildings in the commonwealth for asap applicant who has not pro duced-acceptable evidence of compliance with the insurance coverage required. " Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivijsions shall enter into any contract for the performance ofpubiie workuntil acceptable evidence of compliance with the insurance requirements of this chapterhavebeen,presentedtathecmtractingauthority." .Applicants Please ,:fill out the workers' compensaiion af�-Idavit completely, by checking the boxes that apply to your situation and, i< iiecessa-ty, supply sub-confractox(s) name(s), address(es) andphonenumber(s) along with their cerecate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees oilier than the members orpartnars, arenotrequixedto can7workers' compensafioniasurance. ZfanLLC oxLLP doeshave employees,apolicyismquired. Be advisedfhatibisafffdavitmaybesubmittedtoiheDepartmentof Tndustxia7 Accidents fox conthe C'4aiion of insurance coverage. Also be sure fo sigh and date the affidavit the affidavit should h e return ed to the city or town. that the application for the pewit or license is being requested, xtot the De,�altment of Mustrial .Acoidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensationpolicy, please, call the Department at the mimberlisted below. Self-in=odcompaiiiesshouldentextheix self insurance license number on the appropriate line. City or Town officials Pleasebe sure thatthe afldavit is complete audpxinted legibly. The, Department has provided a space atthe bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. ):'lease be -sure to fill inthe permit/license number whichwill be used as a reference number, fn addition, an applicant thatbaust submitmultiple permit/license applications .int any glvenyear, need only submit one affidavit indicating current Policy information (ifuecessary) and under "Job Site Address" the applicant should wrife "all locations in (city or town)" A: copy oldie affidavit thathas been officially stamped or marred by the city ox townmay be provided fo the appllcantasproofthatavalid affidavit•zsonffia�orfufurepennitsorlicenses. Anew afddavitmusibaffiedouteach year. W here a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture (i.e. a dog license orpermit to burn leaves eta.) said person is NOT required to complete this affidavit. The Office of Tnvestigafions would life to thank you in, advance for your cooperation and should you have any uestions, ,please do not hesitate to give us a call. q The Department's address, telephone aiid fax number: Tho GQow�at oasao?ueif Off ke offiRvottWou 6Q4 WaWngto.a Stceot Bostq, MA 02111 Revised 526-o5d� v�[fiFw•�t�Ss,gilv�c�a Date ......�. ...j..L. --j TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ......� .� . fa. .......... �. - '�' '�. .......................................... has permission to perforrii ................ . :..-........................... plumbing in the buildings of ...........�................. .......v."...s.'.......�.........!.:G ..................................................�... at ........... i ................. North Andover, Mass. Fee .'5 ..-. Aic. No....,A.,,41 ............................. ................................ ............... �1 PLUMBING INSPECTOR Check # / P TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY �MADATE JOBSITE ADDRESS 3� '�� � PE`RrMIT# ub� `�` S OWNER'S NAME OWNER ADDRESS _+ C= �" S-' TEL OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ NEW: ❑ RENOVATION: ❑ REPLACEMENT: FIXTURES 1 FLOOR, BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAC TASTE DEDICATED GAS/OIL/SAND—SYSTEM— DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEh DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTE�^ KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET — URINAL WASHING MACHINE CONNE WATER HEATER ALL TYPES WATER PIPING OTHER BSM 1 1 1:4 2 FAX RESIDENTIAL 9--" PLANS SUBMITTED: YES ❑ NO ❑ 10 11 I 12 13-1-14 I have a current liabili insurance policy or its substantial equivalent whichCE meetsrequirements of MGL Ch.142. YES V NO 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 th Massachusetts General Laws, and that my signature on this permit application waives this requirement. e 0wlv� I URE OF OWNER OR AGENT CHECK ONE ONLY: OWNER ❑ 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 m know) and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of Massachusetts State Plumbing Code and Chapter f42 of the General Laws. n edge ' e PLUMBER'S NAME D Z C;,,n %�j� A '(ale LICENSE # MP Jp ❑ L r0 CORPORATION SI ATURE �#3byt� � PARTNERSHIP ❑ # �� Ate,'I LLC [:] # COMPANY NAME CITY eg'G� k,,( -ADDRESS ✓I� I — ; Cz� STATE /�� k ZIP i TEL �{ FAX `�'��i=� - y�. i 1 CELL " 1000 EMAIL (A P.0 k A llri -, f -1 , : --4 - N' f`i•1 LA- r U � �j Ayotte Plumbing, Heating & Air Conditioning. iA P.O. Box 218 North Chelmsford, Ma 01863 Phone: 978-251-1000 Email: deanj2ayottexom sue@aMptt-e—.com avotte.com scoff a o^y ,ttexom Iori@aY29ft. , Dm Facsimile Cover Sheet Date: To: Fax: From:d Total Pages - Urgent Ur ent Review Reply Comments: Ige intertek [57 , 4111Q,5' �mmJ --uO MMJ t4V MM] 67/8" L176 mm) [171 rnM1,1 intenek 7 114" T [193 MM] 4518' HU [Its MMI [127 MM, [224 MM] 7 5/5" [05 MM] 75 MM] .