Loading...
HomeMy WebLinkAboutMiscellaneous - 41 HIDDEN COURT 4/30/2018 41 HIDDEN COURT 210/065.0-0175-0000.0 or `Dated . . . . . . . . . . s TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . . has permission for gas installation . .1/��/�/.��/2 . . . . � �!�^�. . . . . . in the buildings of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . , North Andover, Mass. Fee 10. Lie. No. . . . . . . . . . . . . . �` c�� ^'. . . GAS INSPECTOR Check# d MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I v. CITY t — �— r._.: __..T- MA DATE ` PERMIT# JOBSITE ADDRESS�_�,� OWNER'S NAME GOWNER ADDRESS TPRINT OCCUPANCY TYPE COMMERCIAL] EDUCATIONALI RESIDENTIAL CLEARLY NEW: RENOVATION:D REPLACEMENT:C PLANS SUBMITTED: YES 0 NO0 APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 1 10 11 12 13 14 BOILER Ii__. �1- _ h ! . ! _ L---J 1 .. ! BOOSTER I. _�. I _�. �( _��... __. . Li 1---A= CONVERSION BURNER - 'COOK STOVE DIRECT VENT HEATERI. DRYER FIREPLACE FRYOLATOR ! _ __:� - I .. _ _. .I FURNACE --- �_... GENERATOR GRILLE E---7-, EJ I I I A I_ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT —,. . L—:—. L . 1 L L— f .._ _�.I . - OVEN POOL HEATER ROOM/SPACE HEATER — ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER _ �. !(.,— _�I_� � __ ! �!,r,�1 I _:�i----- i— ' OTHER - - - -- --__• --- -- -- ._l!_ _._ 1 l�._-�l--r�l ,... �� _izl �--�L___-.J i_Y�. I i �_J I-i I �!I�__-I --J�{ INSURANCE COVERAGE have a current liability nsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ..._1 NO Q IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLIO OTHER TYPE INDEMNITY BOND I_—! OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER [� AGENT SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accur the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance wi rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME !/ f :_ w! I —_ _ LICENSE# � _I_ IGNATURE MP 0 MGF 1 JP JGF E LPGI CORPORATION GSD# PARTNERSHIP©#��_~ J LLC[ IJ# COMPANY NAME: ADDRESS CITY eto ..j fJ. STATE - / 1 ZIP ]TEL FAX CELL[ EMAIL _ jg �2f<< f �� �� _._. i� fix ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ F FEE: $ PERMIT# PLAN REVIEW NOTES 9 The Commonwealth of Massachusetts " Department of Industrial Accidents Office of Investigations 600 Washington Street 02111 on MA Boston, www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name(Business/Organization/Individual)�I/%}1A ec r_�Ig`C, r Address: City/State/Zip: Phone#: 41f -7 DQ-DoG_1 Are you an employer?Check the appropriate box: Type of project(required): 4. ❑ I am a general contractor and I 1.El I am a employer with E]6. New construction III oyees(full and/or part-time). have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition 4 working for me in any capacity. workers' comp.insurance, g• ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] employees.[No workers' q ] 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:. Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 insuran coverage verification. I do hereby certify under th ns and penalties of perjury that the information provided above is true and correct. Si afore: Date: Phone#: 20-2-006 z Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - 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. However the 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 insurance 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-contractors)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,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. 