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Miscellaneous - 37 PEMBROOK ROAD 4/30/2018
,r 475 Co.,�.o ,� •moo (.-.. A Date ....... '?• . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING _ JSACMUSE� -� v This certifies that ...... `` `^ .. ... �... ? ............ has permission to perform .....--. ....:............. . plumbing in the buildings of .-.r7 ..... 'd ^ ..................... . at ... !.... ....... ,North Andover, Massa Fee�/`:S .. Lic. No <.:'..... <� :�* r._ PWMBING�I'NSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MAP � � TS UNIFORM APPLICATION FOXPEIT ISO PLUMBING (Type or flhtgCEL , -0'o NORI O _ '/ ,� Owners Name -SNDate D Building Location 3 / &,,j ra0A( l� ` //Q �9 Permit # Ci Amount Type of Occupancy New ® Renovation Replacement ® Plans Submitted Yes ® No FIXTURES (Print or type) Installing Company Address or f. Name of Licensed Plumber. -�- 6 Insurance Coverage: Indicate the type Liability insurance policy -e //; /)� Check one: Corp. 'e Partner. 0�um/Co finsurance coverage by c1kcki Other type of indemnity ell the appropriate box: Bond Certificate Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance 1 Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations Eed under Permit Issued fo �the lication will be incompliance with all pertinent provisions of the hus State Code and C pt 1 eneral Laws. By: grialure or Eice um er Type ofPlu ing License Title ' City/Town ick um er Master Joumeyman APPROVED (OFFICE USE ONLY • (Print or type) Installing Company Address or f. Name of Licensed Plumber. -�- 6 Insurance Coverage: Indicate the type Liability insurance policy -e //; /)� Check one: Corp. 'e Partner. 0�um/Co finsurance coverage by c1kcki Other type of indemnity ell the appropriate box: Bond Certificate Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance 1 Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations Eed under Permit Issued fo �the lication will be incompliance with all pertinent provisions of the hus State Code and C pt 1 eneral Laws. By: grialure or Eice um er Type ofPlu ing License Title ' City/Town ick um er Master Joumeyman APPROVED (OFFICE USE ONLY Na 1940 Date...... ' ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... )* ......... .................... has permission to perform ......... 7 ...... 2 wiring in the building Of . . . ....................................... ......... ............................................... . North Andover, Mass. Fee ..Z..:`.`........ Lic. N0" . ............. ............................................................... tl ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Y Office u.. onty -__ The Commonwealth of Massachusetts_ -:, :.r:` ►!lift !IO. Department of Public Safety -r r occupancy & Fee Imacked ' BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 heave !,lank) APPLICATION FOR. PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Mossachusertt Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR ����TYr�PE INF 'ION) Date O 4 Ap City or Town of /C/, (� o� To the Inspector oi Wires: The undersigned applies for a permit to perform he a ectrical work de cribed below. Location (Street & Number) Owner or Tenant Vi /U 6wiv Owner's Address V t Is this permit in conjunction with wilding rmit: Yes IT No ❑ (Check Appropriate Box) Purpose of Building r �GC'� Utility Authorization NO. Existing Service Amps 224 /-" o Volts Overhead ndgrd ❑ No. of Meters New Se�e fl/�L Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work �4 No. of Lighting OutlettX Outletd No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures Swimming Pool Above In- grnd. ® grnd. ❑ Generators KVA No. of Receptacle Outlets b No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices � Municipal ❑Other Connection No. of Ranges No. of Air Cond. Total tons No. of Disposals No. of Heat Total Total -pumps KW No. of Dishwashers Space/Area Heating KW dh No. of Dryers Heating Devices KWLocal No. of Water Heaters No, of Ballasts Signs Low VoltageWirng d No. Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE! Pursuant to the requirements of Massachusetts General Laws I have a currentLi lit Insurance Policy including Completed Operations Coverage or iss•+subsstantial equivalent. YES O [J I have submitted valid proof of same to this office. YES Q2r' NO l If you have checked YES, please indicate the type coverage b checking app opriate box. INSURANCE OND ❑ OTHER ❑ (Please Specify G , C. 41 Apq Estimated Value of Ele trical Work $ S xpir tion ate Work to Start Inspection Date Requested: Rough & /�.XkFinal Signed under t e p a ies of perjury: FIRM NAME / l_ �'� G/��+ LIC. NO.. %J��� Licensee iC�� _ Signature LIC. NO. Address �".-v C/ Bus. Tel. No. �6/-7 Tip y 46-22 Alt. Tel. No. OWNER'S INSURANCE WAIVERt I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts Generalawl s, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent Z 070 627 410 ,M -e fj b t eo K US Postal Service F eceipt for Certified Mail No Insurance Coverage Provided. Db not use for International Mail (See reverse) Sent to �';Am CaM 6t) ( Street ; N w eM t 1 K S+ Postc' tate, & ZIPS ;JX O Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee LO rn Return Receipt Showing to T Whom & Date Delivered Q Return Receipt Stowing to Whom, Q Date, & Addressee's Address 0 TOTAL Postage & Fees $ M Postmark or Date (L C a (JGAOU)»ev`pEags - D \ §,§ rs - CD kk{CD \ E_■ E CIT, UO { /� \\ .\/ t\\ .E //\ �� �- _ «« \) tf§ _ /ƒk�\f�\\\E6 * / 92 -« ■0 - �U) ® -! -_ o kms{ § -k/2 kc a .§f , \ E a�f§ 2) ; ©&\\ 2\\f ; - QwA§ 'k \ - §{]§f}iQ t5 Lu ;k 15 O' }f) §2 \k/% �� f, -_ �©o {( _ �§ §y,� }§ -- a� 2_ E \ $ Z ]0Ke s _ 2§ {0 �; ) ))5 k) ■&{■ ® i@( (a cc } e »=E/$E ƒ3 2{ 2§} w/ w§1� �§ a■ 6 Town of North Andover; OFFICE OF COMMUNITY 'DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 w1LLLAM J. SCOTT Director (978)688-9531 John Q. Campbell DBA JBC Construction 15 Milk St. Methuen, MA 01844 March 14, 2000 Dear Mr. Campbell, O O ,p Fax(978)688-9542 Please be advised that this department has received a complaint in regards to a permit obtained by you for work to be conducted at 37 Pembrook Rd. North Andover, MA The homeowner is very concerned about your failure to complete this project in a timely manner, and your failure to return their phone calls as well as your failure to return my phone call. Please be advised that this is unacceptable and prohibited under the home improvement registration and will not be tolerated. This department will be forwarding your name and registration to the State Board of Building Regulations and Standards if this matter is not resolved within 72 hours of receipt of this letter. I may be reached between the hours of 8:30 — 10:00 AM and 1:00 — 2:00 PM Monday through Friday. Respectfully, ichael McGuire Local Building Inspector cc: file Homeowner BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ug cl m -n EyC u t- myour RETURN ADDRESS completed mthe reverse side? w C — tJ � �§\a \Q}2- T % 2 5 a ,cD a) | �_ (@!\-'-}\\ m CD k�;! 