(R. tntanek eur tae n.N HU Riobe • Y2" female Inlet NPT • Ceramic cartridge •Solid brass • Without drain -Flow 5.7 L/min, 1.5 gpm (US) 60psi ED03LC Chrome ED03LON Brushed nickel •1/2" male inlet 4T • ceramic cartridge • Solid brass • Push drain • Flow 5.7 L/min, 1.5 gpm (US) 60psi ED08LC chrome ED08LBN Brushed • 1/2" male Inlet NPT or sweat -Ceramic cartridge -Solid brass -1 jet hand shower - Flow 41.5 L/MIn, 11 gpm (US) 60p5l E012LC Chrome E01ZLBN Brushed nickel g,— • 3W, female inlet • Ceramic cartridge • 0ouble check valve -solid brass • I jet hand shower • Flow 44 L/mIn, 11.6 gpm (US) 60p5l ED06LC V chrome ED06LBN Brushed nickel S 631 367 15 • 477 $ 574 1$ 752 EX: E008 L C EDOS + C www,riobel-ca December V, 2012. USO Prices subject to change without notice. M M Edge Pressure:ba�l��fi��.e>va•IV'e'.'wrth:se . ce.,. ,t ., Riobel •+h" male inlet NPT or sweat • Cycle action: temperature control 00 • Ceramic cartridge and balancing spool with check valves 1153rmn] „ -$ervice stops inoerftk -solid brass • Flow 20 L/min, 5.3 gpm (US) 60PSi r_1�J EOTM61LC Chrome $ 286 EDIM61LBN Brushed nickel, (PVD) S 369 1 .•,..,.,', •'r:: *\•>. ;';...,?'- ::}..: i7 y� ,y.., .-�,,,,.y,..;,�,,,,-',,,�;r ;•.r . - ";fir.°'' ;,,'�.' - ',:':•:�'•. • 1/2" male inlet NPT or sweat O•• • cycle action: temperature control Ceramic cartridge and balancing spool with check valves [153 mm] • Service stops Q lnterrek • solid brass Diverter 00 • Flow 20 L/min, 5.3 gpm (U5) 60Ps1 ' EDTM65LC chrome i 477 EDTM65LBN Bruahod nickel (PVD) S 631 ��' � w'a. •the,rrrtostatl�'.taa.x.l�1 u'�L��.'wl.th'�����ri:��°SGO.:5... ,.,1.;;.::;q',r--=� ,.:•L>i. ,,...... -... . • 1/2" male Inlet NPT or sweat • 2 outlets '/z" males NPT or sweat 06. • Coaxial thermostatic cartridge with check valves (153mm) \�/� •Servlcestops ertsak • solid brass • 4 positions (055,1, 2,1 and 2) • Flow 30 L/min, 7.9 qpm (US) 60psi 00 EDTM23C Chrome $ 459 EDTM238N Brushed nickel (PVD) $ 551 'EYP:..::,...... i ...... .. ..: � ''/� .,., , 1{F ..'•. ...1.. 1 ..' f' .,. oaxlal.th.erm.ostatl�c.�L7,W 0 "1Y l•7'n' ,:'.j.•.7 '.,:f •':. t�•t 7r•. • V2" male inlet NPT or sweat • 2 outlets yz" males NPT or sweat 06, • Coaxial thermostatic/pressure balanced cartridge with check valves [153 mmJ q c� • -Service stops Ittm k • 50114 11155 • 1 Integrated volume control • Flow 41.4 L/min, 10.9 gpm (U5) 60p5i EDTM43C Chrome s:. 516 EDTM438N Brushed nickel (PVD) S 608 4 R. Create., ,oil.r:.:�ouu�n:.f'aUc'ef>�rlth%�ov�: �"ii;' . •:�: tiO�rS;;;''},. ..,.::-„',� �� ,,.a:;>;;;��.:':��::'-�, .. �:'y T*R>: EX: ED08 L C EROS + C wwwriobel.ca Decemberl", 2012. USO Prices subject to change without notice. Division of'Pro fessional Lkersure A Mms�,.Gov Mame 9t,?iaAQ9ndEW Az2 Tdpir s Hcrhe) Divi'slon Pf?r64s ,siqnal •of PIUMOFS,Rhdt23 RWSY Accepted Plum bing Prodacts Oull"'M System. Sythi DMsiom 6fEmkUlpmabUomsum ONLIMP, SERVICES Ch�k a Lagnse Locate a. Ueenv�d Professional Online Addrem Change Contact the Ager, cv . ........... .... ... . ....... .;. 1-- - -', - - "I"'! I..'J,. ", , " . . ", "-I..".. " ,' ".1.1"... 1... , - " -- I , Ta,•Ee- QN,LIM'E PLUMBf!Lq P.id?DY.;,T3.SYSTEA- $.CAR". REWLTS I S0$rch Criteria::ord(� There reci � n , our da�b�Ea Type: Pipthbing Man,ufacturer:, Chat if�-y6ur Pr6dubT.is not'diSplaVed ip. t6e i. Prqduct: -�,-4rqh- resp .ybp, �an refine your search.. Model ejd061 c riterla. Vescripriorv, DispLqing pago,.- 1 of,'05 .search results �--n —Seach Reqao5ted: pmd�ct&,per-pna: LC07 ....... J PR60OCT, APPROVAL CONVfTiGN ...... ....... ..... . ..... - AFPRO�A.L MANUFACTURER AODEL ACCEPTED EXPIAMS GGDE :.V Tbb fa(ket with Nadd6/ shower :1 igiow, 1 M47. ;MO6L. 6 *1 46/&261506-1.2,5 /A 31- ........ ... . .. . ............. ... . ....... .... ............ N0,4 P"g j..L9&tp,dg6 (%-Yiwomv� SLAP d Sift-, Dnrii—1 ""'i �;Hwif"I r7 m wv.11-imom PROUUM TEDNICAL SUPPORT MEDIA ZONE ................. ... Type T/P (th,e(Mcislalk/pressure bz1ance) mr coaxial complete valve . ........ . . . .. . ...... ...... ...... ...... . . ..... ...... . SPECIFI'CATIO'NS COLORS DOCUMENTS Products D es c d pti ci ri C Technical sheets New V i6w.t M. afe NPT.'cr.�W4,4 qiae6s Spaces Service stop$ fifol)qr 510es -6 Tiiaim, 43talcjpre55A bi%ife chh I k yalves jf. Two W'OuOk� male NPT or sweat qmlFnc cafteclians Repair ordic . .. . .. .. .. ....... HOW rates user qkfide Spare- parts jo cipon . ..... 4 TA, L/M.K. 10.9 0* (U? 60tl CSA 8.125.1 1016, Wz4s A'Opvoval . ........ . . . .. . ...... ...... ...... ...... . . ..... ...... . Products contad U4 New qiae6s Spaces fifol)qr 510es rAq ,Grovps qmlFnc cafteclians Repair ordic . .. . .. .. .. ....... InapiraWr(al: photos I.. -I..-.....--.... . ..... . .. ....._..:v_..._._..._..•.._.._.__......