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Miscellaneous - 43 NADINE LANE 4/30/2018
43 NADINE LANE 210/025.0-0133-0000.0 i �h f 4 L I, I i t I 7700 Date. I... .. .. eaORTM ,ti0 TOWN OF NORTH ANDOVER 41. � PERMIT FOR GAS INSTALLATION . o �9SSAC14USEtS V This certifies that . .! r .?. . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . �w in the buildings of . . �(-.5 5✓�. . . .`►�!�+ ' �. . . . . . . . . . . . f at Al.I A . .L.V^... . . . . . . . . .. North Andover, Mass. Fee. �O.-5.?. Lic. No.,I3 � . . . . . . . . . . . . . . .. . . . . .. . .. . . . GAS INSPECTOR Check 4 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:N t 1,GCXJI/t/1l- MA. Date• P rmit# /VJ-AM-Building Location: ' /l (( Owners Name—A&A, Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential NK New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No❑ FIXTURES W LU Q U)N 0 = Z D 2 O W Lu V N (Al O = lZ W Z J Z H 0 ix W D X 0 H O cn w W W m Q a. IW— a O W X W to U Z LU W Z W Z W W W 0 = 1i > W W 2 O J H O Z J O u_ = Lu l.- W W 0 3 Q W W > O Z O W Z 2 W Q F o o U. 0 0 _ _ 0 a a� I- > > > 3 0 SUB BSMT. BASEMENT 1 FLOOR 2 u FLOOR Vu FLOOR 4 FLOOR 61n FLOOR —C—FLOOR 7 FLOOR 8 FLOOR Installing Company NameCheck One Only Certificate# . orporation Address: City/Town: 4h State: ❑Partnership Business Telbut Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter: L2e INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes ala-o❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy fid' Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:1 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 ❑ Signature of Owner or Owner's Aclent Owner El Agent By checking this box❑;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 compliance with all Pertinent provision of the Massachusetts State Plu ing Code and Chapter 142 he General Laws. By Type of License: ❑Plumber Title �❑�Gd�ss Fitter ature of Licensed lumber/Gas Fitter L�'Master City/rown Diourneyman License Number: APPROVED OFFICE USE ONLY r-1LPInstaller 7 . . Date.f .T. ..�'!. ..... I f NORTH 1 ir. 03 A TOWN OF NORTH ANDOVER i PERMIT FOR GAS INSTALLATION SNcNUSE� This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . • • . • • • in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . .. North Andover, Mass. '} Fee. �� . . . . Lic. No.`7 >. . . . '`�' � .. . . . . . . . �dAS INSPECTOR Check# 4 5426 MASSACHUSETTS UNIFORM APPLICATION FOR'PERMIT TO DO GASF �� (Print or ype) ITTING 1 I Mass. Date20 /e � _=.Y_ Permit Building Locatio owners Isr Type of Occupancy New❑ Renovation D Replacement/ Plans Submitted: Yes D No D 0 , I OUj �2 c� m o = � � uj ZI > � � � Zoo .� W = O C7 = D C70 O . . SUB-BSMT -SiL AL BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR nstailing Company Name Check one: Certificate kddress ❑ Corporation 3uslness Telephone_L _U ❑ Partnership dame of Licensed Plumber.or tans Fitter Imo• INSURANCE COVERAGE: 'I have a current 11 blllty insurance policy or its substantial equivalent; which Yes No D h meets the requirements of MCL C 142. If you have checked yes,please Indicate the type of coverage by checking the appropriate box. A liability Insurance policy a/ Other type of indemnity ❑ Bond OWNER'S INSURNACE 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 ffTs7pie-rifirFaipplication waives this requirement signature o Owner or0 wners Agen Check one: Owner ❑ Agent D iereby certify that all of the details and Information 1 have submitted for entered(In above application are true and accurate to the best of y knowledge and that all plumbing work and Installations performed under the perrNt is e r this application be in compliance with I pertinent provisions of the Massachusetts state Cas Code and Chapter 142 of the Ce L Type of License: By ❑Plumber Title S gn re of L tensed Plu ber or Cas F tter ❑Casfitter APPROVED(OFFICE USE ONLY) &M23ter License Number ❑Journeyman r r. BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES � PROGRESS INSPECTIONS FEE N0. , APPLICATION FOR PERMIT TO 00 PLUMBING HAVE&TYPE OF BUILDING LOCATION OF BUILDING ►LUMBEN PERMIT GRANTED 1 DATE MBING INS►ECTOII I Date. . . . . "°R'"1ti TOWN OF NORTH ANDOVER . o PERMIT FOR PLUMBING ,SSACHUS� ,��/ f hat %%t l I�- . .. L Gt L G . . . . This certifiest f IJ has permission to perform Y .// . 1./1 -.1.- ./. . .'./�. . . . . �� W Plum . in g in the uH lings of �. .�. `..� . . . . . . . . • . . . . at .� / . .�/(_%t .,. . . . ....1- . . . . . . , North Andover, Mass. Fee 1. ... . . . .Lic. No.,/��A� PPPPPP . PLUMBING INSPECTOR . . . . . . . P� PLUMBING INSPECTOR Check # z 653 { fill [ N9 1,1 1 � $ c � � o -41�. WATER CLOSETS 3 KITCHEN SINKS c " LAVATORIES if 9 a '1 BATHTUB [ O g ( SHOWER STALLS ti g _ DISHWASHERS � Ir 3 ti O ,K DISPOSERS �.�----"' 4 LAUNDRY TRAYS WASH. MACH. CONN. S HOT WATER TANKS TANKLESS O g SLOP SINKS FLOOR DRAINS -q O OAS TRAPS o 00 9' Q ❑ O URINALS \ H � ,0 ORINKINO FOUNTAIN AREA DRAIN WATER PIPING 171n ROOF DRAINS N � O old ❑ DACKFLOW PREV. v C. OTHER FIXTURES: O BOILER MATE -p GREASE TRAP C SCULLERY SINK O W g SHOWER VALVE `� Z BELOW FOR OFFICE USE ONLY l' s FINAL INSPECTIONS SKETCHES FEE PROGRESS INSPECTIONS NO. APPLICATION FOR PERMIT TO 00 PLUMBING UNDERGROUND ROUGH COMPLETE ROUGH FINAL INSPECTION PERMIT GRANTED DATE PLUMBING INSPECTOR Date. . . /./. . .0 1. . . .... . �- Of 40 DTH 1ti of �' °�° TOWN OF NORTH ANDOVER F 9 • PERMIT FOR GAS INSTALLATION �9SSgcmus t jJ � This'certifies that . of.. . has permission for gas installation . . . -; .. � !. . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Lic. N / . . . . . . . . . . . . . . . . . Fee. . . . o. .� GAS INSPECTOR Check# - 44762 <� wssACHUSETT _UNIFORM -APPUCATI0N-F0fr:pEFfMff TO DO GASFtTnN ftnt��or Type).. i'Iv , C n r . Mass. Date 40 420 Permit Bubidfcp Loatioa � /ULMW / Owner's Name- !'l�Ar Type of Occupancy New ❑ Renovation.