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 will be used as a reference number. In addition,an applicant that must submit multiple permit/license 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.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum 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 Commoawealtlj of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston?MA,02111 Tel,#617-727-4900 ext 406 or 1-877,7MASS.AFB Revised 5-26-05 Fax#617-727-7749 www.mass,govfdia E CommoNWEALTH OF MASSACHIJSETTS ;v 'PLUMBERS AND GASFITTER+S LPCENSED AS "J, URNEYMAN :PLU ER ISSUES,THE•ABOVE+LICENSE TO -E-S-M_. 'B- HR�AK_.jS P-II 3 `.BRENN:ER D-R f NEWTON: NH 03858=3800: 242:81 05/01/14 :175083." c , r. y ;r © 9825 Date /°7 7 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies hat-.—. . . . . . . . . . . . . . . has permission to perform . . c�Jv..� �r . 1 , , . . . . . . . . plumbing in the buildings of V,e••,4 ICA-k"I. . � pp at . . . .�f Xc e�. .t�.cJ .�-�. . . , . ,North Andover, , ass. Fee .. . . Lic. No. .��1 ,Q . . . . t�C` . . . PLUMBING INSPECTOR Check 4 �� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATEL ( PERMIT# JOBSITE ADDRESS OWNER'S NAME, _ jr OWNER ADDRESS Sof ,l'pfc�P C f s TEL , elf y� e/ FAX f TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL M RESIDENTIAL ffr' PRINT CLEARLY NEW: RENOVATION: REPLACEMENT:�� PLANS SUBMITTED: YES 0 NO© FIXTURES 7 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN [ ._.._....._[ � __--_____( ---- ( ! -_.--.__i .__....__1 ._..____.I _._....._.-_-( ._..__.1 ___.._-¢ --_-.-_.[ FOOD DISPOSER ( ...__.._ -_-.-__l ____1 FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK __—( I IN----jj _.--.._--( ..___1 .__.�! J � ( ( ---__-! -_____I LAVATORY _..! J 1 ! ...-..._._� J IJ _:__-..._..! ._._._...-_..t _( [ _..._J ROOF DRAIN __!SHOWER STALL [ 1 [ [ I ( I ( ( i 4 _.___.� —_7( iSERVICE/MOP SINK ( J [ [ !TOILET _-.__^.� _...__._ _.__._.._! ._.__._ -- -__ ___j _—.._I URINAL I -..._.__i ._....._._1' ( __.._..__ ._.__...._( ...___... f _.......-_..� ` � _.._._( ._........_1 ..._..__-.1 WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING ( ._.—► --( _-.__.._-.1 _; __ 1 -------_..f OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0--NO _ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY l OTHER TYPE OF INDEMNITY DI BOND 0 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT 10 SIGNATURE OF OWNER OR AGENT L I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complianc with all Pertine rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME LICENSE# ! 9 - I SIGNATURE MP El JP CORPORATION 0#=PARTNERSHIPPi##[=LLC LLC COMPANY NAME = _ /'�, �. ; ADDRESS CITY - j STATE ZIP TEL FAX � YB CELL 6, .474¢. ►o OIAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# �7PLAN REVIEW NOTES The Commonwealth of Massachusetts Department of IndustrialAccidihts Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 7 �%,r✓,-'n,r-) Address: City/state/Zip:,, /L/�,,,® %1r feg n(' 421- Phone#:6,J - .3P2 9 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. am a sole proprietor or partner- listed on the attached sheet.# ? ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. E]Building addition [No workers'comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3111 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.