__...._..: user qkfide jo cipon . ..... OR IrREFfvk z 90TM43, Type Y/P (thermbgta6c/pretsure balance)' YkI,'CCaxia4 ,��rai, ' =463, 20 cm *01 5WWet head -79.0, 91bbw sogiy wjili ffiut-off Naive 6" vertial eh, A W#343gOTMC Cfir�sve 1034 KIT4343'EQ,T' MON, Rroshed'nickel (PVD) KIT#483EDTMBN 16rushW nickel (PVD) KWO483EQTMC=6° Chrorne S 17.8.1 Bfushed nickel (PVD) $1321 KiT#48.5ED`MK$N-6` 1 UusW nickel (FVD) _7$ M� E. T'M (thermogtatc/Pressure balante) 3W coaxial complete vaW, 77 -5005, Hb6shbwlgf - 46% �O Cm.(h shower head -503,40 dil (:i6°) shower arm supply with sfivt-ofi Valve Bauble Type T/F WWO) 3/4"coagfal .n6l, Era body jet tnomk 6" v>rrtital arm XITOMDTMS� Brushed nickel (PVD) kIT#793ED,TMBN-6' Scu5hedrlilkel,(PVD) enol ra KA.vrk 01 *IAMB lien T3,;, -61- ... $ 2069 S 2644 $206.9 S2644 Chrom KIT#483EDTMBN 16rushW nickel (PVD) KWO483EQTMC=6° Chrorne S 17.8.1 KiT#48.5ED`MK$N-6` 1 UusW nickel (FVD) _7$ M� 77 Bauble Type T/F WWO) 3/4"coagfal � Sol AO, CM 1468, 20 -Cm (S!')'5hOWr bad '?,50'05, Handsho wer i*il -10, Elbow'5�up y P.1 -with valve 390j ECO body let tnomk 6" v>rrtital arm XITOMDTMS� Brushed nickel (PVD) kIT#793ED,TMBN-6' Scu5hedrlilkel,(PVD) enol ra KA.vrk 01 *IAMB lien T3,;, -61- ... $ 2069 S 2644 $206.9 S2644 Type:. Pfijhjbj.7jjg Manufacturer Mobel, Iric, Product: �vc Mo-detz edtm' Description, Mew 5��rh, ... .... .. ... .. .. ..... . ........ I ... ....... .................................. akial th coaxial ermosta.tk I' prebalance system Riobel Inc. With hand shower rail and i�shawer head 1,0" Coaxial ihermostatic (pressure balance, Syttem iRiokl Inc, m1th hand shoWor rail and .skower head .... ....... ........ .... . ... ............ IRiobef . .......... .... .................... ...... ........... *." Th6emokatic systern (with handshowerrail and Rlobel Inc, I ,shower head ...:..............I.............._......_...... Ripbe f --............_,._......,.....,....,....,I,,...,.,., Thermostatic -system ;with hand shower raft and 'RlobeL Inc. :show'& head AiobollRibbet Inc, ..... .... .... . ........... -- .. .... .............. . - ------------ -- L'- KIT#-343-EDTM X2/6/2013 KIT#341EDTM- i[, 2/6/2016'P1-0213-304 3 12/6/2016 ;N-0213-304 EDTM+ [1/5/2011 KIMOTML 11/5f.2011 ..... . ........ ... . ........... .. . .. ... .. ............ ........... !6/6/2015 liN-OW-53.5 . .......... . . ............ : .... ........ 6/6/2015 T3-0612-535 i 'D' T ... ........ D' �1'6` 6" 2*'"* 0" �-03-* 0*'617-53 5' ...... ........... . .. . ...... Date. /. l:.��...� . `... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION '�r* This certifies that ..r..-:. 1.' ........................... has permission for gas installation : ........ in the buildingsof r ................. . at .. ?. ..c: / . /. :./ .............. . North Andover, Mass. Fee.. ....... Lic. No.. �.'... . GAS INSPECTOR Check # / t t C 4 2 u 5 h '0/0 MASSACMSVM (Type or MA print) �RRAPPIdCATo N�R NORMpow �� �� GAS Building Locations �� SSAC11 fsfn� _ p?'I'nNG New Renovation ❑ �Owner,,Jvame Replacement ❑ 8T H, FLDHR H FLOOR F (print or type) r �o/4 Nam e •l .s ess Address � Bus- I T elephone Name ofLicensed Plum be!' or Date j Permit# Amount $ a J Plans Sub nuttOU ❑ a N CIff U CertiScate Corp. Itallinb' Company 1'ner INSIV G4s Fitter . I havee a COURAGE i ❑ F Co. Ifyouvicent liability v Liability inscheckecl L, Please indurance i cy or it's �m� the substantial al Owner.' cY l e type coverage b elury ent. Check one; Yes Mass. waivnerwer I Other type ofyjt: i� Ile appropriate box❑ No Si �ws' and that my S w t the /ieensee dog ❑ ❑ 7 qty f Owner or �er,s Agen gnature oir flus Pcnwt application�a ante coveraged 4 bes at compl ante wledgeland a details and information Check oaives n is "�9urrem�u'r'� by Chapter 142 of the th all Pertinent Plumbmg w I have subrnitt� Owner' Provisions 0 e and installations �� 'gent ❑ assachusetts S nedder P) Dina aPpligti iss Or ti+re itle Code and C apte�r 142 0 this IIIl1IiIIns to to the t3/Town Signa a General Lawson will be in ❑ PI t of Li Z, D' ❑ um� Gas Fatter ter ❑ Journeyman �•P1 190 -61S o Ug_.8 Z m S ENT SEE NT T, F D, 0OR D, FLOOR Fr�__LO OR 8T H, FLDHR H FLOOR F (print or type) r �o/4 Nam e •l .s ess Address � Bus- I T elephone Name ofLicensed Plum be!' or Date j Permit# Amount $ a J Plans Sub nuttOU ❑ a N CIff U CertiScate Corp. Itallinb' Company 1'ner INSIV G4s Fitter . I havee a COURAGE i ❑ F Co. Ifyouvicent liability v Liability inscheckecl L, Please indurance i cy or it's �m� the substantial al Owner.' cY l e type coverage b elury ent. Check one; Yes Mass. waivnerwer I Other type ofyjt: i� Ile appropriate box❑ No Si �ws' and that my S w t the /ieensee dog ❑ ❑ 7 qty f Owner or �er,s Agen gnature oir flus Pcnwt application�a ante coveraged 4 bes at compl ante wledgeland a details and information Check oaives n is "�9urrem�u'r'� by Chapter 142 of the th all Pertinent Plumbmg w I have subrnitt� Owner' Provisions 0 e and installations �� 'gent ❑ assachusetts S nedder P) Dina aPpligti iss Or ti+re itle Code and C apte�r 142 0 this IIIl1IiIIns