710 & . \ / f / (/ 33 3 3 .. $ G _� 4 BL % CD } \\ ` ƒ -� Dw aLV _7 / R % ® \ a aL. = ia / e } 3 2 �3 { | ƒ - $ ■ }0 , \ _ ! C !g / r } tCL_ ( / i @ 9 O o E $ § ƒ 2 2 (J C « (-D' » &§ ( t a \ § a \ / #. _ kS =U) - CD _ «[ _ 2)Kc/-)§ = > \E -R f a- COZn ƒ O E $S CD ƒ2 «£ § in =r \ CD / Cn . _ k\ �\ / ] E []I&, \ \ j \ ( E § / 2 ` E » — & 0 2 $ ) ; 7_ \ k _ % (� \ Cr ^\ 0 E 9_k you for using mturnmc M Service. X�� b ra ce- dr r I se - m de r rlS c ldse-4 ra t4lo 1" - St r1 c 1-renck lolye,-1 himc �o 6 /Y) 5 �lc V's 0.0 c CA&LuEts n6l� COM/ok-le(I Lct-/4, -�+ s -:° r S -4d rz, rr- --) C/I\ j 9 C) CI(I Ll 17,s - so -) X00:00 C CC,),s 0,4 WA o If �/L ;3-A- C- SIJI L) A� � �s v�`�� /� IMPORTANT MESSAGE FOR A. M. DAT TIME P.M. M OF- PHONE F PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH . RETURNED YOUR CAL4. WILL FAX TO YOU <<I I A / �. pj ma wn G -N ED 48005 LITHO IN U.S.A. Location No. s-3 6 5— Date R//,3 S NOR7h TOWN OF NORTH ANDOVER a p Certificate of Occupancy $ Building/Frame Permit Fee $ CNUSE<�' Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 9� -- TOTAL $ Building Inspector 3 3 10016/99 14:31 195.00 PAID Div. Public Works t 2 � M � z i y 5 F W v FSI Or� x x � -x W O z c c i z z X y — C ,f W C C � tl O Ucr - — Z c G Ys• L O w O z U z U - C i y 5 F W v FSI Or� FSI O z c c i — C ,f W C C � tl Ucr - Z i y 5 F W v z c c i — C ,f W C C � tl - Z c Ys• L - i y 5 rn O F W v rn O 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. *****************�**'r****"APPLICANT FILLS OUT THIS SECTION******"******" APPLICANT fyLKS, I t -U) S"klll1ffid . PHONE LOCATION: Assessor's Map Number PARCEL 53 SUBDIVISION LOT (S) STREET �L&bb D J ST. NUMBER—3 rl USE ONLY*********a-7 ;*X*3& RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED - COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED _ COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT. RECEIVED BY BUILDING INSPECTOR Revised 9197 jm TE 07/26/99 10:56 FAX 508 6889556 IN TOO'd 6C09'ON MAL 0:01 Q001 T% T ',zr L-Itr, 8 * Cit'l 5301 -d --A) P'fH-*7 fr3K-ID wJtzr. of 666 T, , CSF * -11,1.c i 1 CJ�1 N w � I � v � C° S "j) QP V 3 �� a ry4 yo t N 0 s Z Q J a. W W � SEE LAT n 00 L LU �., W- Cl) F C Z OZ M oO Q .0 O O O Ia m _ U. N ' O Z -o co uj dt t -�- - U W II pp d' O = = Z `+ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print aticn: Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �Tr 1 I am an employerprovidingworkers' compensation for my employees working on this job. l CCoomoanv name Address / (aCel'"�C�e�✓t� City: 10 �'l A(g0c Phcne # Insurance Co (moi lj Policv # ne Ci Phone #: Insurance Co. Policy-:!! Failure to secure coverace as required under Section 25A or MGL 152 can lead to the imposition of cnminal penalties of a fine uo to 51,5C0.00 and/or one years' imonsonment as we!! as civil penalties in the form of a STOP WORK ORDEF and a rine of (S,00.0 . 0 . ) a day against me. I understand that a copy of this statement may be forwarced to the Office of Investigations of the DIA for ccverace verfcation. I do hereby cert tv under the tains and pe lues of pejury that the information provided above is true and correct. / SignatureDate / Print Mme 6 e P h c n e # �� � �d 3� Official use only do not write in this area to be completed by city or town ,, ic!ai City or Town Permit/Licensing Building Dept ❑CI,eck ,-f immediate response is required ❑ Licensing Board ❑ selectman's Office Contac: person: Phone #: ❑ Health Department 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 disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: ,5 CJ e P - 14 r (Location of Facility) Signatureof Permit Applicant Date NOTE: Demolition permit from the Town of North And must be obtained for this project through the Office of the Building Inspector (y) 0 z x �¢ O d cOA .c O w T C/)o v V) u O w O r� v E r U m C u: CG O U w C7 ] a+ on p a; m C w � O 1-4 w w W p a: y cn is C w O v' O u: in C ii w Q w a w z cn ° ---,4 E u) o m c o � c ` O N ' O V V O. d C m l0 0:CD O O � Ea a' c �. m -: E c C m 0 0 m C CL= zi o z' 3 N at m J C � � T O'fl N N �►:�: �: av `m isttym> CcO C y Q d C L i 00 Jy O v c o m N m C = U CL m m� G H O ++ N m �.. W C O=..'flt ui ccr.. � •N d t A C p •-. LU Q u m m CO2a m - O .O = ca A 0 H = �- s CL� m Q L U CD O CD 0 Z f -J y Co .E CD L co L C C) co v CL y O 0 H C CO) 5 L O V CD C. CO2 C CO Q, c o c 0 m Co 0 CD H =_ ca co L O a' Q Q� 4 � C O O O CD Z co Q. y C LLI 0 U) Cc LLILU LliW ul i C� 11 �3 �,Iry Cf� Oxy r c. Ls� C� �3 �,Iry Cf� ME I -L La" TV D cl, -)n X096- yea LO 0 O G! U z M Eb Up 2 n~� CL 2 Q -2� t-0 El w 0 nn� (! h 0 9 cm to M.