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Miscellaneous - 40 BOOTH STREET 4/30/2018
1 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD 1)ATE: Sl'S"I'E I OWNER & ADDRESS TSYSTEM LOCATION ----- 1 rI56n (example: left front of house) IV 0, v DATE OF PUMPING: otl� QUANTITY PUMPED GALLONS CESSPOOL: NO V YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE v EMERGENCY 013SERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: �"/Li''f' �/,�'���%' L' i- COENTS: j CONTENTS TRANSFERRED TO: ' Location- Z/U Nd. ��il Date 40*TM TOWN OF NORTH ANDOVER o��,..o ,�,4•C F 9 > Certificate of Occupancy $ ,SSA�MUSEt Building/Frame Permit Fee $ , Foundation Permit Fee $ Other Permit Fee $ TOTAL $ l �� Check # f �� 1 v� /j �I building Inspector e 33' i SA ST p — �Jdl 36' .OX.=2 ,.,. � N v ,y o - LOT A �► 00Th, ST FOUNDA Tlok LOCATION PLAN CMY s E SH° RMS TV THE T� APPUCARLE ZONING 8Y-4AWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTTFICATTON DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANPS,WETL4NDS.EASEAfE M WILLIAM .JOHNSON ORDERS OF CONDlWNS,ETC) CLIENT: TMS DRAWING SMLL NOT RE USED BY THE CUM FOR ANY PURPOSE OTHER THAN THAT OU7UNED AROVE.EXCEPT WITH THE THIS CERTIFICATION IS MADE AND UMITED WRITTEN PERMISSION OF CHRISTIANSEN & SERW INC. TO THE ABOVE CLIENT. FURTHERMORE INNS DRAWING LT THE COPM101 1ED PROPERTY OF CHRIS17ANSOV d SERM INC. AND ANY UNAUTHONZED USE IS PRON/RRED OUR STMNSEN & SERGI TAKES NO RESPON &UTY *� FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY lNFOR-- M4710N CONTAINED LOCATION: NORTH ANDOV£R,MA. P��H OF M404! MICH CyG J. n+ SCALE: 10-400 DATE: 9/18/01 o ER , Q CHRISTIANS/.N PROFESSIONAL ENOWEFRS s�O G/STER�QS�o &SERGI LAND SURVEYORS NAL LANA 160 SUMMER ST. HAVERH&4ALt 018M TEL SOB-J73-0310 001 BY CHRIST IANSEN & SE1iK,Y )NC. DWG.N0.:94014020. Location Aj 0 6o c3�t S +— No. /� Date NORTIy TOWN OF !NORTH ANDOVER F n Certificate of Occupancy $ �'��''••°•E<� Building/Frame Permit Fee $ _ �CNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �— Check # ?2 15173 f BuildiKg Inspector � A TOWN OF NORTH ANDOVER BUILDING DEPARTMENT PPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING WE UILDING PERMIT NUMBER. w DATE ISSUED. 'GNATURE: Building Commissioner ctor of Buildings Date ;CTION I-SITE INFORMATION 1.1 .Property Address: 1.2. Assessors Map and Parcel Number: / 5 Map Number Parcel Number rV 1.3 Zoning Information: 1.4 Property Dimensions: ning District Proposed Use Lot Area Frontage ft i BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided red Provided f Water Supply M.GLC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: lie ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ .CTION 2-PROPERTY OWNERSIiP/AUTHORIZED AGENT Owner of Record me(Print) l Address for Service: _� nature Telephone Owner of Record: Q ame Print Address for Service: �. iature Telephone CTION 3-CONSTRUCTION SERVICES Licensed Construction Supervisor: Not Applicable ❑ 1l(l�K/VJV ]-65 vysyr,) I :nsed Construction Supervisor: j License Number i res s Expiration Date ature Telephone 2e istered Home Improvement Contractor Not Applicable ❑ ` i 1 � pany Name i Registration Number I "ess � 1 i Expiration Date tture Telephone L 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 SECTIONS Descri tion of Proposed Work check all a Ucable New Construction�i 9-- ' Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. 0 Demolition . 0' Other ❑ Specify VN Brief Description of Proposed Work: I-A I? i•,s' "' ;SECTION G-ESTIMATED CONSTRUCTION COSTS • Item . Estimated Cost(Dollar)to be Completed by permit applicant 1. Building (a) Building Permit Fee 3>UD Multiplier 2 Electrical (b) Estimated Total Cost of p0 �_- I Construction 3 Plumbing Building Permit fee(a)x(b) - 4 Mechanical. HVAC l 5 Fire Protection 6 Total 1+2+3+4+5: Check Nuritber SECTION 7a OWN`TER AUTHORIZATION TO BE COMPLETED WHEN :,OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERNUT as Owner/Authorized Agent of subject property `Hereby.authorize to act on behalf,in all matters relative to work authorized by this building permit application. x t-.. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 LSignature of Owner/Aent Date I Iowa= NO. OF STORIES SIZE { BASEMENT OR SLAB 1 SIZE OF FLOOR TIMBERS 1 2 3 SPAN = DINPENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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 I the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION I _ _ APPLICANT COA PHONE LOCATION: Assessor's Map Number gg b PARCEL_ qSUBDIVISION *kS�' w� �� i - LOT(S) STREET d F- o c)+Jl,- � ST. NUMBER IUSE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROV9D DATE REJECTED //-/6 -o/ COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED I S IC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised M7 im 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: e k©L)jz- 1 r S d�i4 L (Location of Facility) Signature o ermit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations g s Boston, Mass. 02919 Workers'Compensation Insurance Affidavit Please Print Name: Location: Yo d 1-�_ Ci0a44-'- Am A)y Phone )`<6 m a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone#: Ali Insurance Co. Policy# Company name: Address d ess 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 well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and confect. Signature � i-� Date �� 5 Print nameyiJ�t�� tv�- �V��S� Phone# l r�47 S Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept p Licensing Board F1 Selectman's Office Contact person: Phone#: 0 Health Department D Other FORM WORKMAN'S cOMPENSATION w. S4 t • ° e r 104 33 ' ! 36 -LOT A V � � 33 .t o � C 0 NORTH Town ® E ®ver TO o�A H,�� dover, Mass., S RATE D'RMI H BOARD OF HEALTH PE T T D . Food/Kitchen Septic System �, ,/ d / _ v BUILDING INSPECTOR THIS CERTIFIES THAT..........'(..p?.............. ..............................�.,..................................................................................... Foundation has permission to erect....V.x....l....4P........ buildings on ... 7 YO P T S. Rough to be occupied as........�je.°A� ....../ Rm+�/zs PO/n Cluj Chimney . . . ................................................................................................................................... provided that the person accepting this permit shall in every respect!conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. / 8 D/ /-/t/'r yy/a S - PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. y Rough PERMIT EXPIRES IN 6 MONTHS V THS Final UNLESS CONSTRUCTION S.T. TS ELECTRICAL INSPECTOR C Rough ............. . ....................... Service ... .. .. ... . . .... ..... .. . UILDING INSPECTOR Final Occupancy.Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final > No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. iLocation No. �Ai/ Date NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ j Building/Frame Permit Fee $ s�cMus U v Foundation Permit Fee $ D' Other Permit Fee $ TOTAL $ A t TA Check # 1 15012 /f Building InspectQ_r� P NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING . >. >.r4 ••�' �:�s_v+:aa"�•r�..L�ar��,.�'rir„_�� �aw..� )�'� lfi�... ..x.� a, w �a�� § � i k'?'.'st�s�'°�F#% sas "�.•�'%° '� t�°��,... ���n� WELDING PERMIT NUMBER: DATE ISSUED: Y 1,51'1 /off -doo / SIGNATURE: r Building Commissionerff for of Buildine Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 66-6 7-61 Map Number Parcel Number A V 1.3 Zoning Information: 1.4 Property Dimensions: __ �. 19 q%q Zoo Zonin DiArid Pr osed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.5. Flood Zone Information: 1.8 Sew a 1.7 Water SupptyM.GLC.40Fld . 54) � � Disposal 8 �P System: Public a private ❑ Zone Outside Flood Zone ❑ Municipal A3— On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Twner of Record —r r, -� I `t0 ` f C)6f K St Name,Print) 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: Not Applicable ❑ �crlra ►�, � �r Jvh►v5� Licensed Construction Supervisor: 15 License Number i Address Expiration�Date �+ 'I SignatureTelephone cam1 i i 3.2 Registered Home Improvement Contractor Not Applicable ❑ I 'ompany Name Registration Number address Expiration Date '4gnature Telephone r I SECTION 4-WORKERS COMPENSATION(XG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction 8'— Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: / t N C-IJ �\A-kv,.1 i SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed by permit applicant 1. Building (a) Building Permit Fee b"r-p©+490 c j3• Multiplier 2 Electrical (b) Estimated Total Cost of Construction ) 3 PlumbingBuilding Permit fee(e)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number I 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 + h_ "y l�<<i�w� Jyh nSa►� ,as Owner/Authorized Agent of subject property ! Herebv declare that the statements and information on the foregoing application are true.and accurate,to the best of my knowledge and belief Print Name t�-- �-9-0 SignXthre of Owner/A ent Date i 7BASENENT ORIES Z SIZE OR SLAB A%e ane•v{- OOR TIMBERS ZX lU 1 ZX t 2 `L}� f 3 Z I SPAN DEVIENSIONS OF SILLS 6 ' DBAENSIONS OF POSTS ! Z 5� DI[v)ENSIONS OF GIRDERS $k I p 1 HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING 2 X MATERIAL OF CEB4NEY D C(eWR�Nt� IS BUILDING ON SOLID OR FILLED LAND p jtif IS BUILDING CONNECTED TO NATURAL GAS LINE /�/ I T 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. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT 6� f y t. PHONE 97ff %6-6653 LOCATION: Assessor's Map Number PARCEL SUBDIVISION UR(14c.yo — LOT(S) STREET �O &Dz` +k ST�, ST. NUMBER —7oS 0 I aS 30 *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED Z/ 6 DATE REJECTED t PEI COMMENTS E �r f' TOWN PLAN ER DATE APPROVED Z DATE REJECTED COMMENTS FOOD SPECTOR-HEALTH DATE APPROVED r DATE REJECTED SEPTIC INSPE R-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS- SEWERANATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECT R DATE Revised 9\97 jm T UAIV1 U I-AJ 1 1<-6.LhAZPh V ORIV1 ,. . %117161 �.T INSTRUCTIONS: This form is used to verify all-necessary approval/permits from •~ Boards and Departments having jurisdiction have been obtained. This does,not relieve the applicant and or landowner from compliance with any applicable requirements. irrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrurrrrrrrrrrrrrrrman 000 APPLICANT �' 2e`'� �'4 f -PHONE ��' WLIItW 3 tJV ✓� ASSESSORS MAP NUMBERS LOT NUMBER SUBDIVISION Lk)A-1,lt&ce S-T=- 'LWII� LOTNUMBER I STREET '` —" --F— STREET NUMBER �rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr�rr OFFICIAL USE ONLY 1rassess Venoms rrrrrrrrmemo rrrr'■rrrrrrrbona nos rrrrrrrrrrr■■rrrrrrrrrmean rr... . RECOMMENDATIONS OF TOWN AGENTS Irrrr5rrsoon was rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrsrrrrrrre•rrrrrrrrrrrrrr DATE APPROVED CONSERVATIONADMINISTRATOR DATE REJECTED CONMSNTS _ DATE APPROVED TOWNTLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD:! ECTOR-HEALTH t ' DATE REJECTED V" DATE APPROVED SEPTIC INSPE OR-HEALTH DATE REJECTED • COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS rr-t D PFRMIT z7 6 > D/ d DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONQvIENTS RECEIVED BY BUILDING INSPECTOR DATE i TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845-2909 J. WILLIAM HMURCIAK,DIRECTOR,P.E. Timothy J. Willett a°HT b qti Telephone (978) 685-0950 Staff Er�gineef �? �'.'a°o� Fax(978) 688-9573 o u 00 May 17, 2001 ��SSACHUS�t� Heidi Griffin Town Planner 27 Charles Street North Andover, MA 01845 RE: Bond Establishment Wallace Street lot Dear Ms. Griffin: The Division of Public Works recommends that a bond be established in the amount of$5,000.00 for work pertaining to the house lot located on Wallace Street. Very truly yours, Timothy J. illett Staff Engineer CC: Bill Hmurciak Jim Rand 1 Oo 1 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. }c}� Application by the undersigned is hereby made to connect with the town water main in Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. Street or subdivision lot no. 7 42 a Owner Address Contractor Address Applicant's Signature I PERMIT TO CONNECT WITH WATER MAIN t The Board of Public Works hereby grants permission to ( fRPZ9,, ( to make a connection with the water main at Street- subject to the rules and regulations of the Division of Public Works: "jBoardWorks B .. j y jInspected by j Date See back for rules and regulations 1 i 711 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. 1 Application by the undersigned is hereby made to connect with the town sewer main in Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. Street or subdivision lot no. v 3� Owner Address Contractor Address Applicant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to U e, to make a connection with the sewer main at G, rim (2ax Street subject to the rules and regulations of the Division of Public Works.. J Division of Public Works By Inspected by Date See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.W I LLIAM HMURCIAK, P.E. Telephone(97a)"685-095C- DIRECTOR 978)'685-6956DIRECTOR Fax(978)688-9573 � NORTH ?OttEo ,s 640 0 L 9 K o t a # � ,VA HUS i I DRIVEWAY PERMIT DATE LOCATIONl.� BUILDER phone i OWNER � phone THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. i I FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. i A PP L► GA N l�5 5! iJAY et GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. 6�-C 7_4 3, q8 3z��+k R i�3-liy-yrs Permit Applicant Property address Map/Parcel 91%glS�(M) Ll--,' Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw.I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit.Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building. permit application and associated attachments,complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw,provided that no additional residential unit is created. The lot(s)was/were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions for thepurpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. APPLICANTS SIGNATURE DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION own of Nom A,FYamer Office Of the Building, Departmerit, ora,..s CommuRitY DeveluPmenl and Services la vislon W WiBiam J.Salt(, Division Dir r 2:Q arl",strezt D. Robert Nicetta Nor'tli Ando%,m,, ,* ,,U&etbrAW Building Comhli5.sianer Telemann{gig)6&o,9545 Fax(978) 688.95U P,,ED ORA NDUM To: Heidi C riffirr "Tovm PII rmier Fr�,m,. Roto.ldreegA Building C'ommissiouf 6 0 Date: Pei':uary 2,2001 :Re: Stephen itr:Cheryl Jh, 0 Booth Strut,Map98l,Paroal 14&15 In the event the PI=4 Board Srmts ac�.ss to the awe-referred property i WA0 I thm be of the opinion that it would comply with Seebon 7,8—Exoeptions-of the 2'on4n bytlaw. to the Section "a lot that was 1,4u ly laid out and duty rworded by plan or aae d pri.og'to January 9, 195)aad had a minimum, frontW of 50 fm 3 mWimurn lot are-4 of 5000&4uarrs feet wex.dd be grandfz0-L4'red"- if you require further asii,,ANncce please cpnwt me. ('C;Donald l?.Boreawin,Psqaxte 1 0" y ok WQ UA,9sa 1 o a�s CIGMSERVA ION 659-933d €F'FALTH 680-� a,C) PLAN,d71 O 538-453,5 1 T H 1-1 0 6 fir, P M C;h4 T E C I T R1.? E: 7. '2045 Town cif North Andover Office of the Building Department Community Development and. Services Divi'sion a Via" 10 William J, Scott, Division Direijor 27 Charles S"Te-et C tls North Apdove.r, Milss?,Chusetts OIS45 1). Robert Nicetta Telepl-Lono(978) 688-9545 Building comimissio-i-iel' Fax (0178) 68&-934.2 Donald F. Borenst,,,in. ESQ Lav,,OffiQ.e of Mark Johnson 12 C'h4'ytnut Street Andover NAIA 0I 8 10-17016 R.e.: 0 B(loflh strec�t De-ar Ati%n,-q Please be advised that the aftac;hed is a memorandum, -to the Tou-n PIRrmer rt.garding Mr, Stcphcn Juba's property at,0 Booth Street. If you have any questions P;e-'3se 0311 TTId W 978-688-9545. Very trufy.5'Ours' Building C(rnmissimcr WART)01;APFEAj,S 688-954 6F8-4545 CC)NEE.r(V,krr--,(-j3•t:.8g.7.53C,, HFA'LTH6Se-951"r) PLAJNNRAIG688-9533 � t •--;s _.,,..,,..mow .... __T r.w.Y...s.sw_...ww.a..n.r-:--' r+� ' +�� ��e TOa»��za�zuiea�i o��aaoacLivaelta . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number CSV 043353 Birthaitel,1/16/1958 1 i Expired 01/-1 003 Tr.no: 9361 I Restricted To:-00 , ° _, �a i WILLIAM P JOHNSON � =I 36 HIGH VALE ANDOVER, MA 01810 Administrator 4W The Commonwealth of Massachusetts Department of Industrial Accidents ' ' Office of investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print r Name: /V///igm 7 Te �t/Sdyi T Ij Location: 14C) i�rsn4h City UfC R11`40J•Q 2 Phone # < e475 ( 3 --- I am a homeowner performing all work myself. . i I am a sole proprietor and have no one working in any capacity 1 FI am an employer providing workers'compensation for my employees working on this job. Company name: Address City Phone# Insurance-Co., :.-— .Policy;# , Coin Pany game. Address City . Phone#. Poll _.# Insr�rant :Co. cv Facture to:secure coverage ad nu�red under section 25A or MGL T52 can lead t4 ttre�tr►pcisipon of'criminal penalties of d fine up to$1,�v0o:llo f and/or one years'irtlPrisonment s_well_as_eivil..penaltiesie2taeform -AS ?P_WORK-OADER.and_afine of j.$�DQ I j sJay�gsinstme. I understand that a copy of this statement may be forwarded to the office of Investigations of the DIA.for coverage verification. i 1 I do hereby certify under the pains and penalties of pegury that the ir►fonnation provided above is true and correct. Signature, ",�C> Date Y15 Print name W\- ` .�b k ftJ S,6 Phone.# 13 3 i Official use only do not write in this area to be completed by city or town official' City or Town a Permit&icensing i ❑ i Building Dept ❑Check if immediate response is required ❑ Licensing Board t p Selectman's ice Contact person: Phone#: E] Health Department j Other MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 8-10-2001 DATE OF PLANS: 08-09-01 TITLE: ONE FAMILY RESIDENTIAL, 40 BOOTH ST. N. ANDOVER PROJECT INFORMATION: ONE FAMILY RESIDENTIAL COMPANY INFORMATION: GERARD E. WELCH, INC. 1213 MAIN ST. READING, MASS. 01867 COMPLIANCE: PASSES Required UA = 384 Your Home = 361 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1030 30.0 0.0 36 CEILINGS: Raised Truss 220 30.0 0.0 7 CEILINGS: Raised Truss 182 30.0 0.0 6 WALLS: Wood Frame, 16" O.C. 1049 19.0 0.0 63 WALLS: Wood Frame, 16" O.C. 934 19.0 0.0 56 GLAZING: Windows or Doors 278 0.380 106 GLAZING: Windows or Doors 41 0.500 21 FLOORS: Over Unconditioned Space 1394 19.0 0.0 66 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, 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 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INS4ECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 ONE FAMILY RESIDENTIAL, 40 BOOTH ST. N. ANDOVER DATE: 8-10-2001 Bldg. l Dept. l Use I I I CEILINGS: [ ) I 1. R-30 I Comments/Location [ ] I 2. Raised Truss, R-30 