to to the t3/Town Signa a General Lawson will be in ❑ PI t of Li Z, D' ❑ um� Gas Fatter ter ❑ Journeyman �•P1 190 -61S MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS �'�- -}— Date Building Location _ �i 1 '�i�1 Owners Name (�C/tv� Permit # - Amount / Type of Occupancy New �/ Renovation Replacement Plans Submitted Yes ❑ No FIXTURES [21 (Print or type)ACffFfp- Address Z Certificate Installing Company Name �- � ! I u / �Partner. Business Telephone d F1 Firm/Co. Name of Licensed Plumber: 1/"T 6 h 9�1 V l 1 4 Insurance Coverage: Indicate the of i surance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted or entered) in above application a and accurate to the best of my knowledge and that all plumbing work and installaO • s pe under is application will be in compliance with all pertinent provisions of the Massachuse s Stat bi and a r the General Laws. By igna ure o sea Tqumoer Type of Plumbing License Title �, City/Town License er Master Journeyman F1APPROVED �OFFtCE USE ONLY let 19 4 Date ..//-13 - a ............................... °;.t�`` "ao� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING Vis: This certifies that U 1 �/to C ..................................................................................... ° has permission to perform .....13 A &Q MIP v� F-1 U /S /7' ......................................................... Uwiring in the building of .... v `3 �-'pSNu S, NortAndover, Mass. at ..................................................................... c CCII _ � Fee .... 6.5....... Lic. No. .IYA3�.....Z:.-b Z.. -M .................... ELECTRICAL Check # ID 3 to TIW C0AM0NWEALTHOFMASSACHUSEHS Orf -i e ly DEPAR7/YRVN1'OFPUBIICS4FEIY Permit No. `Z 1 BOA RDOFFIREPREVEWONREGUTATIONS527CM12.00 Occupancy & Fees Checked APPLICA71ONFOR PERMIT TO PERFORMELECMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 3?igYCQ uy7- Owner or Tenant LIDD Owner's Address Is this permit in conjunction with a building permit: Yes No �r� (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amp =Volts Overhead M Underground :� No. of Meters New Service Amps / Volts Overhead ---� Under found g � No. of Meters Number of Feeders and Ampacity -- Location and Nature of Proposed Electrical Work /IqF No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures 41 Swimming Pool AboveBelow ----AGenerators round round No. of Receptacle Outlets � No. of Oil Burners No. of Emergency Lighting Battery Units KVA No. of Switch Outlets No. of Gas Burners No. of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons —� No. of Disposals No. of Heat Total Total No. of Detection and Pu--- Tons KW Initiating Devices --� No. of Dishwashers Space Area Heating KW No. of Sounding Devices No. of Self Contained �� No. of Dryers Detection/Sounding Devices Heating Devices KW Local Municipal 00 Other — No. of Water Heaters KW E3 Connections No. of No. of Si ns Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER Y R r&=COMM�r- PUISMt6Dthe 10C1twUnI f1SOfWbMd111d1sGef=1 Lam ilaveaamtitLdxky)ns mmpbkymdudr>gCmP]ct Covtnworzabstanalegmvabt YES �' NO havuusubmatddvalidproofofsarrletotheOfl YES � If ouhavedrdodYES,plea9eirlrk*the typeofmvt�ageby heddrlgthe box ED ��// VSURANCE�--BOND OIHQZ (PJ mSpedfy) •;1. �• �r Boafi �D& 1Estimated VakrofE�cat Wolk $ hWectionD*ReWesbd Rough Final RMNAME /fi �2E�T�21C Liceim.No. 11;1454 owe_ �� h�4G-�9i� Signatufe �--._ LkffwNo T;XsTel.No. R7� 6a2 !>ZGZ JVI�R S INSURANCE W Ah. Tel No. RIVER,Iamaw-mdiatthel-mwdoesnothavetlteinsinancecovaageoritsatsta-itialeq nvalulasmgttuedbyMassacl�GatetalLaws dthatmysigmhueontbspmntapph=onvam*m ibs,afkPnott lease check one) Owner � Agent 17 Signature Telephone No. PERMIT FEE o wner or gen Location No. Date 04�OR,M Ah TOWN OF NORTH ANDOVER t.�su Certificate of Occupancy $ sCMUsE<�' Building/Frame Permit Fee $ /Z- > Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 10 �- Check # r U C Building Inspect TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Sectin for 00, Use dfo BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: 160_� Building Commissioner/Ifi for of Buildin s Date SECTION 1- SITE INFORMATION 1.1 `Property Ad 1.2 Assessors Map and Map Number Parcel Number: Parcel Numb {��tX 1.3 Zoning Information: Zoning Diai Proposed Use 1.4 Property Dimensions: Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide kegaired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private 0 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner o ecord Name (PrinU Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: dM _ Li snce ed C Supervisor: Address S' ature Tele one Not Applicable 0 // OV�onstruction OS3 License Number W4 Expiration ate 3.2 Registered Home Improvement Contractor Not Applicable ❑ /p 111 Company Name Registration Number Address Expiration Date Si nature 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ 1 Demolition ❑ 1 Other ❑ Specify Brief Descriptilo/nen off Proposed Work: I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building vz ( (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 OWNER/AUTHORIZED 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 Signature of Owner/Agent Date NO. OF STORIES SIZE s BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 ND 3 SPAN DINIENSIONS OF SILLS DIMENSIONS OF POSTS DiM NSIONS OF GIRDERS f1EIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print City Phone # ZaI-ahomeowner performing all work myself. 