HomeMy WebLinkAboutMiscellaneous - 38 MONTEIRO WAY 4/30/2018N
O
O
J
Q
Q
Date ..
HORTM
py ao ,e 1ti00
TOWN OF NORTH ANdOVER
PERMIT FOR GAS N' STALLATION
This certifies that .... .'? r L r.. * * ).-..` ..............
has permission for gas installation ..T.� �'. �.:% ...............
in the buildings of ..........................................
at ... .`-'.. X.. . , North Andover, Mass.
Fee . 30 ..... Lic. No. .l (,5.c.. . .... . . f,..t.)) ....... .
GAS INSPECTOfi'
Check # �, r t
64!63
A
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
Mass.
City, Town :+
Buildingj��I
AT: Location --5 W,� 1%
New ❑ Renovation ❑
Plans Submitted Yes ❑ No ❑
Date 2 ' 20 of -
Permit # L. (dei C%
Owner's '
Name
Type of Occupancy:
Soo�
Replacement I
(Print or Type)
Installing Company N
Address
Check One: Certificate
❑ Corp.
❑ Partnership
Ly ,,,ij hl OE 42!� 0/7XGA EI—I-irm/Company
Business Telephone 7 / 2-4 Name of Licens lumber Gasfitter
I hereby certify that all of the details and information I have submitted (or entered) in above a/plication are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. /] Z-7
Signature of Owner/ Agent
I have a current liability insurance policy to include completed operations coverage. ❑
By TYPE LICENSE: A� wzv
Title ❑ Plumber Si ature of Licensed
Plumber or Gasfitter
City/Town ❑ Gasfitter l
APPROVED (OFFICE USE ONLY)
aster
❑ Journeyman License Number
FORM 1243 I-IOBBS & WARREN
p.
............................
��nn�nnnnu�n��nnn�
��mnnnnnnnnnnmr
(Print or Type)
Installing Company N
Address
Check One: Certificate
❑ Corp.
❑ Partnership
Ly ,,,ij hl OE 42!� 0/7XGA EI—I-irm/Company
Business Telephone 7 / 2-4 Name of Licens lumber Gasfitter
I hereby certify that all of the details and information I have submitted (or entered) in above a/plication are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. /] Z-7
Signature of Owner/ Agent
I have a current liability insurance policy to include completed operations coverage. ❑
By TYPE LICENSE: A� wzv
Title ❑ Plumber Si ature of Licensed
Plumber or Gasfitter
City/Town ❑ Gasfitter l
APPROVED (OFFICE USE ONLY)
aster
❑ Journeyman License Number
FORM 1243 I-IOBBS & WARREN
p.
N
m
A
Z
m
N
D
T
m
m
Date. 7 16.0 ,(- .
TOWN OF NORTH -ANDOVER
3r �. �, ... •. dot
PERMIT FOR PLUMBING
0
This certifies that ...�°.
has permission to perform ...�'�` " ` �4 {`` —'
plumbing in the buildings of ...............................:. .
at .... 3!�..�"' ° ' ` �' ' `"` ........ North Andover, Mass.
Fee.3."... Lic.No.. .......-----
PLUMBING INSPECTOR
Check # (34
/7&0
w
It
h1:.SSACHUSc'�"i Ts UNIFORM APPLICATIGN FOR PE��NT TO DO PLUMBING
fprtnt or Ty, r ��
Mass. ..ate - (_�' I -- ~ ':
New nercvzr'cn Yes
FtX: URSS
i I � i ► I
4'7r'. FLOOR
FLOC; I ! ! I !
I
57,14 FLOOR ! I ! !
"K FLOOR
E -H FLOOR
Irs�llln� C.•�fst�ry � - n- , , ,,
AGCress
3usiness Te1•,.tn.ne / %.' r`
i`lifr4e Ct l_lC�� SCG ��%•'�'•=>e� � ��
! t' I I I! i l l i l I► 1! I ! I
� ,/ �%" G�er•.z rne. Cc ��icate
r
INSURANCE CrYEA.:GF,
poiic� _
:.i! e-=vc: ^�
wni_ts t,�'e ; ec :remer�z --f MG_ C.`. 1
i have a axrer't tom: dty � s:.:zn� cr4lis sc:�s�. =v
Yes 'S , No
�. vr.e � ♦ ='vel
It you have cte :iceC ... lease rete ..'x type C< 5y -�nC
A iiabd'c:y frsuranr_ periicf �- C* 'e- type of inCc.^, Witty Gond
0YlN�R'S tNSt.tRA.yCE WAlYER: I am avrare tttiat :t a i�nsee does not ^'ave me irs'.•rarce coverage re uira.` �y
C`s:er 142 of ttse Mass. General _zws, and tfat r:ry uq atc;re an itis pen,H, apollca-on waive .`s re-uiresnert
(:he --x one:
rl-AM•- n aC!&r:t
•at=e of Or or U*"I f s ACOM
/
>sreby �r y t.at ail of dtuais anc starritian I tray* sw,_Vmr•bd c tared) �� aapucation ire true
ase acunta
tticwy�e;a and t. it ail Dwrrscv wuz mnd .:sita5wz �ertcr^�eC � �'se pefmit
dor tRts aO tion will De ir! tr:(u ` 34
pas�inee ; pror sons of tlA Massae UMI -..s State Mw-biN Coda jy"tef S42 of L Gtnecal t iw"�
y;latLt 4 -SI :1cen•
lype Of
• l r� .. V� �"tl license Number —
C.