[i Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. Idoherelycero der the pains andpenalties ofperjury that the information provided above is true and correct. - Si ature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: cI r J 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. However the 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 producedacceptable evidence of compliance with the insurance 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 ofpublic 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-contractors)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,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. 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 will bei used as a reference number. In addition,an applicant that must submit multiple permit/license 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.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or 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 fnvestigations 600 Washington Street Boston?MA 02111 TO,#617-7274900 ext 406 or 1-877:MASS.A.88 Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia • ��''''C"iUlY1tY11%1% �`ti�..+.t-� .- a.rt `"'= —„�,�--,,<�f„ PLUMBERS AND t A-SFITTERS =� LICENSED"-AS A J:OURnN,EYMAN PLUMBER: wiSSUES.THE'ABOVE•LICENSE T, I THDMAS S,,0ARHAI)IAN 415 HAMPSTEAD N'H. ,03S41 2U:73 r =, .. 'II 19420 05/0.1/14 1636615 _. Location No. y Date NORTN TOWN OF NORTH ANDOVER p Certificate of Occupancy $ r - b Building/Frame Permit Fee $ Foundation Permit Fee $ / 7!T/y SACH Other Permit Fee $ 9 � Sewer Connection Fee $ 0 //Z.. a 9.,Water Connection Fee $ lei 7111 L— J tOTAL $ /-2"1;7'�-'-- Building Inspector 01, Div. Public Works Location No. �� Date goRTH TOWN OF NORTH ANDOVER . p Certificate of Occupancy $ -Building/Frame Permit Fee $ Foundation Permit Fee $ /vv s�c�usE / Other Permit Fee $ _. tPpSewer Connection Fee $ ha',77112- 5o! �t 7_ f � }?r) T/llyz ?7 Wae� , . 3 TOTAL '" Building Inspector Div. Public Works Location No. d Date ,%ORD TOWN OF NORTH ANDOVER F i.AhLA Certificate of Occupancy $ Building`/game Permit Fee $ sACM�s t Foundation Permit Fee` $ �` �Oth�e�r,�perrfiit Sewer Connection Fee $ Z� Water...yan�on Fee $ • TOTAL t$ ��'� $ Budding Inspector Div. Public Works APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. v AGE 1 MAP 4J0. LOT NO. `p't 2 RECORD OF OWNERSHIP .'DATE BOOK .'PAGE — ZONE I SUB DIV. LOT NO. I LOCATIONr�. PURPOSE OF BUILDING 01 j— OWNER'S NAME NO. OF STORIES SI X300 J � J OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME C1411 TEG' ��H G SIZE OF FLOOR TIMBERS 1STA�/,j 2ND A PS 3RD '3 y BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING / DIMEN61ON& OF SILLS XI (- Tia To- DISTANCE FROM STREETL if �" POSTS DISTANCE FROM LOT LINES—SIDES "REAR GIRDERS 7 � L✓X t! AREA OF LOTS, FRONTAGE l�/S HEIGHT OF FOUNDATION ti! THICKNESS IS BUILDING NEWS - C�� SIZE OF FOOTING G X IS BUILDING ADDITION �A�� MATERIAL OF CHIMNEY IS BUILDING ALTERATION fes°" IS BUILDING ON SOLID OR FILLED LAND I WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPER INFORMATION ony Famum "o"' LAND COST SEE BOTH SIDES SEG By PAK 114.8-5. B•C• EST. BLDG..COST PAGE 1 FILL OUT SECTIONS 1 - 3 p EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12DATE 71 � . f��D /r �U EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED.AND APPROVED BY BUILDING INSPECTOR DATE FILED �n BOARD OF HEALTH • GNATUR OWNER OR AUTHORIZED AGENT ol— OWNER TEL,P- FEE /39' . Std CONTR.TEL.#_-. CONTR.LIC.