-❑ Rebar Plans Submitted: Yesp No p - r Z-1 Itz a C' . a. a o: W j a W. O- Li m �' S• . = o i s z Z- C 0 - Z j 1�-. Z W SUB—aSMT. BASEMENT 1ST FLOOR 2ND FLOOR 980 FLOOR _ 4TH FLOOR . STH FLOOR STH FLOOR 7TH FLOOR STH FLOOR.. Na Installing CompanNam= Cheek-one o. v. Certiriata Address- 544 2P �f . ❑ Corporation- le Im orporation- eIm,(l,Q rn n ► I ❑ Partnership Business Telephone -7'Fs i- M F.9 - ?, q 1 Firm/Co. Name of Ucensed Plumber,or Gas FEW, teo-en INSURANCE-COVERAGE:. J61 have a curve Ilability•insurattoep%cy.or Its� equivalent.Whkh-meets the Yes � No 13requirements ot:,MGL-Ch: 142.. !: you have checkedaM"Aw Jndiaatia�gw fte-:coverage%by the*kV the appropriate:box. A IWAlty insurancevolky Other:type-OLkwemr#y.[I Bond ❑ OWNER'S INSURANCE.WAIVER.1 am�aware that.the ficensee does•not:have: the insurance.coverage required by. Chapter 142 of the Mass. General-law & and1hat.my signature-on.this-permit-application waives.this requirement Check one: Signature ot.Oww_*r'Owners Agent- OwnerO Agent.❑ I hereby certiy that all of the details and information l have submitted(or entered)in.above application am true and accurate.to.the beat of my knowledge and that all plumbing work and installationspedom"d under the pem*issued for this application will be in compliance with aq. Pertinent provisions of the Massachusetts State Cas Code and Chapter 142 of the GLaws Tyoe of bkense: AL_11= ,ff��A4�w_ Plumber 9r!Vdensed PlumberFitter Title fGasfitter Master License Number 310(0. r /Town Journeyman 1 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME l TYPE OF BUILDING, LOCATION OF EUILDIN.a PLUMBER Op OASFI*TER Ljc. w0. _ - i PEMMIT ORANtED DATE .... 20 •, OAS INSPECTOR FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and bepartments 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 APPLICANb�1,1 tk% PHONE X78 "6�Z LOCATION: Assessor's Map Number 6)2-S PARCEL__0 f3 3 SUBDIVISION LOT(S) STREET LA-KJLL L f 3 ST. NUMBER ********** * ** ******OFFICIAL USE ONLY*** ** *** ***** * * ICNSERVATION MMENDATIO S OF TOWN AGENTS: ADMIN RATOR DATE APPROVED DATE REJECTED_ S , D 0. COMMENT 60� -F -zone-. Mas �1. TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9W im LOT 16 r A=5000 S.F 1 _ + 43 NA, Aj IN p �Ie30ow no s r. - a T 248 73 7� N p CA TlD N PLA lV [ c€Rr,FY TKAr > eR/MARr,sTRlncTURE,SNOWH CONFORMS TO,. s � e ;- 7.- TNENORIZQNIAL SETBACK REOUI'EA/ENfS O THE L00�4L t - - APPttCABLE ZONITI& BY;SAWS [N EFFEG;t WNEN CONSTRUCtEO. .c r a rte_SUCH D&ES �CON LrJr NDSYEAS£AIENlS. ct EN1' SCDTT CQN�Tf� �,, �► � . oRnERS aF Ery) .: ' THIS,�DIPAWMIC SNAlL;NOT+BLr USED ENT FOR ANY ...' THIS -7 THE.15'MAQE. AND L%M/TEU: RPO ° !^�. TNAr nvTuNm AeovE;ExcEpl knm THE. WRilTENrPERAf/SS/0Af'OF CItRISTIANSEN- SERA INC T,O THE-"AA6 `Ct: FI/12THERMORf1TN/s aPAwarc /s THE corYR,cyTED arROPERTY + SET/ ,sM /Nr_ AND ANY l) AU0 R120,u E , O�CHRISTIAN IS PI4aN/KITED CNR[S7LtNSEN h`SERC[ TA/( S NO RESPON, BIU,TY . FOR THE UNAUTHOR/ED USE QF TN/S bRAWl11G`.xOA` ANY INFCR-. . Affil TION CONTAINED ADMON. # ` LOCA TION: NA:D7NE -LN.-NO A`NDOVM MA . `�jH QF ,yT SCALFt 1"-2p' DATE: 1 /14/95 ER CHRISTIANS EN SERGI PROFESSIONAL Y "o ENGINEERS 160 SUMMER Sr. HAV&H"MA. 0:t83.0 TEL 508-373=0310 ©1995 BY CHRISTIANSEN 8' SERCI INC. DWG.N0.:-94015014 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.......❑ SECTION 5 Descri tion of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑Tddition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Prop�o(sed Work: btk < Acv Jesed, SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFI+'I�IAL USE UNLY �< Completed by permit applicant 1. BuildingGUO (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 2-00 O. c.t-�' Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, t ` t w ��`"��{'�' ,as Owner/Authorized Agent of subject property i Hereby authorize to act on My behalf,in amatt 1s r� elative to rk uthorized by this building permit application. y 2-0 Signature of Owner Date SECTION 7b OWNER/AUTHORIZED ArGE,N.TnDECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief PrintName Si ture of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlvIBERS 1 2 3 SPAN DIMENSIONS OF SILLS j DIN ENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGFIT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: X 3 SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 't` - 9 J e r Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Dist c—t Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R aired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ 7-one Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record (� IIQ A.-• C �I 3 Nadia Lk N R mm Name(Print) Address for Service: '9-1 p` Qj�� Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Mn Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name M Registration Number r Address r Z Expiration Date /1 Signature Telephone Y/ North Andover Building Department A 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 c 11, S.150 A., The debris will be disposed of in: ct"451Cb (Location of Facility) Signature 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 � � I 'i_� ' � 101 .1-1i = i f � - s,��� � - i- +- � -r it - � - 4f` �i _ _�i� '�- - - - � � � - � 4 - - ,! - � _r tI - _ ht � � I II -4 I ` I � 'iI 'i r � � � ; I � rt I I I I I I I I I I 1 I 1 I � I I I I I I i I I i I , 1 � I I Il 1 I I I I I I 1 j I I I I I I 1 I I I I 1 I �-I LOT 16 A=5000 S.F. P1 � L=29s, P s � F.248.73 \ 71.7' Nz• I CERTIFY THAT PRI STRUCTURE FO UNDA TION L OCA TION .PLAN THE HORIZONTAL T SHE ETBACKA RY REQUIREMENTS OFOWN THE LOCALRMS TO APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTSWETLANDS,EASEMENTS, CLIENT: SCOTT C 0 NS TR. ORDERS OF CONDITIONSETC.) THIS DRAWING SHALL NOT HE USED BY THE CLIENT FOR ANY THIS CERTIFICATION IS MADE AND LIMITED PURPOSE OTHER THAN THAT OUTLINED ABOVE,EXCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC TO THE ABOVE CLIENT. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR. THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. LOCATION: NADINE LN.