�:.EZ—.y9 $ 94.68 � 52._3•—`�� � O 0 rm�nmrs.^t:+m�rcet_heetsx� .•.w�•�•�• 0 m � H Q m co tu W o H 4 v O HN CD} O� 19 O N tTs p da O L/J h S r d O Z _17 3 -7 "a li G� Location 0� Nb. r '7,1 cla Date NpRTIJ TOWN OF NORTH ANDOVER Certificate of Occupancy $ • ; ; Building/Frame Permit Fee $� Gu E<�' s�cHus Foundation Permit Fee $ i Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ C zp t uilding I spector 1274 () Y' /98 09:t"ri.r Div. Public Works Location `N6, t/J c Date t . _. ,►oRT� . TOWN OF NORTH ANDOVER 3 97 0 A Certificate of Occupancy $ • ; ; Building/Frame Permit Fee sACMUS Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ IJ TOTAL $ > j�' I' Building Inspector 08/14/98 09:04 292.00 DnTtt �• / Div. Public Works N N u z 1 L) L.. El N u,/ W z 7. F O s � o ct Z z g - N z N _ y - � uj 1 S V TC N Z ` N z z s y N N u z 1 L) L.. El N u,/ W z 7. F O o V Z z - uj 1 S � W � IQ z s y Q W uj Z _ 3 < W W W V1 WUJ "'► � V') - uj 1 � W � IQ Q W uj Z WUJ 5_ ui pc Z 7 m F E 7 te M" C H 9n � V7 l w < 0 Ln J F ! C s z o W L 0 O z i� 3 O N coo Am O ' aC% L o a ymCO c c* N aka== W CO fir=.. Cw r V N Z O O cc E v v y v m o cm o V4 d m .5 O 10 H _ �p =,a .0 O ,m OWZ H o c� A z z u z Q a o clj o c W c o o o w w ocz w o u: u: chi c� u". W cn cn 3 O N coo Am O ' aC% L o a ymCO c c* N aka== W CO fir=.. Cw r V N Z O O E 16- O c* N W CO fir=.. Cw r C/) 7 o cc E v v y v m o cm o V4 d m .5 O 10 H _ �p =,a .0 O ,m E \,O O O � C/) 7 o W pU v c 4 m cmw C� vs O cn -E m m co 0 CD = O.0 3 .o CO CD O i cvv o a y C oCc �Zco 0 CL C D coo m C CL H 0 O z cz ►5 ui om 0 d. p H a � N m C x a 79:5 .O o .y C � Q 7 v N O Z 0 v o:2 O� a x Ca =tea. 0 o w w x z w a r z Q v � A O,� a ¢ w ° L co � c w x a ;tov w $ CL o o c w o a w o w o c w E chi w w c� w chi rx m cn U) ui om 0 d. p H a m N m C 79:5 .O o .y C � Q 7 v N O Z ui om CO CM I LM :2 m m .O O CD � O � C� CDCJ L CC O a c cCc c co C Zts CD CL ) V� � C c .y D 0 d. p H a m N m C 79:5 o .y = C 7 a o:2 O� a x Ca =tea. •`•`o -m CO CM I LM :2 m m .O O CD � O � C� CDCJ L CC O a c cCc c co C Zts CD CL ) V� � C c .y D �' � �%e 1�an>rnzo�uuea�c o�:/L%aaaac%uaelta DEP,PRTMENI Of PUBLIC SAFELY CONS -jR0CjjON'SUp[RyjSOR LICENSE Nu+iber Expires: Birthdate �$ � 463604 •:,> 10/30/1998 10/30/1911 ' Reslric�ted I�.N 00 '` JOT�N 0 CAMPBELL ASHMONT STREET MELROSE, MA 02176 Registration .123359 Type - DBA Expiration 02/05/99 JBC CONSTRUCTION JOHN 0. CAMPBELL 61 CRESCENT AVE f ADMINISTRATOR LROSE MA 02176 MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 CITY: Middleton STATE: Massachusetts HDD: 6063 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 8=3-1998 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 103 Your Home = 102 t i t Permit # t Checked by/Date t t Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------- CEILINGS 660 30.0 0.