W 1 Y
r
A<
F'
H
)I
J� Nl
m
A
W
a
t-
<
W
a1 YSI
= �
s I Y
m
O
Q
�
SSa--ssm'.
I
! I
!
( !
!
I�; I !
4 ! ►
! ! ! I i:..,,� �►` i
s.�s_��y-
! I
I i
I
,_1
.S_r-l-OCR
I
! ! ! I I I
'HO FLOOR
! !
I !
!
1
I
I !
!
! I
I ! (
I ! !
!
4'7r'. FLOOR
FLOC; I ! ! I !
I
57,14 FLOOR ! I ! !
"K FLOOR
E -H FLOOR
Irs�llln� C.•�fst�ry � - n- , , ,,
AGCress
3usiness Te1•,.tn.ne / %.' r`
i`lifr4e Ct l_lC�� SCG ��%•'�'•=>e� � ��
! t' I I I! i l l i l I► 1! I ! I
� ,/ �%" G�er•.z rne. Cc ��icate
r
INSURANCE CrYEA.:GF,
poiic� _
:.i! e-=vc: ^�
wni_ts t,�'e ; ec :remer�z --f MG_ C.`. 1
i have a axrer't tom: dty � s:.:zn� cr4lis sc:�s�. =v
Yes 'S , No
�. vr.e � ♦ ='vel
It you have cte :iceC ... lease rete ..'x type C< 5y -�nC
A iiabd'c:y frsuranr_ periicf �- C* 'e- type of inCc.^, Witty Gond
0YlN�R'S tNSt.tRA.yCE WAlYER: I am avrare tttiat :t a i�nsee does not ^'ave me irs'.•rarce coverage re uira.` �y
C`s:er 142 of ttse Mass. General _zws, and tfat r:ry uq atc;re an itis pen,H, apollca-on waive .`s re-uiresnert
(:he --x one:
rl-AM•- n aC!&r:t
•at=e of Or or U*"I f s ACOM
/
>sreby �r y t.at ail of dtuais anc starritian I tray* sw,_Vmr•bd c tared) �� aapucation ire true
ase acunta
tticwy�e;a and t. it ail Dwrrscv wuz mnd .:sita5wz �ertcr^�eC � �'se pefmit
dor tRts aO tion will De ir! tr:(u ` 34
pas�inee ; pror sons of tlA Massae UMI -..s State Mw-biN Coda jy"tef S42 of L Gtnecal t iw"�
y;latLt 4 -SI :1cen•
lype Of
• l r� .. V� �"tl license Number —
C.
a
e
�
N
N
tl '
A
ff
O '
s
.J
r
tl
n
I
�
I
VA
{f
I
�
I
I
ps
lE
O
O
O
C
t+s
r
�
o
�
_
o
a
e
�
N
N
tl '
A
ff
O '
s
.J
10
Date .......'/.. `�0...0�'�......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that....y............:....................................................................
has permission to perform .....
wiring in the building of ........ ..........................
aft -7? ...... .`. °`'^ . ..... ..... ...... , North Andover, Mass.
Feed....................... Lic. No l � . 425 425 ....... �� ��•//oo'//. �'%%ma�yy� `,� �'.
LECMICAL SPE= n
v
Check # nr�0
820
t4
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No. Raw
Occupancy and Fee Checked \ ) (J
,[Rev. 1/07] neavP � .. t_N – _
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEA SE PRINT WINK OR TYPE ALLINFORMATION). Date: 1_'
City or Town of. NORTH ANDOVER 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) 3,
Owner or Tenant
Owner's Address
Telephone No. �l %�3 �'�'a
Is this permit in conjunction with a building permit? Yes No
❑ (Check Appropriate Box)
Purpose of Building A.0 Utility Authorization No.