Comments/Location Insulation must achieve full height over the exterior wall. [ ] I 3. Raised Truss, R-30 Comments/Location Insulation must achieve full height over the exterior wall. I I WALLS: [ j I 1. Wood Frame, 16" O.C., R-19 Comments/Location [ ] I 2. Wood Frame, 16" O.C., R-19 Comments/Location I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.38 For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location [ ] I 2. U-value: 0.5 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 Comments/Location I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I, ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values and glazing U-values must be clearly I marked on the building plans or specifications. I I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I [ ] I CIRCULATING HOT TATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : I PIPE SIZES (in.) NON-CIRCULATING I CIRCULATING MAINS 5 RUNOUTS i I I� HEATED VZTER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- I I U w The Commonwealth of Massachusetts M r tl Department of Industrial Accidents e Office of Investigations w Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: U /`,, 1� Ll r✓Sa vV Location: City V- 2 Phone # 7 �!7.5�oj6 I am a homeowner performing all work myself. I am a sole proprietor and have no one working In any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: IOU A L l //Cv S. Address .5 SGv/�Or L tz City: w 5 Phone#: 9-7 y7 6 6 I Insurance Co.. AC,AI AC wolicv# .. �►�t, S 6 ,6 6 7 3 CQMORY.:name Address . City: Phone#: Insran:Ge:Co. Policx.#. FailuFe to secure coverage as requlrecJ ur►der`Section 25P►6rMGL 152 can lead fo the imposipon of criminal penalties 0.11- of,2 ane up fa$1, Ob.00 and/or one years'imprisonmentAs Wallas.cixil.penaKies.in2tiaSnrin �SIQP_1NDF K9RL)FR.aritl_.afine_of $ADO DBS eslay-agwnst—m I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for Coverage verification. I do hereby certify under the pains and penalties of pequry that the information provided above is true and correct. /J Signature Date r� Print name (t uv` I' V IQ S Q Phone.# 9 y�- `/7S 6 J 3 Official use only do not write in this area to tie completed by city or town official' City'or Town Permit/Licensing Building Dept OCheck if immediate response is required .0 Licensing Board p Selectman's Office Contact person: Phone#: Health Department F-i Other R North Andover Building Department Tel: 978-688-9545 s I 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: U L eZ (Loc tion of Facility) Signatur o Permit Applicant +0\ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 04/04/2013 20:49 FAX 001 t Town of North Andover *� Office of the Building Department �a"`-'� •`'� h 9 Community Development and Services Division WBliam J.Scott,Division Director 27 Charles Street 4�s D.Robert Nicetta North Andover,Massachusetts 01845 Telephone(978)688-9545 BuiIdfng Commissioner Fax(978)685-9542 February 6,2001 Donald F.Borenstein,RSQ Law Office ofMark Johnson 12 Chestnut Street Andover MA 01810-3706 Re: 0 Baotii Street Dear Attorney Borenstein: Please be advised that the attached is a memorandum to the Town PIanner regarding Mr.Stephen. Juba's property at 0 Booth Street. If you have any questions please call me at 978-688-9545. Very truly yours, D.Robert Nicetta, Building Commissioner BOARD OF APPEALS 685-9541 Br11LoTNG 6gg.9545 CONSERVATION 68&9530 Hl?a11'H 68A-95x0 r1 AMvtNG 6$8.9535 04/04/2013 20:49 FAX 0002 b• Town of.North AndoverCommmiID ty Dev�dapraeat and Services • - . WMM J.•Smtt;Dlvieicel Dhectm Vc sir D.Robert Nicetta Noatth Andover,lbI m ad ueeft 01885 686�J6g5► BnMB9 cmmdssion& Fax(9M GS&W}2 AMM ICI ANDUM To, Heidi Griff>n,?owaPla Fpm: Robert Comm6sionar 4 Dene: FAhay 2,2001 Re: Std 8t Cheryl Juba 0 Booth Street,MMM PSW 14&15 In the avant the PlamologBoard gets acorea do the above- poperty I wudd bran bs of the opinion that it would aom#y.vA&Section 7.8—Exceptions-of the Zamagbplaw. PursaWtotheSection "a lot that was lawfully Wad tend duly raoouded by planar dead prier to Jeooacy 9,1957=dbgamwmmm flantage of SOfeet endamiuimomlotsm of 5000 so= wootd be gam" If you requireftowmimmlAinsm amtact me. Cc Doealdk Baens6oin6 Esquire BOARDOFAPPEAUdga. S41 StALUM63SOM CCMMSWVAIM 6Edg�p imaim6w4me pL1N4aV!