-NO.ANDOVER,MA. . \N OF, SCALE: 1"=20' DATE: 11/14/95 EA f o"c° is OSA( lk CHRISTIANSEN42 h SERGI PROFNDONAL EYORSNGIN ERS 160 SUMMER ST. HAVERHILL,MA. 01830 TEL 508-373-0310 ©1995 BY CHRISTIANSEN & SERGI INC. DWG.NO.:94015014 q g-4tf Az 1L� L:cZat'ion orb t tq P_; L No... Date w: w g� $ of "�"T �h TOWN OF NORTH ANDOVER ? � , 00 mighp Certificate of Occupancy $ Building/Frame Permit Fee $ �sJ�cHuSE�h Foundation Permit Fee $ n a Other Permit Fee - $ f ' Sewer Connection Fee $ Water Connection Fee $ !► TOTAL. lK �JZ I�vU Building Inspector 09/01/95 13:57 870.00 PAID - 8744 Div. Public Works location k- Dafte Of °MORTM O '1 TOWN OF NORTH ANDOVER �• 'ti'p p Certificate of Occupancy $ - 9 Suiidjng%Frame Permit Fee $ ► �7 n° I` cMusEth Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee i $ Water Connection Fee $ /n77, 5,f,* TOTAL $ z07�•JZ�� Nr f 2-9t _ Duldi g Inspector Div.Aublic Works 83$9 PE&AIT NO.' "VD APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. J PAGE 1 MALOT NO. `�� -�� 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. 1. i — /6 ( 1-3 LoCATION4S /I�ftA b� PURPOSE OF BUILDING C �2 "e— OWNER'S � OVL'NER'S NAME /es�p� E/e NO. OF STORIES SIZE zC*X3 M_ 11/04; / h� >✓Y _ mpow J OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME C O � ` IESIZE OF FLOOR TIMBERS 1STX:6 J (O 2ND 3R jj 3 P ,BUILDER'S NAME ��--/+oW!n co SPAN I Q 1I -��(,� 2—XB TO NEAREST BUILDING 1. DIMENSIONS OF 1I SILLS �x/ I.- - DISTANCE FROM STREET (90t POSTS DISTANCE FROM LOT LINES-SIDES •- REAR I571+Ir GIRDERS V i AREA OF LOT FRONTAGE -� HEIGHT OF FOUNDATIONGw^ �r l� 6,1000 !75 — THICKNESS I®F/ IS BUILDING NEW f SIZE OF FOOTING Y X 1� �I 1 IS BUILDING ADDITION y� MATERIAL OF CHIMNEY IS BUILDING ALTERATIONV® IS BUILDING ON SOLID OR FILLED LAND 570(('t WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ,IEC IS BUILDING CONNECTED TO TOWN WATER �S BOARD OF APPEALS ACTION. IF ANY pr® 7 J ly IS BUILDING CONNECTED TO TOWN SEWER �S IS BUILDING CONNECTED TO NATURAL GAS LINE YES •s INSTRUCTIONS 3 ' PROPERTY INFORMATION SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY LAND COST REGULATED BY PARA. 114.8-S. O.C. EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. � >PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM ` FEE PAID I PE SEPTIC PERMIT NO. +r-�l ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDI q APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED V[Srav BUILDING INSPECTOR SIGNATURE OF OWNER OR AUTHORIZES AGENT py i' `�� 3114cso3y FEE u�� OWNER TEL.# PERMIT GRANTED PERMIT FOR FRAME/BUILDING - CONTR.TEL.# 3?V o4c�3� 19 � CONTR.LIC.# �✓G ATE. FEE PAID t H.I.C.# - f AUG 2 6G.PERMIT FEE 838�t 8Z4 LESS FDA FEE......._...r.. _._,.. a'T`M-08 �w� WE FRAME PERMIT 8 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI.'FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS . RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION ' 2 FOUNDATION I MINE- BRICK8 INTERIOR FINISH ! ry CONCRETE ��(�II� d 1 2 I3 j CONCRETE BL'K. OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN.' 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/, '/2 �/, FIN. ATTIC AREA HOPLACES T D ROOM MODERN KITCHEN 4 WALLS I +9 FLOORS ` CLAPBOARDS 1 22 J 3 f DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"V'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME I rr BRICK ON MASONRY ATTIC STRS. 8 FLOOR I_ BRICK ON FRAME. CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR _ Fr ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I IP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) L i-LAT11 SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK ' SLATE NO.PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TIL DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE I' FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS.' HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING I � RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS + OIL B'M'T 2nd -ELECTRIC v� 13rd I Ni#Vqm ..iSf t �I f TIMMRAW 3 ORT own of - 4 over .I� L y - s. 'ort dover, Mass., A oct ?A 19 c"' l- O , LA1lE /. COCHICHLWICN E BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT... S.I S? .... ....... .1 �................................... . Foundation f has permission to erect.... ...... buildings on ... ..... .��.1.irk ........1�- {...............'( �..0*...��� Rough to be occupied as...s 1,.t6(t....TAML<. . 4�.�it�.ni6...... /........I...<A. Q ,.....��1. >X444:......�&P.Ut.CO�+AW� Chimney l�tl� / f the licafion on file in provided that the person accepting this perrrlit shall in every respect conform to the terms o pp 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. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough 0��' � Final PERMIT EXP 6 MCWnLQ -FEE PAID �..�► � , ELECTRICAL INSPECTOR UNLESS CON TR S Rough Service L-T) NG INSPECTOR Final Occupancy Permit Required to Occupy Building ��V PECTOR Display in a Conspicuous Place on the Premises — Do Not Remove P y No Lathing or Dry Wall To Be Done _� FTRE DEPARTMENT Until Inspected and Approved by the Building Inspector. pet Burner PLANNING FINAL CONSERVATION FINAL street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT l was-...-.tea.... .� .. - ...._.�.r� r ._.-.__ i.•. �_e. -ti-a:_< c�f-. Y _:..L::. - . �tx -.:.1-�-tix ..__ .ago _ .. =FORK U -- LOT RFTEASE FOM( _. INSTRUCTIONS: This fora is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state lav, regulations or rez�? �ts. _ _....... - s fills out .this section***************** ' APPLICANT: I to E1% ` -. r Phone 7 4 Oy 7 LOCATION: Assessor's :dap Number C Parcel �a 1 -,�-3 Subdivision /YAni WE Ll��/F Lot s /6 Street St. Number ' c4a1 se Only**x*****x*************** RECO '1D N TCWN, AGr:.`1TS: Da_e ALoroved 7; j J" CvII:�e::LS �ig) Date Approved 12,11 9 _cwn Planner Dasa Rejected �cswe.