-.0 23 WALLS: Wood Frame, 16" O.C. 381 15.0 3.0 25 GLAZING: Windows or Doors 103 0.350 36 DOORS 18 '0.350 6 DOORS 34 0.350 12 HVAC EFFICIENCY: Boiler, 96.0 AFUE -------------- ----------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building pians, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The -HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and .14.4. Builder/Designer Date r.. MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 8-3-1998 Bldg.; Dept.; Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C., R-15 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U -value: 0.35 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U -value: 0.35 Comments/Location [ ] 2. U -value: 0.35 Comments/Location HVAC EQUIPMENT EFFICIENCY: [ ] 1. Boiler, 96.0 AFUE or higher Make and Model Number THERMOSTATS: [ ] ; Adjustable thermostats required for each HVAC system. AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. ' VAPOR RETARDER: [ ] Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] ; Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: ] All ducts must be sealed with mastic and fibrous backing tape. Pressure -sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. I TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified, in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- 4 G . _ -rj Ct 00 1 CIO 70 you 5 e TT WI MA ft A I-- � � 1 V ry t --- 43- V � \ a 1 c I-- ry --- 43- a .r VI I-- S --- 43- I-- FORD U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from 1 Boards and Departments having jurisdiction have been obtained. This does not relieve —1 the applicant and/or landowner from compliance with any applicable or requirements. cl— FILLS OUT THIS SECTION APPLICANT PHONE J OC1 LOCATION: Assessor's Map Number PARCEL SUBDIVIS N LOT (S) STREET ' ST. NUMBERa *************OFFICIAL USE ONLY*** J .� RECO ND_ATIONS OF T01 ILC NS R ND ADMINISTRATOR COMMENTS 6 AGENTS: 4 ` DATE APPROVED DATE- REJECTED. /1, l 6 b TOWN PLANNER DATE APPROVED rJ� DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR - DATE :� d w •"` r. I WWF r S J "4 { •j� L 07- 0 -90 -*'-14 of -*'-14 �OCtIOn = // e , -- No r Date °R'M, TOWN OF NORTH ANDOVER .oyt,�.o ..• do _ ,. Certificate of Occupancy $ + Building/Frame Permit Fee $ '� s """' E Foundafion Permit Fee $ � t Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 4` OTAL $ !0 97 13:51 BgtdiRB InpRpgtor is —10971 Div. Public Works,. a al \�Wo O u W �. 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't� �\. ..�/> .. r � � �/[ (LGLCIdPG[O jh DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Huber: Expires: Birthdate CS_ `063604 10/30/1948 10/30/1971 f, Resr`icted 1`0� 00 x 39 A 0 CAMPBELL '39 SHMONI STREET MELROSE, MA 02176 Registration .123359 Type - OBA Expiration 02/05/99 JBC CONSTRUCTION JOHN Q. CAMPBELL 2g6�1 CRESCENT AVE ADMINISTRATOR 19CLROSE. MA 02116 R i N° 2079 Date....�!.ls j... <•`'° : "o TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... �A..L...i( e...S:e.ST. has permission to perform C.. �. f. W . 2 ' ...` ............ ...................... .................... wiring in the building of ..... t.. `� a ..................................................... at .......... 7....r.n... w.c d.... ............ . North Andover, Mass. F Fee. . -.-.w..... Lic. No... �lv ................................................................. ELECTRICAL INSPECTOR `i C\ iQ�:3525.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0 (Please r,�E eara~�urE,r 07ss�rts�-7s a 14;v-dzl- sem, BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only 7 9 Permit No. a6 ` / Occupane/ & Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �`` All work to be performed in accordance with the Massachusetts Electrical Cade 527 CMR 12:00 nt in ink or type all information) Date ` a To the Inspector of res: Town of North Andover The undersianed acolies for a permit to perform the electrical work described below. Location ( Owner or Owners Address-Q� Is this permit in conjunction Purpose of permit Yes C,--' No ❑ (Check Appropriate Box) Existing Service ___/ Amps Y" Volts Itlew Service Amps Volts Number of Feeders and Ampacity 4:->2 V /Olryy �i Location and Nature of Proposed E'.ectrfcal Work r Overhead