}63d.9535 Building Value Calculation - for Pro a at..... LOT# Room Length Width Sq.Ft. Cost per Sq.Ft. Total Cost Kitchen 24 12 288.00 65 $ 18,720.00 j Brkfstnook - 65 $ - Dining Room 14 13 182.00 65 $ 11,830.00 Family Room 24 14 336.00 .65 $ 21,840.00 study/office - 65 $ - Living room 19 13 247.00 65 $ 16,055.00 Garage 24 22 528.00 35 $ 18,480.00 Entry 17 12 204.00 65 $ 13,260.00 2nd floor foyer/sitting - 65 $ - Sunroom - 65 $ mudroom - 65 $ - Walkin closet 10 6.5 65.00 65 $ 4,225.00 Basement Finished 65 $ _ Balcony - 65 $ - Screened Porch - 35 $ - laundry 8 7 56.00 65 $ 3,640.00 Bedroom 1 17 13 221.00 65 $ 14,365.00 Bedroom 2 12 13.5 162.00 65 $ 10,530.00 Bedroom 3 14 13 182.00 65 $ 11,830.00 Bedroom 4 15 13.5 202.50 65 $ 13,162.50 Lav/Bar - 65 $ - Bathroom 1 10 8 80.00 65 $ 5,200.00 1/2 Bath 7 6 42.00 65 $ 2,730.00 Bathroom 2 10 8 80.00 65 $ 5,200.00 Bathroom - 65 $ - Balcony - 65 $ - /'-e�e r ORTH T 6 own o n over 0 No. - 0 ndover, Mas C% S. - L AK 6 COC mC .WICK 0"�ATE D P9�L SSAC H US���� FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ....... ........ .P YX. ............ ... ... ....... has permission to excavate and pour foundation at ...�D N - 15- ,O ...,& .... ............................................ V� ....................... for the purpose of...8..F ...... at!q*I ZeS�C.�QNB!L' The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. C .101 0/4-444.0/ i�� ................. ................................................. BUILDING INSPECTOR NORTFI E Town of And 0 No. C' �` r Mass. —/o? CocH,c 10 dove , , ATED OPS\ �C2 '9S H BOARD OF HEALTH Food/Kitchen PERMIT T D � Septic System �� �c a I��/ 77�.&s B.UILDING INSPECTOR THIS CERTIFIES THAT..........QUaZ.. /..... .............. ......... ...... Foundation has permission to erect..................1.................. buildings on ...' D....�.0.PW.................. ...................... ....... I - Rough g ?C 0.O. cC.J ' n Ol S�d VA).de 5( /� iR.Sf V 1imney tobe occupied as......................................1.......................................1........................................................... ....'!��� ................. provided that the person accepting this permit shall in every respect_conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-laws relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. / S /y4/S— QC)!f* PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ...... ............ ....... ............ .... ...................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. HOR1H O Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: ``� � I � DATE: ���49 ` UNIT NO.: FLOOR: WING: BUILDING NO.: 1.�0 S4 REMARKS: Excavation-depth and soil conditions Framing- Other: Date: 9" 1 0� Date: Date: Inspector A4 Inspector Inspector Footings and foundations and drains- Insulation- Other: Date: 10— 3 Q2 I Date: //�� r/ Date: ✓VI Inspector Aj (tt- '_ Inspector Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector. Inspector Electrical-final Plumbing and/or gas-final Other: Date: Date: Date: Inspector Inspector. Inspector Fire Dept- oil burner,tank,stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: —Cof 0# Inspector Inspector. Inspector Form#995 Action Press,685.7000 y TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845-2909 J. WILLIAM HMURCIAK, P.E.,DIRECTOR Tares Rand, .Ir, NORTH 7 Telephone(978) 685-0950 Director of Engineering 3r�°';`" "'0� Fax (978) 688-9573 ►' ,jrand(Afoit,tPofaaortlaaazdover.coat • � Aw� 0 471D �4SS�lCRU September 21, 2001 Mr. Thomas Thibeault T. R. Thibeault& Son's Construction, Inc. 10 Ledge Road Atkinson,NH 03811 RE: Wallace Street,North Andover, MA Dear Mr. Thibeault: The proposed changes we reviewed today are NOT acceptable. All permits issued by this department have been based on the approved subdivision plan. If the work is not done in accordance with said approved plans it will automatically void your existing permit and put in jeopardy your privilege to work in the Town of North Andover. Also, all illegal construction work installed will have to be removed by you at your expense. These changes also effect the subdivision approval granted by the planning board. They will VOID the existing approval. I am notifying Heidi Griffin, Town Planner of the proposed changes and ask that they take appropriate action. The subdivision approval was granted on very specific plans and these plans cannot be changed on a developer's whim. Then there is the question of engineering. Are you a Professional Registered Engineer? New plans are need and they must be submitted to the Planning Board for their approval and also submitted to this Department for review and approval. A new road-opening permit will be needed and the existing one voided. Please remember that the existing permit is valid for the existing approved work only. If you have any additional questions please call. Ve truly yo , � � � � V t5 SEP 2 4 2001 ames Rand, r. BUILDING DEPT. Director of Engineering tr -Tq a romiggii WA T.R.Thibeault&Son's Construction,Inc. Page 2 Wallace-Street 09/21/01 JJR/hs CC: J. William Hmurciak, Director of the DPW Tim Willett, Staff Engineer Heidi Griffin, Town Planner Michael McGuire, Local Building Inspector Conservation Commission Christiansen& Sergi,Engineers William Johnson, Developer I I i i C:Wallace Street/Revision Letter TOWN TOWI� OF NORTH ANDOVER-DIVISION OF PUBLIC: WORKS 381 OSGOOD STREET NORTH ANDOVER. MASSACHUSETTS 01845-2909 "rel. 978-685-0950 Fax 978-688-957 ' Date. . . HORTM TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING 41 ,SSACHUSE� I This certifies that . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . 11 . . . . .� -. . . . . plumbing in the buildings of . � • • • ' ' � , North Andover, Mass. �. . . . . . . . . . 3 Feer. " . .Lic. No.471) . . 1.. . . i M ING INSPECTOR Check # 6062 MASSACHUSETTS UNIFORM APPLICATION /ORP' ERMIT TO DO PLUMBING (Print or Type) _ ( fir!! k _ MaDate �i ss. �� ?U.e--4/— Permit Building Location y0 �,,,(/, ,g��, Owner's Name_ /Sr>:s =TYpe of Occupancy_S✓i+s.� New 93" Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No 0r_ FIXTURES L i rn = _•� U) 2 x < w' Y < = < O ~ Z 0 O y ¢ ¢ d J h W q 2 C V W y 3d < y W d !- ft W O O ¢ < ¢ .2 < W O < m .= Q d Q O I W S F- 1- W O p ` ' 3r .I y C C J sue -BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR w STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR EJ TT Installing Company Name. Ar .901Gioljoli Check one:. . Cert)ficate Address ❑ .Corporation LIU�_✓�i��� /�i�: />� Q-6/3/9 O Partnership Business Teiephone���B-3?2��,Z f,Z 13Pann/Co Name of Ucensed Plumber r / K✓� s - A r INSURANCE COVERAGE: I have a current!ability Insurance ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142: r+ Yes if you have checked Vis. please indicate the type coverage by checking the appropriate box. s A liability insurance policy 0� 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 1 have submitted(or entered)in above knowledge and that all plumbing work and installations performed under the permit issued four this application are true and accurate li the best of my . pertinent provisions of the Massachusetts State PlumbingCode and application mMll be in compliance with all Chapter 142 General ws. Title gna ure censed umber Mt Master CitylTovm Type of License: ❑ .lburneymarm f0 's NL License Number��/? i BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION FINAL INSPECTION SKETCHES FEE - NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME & TYPE OF BUILDING LOCATION-OF BUILDING PLUMBER OR GASFITTER LIC. HO. ti PERMIT GRANTED DATE -20 OAS INSPECTOR t Date. . . "oRTM TOWN OF NORTH ANDOVER 3: 0. 0 9 PERMIT FOR PLUMBING s r10L � �► �O++rm.A��1h ,SSACHUS� This certifies that �. . . . ./. - � . . . . . . . . . . has permission to perform . f -� . . i :3 plumbing in the buildings of . ..-. .. . . . . . . . . . . . at. . . . . . . . . ..... . . ., North Andover, Mass. Fee:,b4.r`.Lic. NoA?.7. . . . . . . � . � �' . . . . PLUM8ING,''JNSR CTOR Check # `f� - 5037 I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date , Building Location Nameh t/jl- Yi Permit# aalzwa�y4/I'LG�r Amount Type of Occupancy �' New Renovation Replacement 1:1 Plans Submitted Yes ❑ No ❑ FIXTURES z � � H >4 z z ' W � W � U C W H W x O Z � �aq A0 x w x o x x a H x w x w o aA a >�mv>avr ani HjOCIR 5M IMM 6M HDM 7MIL" 9M Hit (Print or type) Check one: Certificate Installing Company Name��� ✓�y �{� �{ �¢�/ Corp. Address � �4,111-el1 G e S -7— El Partner. kt-/r-/ v /1;1 4-� Business e ep one (6 !14 f—l61 13 �Firni/co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: a Liability insurance policy ® Other type of indemnity 1:1 1:1❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance signature Owner ❑ 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 Massachuse State Plu eC de an Chapter 142 of the General Laws. By: igna ure or Licenseau er Type of Plumbing License Title City/Town Wense IN UMDer Master rM Journeyman APPROVED(OFFICE USE ONLY I l. N2 Date l.� . ... ... . ........... r10R7M TOWN OF NORTH ANDOVER 3ae.r - '• o� p PERMIT FOR WIRING fR This certifies that ... ..?.�c?.. N�D2 C-21��................ ................. ........................ has permission to perform ... ................................. ........................................... ` wiring in the building of.42!7.! fj � � � at... .North Andover,Mass. Fee.S - ........ Lic.Noffi.S..