# PLANNING BOARD PERMIT GRANTED LO 19 97-- UK PERMIT1 `7.So LESS FDA f f..._..., - - DUE FRAME PERM Cl 1'2-'F Sa BOARD OF SELECTMEN ",Wf't FOR FRAME/BUILDING rx>t i.�ttzw�s FEEPA# BUILDING INWP CTOR BUILDING RECORD „ i OCCUPANCY. 12 - , �;�•. -_=. '<. • ::.t SINGLE FAMILY �., STORIES THIS SECTION MUST SHOW EXACT DIMENSI.ONS`O•F LOT`AND`DJ$TA°N�E FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF,,BU;ILp17VGS.''VHITH'PORC-HES. GA- APARTMENTS RAGES. ETC. SUP 1 ro ER MPOSE•D..TMIS REPII.AGES'•.PLOT P.LA�N,•`,�� CONSTRUCTION 2 FOUNDATION � }8 INTERIOR FINISH^ v t ` CONCRETE :I 3 1 2 I3_ - CONCRETE BL K. �� PINE (ri _ BRICK OR STONE HARDW D l PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMERi-',• I V AREA FULL ^ FIN. B'M'TAREA '/ FIN. ATTIC AREA ., NO BMT FIREPLA�E$..-, HEAD ROOM MODERN•'AGITCHCIN 4 WALLS .9 .,> FLOORS CLAPBOARDS - B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D ASBESTOS SIDING _ COM _PH _ x VERT. SIDING ASPH. TILE - STUCCO ON MASONRY STUCCO ON FRAME Y BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME I - CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME tl'- 37 SUPERIOR I-I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I I HIP % BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ + ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR.& GRAVEL STALL SHOWER ,_ "_`•�_�` "' .`� _ ' ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO D 6 FRAMING I 11 HEATING -.,• ._ WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. ?�� TIMBER BMS. &COLS. STEAM Tjo STEEL BMS. &COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING - ' RADIANT H'T'G UNIT HEATERS � ?�iRiS; 7 NO. OF ROOMS GAS i +` r r R.,E r gK+ .• ✓_. B'M'T.. 2nd'." _ ELECTRIC �:1+:itl s attar o 3� 1st 13rd I NO HEATING FORM Uj` TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION G� f:�/e�lC'G1'7 ASSESSORS MAP SUBDIVISION LOT(S) . PERMANEWT ADDRESS (�S_SIGNED BY D.P.W. STREET i ef7 APPLICANT ' Q let CC) C5 �-- PHONE DATE OF APPLICATION 24 TOWN USE BE14OW THIS 'LIN PLANN NG Bt OA APPROVED �•� �x . TOW PLANNER DATE REJECTED CONSERVATION C MMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT 4.f0,61 SEWER/WATER CONN CTION /'h S!/ 7 ✓ FIRE DEPT. y RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of tie la-nuns and- 4iealth Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. a �OGATEc� l U 1LJo12=✓ A tiJ Oo'4e=- ..M(cN, SG�c�E,:l"= 4-0` QP►-rE.: g12��92 � A 1 3 CJ 1 1 U �. N 44-1 N i 1 2s4J 4Z 41 i A� f u--ea,- // �l 2825 ` -... �,•-8.46 ,i � ,� .O = GE�i�Tli~� THA c PFS�TS S+idw�.1 A2EOTL T4{E �A`tH OF l G�H a kJ�3 C.oMPLy O/J C.-Y .A k-A Er t]rc,TE.2 til��•j ATtowJ aF �oa1 i►.�Gr '3 V► \,LJ rr-F F TH E ZaA1 IU Cz .13M Cou�ofZM Tom/ . 02.. Uo�.•i Goti F-oQ�M fTY k[ N E.U C o►.,i 5"r fZ.UGTEiD. /(t��L 9 8�ZC_1`t2 1 i OWERMATER FINAL e=OR 7 P:# }, .n c n �pf Own ® �� ® f �� Andover o. it- '4 i�' tY h} y. DR IVEWAY ENTRY PERMIT QerM�EArt ovass., �c�L �. 19SZ oRF 1Pof PERMIT T LD to BOARD OF HEALTH � 1 1 THIS CERTIFIES THAT............. •...M �+"{..�r....................................1...... . BUILDING INSPECTOR has permission to erect Pd�.Fk � buildings on4.� �.- dd '...f�I�bo�...`p .. � Rough Chimney to be occupied as....... �. �.�� .. f4'N!�d;�• .,��,Wt�;l./.N! ..�!'J/ ".:� ..1�ICHI` Fina provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. MR FOUNDATION ONLY RI ED BY . 114.1K &C- VIOLATION VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTH �3,9i PA�p Ro ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S'I_h I S service PERMIT FOR FRAME/BUILDING Final ............... ....................................... DATE:9��4�FEE PAID: .