Existing Service 2.410 Amps 1,26 / 290 Volts '. Overhead❑ d
_�No. Meters
New Service "—� Volts Over he_ Und I'�' of
ad ❑
gr � No ofp
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
of Recessed Luminaires
o. of Luminaire Outlets
No. of Luminaires
the fo owing table may be waived by the
No. of CeL-Susp. (Paddle) Fans
No. of Hot Tubs
Swimming Pool Above In- ❑
erred. ❑ arntl
i ranstormers KVA
Generators KVA
No. of Receptacle Outlets
No. of Switches
No. of Oil Burners I
No. of Gas Burners r
No. of Ranges %
No. of Air Cond. Total
t
Tons
No. of Waste Disposers /
Heat unip Nwmber- ons KW
r
Totals: -
--- _ I
No. of Dishwashers
Space/Area Heating KW
I
No. of Dryers
Heating Appliances KW
S
No. of Watero.
Heaters KW
of No. of
D
signs Ballasts .
No. Hydromassage Bathtubs
No. of Motors Total HP
T
OTHER:
o.
o.
o.
ALA -R- I IS No. of Zones
of Alerting Devices
❑�viunrcrpal
Connection Other
uritySystems: *
No. of Devices or Equivalent
.a Wiring:
No. of Devices or Equivalent
mommunications icing:
No. of Devices or Eauivalent
Estimated Value of ec 'cal Work:
y2" tI Attach additional detail if desired, or as required by the Inspector of Wires.
{When required by municipal policy.)
Work to Stark Q� Inspections to be requested in accordance with MEC Rule 10, and upon completion.
INSURANCE O GE: 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 they * s and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: L-� e-r!'OS C� ��
LIC. NO.:
Licensee: f t'� n IC%� <O S Signature /
(If applicable, enter "exempt " in the license number line.) LIC. NO.:1/ %3,S
Address: Bus. Tel. No.: '�/
*Per M.G.L c. 147, s. 57-61, security w rk requires Department of Public S�ety S"License: Alt L cl. No. �t/
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 El owner's agent
Owner/Agen
Signatures Telephone No. Fr PERMIT FEE: �---
I
r--I(44Lj PAC
01
The Commonwealth of Massachusett
kf ! Department of Industrial Accidents
Office of Investigations
i'cif l' 600 Washington Street
a Boston, MA 02111
www mass.gov/dia .
Workers' Compensation Inshranee Affidavit: Builders/Contractors0ectriciaas/pfambers
Applicant Information
Please Print Le�bly
Name (Business/Qrganization/Individual);_ / d44 C�/YGS
----------------
Address: 7 Al�r,o %l,�,,,,
City/State/M13:p��� Phone
Are you an employer? Check the appropriate box:
1. ❑ 1 rim a employer with 4. ❑ 1 am a general contractor and I
loyees (full and/or part-time).*
2. I am.a.soie proprietor or partner-
ship and have no employees
working for me .in any capacity.
(No workers' comp, insurance
required..]
3. ❑ I uiin a homeowner doing all work
myself. [No•workers' comp.
insurance required.] t
have hired the sub -contractors
Iisted on the attached sheet =
These sub -contractors have
workers' comp. insurance.
5. ❑ We are a corporation and its .
Officers; have exercised their
Tight of exemption per MGL
C. 152, § I (4),' and we have no
.employees, [No workers'
COMP. insurance required.]
"Any applicant thatchecks bmC # I must also fill out the section below showing their workers' compensation policy information,
t fiomeownem who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such
iCoatractors that check this box must attached an additional sheat showing. the risme of the sub-conttact= and tdry workers' cema. policy issfomi uion.
I am an employer that -h promding:workers I compensation insurance for my. enrPloyem Below &the policy and job site
information,
Type of Project (required):
6.❑ Ne onstrvLdon
7. Remodeling
8. Q Demoitti.on
9. ❑Buil ' addition
10leetrical repairs or additions
11.❑ Plumbing repairs or additions
12. Q Roof repairs
13.❑.Other
Insurance Company Name: '
Polley # or Self=ins. Lic. #:
Expiration Date:
Job Site
Address—City/State/Zip: —
Attach atopy of the workers' cotnpensalaon policy declaration page (showing the policy number and expiration date
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500;00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ce ril nder the pains and penalties of perjurythat the information Provided above is pue acrd correct
4f j`tcial use nnly, Do not write in .this area, to be completed Iry do or town officio(
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2- Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing inspector
6.Otber
Contact Person: Phone #:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. *Howeverthe
owner• of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence.of compliance with the insumnee'coverage required."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation. affidavit completely, by checking the boxes that apply to your situation and, if .