^.:s Date Approved Fced inspector-Healt'n Dare Rejected Date ADaroved d Dat_ Rejected .fir Public worts - sewer/water ccnrectionsW - driveway cer-m.it '7:5J tA) 6-21- qS S,wo Kc Fere w S11-1.v g# ZE ZZ3 Depa=tnent ,�� l�eG/CC� D t/T 7764 Redeived by Build-- Irspeczc_ Date AUG 2 0 1995 L ® / 16 A=5000 S.F. L-2$s. 0 lz- T.F.248.73 \ 71.7' FOUNDATION LOCA TION PLAN' THE HORIZONTAL TTSETBACK REQUIREMENTS OF RMS TO THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS,WETLANDS,EASEMENTS, CLIENT: SCOTT CONSTR. ORDERS OF CONDITIONSETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY THIS CERTIFICATION IS MADE AND LIMITED PURPOSE OTHER THAN THAT OUTLINED ABOVE,ExcEPr WITH THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. TO THE ABOVE CLIENT. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR MATION CONTAINED HEREON. LOCATION NADINE LN.-NO.ANDOVER,MA. StA OF �qs a� Jq • o J. SCALE: 1"=20' DATE: 11/14/95 EA ti F D fClS 0`,Qyz�� �q( LA 5 CHRISTIANSEN ! SERGI PROFESS ONAL EYORSNGIN ERS 160 SUMMER Sr. HAVERHILL,MA. 01830 TEL 508-373-0310 ©1995 BY CHRISTIANSEN & SERGI INC. DWG.N0.:94015014 NADINE LANE North Andover ......... -------------- oo GD o0 00 00 22 X ' 30 SPLIT COLONIAL AUG 29 3 BEDROOMS - 2 1/2 BATHS - GARAGE 5030-10134 r I I I I I i EEJ EEI E��H LL3 FH El E�d Kill kr PEEB. -EM1, ......... I I I - - - - - - - - - T - - - -I FRONT 1 ELEVA r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - = - - - - - - - - - - - - - { 1/4�► _ l,p„ 10234 1- 9 _ (= _ o OOC LEH p o IN'S ■■■ ■■■ � _ ■■■ ■■� = LLIJ - C C iii ■■■ ■■■ ■■■ _ _ C iiil ■■■ ■■■ ■■■ _ ■■■ ■■■ C C ■■■ ■■■ Date — e ■■■ ■■■ C � .7 IIII.. 111111 :� C � • • ■ A , \ a i , \ i 1 : 11011 GeneralNotes: 1. All dimensions are to be field verified by the Contractor and any adjustments made accordingly. 2. All work shall be completed in compliance with all applicable Building, Plumbing, Electrical codes. Any other local, state and/or federal codes ■■■ a Ithat mayapply to this project shallbe considered as part of e construction documents. 3. All waste materials and debris shall be removed an ispose o proper y 4. All structural materials shall be void of any defects that may dim inish their capacity to function in an adequate manner. Structural Engineering or any other professional services that may be required shall be provided • others. 5. All penetrations (Plumbing, Electrical, Heating, etc.) thru floors shall be completely Fire Caulked. • All wallsadjacent to stairs shallhave Blocking -• adjacent to the stringers. LFFT O \ 10011 • 10'6" 11'6" 2'0" 81 0" 2'0" 5'3" 513" 6'8" 4'10" 490" ~ 4'0" . 6'0" DING 2'10" 3'5" 01 i 0}q iLL ir3 o DINING ROOM KITCHEN ° p 5'9'/2" X5'5" LO o � X C) o , , " , " Z 41 BREAKFAST 30" 56 34, �a o ;n L r x o It 0 0 F CV N O I cV � — — — — — — — — — — — — — — — Ecb)- 2 - 26 2'6" C) GARAGE FINISH 0 2'6" 2'6" 41. 0" All wood constructed walls and oI ceiling to have 5/8" type 'X' fre 11' rated Wallboard 'installed 00 O �C) o0 d" — (V f , N a i� U `J C1' C--) i� a Z o N tV O — — — — LIVING ROOM =� Z16" 4'0" GARAGE o } VA" X 5'5" � PORCH F 6'4" 6'4yz" 4" 6'2" 9'0" x 7'0" Overhead door El 12'81/2" 9,0"A- 6'13/4" 6'134" FIRST FLOOR PLAN . 210" 34,011 1/4" = 1'0" 10234 3-9 12'10�4" 9'13/4 12'0" 5* 7►71/4" 5'13/4 400" 2'10" X 4'5" 2'10" X 305" Lo BEDROOM #2 � O } BATH x o 0 (V = NO • Lo —� cel C L. 1 204" 2'o" 5'0" SLIDING `" 316" 3'2112" r N CLOSET CNLo M BATH xCD _ o � o CN CLOSET FN CD 5'0" SLIDING ° CLOSET 710" 5'101/4 2'4" p N 24 O5'0" SLIDING - _ LO � I 710" 5'13/4" � cD X O ZC14 : O N � N (V co BEDROOM 3 M BEDROOM 1 5'91i' X 4'5" o 0 11 5'91i" X 4'5" 5'Am X 4'5" 6'4" 6'41'2 496" 416" 6'13/4" 6'13/4" SECOND FLOOR PLAN 12'812" 9'o" 12'3112" 1/4" - 1'°* 10234 4-9 34'0" 220011 12►01. 12'82" 9'32 210" 8'0" 2'0" up IN low.4 r ----------------------------------- ------------------------- I , , 1 , w ------ 1 -------- -- 35 ------I LO FOUNDATION " " I 1 10" Concrete Wall / 4'0" Pour o 4'10/1 10" Dp x 181 " W Cont Footing i' 1 I 1 I r -----------------------1 1 i A p r--------------I ' 1 1 I 1 I 1 1 1 Bulkhead '--- --------j L--- ' 1 1 size & location o ' 3 2 x 12 Center Beam ; by builder `D I ( yp) > 1 0 ------------------------------- r 1 1/2" Dia.Lally Columns oC I ith 2'6" Sq. x 1'0" Dp. ; °' r--•------------------------� ootng (4 req d) ° GARAGE FINISH ° All wood constructed walls and '► ; celing to have 5/8" type 'XI fire N 1 ° ; rated Wallboard installed i 1 a1 , 1 1 ,► 1 - 1 I O 1 ' 1 1 ' 1 O C: 1 1 1 1 I ' 1 ► 1 O 1 ► 1 a 0 N c 1 ' --- 1 ► 1 � � 1 ► 1 Q � N 00 1 I 1 1 U \ 1 1 I I 1 1 C 1 1 .O d � U) 69V X 3'5" ------------------------ ----- ' -i-1--I--I-- -------------' 1 E 1 o e •►► 1 1 '►► J - ----------------- ----------------1 r--------------------- 1 1 1 1 1 1 a j ,° j j °► 1 1 °. � O 1 1 1 1 1 1 1 L-------------------J !_-------------------------! ' 1 1 — — — — 1 - ------------------------ --- -------------------------- --- J FOUNDATION PLAN 6'4" 6'4y2" 910" '33/4 918" 1'33 1 1/4" = 1'0" 10234 5-9 Continuous Baffled Ridge Vent 2 x 10 Ridge Board 12 i 2 x 6 Collar Ties ® 4'0" O.C. ROOFING -{ Asphalt/Fberglass Roofing Building Paper -. 1/2" Plywood 2x10 ® 16" OC. CEILING Fascia Board 2X8 ® 16" D.C. R30Insulation Vapor Barrier 10" Overhanging Soffit w/vents . Vapor 1/2" Wallboard. FLOOR 3/4" Plywood I r3 2x10016NDC. WALL Siding,Air Barrier Sheathing,2 x 4 ® 16" O.C. T Insulation,Vapor Barrier 2 x 6 ® 16" 0!C. 1/2" Wallboard if LL FLOOR 3/4" Sheathing 2X10 ® 16" OC. Porch post� WALL Siding,Air Barrier Sheathing,2 x 6 ® 16" D.C. Insulation,Vapor Barrier 1/2" Wallboard _ SILL r- 1 — 2 x 6 P.T,1 — 2 x 6 KD. Continuous Sill Gasket 1/2" Dia.x 12" L .Anchor Bolts 4" Concrete Slab ® 8'0" D.C.(max • ,s .a _ _a _ .s .a _a .a .a .a SECTION - FOYER & STAIRWAY, I 1/4" = 1'0" 10234 6 -9 Continuous Baffled Ridge Vent 2 x 10 Ridge Board 12 8 2 x 6 Collar Ties @ 4'0" DC. ROOFING Composite Roofing Building Paper 1/2" Plywood 2x10016" O.C. r` CEILING 2x6 ® 16" D.C. R30 Insulation 10" Overhanging Soffit Vapor Barrier with Venting DO�' 1/2" Wallboard FLOOR 3/4" Plywood . 2X10 ® 16" DC. o WALL Siding,At Barrier Sheathing,2 x 4 ® 16" OC. Insulation, Vapor Barrier X00 1/2" Wallboard i— FLOOR 3/4" Sheathing 2X10 ® 16" DC. 0 WALL Siding,Air Barrier Sheathing, 2 x 6 @ 16" O.C. _ Insulation, Vapor Barrier 1/2" Wallboard (30 FOUNDATION SILL 1 - 2x6KD 1 - 2x6PT ' 10" Concrete Wall Continuous Sil Gasket 10" Dp x 1'8" W Cont. Footing 4" Concrete Slab - 1/2" Dia.x 12" L .Anchor Bolts ® 8'0" O.C.