___ /2 71 BUILDING INSPECTOR GAS INSPECTOR �— Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner STRENo Lathing to Be Done Until Inspected and Approved by mo erDe' �� � Building Inspector K� 5► ,J CERTIFICATE OF USE OCCUPANCY a P To Building Permit Number 304 Date DECEMBER 18 1992 THIS CERTIFIES THAT THE BUILDING LOCATED ON LDT 12 - 41 Hidden Co u r'_t MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. NORTH oF,+neo ,b�ti CERTIFICATE ISSUED TO A. J. Mai 1 l e t ` ' 1 p 41 Hidden Court) 3 Westcott Rd. ADDRESS �9S Andover , GL SA HUSES h Y BuiIdil Kg Inspector F NORTly �Z )wn of 6 ndover ;RM 1T �- - Ks nc o er, Mass., �"�L` 9 19�� Cu M CNE WICK •; Q \� OR Pa SS BOARD OF HEALTH ..... .........M�+l..........11T T LD ......................................... ..... !� 14N!�, 4,1,n1k.n.4.1...�1 bAer ..�Cc .#tr RoughUILD,M I/,0CT30�Rbuildings on IlJ�v w/4�4�c t ..�f � Chimney)_Gtr �)O/&4_,)) j. 1 Final&4_0(7, lcZ—Ir /i1Z this permit shall in every respect conform to the terms of the application on file in ALU IING.INSPECTOR the Codes and By-Laws relating to the Inspection,Alteration and Construction of "Rou / kndover. PEM FOR POUNWO ONLY IMMLM BY PARA 1t1k& B.C. .Ki — Wilding Regulations Voids this Permit. =RMIT EXPIRES IN 6 MONTHc, w ELE&RICALINSPECTOR D. VIVO FEE PAID�.,�... . Rough NLESS CONSTRUCTION t �S Service Final ............... ....................................... BUILDING INSPECTOR GAS INSPECTOR Wey Permit Required to Occupy Building Rough list n i Conspicuous Place on the Premises - Do Not Remove Burner FIRE DEPT. Done Until Ins ected and A roved sTREErNO. ��° � P PP J by Smoke De . •"'•, Building Inspector ector j r Location _a N0. ? Date r°"T" TOWN OF NORTH ANDOVER aamwiMk S Certificate of Occupancy $ + + ��ing/Frame Permit Fee $ �'s'„"°•� � oundation Permit Fee $ 1o�� Other Permit Fee $ = y $ewar Connection Fee $ ater Connection Fee $ (�•� TOTAL Building Inspector Div. Public Works Fa�trlt:xTo. � APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 Aa MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP jDATE BOOK ;PAGE ZONE I SUB DIV. LOT NO. %LOCATION ] M P f OSE OF BUILDING OWNER'S NAME/ NO. OF STORIES OWNER'S ADDRESS �- W BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1S 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST D^Ih r PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ.SFT. EST. BLDG. COST PER ROOM .t PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILEDA p APP/R/OVE///D���BY BUILDING INSPECTOR DAT FILED / � BOARD OF HEALTH IGNATURE 151F OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED OWNER TEL.011i " c3"" 7 PLANNING BOARD CONTR.TEL. # 19 CONTR. LIC.# BOARD OF SELECTMEN BU ILDI O INSPECTOR C-- BUILDING RECORD 1 OCCUPANCY 4"`lr*-4x l`4 12 SINGLE FAMILY Si3Ok1E5 J , �'^� `' '_� t~� THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES ` ` "` 1 LOT LINES AND EXACT,. DIMENSIONS�OF\BUILDINGS, WITH,PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES,,PLO ,,PLAN.WITH, CONSTRUCTI 2 FOUNDATION 8 ``1`NTERI6RlFINISH CONCRETE 3 1 2J,, CONCRETE BL K. PINE _ I^ 1 BRICK OR STONE HARDW PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 —2 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDI!J'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME A SUPERIOR I J POOR ADEOUATE I NONE f 5 ROOF 10 PLUMBING a. GABLE I HIP BATH 13 FIX.) {{� GAMBRELMANSARD TOILET RM. 12 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL - STALL SHOWER \� ROLL ROOFING I I MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING ( 1 WOOD JOIST PIPELESS FURNACE til iJ C1 FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR \ C""\ WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 ",NO. OF ROOMS GAS OIL B'M'T 2nd ! \'\ ELECTRIC' N . Ist �`I , O HEATING \ �� �_ NORTH �� Fr ovm ,r ,, o �or ,� ? Andover ,. 