Overhead Utility Authorization No. Undgmd ❑ No. of Meters Undgmd ❑ No. of Meters OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws � I have a current Liability Insurance Policy includi ompleted Operations Coverage or its substantial equivalent `` NO = have submitted valid proof of same to the Office NO = If you hive checked YES please indicate the type of gPVera checking the appropriate box INSrANCE = BOND = OTHER = (Please Specify) Kf— a (Expiration Date) Estimated Value of El w W rfc Work to Start Ins on Date Resquested `,. o,u h Final Signed under the Penalties f perjury: ��oo��� ')—' < C�� ?a 4 FIRM NAME Wle' .`'el L / t/)�U /, �����7' L1C. NO. Ucansee M%,��c.1 C:o 7z Signature��]� UC. NO. W BAlt Tel. No. 77 `�Q 6 6 7 Address OWNER'S INSURANCE W : I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as'required by Massachusetts General Laws. And that m signature on this permit application waives this requirement. Owner Agent (Please Check one) ,dd Telephone No. PERMIT FEE 5 (Signature of Owner or Agent) Total No. of Light6nq Outlets No. of Hot fuse No. of Transformers KVA Above C In C No. of Lighting Fixtures A# Swimming Pool gmd G gmd ❑ Generators KVA No. of Emergency Ugnting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Svntcn Outlets / No of Gas Burners 1 FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total NN. of Dioosal No. Pumos Tons KW No. of Sounding Devices Nod of Self Contained _f` No. of Dishwashers Soace/Ares Heating KW DetectiorvSounding Devices ❑ Municipal ❑ Other NNof Dryers Heatinq Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Si ns Barlases Winn No. Hvdro Massage Tuds No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws � I have a current Liability Insurance Policy includi ompleted Operations Coverage or its substantial equivalent `` NO = have submitted valid proof of same to the Office NO = If you hive checked YES please indicate the type of gPVera checking the appropriate box INSrANCE = BOND = OTHER = (Please Specify) Kf— a (Expiration Date) Estimated Value of El w W rfc Work to Start Ins on Date Resquested `,. o,u h Final Signed under the Penalties f perjury: ��oo��� ')—' < C�� ?a 4 FIRM NAME Wle' .`'el L / t/)�U /, �����7' L1C. NO. Ucansee M%,��c.1 C:o 7z Signature��]� UC. NO. W BAlt Tel. No. 77 `�Q 6 6 7 Address OWNER'S INSURANCE W : I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as'required by Massachusetts General Laws. And that m signature on this permit application waives this requirement. Owner Agent (Please Check one) ,dd Telephone No. PERMIT FEE 5 (Signature of Owner or Agent) I 3836 Date/� ? TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies thatr/.le . s ... ! ?C !? .......... has permission to perform ... P -40A' A .i................ plumbing in the buildings of .. !�; V. 4.4 < L: ^ ............... . at . 'Q . PC ......... orth Andover, Mass. PLUMBING INSPECTOR 10/15/98 09:35 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer (Type or Print) NORTH ANDOVER ,Ma S. r Oates 'mss t- �C Permit 1 c Replacement (Print or Type) Installing Company Name Plans Sybmitted Business Telephone q F1 31? -7 ((P TOO",/, Name of Licensed Plumber: %��rcw ,/ (O",/, /_/ yU"v 101, r : Check one: Certificate Corp. PartW._ Firm/ Co Insurance Coverage: Indicate the ty e of insurance coverage by checking the appropriate box: Liability insurance policy Other type .of indemnity Q Bond Li Insurance Waiver: I, the undersigned, have been made aware -that the licensee of i ;this application does not have any one of the above three insurance coverages. Signature of owneriagent of property Owner Agents. l butbr Certify Wal all of the dclaJs and infotntalion I have submilicd lot cntctcd) in Am- applicalion site Ime z844 to Iles btst r of k"wicdge Cad Out all plumbing walk and installations l.ct(at nocd under r-41 i( Iuued fat this applk-36" wiN be io pwpWwp riW W rall"M PMI rYis" of"Ma"acbusetls State rlumbiat Code and Cluptct 112 0( the General LAW , , .1 44 By i Title City/Town: i. AD0Qr)VFn 70FFICF USE ONLYI Signatur�f -Licensed Plumber ma of Plumbing License License NumberMaster ci IL Journeymm 6 2 Date. "(..... NORTH TOWN OF NORTH ANDOVER 3? PERMIT FOR GAS INSTALLATION • s This certifies that<9/�.