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. ComDanv name: Address City: Phone #: 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 $1,500.00 and/or one years' imprisonment.as weU-as_civil.penaftiesin thei=-cfa STOP WORK ORDFR-and..afine..ofl.$l.ODM).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. Y 1 do hereby certify under the pains and penalties of perjury 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 Office Contact person: Phone A ❑ Health Department ❑ Other TPM CONSTRUCTION THOMAS MCDERMOTT 20 WHEELER AVE SALEM, NH 03079 Administrator ';�1�6 t�om�na�'cc`!l%i o�✓r!fcr.�a�'��use� DING BOA CONSTRUCTION SUPER SORS License Number: CS 058632 Birthdate:0610g/1962 25539 Expires 0610812004 7r. no: Restricted: 00 THOMAS P MCDERMOTT 20 WHEELER AVE SALEM, NH 03079 i'1 Administrator �%ieanamanueatl�e o/ . %lfa f stxr�cl� ` 1 Board of Building Regulations and Standards t HOME IMPROVEMENT CONTRACTOR Registration: 118788 Expiration: 04121!2003 Type: DBA TPM CONSTRUCTION THOMAS MCDERMOTT 20 WHEELER AVE SALEM, NH 03079 Administrator ';�1�6 t�om�na�'cc`!l%i o�✓r!fcr.�a�'��use� DING BOA CONSTRUCTION SUPER SORS License Number: CS 058632 Birthdate:0610g/1962 25539 Expires 0610812004 7r. no: Restricted: 00 THOMAS P MCDERMOTT 20 WHEELER AVE SALEM, NH 03079 i'1 Administrator • TPM CONSTRUCTION 20 WHEELER AVE. SALEM, NH 03079 fa (603) 898-0864 PROPOSAL SUBMITTED TO PHONE Jennifer Costello 978-7254919 STREET 37 Chestnut Street JOB NAME CITY, STATE and ZIP CODE N. Andover, Ma ARCHITECT DATE OF PLANS We hereby submit specifications and estimates for: - wU^ i iuiv ADDITIONAL PROPOSAL Page No. DATE of — Pages 10/17/2002 jOB PHONE Frame for new % bathroom - %" blueboard - skim coat .trowel finish. Install vent farm, vanity and fixtures $2,435.00 .............. ........ ..................... _...........-........................_....._.............. __.._...,..................... .................... .......................... ............. I....................... .Electrical price includes new playroom and new % bathroom as discussed with electricians _........................................._....................-............_........._.............................................. $4450.00 _ ......... .............. _.... ...... Plumbing price — new wet bar sink, feed drain. Rough in new % bath, rip. up floor and re -cement floor ...................................................................................................._.........._ .......................... �........... ......... .......................................................... . supply new toilet, and fixture for new sink ...._.............._.............._......................._........._..._.....................................................................................................$4.7.50.0.0.................................... ................................................................ ttur propOSt hereby to furnish material and labor --- complete in accordance with above specifications, for the sum of: Payment to be made as follows: dollars ($ X12415 on At start of job: $4,138.34 -'/s way through job - $4,138.34 — Upon completion of job - $4,138.32 All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration cr deviation from above specifications involving extra costs will be executed only upon written Orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Insurance. Our workers are 'ulhj covered by workman's Compensation Insurance. Authorized Signature Note: This proposal may be withdrawn by us if not accepted within Aire Lance of Proposal— The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature _ to do the work as specified. Payment will be made as outlined above. Date of Acceptance: _ Signature days. 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 ir): (Location of Facility) Sig�+n/ e 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 Cl) m m U) 0 m CO) .p Cl)CD Z cl CD ar d n� .p O p CD cr d CD O .p CD O C2 y d O CA O y W C7 CD O CD CD CO) CD CO) O O CCD O CD p 0 O �• N O Q N d O :S m 0 H C! d O m Z ?-o CO) = w ea ti T =r m nod O CO) CO O m N p N o ?m : m = > > O N m .� So" p O 01 C y n 'm: c =r d n h O � •� C CL m O m :' c7 O c Cc L 0 CN N d H o W= a -CCD H 1 1 mayn m D co o h o CD o CD ViC=Cl m: .A ® N 't dd0 oma. a� n� C', O C O C") O O C . z m �q C/) b (rt ti o W rD �.��.�yy w 0 z y Z7 ?? c '-Ci O ��1 pt tyjd w O o�n r� �l1 ?1 2 n `� O oGa 0 r z ( • r)rD n (D O Q x n Mr- a o x a 1 omq 0 9 O C Date ... ... ��... .. ? .... . TOWN OF NORTH ANDOVER a PERMIT FOR GAS INSTALLATION This certifies that .. ..,:...