(mC I - a- -qFCTION DININGILIVING 1/4" = 1'0" 10234 7-9 Continuous Baffled Ridge Vent 2 x 10 Ridge Board s 2 x 6 Collar Ties ® 4'0" D.C. ROOFING Asphalt/Fiberglass Roofing .� Building Paper 1/2" Plywood 2x8 ® 16" OC. CEILING 2x8 ® 16" OC. R30 Insulation Vapor Barrier 1/2" Wallboard. FLOOR 3/4" Sheathing 2 X 8 ® 16" OC. 10" Overhanging Soffrt'w/vents R19 Insulation suu� sins sins sus s�tsts sus stsisis stsws s�sis stasis stsisis sutsis sins s�s�s sus WALL Siding,Air Barrier GARAGE FINISH Sheathing,2 x 4 ® 16" D.C. t All wood constructed walls and Insulation, Vapor Barrier ceiling to have 5/8" type 'X' fre 1/2" Wallboard rated Wallboard installed m FLOOR WALL 00 3/4" Sheathing Siding,Air Barrier 2 X 10 ® 16" O.C. Sheathing,2 x 6 ® 16" D.C. Insulation,Vapor Barrier 1/2" Wallboard 00 00 4" Concrete SlabSILL 0 1 — 2 x 6 P.Tj — 2 x 6 KD. Continuous Sill Gasket 1/2" Dia. x 12" L .Anchor Bolts ® 8'0" D.C.(max e FOUNDATION - - 10" Concrete Wall - 10" Dp x 1'8" W Cont Footing SECTION M BEDF AGE 1/4" = 1'0" 10234 8-9 . • ami m 0 CD t r+ O is Go X N Double up floor joist under partition walls above Walls shown are below the framing Walls shown are above the framngDouble up floor joist under partition walls above All members are 2 x 10 ® 16' D.C.(UN.O.) All members are 2 x 10 ® 16' O.C.(UND.) FIRST FLOOR FRAMING SECOND FLOOR FRAMING 1/8' = 1'0' 2 x 12 Ridge Board Fo 2 x 10 Ridge Board ush Framed Beam Walls shown are below the framing All members are 2 x 8 O 16' O.C.(UND.) Double up floor joist under partition walls above All members are 2 x 10 O 16' O.C.(UND) ATTIC FLOOR FRAMING ROOF FRAMING `z Xre O 16" O.C. 10234 9-9 1/80= 10 1/8 — 10 urae....r..., _..�r.....v..a.,.-.�._:�.,.Ym..._.r....:.:au:-- ,m:v.....,.>s�-.r::rY.rtx+.arz�a:r.,rs-.- s-.mw•ssx.o - .:..a.. a:..........•...__...._.._.__" - CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON J7 3 N 04 Of Al E MAY BE OCCUPIED AS f/tit c 4 €' -Ft4 m /v IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. pORTM • �'� � ot CERTIFICATE ISSUED TO R �� O T ADDRESS SACHUS uilding Inspector - ,a } ORT Town of -�A Y 'li, 11" T rt, dover, Mass., Atz4 zz 1918 c' 0 LAKE COCHICMEWICK �A ORATED PPa\ 1 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System N A BUILDING INSPECTOR THIS CERTIFIES THAT.... .1. :C?U.... i ... z �1y1 � n atton has permission to erect.... .., buildings on �`� to be occupied as...�'�.1`.i_(,E�,Mr .....C7��I... ��t.(�4a...... !/....... ... .....! SIQ�Q ......�..�pl.lt.. HI, Chimne provided that the person accepting this perrrlit shall in every respect///conform to the terms of the a licafion on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Finales Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR -Fau VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. a�I►- '94 PERMIT EXP 6 MCMI FEE PAI ELECTR/C/ INS:?PC UNLESS CON TR S � �-�y/ F �p Roug �i��% PERMIT FOR FRAME/BUILDING DATE: t _ FEE PAID "BUI G INSPECTOR Occupancy Permit Required to Occupy Building G INSCTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough / ✓ No Lathing or Dry Wall To Be Done FIRE E T Until Inspected and Approved by the Building Inspector. 3 � Burner V (� PLANNING 1 FINAL CONSERVATION 3 26Ig� Street No. r �'" Smoke Det. G5,,pp d FW' FR LWATFR A,1c�) GINAI noIXIMMAV CAITDV DCDIIAIT �.h� v,__ office Use Only ubE Lfammnnumfth of sa># Permit No. le�ImtUrm of JIUbLIC —Aa&2q Occupancy&Fee Checked �-A 319 BOARD OF FIRE PREVENTION REGULATIONS 527 C1dR 12:000 (leave blank) Aw APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Oate M� or Town of NORTH ANDOVER To the Ins ecto of Wires: The udersigned applies for a permit to erf rm the lectricai work�descr ed below. Location (Street & Number' rr Q Owner or Tenant Owner's Address Is ;his permit in conju tion with a b iidi permit: Yes No C (Check Apprcoriate Box) Purpose of Building Utility Authorization No. Existing Service Amps _J Volts Overhead _ Undgrnd t. No. of Meters New Service a92) Amps ,/?4 1-1—Ad_volts Overhead _` Undgrnd 11r No. of Meters Number of Feeders and Ampacity / Location and Nature of Prcoosed Eiectricai W= ITotal No. of Lignting Cutlets No. :t 'rot tics I No. of,ransformers KVA 1 _ Above.— ;n- —No. of Lignung rixtures /1 Swimming P-ci grne. _ _rr.c. _ Generators KVA U ��[ No. of Emergency Lignung No. of Receotac:e Cutlets No. of Cil Burners Battery Units No. of Sw tcn Cutlets I ! No- of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cor.c. otai No. of Detection and I A� tons Initiating Devices �►J I No.ot ~eat Total KV1 No. of �isoosais Pumbs 'ons <':! No. of Sounding Devices No. of Seif Contained No. of Disnwasners / I ScaceiArea Heating K%v DetecnoniSounding Devices No. of Dryers A,S i Heating Devices KN Local Con ecli Other Connec;ion ` No. of No. at Low Voitage No. of Water Heaters KW ! Signs Sailasts Wiring No. Hycro Massage Tubs j No. of Mc[drs T ,ai HP CTHER: !NSURANCZ COVERAGE: Pursuant to the recuirements of `.tassacnusetts general Laws I have a current Liability Insurance Policy inc:ucing Comc:e:ec Cceravcns Coverage or its sucs:antial eeuivaient. YES = NO = I have submitted valid proof of same to the Cffics. YES — NO = if you have cneckea YES. aiease indicate the type of coverage by checxing the aopropnate box. INSURANCE —— BOND = OTHER = tPtease Scec:fy) (Expiration Date) Estimated Value of e I ` ork S Finai Worx to Start inscec;:on Dare =ecuesled: Rougn Signed under the P naities f periu 8 _ FIRM NAME C 1 U'L ,L dA f-L UC. NO. -;censee Signature LIC. NO. Sus. Tel. No. A.' 3�T Address Alt. el. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- cuirea by Massachusetts Generat Laws. ana that my s:gnature on tris ;ermit abptication waives this requirement. Owner Agent� ;P!ease cnecx one► g 'eieonone No. PERMIT FEE S c-6565;Signature of Owner or Agenn .W Date../ To 2613 f NORTH ° ° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING C CHUS i` .... C-'.. .. ...t�.x.S.....