��" f .. ��• • . • • • • • • • • • • has permission for gas installation in the buildings of ... S'z-. E. Z r . L .,-A ........................ at J.. ?.,!e...5�. < c . �� ............ . North Andover, Mass. Fee. Lic. No.,?..Q. !... .......... 10/15/98 09:35 25,00 pAj GASINSPECTO WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING e or print) Date /0 �� 19 J twttTH ANMY VLK, IVJ,�4SSACHUSETTS / Building Locations 37 rc rn a ryy K ("', �— Permit # e7l�� 4' 4 Amount $ aJ � A,� (C") �-U1l Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type Name Address P /,?a x ;7,6'7' Zi6 G A"'P Business Telephone = 3 G Ck-2 Name of Licensed Plumber or Gas Fitter I Check one: Certificate Installing Company ❑ Corp. Partner., Firm/Co. INSURANCE COVERAGE Checkone: 1 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 compliance with all pertinent provisions of the Massachusett to Gas Code an C ter 142 of the Gee 1 aws. 71 _� � / - � o�� Bv: Title `", City/Town 'j, APPROVED (OFFICE USO NLY) S' nature of 1 - ffPt ber Gas Fitter M-,VItster ❑ Journeyman sgo Plumber OrZas itter ense I u ber .� .r 1 z — C� ►� W F N ." — Z C C W p C (Y W '� � � � irJ L ,Z' � '� — � N z W � x '✓,� C C F W r Q U G � Z L z� — :s7 W L— zt w -t -t C C CCZ w F SUB-BASEME NT BASEM ENT IST. FLOOR 2ND. FLOOR 3RD. FLOOR 4T H. F L O O R 5"rH. FLOO R 6T H. F L O O R 7T 11. FLOOR 8•rH. F1,00 R (Print or type Name Address P /,?a x ;7,6'7' Zi6 G A"'P Business Telephone = 3 G Ck-2 Name of Licensed Plumber or Gas Fitter I Check one: Certificate Installing Company ❑ Corp. Partner., Firm/Co. INSURANCE COVERAGE Checkone: 1 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 compliance with all pertinent provisions of the Massachusett to Gas Code an C ter 142 of the Gee 1 aws. 71 _� � / - � o�� Bv: Title `", City/Town 'j, APPROVED (OFFICE USO NLY) S' nature of 1 - ffPt ber Gas Fitter M-,VItster ❑ Journeyman sgo Plumber OrZas itter ense I u ber 9 3287 Dater-. ..!.. / ........ NARTM TOWN OF NORTH ANDOVER p PERMIT FOR GAS INSTALLATION This certifies that ........ r :........ T. . . ............. . has permission for gas installation .. ..." �.................. . in the buildings of -'� ': �-" ..' ................... . � . = L:... , North Andover, Mass. at Fee.'Y Lic. ..... .. ....e c',F. ......... GAS INSPECTOR ej �Ilf WHITE: Applicant CANARY: Building Dept. PINK: Treasurer orprint) txvxtH ANDOVER, MASSACHUSETTS Date 19 Building Locations 3q e Permit # � � f1 _ Amount S Owner's Name 7 Su �/, ;2 �l New ❑ Renovation �� Replacement ❑ Plans Submitted ❑ (Print or Name Address ,'���i�U• fZk/- �7y6 - 9, Business Telephone 7o3G Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. ❑ Partner. D_ri, Co. INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes M/_ No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's,tnsurance 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 herebv certify that all of the details and information I have suhmirted (or entered) in shove annlicarinn 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 Massach�L its State Gas Co)0A Chapter 14?7of4te (;wferal Laws. By: Title City/Town PROVED (OFFICE USE ONLY) Si n e of L/cc�nsed PlumXr Or Gas Fitter / Mas Fitter (cense Numt5er ff-<asler ❑ Journeyman