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit.may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage.. Also 'be sure to sign. and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not'the Department of
Industrial Accidents. Should you have any questions regarding the law or if you.are required to obtain a workers'.
compensation policy, pleawcall the Department at the number listed below. Self-insured companies should entertheir
self-insurance- license number on the appropriate Tine.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided .a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which vvilI be used as a reference number. in addition, an applicant
that.must submit multiple permittliemm applications in any given year, need only submit one affidavit indicating•current
policy information (if necessary) and under, "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of -the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. When a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license of permit to burn leaves etc.) said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Iavesfigai ions
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4940 ext 406 or 1-8.77-MASSAFE
Fax ## 617-727-7744
Revised 5 -26 -QS www.mass.gov/dia
Aft
Date.
TOWN OF NORTH AND
PERMIT FOR GAS INSTALLATION
This certifies that . /y1'..'1/> *... .% ...................
has permission for gas installation , ...` ..1v' ............. .
i
in the buildings of A%�/.�. v ! 1. "9.1. L x ....................... .
at ..r!!in k(. 'q ". y .......... , North Andover, Mass.
p �V
FeO.) ..... Lic. No..� 2 f..� ... ...... T'-:..
GA� INSPECTOR
Check # /,/I C
5558
MASS APPROVAL # lT -:�> 110 q /0 q
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT �� GASFITTING
!Print or TY*,
Mass. Date Permit
l utidino Locationo N �e wl3" owners Nam*A16 -WW ;i 40y®2J /9-t
_
Type of OccuMncY S
ru
New p Fla avation Q/ Replacement 0 Plans Submitted: Yap No
Indaiifnp Company Name YANKEE GAS Check one: Certificate
Address 140 SOUTH MAIN STREET Q Corporation 103C
MIDDLETON F MA 01949 [ . Partnership
Business Telephone • 978-774=2710 C Frm/Co.
Name of Ueensed Plumber or Gas Filter
INSURANCE COVERAGE:
I have a current IiaMlty Insurance policy or Its substantial equivalent which faeces the requirements of MGL Ch. 142
Yes 13 No 11
It you have.checked AS. please Indicate the type coverage by checking the appropriate box
A Iiabbility insurance policy 13 Other type of indemnity O Bond 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does nct have the Insurance coverage required by
Chapter 142 of the Mass. General Laws. and that my signature on this permit Wication, waives this requirement.
Check one:
Owner`.] Agent ❑
Signature of Owner or Owner's Agent
I hereby artily that all of the details and information l have submitted (err entered) in above a�7catierl err true aavrate to bast of my
• btoaAedge aruJ flail ap plumbing worts and insWlatiarls =v 69d under 0 partnil a this do Alt e in m with all
pertinent provisions of 1M 11AassadlusatlsSfate Gas Code and Chaptertt2 of Un Ge
fly T of License:
Plumber gnature o umr or beas rater
Title r3as8rier
Paster License Nurnbes 3 7 8 5
Oty/Town Joumayman
a
a
W
w
a
r
s
a
W
re!.
W
0
0
M~
2
O MJ
~
G.
C
M
O*
It
R
I
•.til
W
6
G
P
`\
W
er
•al
Y t
C
e
W
O
C
W
�"
W
r
O
s
Oi'
st
W
O'
C
ao '
O
G
1M1.
>«
0
0
1
10,f
C
Y
C
6
O
tltlf3�eSMT•
BASIMENT
,I ST FLOOR
X1
I
IND FLOOR
ORD FLOOR
4TH FLOOR
STH FLOOR
4TH FLOOR
I
7TH FLOOR
=.
I
`TN FLOOR
I
I
I
I
Indaiifnp Company Name YANKEE GAS Check one: Certificate
Address 140 SOUTH MAIN STREET Q Corporation 103C
MIDDLETON F MA 01949 [ . Partnership
Business Telephone • 978-774=2710 C Frm/Co.
Name of Ueensed Plumber or Gas Filter
INSURANCE COVERAGE:
I have a current IiaMlty Insurance policy or Its substantial equivalent which faeces the requirements of MGL Ch. 142
Yes 13 No 11
It you have.checked AS. please Indicate the type coverage by checking the appropriate box
A Iiabbility insurance policy 13 Other type of indemnity O Bond 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does nct have the Insurance coverage required by
Chapter 142 of the Mass. General Laws. and that my signature on this permit Wication, waives this requirement.