�'�.c,/. .5.. .. Q... l`�c.. This certifies that � i2..�.... `�'I� has permission to perform ....... I' wiring in the building of &'1110,11 -e P � V ...... .............. `.................. e... -.. . Q, w at..cT.. ...U. . ti?�..i^V............t...O.16................:,North Andover,Mass. Fee... Lic.No.Q0.k!0 ............................................................... ELECTRICAL INSPECTOR 4 0/17/ 210.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File ✓fl 1 Office Use Only �lv Gibe C amnwnmMith of S�Ef s Permit No. (J r Ilep tritm of 11uhCct Occupancy&Fee Checked ARD F 3190 peave blank) 80 0 FIRE PREVENTION REfULAT10NS 527 CZAR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date OLO4 MQ or Town of NORTH ANDOVER To the Inspector/of wires: The udersigned applies for a permit to perform the el ctricai work��/scrib d below. Location (Street & Numbers er v Ya 0S Owner or Tenant Owner's Address yC .! s, Is this permit in conju ction wi a building permit: Yes �� No (Check Appropriattee Box) Puroose of Building _e.�f Utility Authorization No.,Eo- < �� Existing Service Amps —J Volts Overhead _ Undgrnd No. of Meters New Service Amps AJjua Volts Overhead Undgrnd No. of Meters Number of Feeders and Ampacity i 1 Location and Nature of Proposed Electrical 'Nom No. of Lighting Cutlets No. :f Hct -.:cs No. dt ranstormers Total KVA No. of Lntin. jwimmin =cc, �bcve�- In7-7 - g g fixtures g gme. _ gr-.c. _ I Generators KVA No. of Emergency Lighting No. of Recectacie Cutlets No. of Cil Burners i Battery Units No. of Switch Cutlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges C I No. cf Air Ccnc. .oral ;ons Initiating CevicI No. Cete vic and J aes , No. of DiSDOsaiS j j �1c.Of feat pial pial Pumas -ons <11V No. of Sounding Devices No. of Sait Contained I No. of Dishwasners 1 Scace,Area Heanr.g KLV Detec::cniSounoing Devices b — Municipal No of pryers / i Heating �evices KAY Local ilOther Connecaon No. at No. ct Low Voltage No. of Water Heaters KWSigns Bailasts Wiring I No. Hycro Massage Tubs i No. cf `.Motors ai HP CT HER: INSURANCE COVERAGE: Pursuant to the recuirements of massacnusers general Laws I have a current Uaeiiity Insurance Policy inc=ing Czmc:eiec Coerancrs Coverage or its sucstantial ecuivaient. YES = NO = I have submitted valid proof of same to the Cftice. YES = NO = if you have cnecked YES, piease indicate the type of coverage by cnecking theappro iate box. INSURANCE BOND = OTHER = (Please Spec-.f•+) ci Estimated Value of E' cthc I Work s 1 �oira on Oate Wi worx id Start © Inscec"n Cate =ecuestec: Rough Final It Signed unser th enatti s of p ury: FIRM NAME �- `R' e'G LIC. NO. Licensee Signature LIC. NO. � ©`�► 10 ACCress Alt. ;el. No. CWNER'S INSURANCE WAI ER: I am aware that ;he Lce'rfnsee aces not have the insurance coverage or its substantial eduivoent as re- cuired by Massachusetts General Laws. and :hat My signature on trrs permit application waives :his recuirement. Owner Agent ;Please chedx one) l' _iv 'eieonone No. PERMIT FE__ S%%%� Gl�� C! ;Signature of Owner or Agent) x-65c5 ', e fz Date.... `*TO . �saa HORT1� :e-1"� TOWN OF NORTH ANDOVER A PERMIT FOR WIRING +� o •"a ,SSACHU�'Et r This certifies that ... .�C'Qv rs......k^• . 'q1. kt. ..... � ,�/ � : . has permission to perform ........�.t..�.�titer.... ......... ..... ..... wiring in the building of........W.c..<.l„ow....... ....................... 000 ....�t,�.C• 1.•tt. '..L-1�/ ,,r1.s......... ,North Andover,Mass. 4ej9-(,.0.Q.... Lic.No. — ......... .cr ' (JO&195 14:39 225.00 PAID WHITE: Applicant CANARY: Building Dept- PINK:Treasurer GOLD: File Office Use Only r 014t ClamInunmralth of Mass IL�lt5ds Permit No. Be artmeui of ubUr $afetU Occupancy&Fee Checked -_ 1J f "1 BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 also (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 2 J^ (%* or Town of NORTH ANnnVER To the Inspector of Wires: The udersigned applies for a permit to perform the elec rical work describ r blow. ' h Location (Street & Number) Ll ' SCC//.• Owner or Tenant ` V Owner's Address 17 is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. ,'S6 G Existing Service Amps _J Voits Overhead 7r' Undgrnd ❑ No. of Meters New Service Amps _ Vcits Overhead r Undgrnd lids No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work OF Total No. of Ugntmg Outlets No. of Hot:Lbs No. of Transformers KVA No. of Lighting Fixtures Swimming Pooi Above!- In- grnd. _ grnd. _ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil turners I Battery Units No. of Switch Outlets No. of Gas 3urners FIRE ALARMS No. of Zones Total No. of Detection and No. ct Air CJrtq. No. of Ranges I tons Initiating Devices No. of Disoosals I No.cf Heat Total Totai Pumcs Tons KW No. of Sounding Devices No. of Seif Contained No. of Dishwashers I ScaceiArea Heating KW Detection/Sounding Devices Municipal Other No. of Dryers Heating Devices KW Local 1 Connection I No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. cif Motors Total HIP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I =have a current Liability Insurance Policy inciucmc Concc:etea Operations Coverage or its substantial equivalent. YES = NO = I have suomittea valid proof of same to the Office. YES NO = If you have checked YES. please indicate the type of coverage by h checking the appropriate box. INSURANCE -- BOND = OTHER = (Please Scec.fy) (Expiration Date) Estimated Value of Electrigai Work S Work to Start fr / Inspection Date Recuesteo: Rough U 5 Final Signed unser the nal ies of perjury: FIRM NAM 4 G S V � L 9 t LIC. NO. Q `? Licensee or Signatures p.LIC. NO.of n g�j ��t 7L s. Tel. No. AL r ` Address ♦S/L�, S I`�A �f ' k-"A'14 V�� Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee goes not have the insurance coverage or its substantial equivalent as re- cuse* by Massachusetts General Laws. and that my signature on this permit aopiication waives this requirement. Owner Agent (Please check one) w Teteonone No. PERMIT FEE S C) (Signature of Owner or Agent) x-5=es G 9 T,T4 2 Date...575 ../. . NORTH 4, OpL TOWN OF NORTH ANDOVER _ PERMIT FOR WIRING SSAcMUSF a This certifies that :..... . � 1. "S.....G^.:f'.t�. SGt.S........ (.. °C.... t has permission to perform ...... `� r wiring in the building of m�s . at.1. i. ..l�!.............. . �....[UQ °.t North Andover Mass. Fee... tl.... U.. Lic.No. K................ ........ ry ELECTRICAL INSPECTOR �,1�C43 ,.i/ 54.40 PAID WRITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File i Date. .... .. . . MORTH °f ..o 3= TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SSACHUSE � / This certifies that . .,f.1f�.� ./x� . . .��. . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . .D.11.xc 13, . . . . . . . . . . . . . in the buildings of 'y>.�cti.� . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . ., North Andover, Mass. Fee.3v: . . . . . Lic. No. S s. . . . . . . . _ 1 GAS INSPECTOR Check# /7/ 4183 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 5V E209 (Print or Type) l 4 ' N I„od 1P.e �CIIU•'it. Mass. Date 11"J- y�0� Permit# 3 Building Location Owner's Name C, Wvl nv 9 3 Type of Occupancy New ❑ Renovation [ Replacement ❑ Plans Submitted Yes ❑ No ❑ I i I t w 30�� U i U) W U). W vX 0 z Ir vi m �- 12 III 5 1- i cry U) w cn w O U CO z 2 = rn z o W ~ Q > Z 0 I- W Co cn F- w O I- W W O o w Cl) tr 0 C7 U W = � Z < cc O W > w i 0 FCn W- Z -•j f- Z W W C7 W > u- W U Cl) j Z Q W 'i Q W ~ t- } U) m Z 0 ~ W '� F- w < OLQ Z 0 I tr 2 0 0 2 U_ D 0 0 J cc > 0 a Fw- O 1 SUB-BSMT. j f 1 11 BASEMENT ' l 1ST FLOOR i 2ND FLOOR 3RD FLOOR 4TH FLOOR j 5TH,FLOOR _ 1 6TH FLOOR 7TH,FLOOR i 8TH FLOOR I Installing Company Name APOLLO PLG & HTG INC Check one: Certificate Address. 1SHATTUCK ST PO BOX 466 Cor1097 C J poration LAWRENCE, MA 01842-0966 '0 Partnership Business Telephone 978-688-1755 'O Firm/Co. Name of Licensed Plumber or Gas Fitter170V.41,Q �QSRV/SSE+4Uk I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes [X No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. j A liability insurance policy 1X1 Other type of indemnity ❑ Bond ❑ - OWNERS 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: Si nature of Ow' ^ Owner C3 Agent ❑ __ _-_ _. j Owner or Owner's'A Agent ' i I herebycertify 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-plumbin.g work and installations performed under the permit issued for this application will j be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142.of the General Laws. BY T pe of License Plumber •�—0 Title ❑ Gasfitter Signature of Licensed Plumber or Gas Fitter: City/Town O Journeyman License Number 8699 APPROVED OFFICE USE ONLY) BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES NO. PROGRESS INSPECTIONS MERCURY TEST FEE FINAL INSPECTION APPLICATION FOR PERMIT TO DO GASFITTING NAME TYPE OF BUILDING LOCATION OF BUILDING i PLUMBER OR GASFITTER r r LIC. NO. i PERMIT GRANTED DATE 19 GAS IN--,PftCTCR Date. . "pR7" TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING 0 a • a � r ,SSACMUS� l lG This certifies that . . . .��/.' . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . f. . . . /.&c[. . . . . . . . . . . . . . . plumbing in the buildings of :. . . . . . . . . . at . .�/.?. . ..f.?. %!c f4'1. z . . . . . . . . . , North Andover, Mass. Fee. 34.7 .Lic. No.., CZ'G' . . . . . . . . OUMBING INSPECTOR Check # /�7i f 5423 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO.PL'UMBING 3� -- (Print or Type) l�/4ca�ave� Mass. Date 10-2k 2 0 0: '�Pe/r"mlt # 3 t u u u Building Location Owner's Name _ Ll 3 A-7/;c&/t-,-P— LIXType of Occupancy New ❑ Renovation IR Replacement ❑ Plans Submitted:. Yes ❑ No ❑ ie- b�•y l FIXTURES B.P. # SEWER # SEPTIC # Z rn Z Y J Cl) } (5 Cr tZ (� Z Q Z_ IL W W in = ¢ ~ ¢ w 0 Y ga a Z o Z 3 itW W Q fn Q W to J Z �. O ll W Q 2 3 3 0 Z = 3 Y n. (� ~ Z Z W LL W t- cn �. c7 p ¢ 3 Q m 0 SUB-BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR .6TH FLOOR 7TH FLOOR i 8TH FLOOR Installing Company Name APOLLO PLG &.HTG INC Check one: Certificate # Address 1SHATTUCK ST PO BOX 466 M Corporation 1097C LAWRENCE, MA 01842-0966 ❑ Partnership Business Telephone 978-688-1755 ❑ Firm/Co. Name of Licensed Plumber DONALD DESRUISSEAUX INSURANCE COVERAGE: I have a current-liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes LX) No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy. ® Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check 6ne: 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 application are true and accurate to the best of my knowledge and that all plumbing work and installation performed under the 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. By Title ignature of Licensed Plumber Type of License: Master X7 Journeyman C.] City/Town License Number 8699 APPROVED (OFFICE USE ONLY) BELOW Fon OFFICE USE ONLY '\ FINAL�NSPEc,ONS sKE[cHEs PROGRESS INS9E[ 6§S FEE \ < NO. APPLICATION FOR PERMIT TO DO PLUMBING \ NAME &TYPE OF BUILDING \ \ LOCATION OF BUILDING PLUMBER \ PERMIT GRANTED \ DATE 19 4 / / PLUMBING INSPECTOR \ y ° Location_ ` /� �(//9 No. Date MORTq TOWN OF NORTH ANDOVER O � A i s Certificate of Occupancy SscMusEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ (� U Check # � $ 650 Building Inspector t t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. / DATE ISSUED: SIGNATURE: Building Commissioner/12SWor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 43 V1cJ i tk L -,�z 0)-5 C)► 33 w 0 r-+l_ w p` e , Map Number Parcel Number Q5( � �/�l V�J 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diaiic—t Proposed Use Lot Area(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zane Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zane Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIDP/AUTHORIZED AGENT M 2.1 Owner of Record i>,C>-�zQ X13 rwi n r Lk.