�,7 ELECTRICAL INSPECTOR Check # f U� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THEC0MM0N9E4L7H0FAWS4CHUSE77S 0cceejUse only RDDEPARTA1MTOFPUBIICS4FNY Permit No. �� ! BOAOFFIREPREVEMONRF.GUL A77ONS527CMR12M Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL 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&Numb 40 Owner or Tenant U Owner's Address Is this permit in conjunction with a buding ermit: Yes" No ED (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service AmpsVolts Overhead Underground M No.of Meters New Service Ampsk2LW2212Volts Overhead Underground fff No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1440 A5�01A V4 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures C:AJ Swimming Pool Above 17 Below Generators KVA round 2round No.of Receptacle Outlets 4. No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges I No.of Air Cond. Total FIRE ALARMS No.of Zones (G Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Soundin evices No.of Dryers Heating Devices KW Local Municipal � Other Connections No.of Water Heaters BCW No.of No.of ,j Signs Bailasis No.Hydro Massage Tubs / No.of Motors Total HP / OTHER' hwanceCovrage.Rnsuanttoftwq�mmiff#sofMassadn>setsCkne lLaws Ihavcaaui> 1tLiabl7ityltistuanoePblicyinchadangComplet-, 2georitsstil�9at�lialequivalerrt YES NO. Ihavesttbmittedvandproofof todieOffim YES Fyouhaw d�dWYES,pleaseindicatedletype ofcovaageby Q IT Q ( Spo*) �4�ori fZ�Ca&�-eO INSURv'1NCE BOND 01HFR EViratimD& EftrkdValueofElec"Wbdc$ WoAstart hrspecdonDat ; uesW Rough Final Signed underI&PUmIfies of pew, MMNAME r LicetwNo. /yc A..r�z:0 L� I-iocrisw _ Signattue Li=wNo Busu>essTeLNo. AItTeLNo. ,Y2 P PlrAVS - OWNER'S INSURANCEWAIVER Iam awated-atheLimlsedoesnothavetheirwmmOD oritsats ntdequivaalentaslupWbyMamchusenGernalLam and that my signahae on this pmnit application waives this wquitm=t (Please check one) Owner Agent d- Telephone No. PERMIT FEE Igna ure ot Uwner or Agentl� IC 3103 Partnership for Education V 818-717-2944 M4124101 137:16 PM p 111 For Gov. ernment Workers Only5 Owl % Off The educational resources on the Internet are growing rapidly. However, an alarming number of Government workers do not own computers. Some surveys state as many as 53% of Government workers do not own computers. 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Plus the Partnership for Education's 100% Satisfaction Guarantee. •Fully equipped with 2001 technology to make these the best performing computers move} e I an buy. Hotiv to qualify: 1) You must be a Government employee. 2)All computers will be available on a first come first-served basis. 3) Call 1-888-600-9288 By 6 P.M. Friday,April 27, 2001 and we will give you free information, and hold thecomputers you request on will call. 4) You are not obligated in any way. 10017o satisfaction Guarantee 5) Visa and Mastercard AcceptedO 9530 Cozycroft • Chatsworth, CR 91311 • Phone (888) 600-9288 • Fax ('818) 717-2944 J NOR7N ss'ACHUa� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 16 Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS 5t N /-*- rbc ���`�!'�� IN ACCORDANCE WITH THE PROVISIONS OFT E MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. l CERTIFICATE ISSUED TO Building Inspector r 1 , s z CoCO'.0 I dover, Ma. ,. RATED -- , n BOARD OF HEALTH . Y P'� Food/Kitchen r;; Septic System:E R M IT T D BUILDING INSPECTOR mal THIS CERTIFIES THAT QqAkYx �iQ S........ ........................ ......... ...... ..G.......................................................... Foundation has permission to erect.. /................... buildings on ...YO....�.00..�.�1............ ......�................ ...... ....... - Ro hs �!I -y� O(O�� t0 b8 occupied as /l 1�V1 11./..........................................................P CI l ICie . � ... �� ti °iimney 1 °� p .....,.... ............CO........)......... ................. provided that the person accepting this permit shall in every respect conform to the terms of the applicatson on file in Final , this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of a Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ° 12 _ y.--c-1 PERMIT EXPIRES IN 6 MONTHS I-- UNLESS CONSTRUCTION STARTS cTRIc INS ECT �R i r ,� ... `.. .................... _ BUILDING INSPECTOR111-9 , Occupancy Permit Required to Occupy Building GAS INSPECTOR gh Display in_-a Conspicuous Place on the Premises — Do Not Remove 'nal ?{ No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. ' Burner ' Street No. SEE REVERSE SIDE smoke Det. oRTH Town of North Andover @O Building Department �� gt�Tt 'e1 6�� o 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 C.[KI[ twKR A MU5���� APPLICATION FORERTIF. C KATE OF OCCUPANCY/INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN TIES TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING CONSERVATION DATE f-18 oZ PLANNING_ ' ` DATE i D.P.W. —WATF�R)METE C DATE l T D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED RIO TO INSPECTIO QUEST DATE. I NATURE/DP AUTHORIZATION i �e � . . . /��,. �� J ,/ ��, E \� . ' .�/' �` ��` _.... \ � \ � � ��� �� \��� �� �. /, ��� f -��<30 l� i