Check one:
Owner`.] Agent ❑
Signature of Owner or Owner's Agent
I hereby artily that all of the details and information l have submitted (err entered) in above a�7catierl err true aavrate to bast of my
• btoaAedge aruJ flail ap plumbing worts and insWlatiarls =v 69d under 0 partnil a this do Alt e in m with all
pertinent provisions of 1M 11AassadlusatlsSfate Gas Code and Chaptertt2 of Un Ge
fly T of License:
Plumber gnature o umr or beas rater
Title r3as8rier
Paster License Nurnbes 3 7 8 5
Oty/Town Joumayman
�.
Location
'.b �-� Date4K�'
MOR7ti
OF NORTH ANDOVER
9
.TOWN
Certificate of Occupancy
$
Building/Frame Permit Fee
$ 7--°•C'—�—
�'�S'•�°''<�
s4CMU5E
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
� Building Inspector
Tr
2 9$ 08:29 25.00 PAID
i
Div. Public Works
Location - -� ,' L i r� �" /i� _✓ , i
y
Date
NaRTh
TOWN OF NORTH ANDOVER
Of «ao ,a,tiQ
a OL
p
Certificate of Occupancy
$
Building/Frame Permit Fee
$
CNUSE<�
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee $
TOTAL $
5,0 NIPBuilding Inspector
Div. Public Works
w
a z
W O w v
p7 to
A
d
x A
LLJ
a
z
•k
A c
a W
=U.LU LL)
u
> z m z o i b'
LLJp m w Cir{ CuS U C U
Z
z F
I0-0
ti Q 2 2 Q
O m a sn
m �n � C � p �. y � _
�1
rO
O
h
6- W
V LU
z F L
o q p
W
L
m
• m z z
O F � z
F � C
L'1LLI
�
Z Q -¢ :
►.n z z ¢ F O z _z z
C ' a a -a,-z Z z O C_
z c z; c o m m
rn `n
m
Town of North Andover t AORTN
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES ° .
146 Main Street4L 0
+ s >
North Andover, Massachusetts 01845
W1111" J. SeoTT �,'•s
SS AGNuSt
Director
41
In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be disposed of in a
properly licensed solid waste disposal facility as defined by MGL c 111, S 150A.
The debris will be disposed of in:
(Location of Facility) 7(!`
Sig ture 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.
BOARD OF APPEALS 688-9541
BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9335
:.
m
0
�D
O
zO
r'
I r
� o
✓
O y
O
'S o e
0
a
V
0
o
°O
f y
a'�
ZJ=
OWm
W
y a,
T 0
D70Z
ZZm
�■
o
z m
OmfA
`
(J)
LWti
7
C)
m
0
D 10
!.
oFn -G
!
[
i
A Ay
`l Z
D
n
Ln133
Y
ETP
�Ln
I
n
=.
w
i. -,3
i
�
m
Flo
t'
�
I
�
G
Ea
C
I
rA
t�
w
�
.�
x
°
a
0
xa
x
o
C N
. O C
W
V V
:ac
O eo
w
m C
z
t �O
a
,.
p M
-O
m
Ea
z
w
16*
:mom
r
oa
7
V)
y
W
c ..
{J
rrhh
v
o c
E
C . C
O C
W O C
O C
7
CL=
N W
UC i.i
r.� ii
a4 «�� w
o4 w
�
v)
cn
uj
z
R
:U
s�
s
C•
L
co
,0
Z V
C.
O CO)
I
cm
CA
o •—
o�
V� O O
•E CO CO
CD 0 CD
CD � .o
3.0
OD
O O
!O O d
y IS
O
CD
CO2 t;
C CD
0 CL
C.3 h
c C
C
• C
CO)
m c
g
o
C N
. O C
V V
:ac
O eo
m C
t �O
p M
m
Ea
w�
16*
:mom
r
oa
vi
c ..
rrhh
v
o c
E
c"
W
CL=
N W
fi:
co
Of
}
� O �
N
t�1((�„
.
ci% m
6 C
y
N
C
O
O_
c.v�
m
- Z
i
t O
:"'_
�
Q!
C
Q.:
C y Q
�
m
^�
lr4
O
H O
Citi
O
C O
COL.
cmZ
c
Q
N C
•O
S
:0.-
N
:a o3
I...
m
m s
Z
Lu
CO
" -0 =0
.. c
0
ac
.E
C36Z
.6.y
o
LU
a
.10
O
_
coo
-L--
g m=m
!20
R
:U
s�
s
C•
L
co
,0
Z V
C.
O CO)
I
cm
CA
o •—
o�
V� O O
•E CO CO
CD 0 CD
CD � .o
3.0
OD
O O
!O O d
y IS
O
CD
CO2 t;
C CD
0 CL
C.3 h
c C
C
• C
CO)