` r.......... . ........... has permission for gas installation ..�:.:::. �. �..: . ........... . in the buildings of........::.....�.:.......................... at .. %. '.. !'......'..... ...... ........ . North Andover, Mass. Fee...'. 1. .:... Lic. No.. !..... .. . GASINSPECTOR Check # r. 7 MASSACHUSETTS UNHURM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 13 L/ / Sf y'`-** Permit # ''''1-� � .• [ Amount $ W W �rr- �O.S�r / `��Owner's Name New Er Renovation ❑ Replacement ❑ Plans Submitted ❑ ante or type) (,(�U o j �� f) one: Certificate Installing Company /l �� C( bi Corp. Address �� � .) o r t4vV lP /U, ❑ Partner. Business TelephonL &0g — C> 3 3 ❑ Fitm/Co. Name of Licensed Plumber or Gas Fitter Sv^9-y✓t e INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please ind' to 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 ofthe 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 ❑ t nereoy cermy inat all or the aetans ana lntormatton 1 have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions ofthe Massachu�& VED (OFFICE USE ONLY) �WWedin above application are true and accurate to the ed under Permit Issued for this lication will be in Code and C� t l f the efal Laws. SL ature of Licensed Plumber Or (As Fitter ❑ Plumber /;—� Z-5-/ Gr>&fitter License Number ffrK4aster ❑ Journeyman Date ....7 ..... �.o ...... 1. la 1= TOWN OF NORTH ANDOVER PERMIT FOR WIRING (I, cul This certifies that ?....... .';r .7 . 9 . .......... has permission to perform wiring in the building of... ......... S -y ............ . North Andover, Mass. FeeJ 6'Q9 ...e .................... T Lic. NO qQ.............. CIT"O**R'* LECTRICALINSPE F WHITE: Applicant CANARY: Building Dept. PINK: Treasurer _ - -- of`!Vf ^GCi7L'Sefts 'Ile ,,,,,r Dt^cr;menr of �'.�blic Sa P`••u :-0. �.. r -� pp BOARD OF FIRE PREVENTioN RECULA NS�Sl7 CMR 1200 occuwncT S ;ee C+eeked V� /� "� Ti a 3/90 ttt,.e blank) �i�-� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR All work to be performed 1n accordance with the Massachusetts Electrical Code. S27 04R 12:40 (PLE.4SG PRINT IN L'Ig OR J� INFORMATION) Date City or Toon of The undersigned appli�jE'�- TO the Zn.:pector of wires: es for a permit to pe -01 electrical work described below. LccaC on (Street & Number) � r) C �� li S� Owner or Ienant �GtV� A Owner's Address Is tl"5 permit in conjunction with a building permit: ' Purpose of Building Yes' ❑ No * (Check' Appropriate Box) Utility Authori: atian NO. Existing Service Amps / Vo -------_lts Ov�_headA a New a 7,...g^: ❑ No. oc N.eters Se: rice Asps / Volts r Overhead ❑ Undgrd ❑ No. o_' Meters Number of Feeders and Actpaeity Location and Nature of Proposed Electrical work � UC \j ak, No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting FixturesSwimming ( Pool Above In- grad. ❑ grnd. ❑ KVA Generators No. of Receptacle Outlets No. of Oil Burners IOTA No. of Lmergency Lighting No of Switch Outlet Batte=r UnitsNo. ( of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond, local tons No. of Detection and No. of Disposals No. Heat Total Total Initiating Devices of Putcos Tons RW No. of Sounding Devices No. of Dishwashers Space/Area Heating RW No. of Self Contained No, of Dryers Heating Devices Detection /Sounding Devices Municipal g Local ❑ Connection❑ Other No. of water Heaters KVNo of Sig Low Voltage No. Hydro Massage Tubs s Ballasts Wiri nzz No. of Motors local HP OMER: Alarr, Installation. INSURANCE COVERAGE; Pursuant to the requirements of Massachusetts General Laws Z have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO C3 have submitted valid proof of same to this office: If you have checked YES, please indicate the type of coverage by checking the appropriate No box. �� BOND ❑ t ❑ (Please Specify) Estimated Value of Electrical work S `� Expiration Dace Work to Start Inspection Date Requested: Rough 8 Final Signed under the penalties of perjury: FIRM NAME A-4 n LIC. N0. Licensee Richard Sampson Signature C. N0. 000090 Address�Central Street'. Arlington, MA 02174 Bus• re . No. 617-641"—' e OWNER'S INSURANCE wAI�%E ZAlt. Tel. No._ 617-648-7200 +: I am aware that the Licensee does not have the insurance coverage or its sub- scancial equivalent as required by Massachusetts General Laws, and chat my signature on this permit application waives this requirement. Owner Agent (Please check one) e_ (Si�gnature of Owner or Agenc) Telephone No. PMIII FEE S v �� I ,f > > N m n ►v r n n m m _ X o 0 N Z Z>" '' n V) E �v> -4 O o > Z m z z r- r, � m-- m cn cn r > c � >> C/)m r 3� Nr -� CA m'U3 _2 �n = m fn cn _7-� O 3 -i O f?o r tai a 17 Oo > Z n n 3" M N ;C 3 C/)f7 t- (n c � ZZ n ,O r z o -{ cn n CT " +> C Z" n u, co > nm N F-+ •-� C _i Sig Btu Ln z N C) m n o n = 2 'n ^' = m > '-' 0 ry m m V) 9 cn m v -+ O mZ m m - r c�nmC - M. r o v m O D 3 Or � -I 3 o C-1)� O o D z r" mM 00 T o cn z n D �-+ � 70 m m> c(n �o --q n Z > �O p 0=0 n V Z = 0% w n t" a `n " m �+�• Signature Location No. 8 Date"__ HORTN TOWN OF NORTH ANDOVEM A Certificate of Occupancy $ Building/Frame Permit Fee $ Z !