0 No. 52D _ -`�-" `^' ' dower Mass. 19 O �n 'T > > 2 cocN�c is ' �` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �A - � BUILDING INSPECTOR mfo ..L... •••••eaves•THIS CERTIFIES THA ..... Foundation It$�� 4L � 1b� SHAPArm.� y. �... ...... : . ... Roughhas permission to two*..................... - • .� irm a.........:: Chimney to be occupied as A :���....��.�..��...�•w. ,.. .: - .. .... om._ ._-........ 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 Con truction of Buildings in the Town of North Andover. �w ��..♦�1l V AE--tT t'-_r III ('P' 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 INSPECT R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL 1 f;/ 2 CONSERVATION FINAL Street No. C41 ` Smoke Det. r.rA.rrn „A,ATrr, MR1A1 x,1,2 nRwPAW FNTRY PERMIT _ �- -- X34. Date. . �.� .e:'.. . ... .. . :X NORTH 6 TOWN OF NORTH ANDOVER O PERMIT FOR GAS INSTALLATION p- SSACMUSE 'T'his certifies that . . . 1 411Y.1�?r. . . . . . . . . . . . . . . . . . . has permission for gas installation . LA.#. . . . . . . . . . . . . . . . . . . . . . in the buildings of . Pd. .61 . . . . . . . . . . . . . . . . . . . . . . . . . at .. . . . . . . . .. North Andover, Mass. Fee. . . . Lic. No.. r_:).3.). AS INSPECTOR 3 Check# 7 5468 MASSACHUSETTS UNIFORM APPLICATION FOR'PERMIT TO 00 GASFITTING : iPrt t Or ypd Mass. ate 0� b Pe t j t3 Idinq LqFatloq Owner's . Type of Occupancy NOWD Renovatlonp Repixemertt� Plans StlbMt:faed: Yes p No p W lu- C7 _ oo CC t6 tz- �� J W Z a o ., ,. . S„B-ISIS . DEME 1SrFLOOR � 2ND FLOOR 3RD FLOOR 4 FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR FM FLOOR t 00911`g Company Dame Check one: Certificate Qtdress 0 Corporation r isiness Telephone --U 0 Partnership itne of Licensed Plumber or 00 Fitter lrnvCo. NBURANCE COVERAGE: have a currentobillty Insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes No 0 f:you have checked yes,please Indicate the •~ type of coverage by ehtxkinq the appropriate box. ►iiabitlty insurance policy a,/ Other type of indemnity 0 now C) f1fVf1ER'S 06URNACfI WAIVIIII: i am aware that the licensee does not have the Insurance coverage required by C hapter E42 of the Mass.General Laws, end that my signature an this'per epptleallon yiralves this requirement linature at caner or canes pen Check one: Owner p Agent p Weby certify that an of the detaM and lnformadon I have submitted for entered)In above a ptication aro true and accurate to the best of knovMedge and that all Pl n eine work and Ins madons performed under the perm{t r this applicaton be in compflance wits~ pertinent provisions of the MassaChusetfs State Gas code and Chapter 342 of the D L Type of License: Sr 0 Plumber ro O cer ted ee Plu er or Gas F iter cif O Gasptter CiryRown Oester Lk:ense Number APPROVED(OFFICE USE ONLY) 13 Journeyman RSELOw roo OFFICS use ONLY FINAL INSPECTION* ( SI'1100Rtii INSI►SECTIONi iEt N0. APPLICATION r4M PSIMIT TO 00 FLYYYINO 11AO1.'i TTI!0/iY1LM114 LOCATION Of OINROIMO - - �iYMYtf1 MMMT OIIANTl0 ' DATW .....�...�.10..,r� Pump"IIM►�CTOw