-e, N ft wm Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: (W; Name Print Address for Service: o Z i rn Si nature Telephone SECTION 3-CONSTRUCTION SERVICES go 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number _ j Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number r Address r Z Expiration Date A I. Signature Telephone Y' T � SECTION 4-WORKERS COMPENSATION(M.-G.L.C t52 § 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.......❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: owe 4-b all r ( SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be QFFICIA, Completed by permit applicant 1. Building Doo 00 (a) Building Permit Fee b 1 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ZoI �t t^ �^�� as Owner/Authorized Agent of subject property Hereby authorize to act on %bbehTlf,Yin all mattes r lative to ork a thorized by this building permit application��� Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION e � hVtI as Owner/Authorized Agent of subject f property 1 Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge ` and belief 4E J Pryuit .-� Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1ST 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS -HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X F MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i s, - LOT 16 A=5000 S.F.. 3 d a7 N„jl 1.3 z ,tg r+Je�-oowoo a i' T F.248.73 0 d 2 � 7 /J /a y- sties FDLINDA TION LOCA TION PLAN £ THE PRIMARY CTURE FWN RAS TO;HHORONTALSETBACKREQUIREEMEN73 OF LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. 7HIS.C£R7IFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH.AS COVENANMWETLANDS,EASEMENTS, CLIENT= SCOTT CONSTR: ORDERS OF CONDMONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY THIS CERTIFICATION IS MADE AND LIMITED PURPOSE OTHER THAN THAT OUTLINED ABOVEEXCEPT WITH THE. WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. TO THE ABOVE.CLIENT. FURTHERMORE THIS:DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC AND ANY UNAUTHORIZED USE IS PROHIBIT£D.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR.'THE-UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- NATION CONTAINED HEREON. LOCA TION: NAD NE LN.N NO.ANDOVER,MA. �,tH OF o J. SCALE I"=20' DATE: 11/14/95ER F is O�AI LA CHRISTIANSEN-&SERGI PROFESSIONAL ENGINEERS LAND SUR160 SUMMER ST. HAVERHILL,MA. 01830 TEL 508-373-0310 ©1995 BY CHRISTIANSEN & SERGI INC. DWG.NO.:94015014 qo--4ikD 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 P60eeh U'�m6fH 1✓x PHONE LOCATION: Assessor's Map Number a-s PARCEL 13 3 SUBDIVISION i�ec�OCv �.f/UCJO' � 1 LOT(S) 1 STREET 1 V� 1 h �' ST. NUMBER 3 kOFFICIAL USE ONLY****************** * *** *** CIRE MMEA,ATlq�y��pjzTOWN AGENTS: —1 O ADMIN TRATOR DATE APP ED — L- .p DATE REJECTED � ENT& w `+ TOWN PLANNER DATE APPROVED - DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT___ FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9W jm LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NAPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the North Andover computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Roileen Chamberlin &James Babson Same return key. Name Name 43 Nadine Lane te6 Mailing Address Mailing Address North Andover MA. 01845 City/Town State Zip Code Citylrown State Zip Code mann 1. Title and Date (or.Revised Date if applicable) of Final Plans and Other Documents: RDA 6/13/03 Title Date Plan of Land 6/11/03 Revised Title 6/16/03 Title Date 2. Date Request Filed: 6/13/03 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): The removal and replacement of a concrete driveway in a new location and the construction of a shed and deck located in the Buffer Zone to a bordering vegetated wetland resource area. Project Location: 43 Nadine Lane North Andover Street Address City/Town Map 25 Lot 133 Assessors Map/Plat Number Parcel/Lot Number wpaform2.doc•rev.12/15/00 Page 1 of 5 i Ii TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)685-0956 DIRECTOR Fax(978)688-9573 � 1,lORTh 3 �L O T F p y9SsgckusEt�y DRIVEWAY PERMIT DATE D LOCATION ] BUILDER phone R / 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. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Co 44 14�/AA/ r A P1'k� CA N l�5 5lGNA-r'✓�E e 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 c 11, S.150 A. The debris will. be disposed of in: Location of Facility) Signature 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 • NORTH � qti ' �2peSt�ao ab�a O Town of North Andover Building Department '� -M-�• 27 Charles Street � CU5&tom North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. r DATE 30 C`f�. LV U- JOB LOCATION 9 ) V ac Ul.'� l__.. N (Jl.���'t /�aGX'u, Number Street Address Section of Town °HOMEOWNERL�_x ���; 4, 2-5 5 0 J Number Home Phone Work Phone PRESENT MAILING ADDRESS Ll I1 G ch Liz n- City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory cessory to such use and and/or farm structures. Aerson who constructs more than one home prna two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such workp erformed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, Pp Y The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. i 1 i NORTH ® ofover E � •4, �� 1 r.4 � e No. O� toC ,� ���` dover, Mass., ORATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT Pe0, NC N /it W r Foundation has permission to erect.... ................................. buildings on ..... 3....,,ti14... ........... hough ....................... .... to be occupied as �• S. 4 '4V )CJQ OOPAN .0 PC le �flpp*Cr p fpiimney ........ ........................................................................................................................................... Y`� 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-Lalus relating to the Inspectio , Alteration and Construction of Buildings in the Town of North Andover. Z 3 3 .ON— PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S T ELECTRICAL INSPECTOR Rough o 0 ........ ................................................ ................ ............................. 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..