� 0 Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $f Water Connection Fee $ TOTAL $ G-�wilding Inspector Div. Public Works Location 'No. Z Date 0 = f� I M°"TMTOWN OF NORTH ANDOVEF j O O0 . ' „ Y. Certificate of Occupancy $ * { Building/Frame Permit Fee $ cMF undation P rmit Fee $ s�USE f frPermit Fee $ Z_ Sewer Connection Fee $ _ Water Connection Fee $ TOTAL $ Buildind Inspector c� t 9 3 q- S Div. Public Works Location 3�Tl`tCSf" S-" No. Date NORTH TOWN OF NORTH ANDOVER Of • • OOA O? ' p Certificate of Occupancy $ SC `g Buildin /Frame Permit Fee $ r�1 tN�iM • 4 + 71 �D�+ns •A't� 1SSACNUSE�� Foundation Permit Fee $ 0o — ' Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ C i �� 3J� �j Building Inspector 10724/95 11:55 150.00 PAID 2, 3 5 Div. Public Works 'on 37� ' .o rJ J T 5� 4 3 i o. `a Z b Date of'401mj 1 TOWN OF NORTH ANDOVEF t p Certificate of Occupancy $ Building/Frame Permit Fee $ * 4160 Foundation Permit Fee $ CHU * Other Permit Fee $ A/0 955 Sewer Connection Fee $ • j : O�p Water Connection Fee $ /077.50 TOTAL $ ` it g ct r` 11000.00 PAID / ,r Div Pu lic Works PER.AfIT NO. G ' 4�V APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. 95CLOT ZONE R NO. SUB DIV'. LOT NO. 2 RECORD OF OWNERSHIP DATE %�12 a o - 1w (BOOK ;PAGE LOCATION r✓ �"`��`T �+� J PURPOSE OF BUILDINfa®4C F1�M1 Dy E L j r4 �e ��1 V+ OWNER'S NAMEo&va> � „_ I v_I NO. OF STORIES n b, -M , SIZE ��J��C%y�� OWNER'S ADDRESS /1' S- . _ I� ^ 1`lA'�jej BASEMENT OR SLABL�SF.,� ARCHITECT'S NAMEI=4& t�a�- �_ !'-•'► SIZE OF FLOOR TIMBERS 1STzx (o 2ND zx Ib BfID=�iTICp d BUILDER'S NAME SPANV���1�' DISTANCE TO NEAREST BUILDING �C> > •/ DIMENSIONS OF SILLS 2 - -( co i`i DISTANCE FROM STREET �s � ` POSTS 72 4 f DISTANCE FROM LOT LINES - SIDES25.� 1. EAR 46':± LL.• `D "" GIRDERS 3'Z x 12I� ✓� AREA OF LOT G I/�•�.s.c FRONTAGE i'ZI1 J V`/i�., 1� L CL_ HEIGHT OF FOUNDATION tib \LI THICKNESS 'QIY L� IS BUILDING NEW SIZE OF FOOTING 2� I) Y `/ X 1r1 IcoilQ u6uS IS BUILDING ADDITIONt-4/` f�� MATERSAL OF CHIMNEY IS BUILDING ALTERATION N_ e w IS BUILDING ON SOLID OR FILLED LAND h WILL BUILDING CONFORM TO REQUIREMENTS OF CODE "IfC^ `•7 IS BUILDING CONNECTED TO TOWN WATER '(VEs 1�/FlS BOARD OF APPEALS ACTION. IF ANY � s IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE £S INSTRUCTIONS g9'S X09'-0� R FOUNDATl01 ONLY SEE BOTH SIDES PERMIT FO PAGE I FILL OUT SECTIONS 1 - 3 REGULATED BY PARA. 114.8-S. B.C. PAGE 2 FILL OUT SECTIONS I - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING DATE 1()�FEE PAID I ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED Lo Z-3 OCT 23 NG DATE: — FEE PAID: 3 PROPERTY INFORMATION LAND COST d EST. BLDG. COS EST. BLDG. COST PER SQ. r EST. BLDG. COST PER ROOM p SEPTIC PERMIT NO. _ y �br. 4 APPROVED BY � L�INo INSPscroe OWNER TEL. A 5v8 -725 �03d ONTR. TEL. # 503'725' 3(03Ca CONTR. LIC. N d5� 321 H.I.C. # '� Qfi3� CZoil•�v) ��'�,� � 928 BUILDING RECORD 1 OCCUPANCY 12 ' SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE PINE E 1 2 13 CONCRETE BL'K. BRICK OR STONE HARDW D _ PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL 1/1 '/t 1/1 FIN. B M'T' AREA FIN. ATTIC AREA NO B M T FIRE PLACES j HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE 8 1 2 �_ 3 _ DROP SIDING WOOD SHINGLES EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDN'J'D COMMON ASPH. TILE STUCCO ON MASONRY fM ?It% STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME _ O WIRING CONC. OR CINDER ELK. STONE ON MASONRY STONE ON FRAME SUPERIOR r POOR 1_ ADEQUATE I NONE 10 PLUMBING 5 ROOF GABLE HIP BATH 3 FIX. GAMBREL MANSARD TOILET RM. (2 FIX.)I j. FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK T_ SLATE NO PLUMBING _ TAR 8 GRAVEL ALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 4 FIX T 6 FRAMING WOOD JOIST 11 HEATING PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. 3 COLS. WOOD RAFTERS HOT W'T'R OR VAPOR AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd _ 1st 3rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. d v, y d C `C H Cl) 10 0 CD MZ y CD r o 0• � CD v CD O Q W CD CD O CD C OCD y �• d O y O I Cc CD � v CA o � Z CD o CD 0 CCD O ALJ' � :I I'm AM C O r O N 0 N Q �O m �m cW y C'7 c0f CO z� 1 m . z � rm O � (, 0 rn m N "qO �mm O m -� a O .00 o'O=� Gy O o x r -� C n a 0 CA O 0� N z C � o �y a [L' H C/Ic�7 ? V J N _ m y c d CD co, j(r Yr r O N 0 N Q �O m �m y y C'7 c0f CO v: n 1 m . z � a 0 O � (, 0 rn m N r O N 0 N Q �O m �m y C'7 c0f CO m 3 ='- CD o n arc T C" "0 O ? a •.• a o T rn m N "qO �mm O m -� a O .00 o'O=� Gy O o x r -� a 0 CA �0a_ N cc CL o CD CD m 1 d CDP CD [L' d N aW:cr W_ _ m y c d CD co, j(r Yr Cf O ..r CD O N .r o CD ? _ CD N cm a CC," d 0: Ooh; co __ 3o °- ro d 0 Ix °= X T y ='- rp o n arc T C" "0 O °= o T P -W z � °= C C. ai C7 7cn � d n y o O x Gy O o x r N W Z 0 c CDol a FORM U - LOT RFJ EASE 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 local or state law, regulations or requirements. ****************Applicant fills out.this section********ee********* %/ APPLICANT: D,L1�l �D tnn �0 euLzar,l� Phone 725 3CpSrD LOCATION: Assessor's Map Number MA 1 w67 4t Parcel Subdivision Lots) 3 Street cks-T4tiq 'sq St. Number '37 ************************Official Use Only************************ RECOMMEND TI NS O TO AGENTS: Conservation Administrator Comments - �c�w �cc,'s� QL d�c;y�-`f�+Vi .�_kq a1 Q Town Planner Comments 2 a � %cue f Date Approved Date Rejected otws5 0, ifs. qTe-., I;, z Date Approved !R11,1W Date Rejected Date Approved Food Inspector -Health Date Rejected DateAwed Septic Inspector -Health Date Rejected Comments Public Works - sewer/water connections J'� - driveway permit/ Fire Department ZI""-. Received by Building Inspector OCT ? 3 Date 2' ALL NDN -PAVED plSTl!RB AND S£E DED£D Ai. -3. ALL WORK S ANDOVER W HALL F CONFORM TL D.P,JTANDARDS, PR£MlS£�SSORS 'MAf7 ,¢`59 ! OT FRONT 20' PARE IONS -D WNIc t SIDE AND S0' REAR 229 ♦ 75,0117 ,9—pq ft ry -5 f+�'` 1. j2 �es N J {' 4" tS , a t 4.+ 4 220.1 - 6 1�\ 'v"2 Y✓ryJ' t i � \ \ \\t % 227.2 90 �t x 7 w ,4t-•• /'i , s � •tire .. S' ! x 228 - .�� x 228.9 N f/AG TMA/E,e fr J-� •' 1X 22&7 , V n,• '(2270.* , 231.8 + x 228.8�r C,0 en:' ,•l '' , �,'at \ ..1{ t a t • y�....: ° + X'229.:, 231 0 V I ,e DD w••�+ iE r \ k \l 'L.Q 73. %x227 G, O�EO r(jo I` /E T ERR E • � ` . -� �� Q , �,��,�� ; ti no 17- x :2 26, 7o..0 -G 3t; ! ( {��*�g_,��! t r t Nnt. 9 • w- 2ze �f `, 224.2 22& 7,230. 6 r 224. 0 t � s ..� liiV ay TECy; y dYf� + 2' ALL NDN -PAVED plSTl!RB AND S£E DED£D Ai. -3. ALL WORK S ANDOVER W HALL F CONFORM TL D.P,JTANDARDS, PR£MlS£�SSORS 'MAf7 ,¢`59 ! OT FRONT 20' PARE IONS -D WNIc t SIDE AND S0' REAR 229 ♦ 75,0117 ,9—pq ft ry -5 f+�'` 1. j2 �es N J {' 4" tS , a t 4.+ 4 220.1 - 6 1�\ 'v"2 Y✓ryJ' t i � \ \ \\t % 227.2 90 �t x 7 w ,4t-•• /'i , s � •tire .. S' ! x 228 - .�� x 228.9 N f/AG TMA/E,e fr J-� •' 1X 22&7 , V n,• '(2270.* , 231.8 + x 228.8�r C,0 en:' ,•l '' , �,'at \ ..1{ t a t • y�....: ° + X'229.:, 231 0 V I ,e DD w••�+ iE r \ k \l 'L.Q 73. %x227 G, O�EO r(jo I` /E T ERR E • � ` . -� �� Q , �,��,�� ; ti no 17- x :2 26, 7o..0 -G 3t; ! ( {��*�g_,��! t r t Nnt. 9 • w- 2ze �f `, 224.2 22& 7,230. 6 r 224. 0 t Of NORTH, t Director ,, m Town of ' NORTH ANDOVER BUILDING A CONSERVATION @SAONU9E4 DIVISION OF, PLANNING PLANNING & COMMUNITY DEVELOPMENT CHIMNEY APPLICATION AND PERMIT DATE LOCATION OWNER'S NAME BUILDER'S NAME (( I MASON'S NAME i I MASON'S TELEPHONE 1 i ?> �q2 MATERIAL OF CHIMNEY &121 C., - INTERIOR CHIMNEY EXTERIOR CHIMNEY P s , 0- 120 Main Street, 01845 PERMIT # �.C_. NUMBER AND SIZE OF FLUES I Fle1�') L 7-'e (y THICKNESS OF HEARTH /o tr Will chimney or fireplace conform to requirements of the code and have rulers and regulations been received: V 5 DATE P/- !L— fG SIGNATURE OF MASON CONTR. LIC. # D �p EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED FEE ROBERT NICETTA, BUILDING INSPECTOR 'VAI, 2l 6t INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES w A6 .d .14 lQ r-� U Q CD CD C -711- O _ CD cc i _ o 0 CD ti CL 0 C CD O q \9 CO m m � Q _ o ® o cjo Q �Q cc a. O M Cc V J 1 `Q 00 y � CD C O Q V W cc C C•` eta � CL c J Date./.�: j....D(....... p•/..o ,e. �O TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION This certifies that (,..<<. .r ... �!�.. �� .............. has permission for gas installation .. 1. l ?............. in the buildings of .... !� . / �. �Xlli......................... at .. 3.. ?... ..:w ................. , North Andover, Mass. Fee.. .` :. Lic. No..& :. ..... �4, ...... ..... . GAS INSPECTOR Check # 4226 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date0 '-.L- NORTH ZNORTH ANDOVER, MASSACHUSETTS Building Locations [^ST �Ui 5r� Permit # Amount $ � 6 Owner's Name � �'�i 7�,n-( New Renovation Replacement Plans Submitted (Print or type) one: Certificate Installing Company Corp. 1-l'a G Address (1 0 biC 1-701 ElPartner. Business Telephone Finn/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 M please cate 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 A 1 nereby certrly that all of the details and intormabon 1 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 States Codr and CbAter 142 of the General Laws. VED (OFFICE USE ONLY) ,Signatum-of Licensed Plumber Or Gas Fitter [ff Plumber 9 L1,11-- 0 Gas Fitter License Number 01"Master ciJourneyman 1 1 YAM - ----------------�-�__ FLOOR ---------_�--______-_ 1 1 (Print or type) one: Certificate Installing Company Corp. 1-l'a G Address (1 0 biC 1-701 ElPartner. Business Telephone Finn/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 M please cate 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 A 1 nereby certrly that all of the details and intormabon 1 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 States Codr and CbAter 142 of the General Laws. VED (OFFICE USE ONLY) ,Signatum-of Licensed Plumber Or Gas Fitter [ff Plumber 9 L1,11-- 0 Gas Fitter License Number 01"Master ciJourneyman