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Home My WebLink AboutMiscellaneous - 436 OSGOOD STREET 4/30/2018 i I r I i Ii i E i W I� l� O Qk C7 V�► TOWN OF NORTH ANDOVER 0* NORTH q BUILDING DEPARTMENT 3= h`ttLED '6'6~OL 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 0 NOTICE OF VIOLATION �9SSACHUSE�� Date: A5 Address: k Building ❑/Z' ing Byla7C3 Stop Work Order D Certificate of Inspections Electrical Plumbing Gas Violation observed: t r - TdI/ - I -J =F= Failure on your part to comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CMR/7 North Andover's Zoning By law. Please contact the Building Department for further information at 978-688-9545 Inspe Home Owner Contractor TOWN OF NORTH ANDOVER NORTH BUILDING DEPARTMENT 41°f<t4EO 6 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 0 �, x - � NOTICE OF VIOLATION Date:/ r- Address: 04g4ml-�/mow BuildingTplumbing ningBylaw ❑Sop Work Order ❑ Certificate of Inspections Electrical E3Gas Violation observed: qlf- Failure on your part to comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CMR r North Ando er's Zon' g By law. Please contact the Building Department for further information at 978-688-9545 Inspe v2 Home Owner Contractor Location 'l0�3 y3(, OS6 (S0-) No. / Date MQRTN TOWN OF NORTH ANDOVER ?o:,'G. ,.hyo F ° C? p S_s ` Certificate of Occupancy $ Eta' Building/Frame Permit Fee $ sACMUs Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ s Check # r 15874 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT i APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING � � ��• ,��..�;.` .�t�t'i:- �^�^.r�3*„�ISi� ;�OF-Q1�F ,.t, s � '�'c��'�--c.�, •�� r �, ��c�� ARS R'_:.. Fa„.;: .,w,•«..,y:4 .,tk.m BUILDING PERMIT NUMB DATE ISSUED: E SIGNATURE: L i Building Commissioner/I ctor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Off, ,3 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: i � r�a�e k-cxrn�� G9, a50` Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft I Front Yard Side Yard Rear Yard ReqWred Provide R red Provided Required Provided 60, 30 1 11'3't 1 '32 1: �30' hoo 1.7 Water S M.GL.C.40rm . 54) 1.5. Flood Zone Infoation: 1.8 Sewerage Disposal System: Public Private 0 Zone Outside Flood Zone ❑ Municipal Q/� On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1 2.1 Owner of Record 7G n 9c,st? C,1%L2 e. Ga,NN e, s-tf/:f--T Name(Print) Address for Service A .K — Signature Telephone i 2.2 Owner of Record: Name Print Address for Service: 0 z k Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisonr:� Not Applicable ❑ Licensed Construction Supervisor: C Is 0 15 aa H License Number 4 9 1 ur S+ M Addr 'li, � to I O� Expiration Date Kigndture Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address SEEM Expiration Date �imnature Telephone SECTION 4-WORKERS COMPENSATION(NLG.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 unit. Signed affidavit Attached Yes....... No.......❑ ' 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: G CL O AJ e- t1`,r`Q L A i+-6 a.. a c a ca a ra a _ *+;!I.. c h e d SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFF'ICIALVSE ONLY Completed b permit applicant Buil cant .�, dm 1. Building ' 0 D D (a) g Permit Fee �/a,s�' /p®fi 5.5- � Multiplier 2 Electrical (b) Estimated Total Cost of j/ q5 0 I'D Q O Construction 3 Plumbing Building Permit fee(L)X (b) 4 Mechanical HVAC 0 n 0 0 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 Sri a.Q I, Clop- G a.M 6.1 P- as Owner/Authorized Agent of subject property. Hereby authorize l l)�i 1 a vh r ) 0. f r e,"{k— to act on My be alt,i all matter lative to work authorized by this building pennit application. x DD X s s y v►, 2 Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1 as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si attire of Owner/Anent Date 111111111111111 11N11111 ' NO. OF STORIES SIZE 1' r BASEMENT OR SLAB 0& " SIZE OF FLOOR TIlVIBERS 1 2ND 19LYlb3 X I D SPAN 14 DIMENSIONS OF SU-I,S +t-r DIMENSIONS OF POSTS °'X DRvENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS 10" SIZE OF FOOTING X MATERIAL OF CHIMNEY N IS BUILDING ON SOLID OR FILLED LAND -SpIlA IS BUILDING CONNECTED TO NATURAL GAS LINE N INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. ............................................................................ APPLICANT W%\,1 a m 6G:''ec PHONE to 8 aa 3 a1 O ASSESSORS MAP NUMBER I Q_cA LOT NUMBER SUBDIVISION LOT NUMBER STREET .S a 0(5 A STREET NUMBER ��o OFFICIAL USE ONLY REC NS OF TOWN AGENTS .. . we owns .............................................. ............ DATE APPROVED Z ERVATIO AD TRATOR _ DATE REJECTED DATE APPROVED Z WNPLAMNER DATE REJECTED COQ DATE APPROVED F INSPECTOR-HEALTH DATE REJECTED DATE APPROVED G" SE C INSPECT-OR-HEALTH DATE REJECTED colv¢yIErI'rs P �- PUBLIC WORKS-SEWER/WATER CONNECTIONS , �G-0 DRIVEWAY PERMIT 9 ATE APPROVED IRE ARTMENT All-1--P D .e (-e/2i DATE REJECTED COMIviENTS RECEIVED BY BUILDING INSPECTOR DATE ORTF1 Town o �� o Andover No. / 5' ndover, Mass., 9' .-/8 -07coat T OLAK E COC-C�EwICK 1 ORATE D P'P5 SSA C H U5� I T FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT .01//�N0* 01 M ITMW has permission to excavate and pour foundation at ........... ............................... for the purpose of.. / f`D01h�. a�� IT��/>� i1 C !��I....,5/mss �C �Ir,��low......... .... ..........AJO. ........... -- ........ The person accepting this permit must return to the office of the Building In ctor a certified plot plan show of building thereon before Foundation will be inspected. /O.Q/a /s VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. • L%SS DPfE - . . ................. ............�� ............................. DUE FRAME PL1Y1� (52- BUILDING INSPECTOR NORTH Town ofAndover 0 No. /ST ^i) 0 =co C HIC dower, Mass., ORATED PPF`�,�� S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System j�, , THIS CERTIFIES THAT J011 �.M...&r1r �'0 p .14`��V G a1 A.- BUILDING INSPECTOR . ........,....,................................................................ Foundation has permission to erect................ ..................... bui ings on . 0 :10,4 3 ... Rough I to be occupied as..l .........../... ........... .... ..1.. �! ....�.�� ....R6iimney ........... 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 B -Laws rel ing to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. �0� 3 , a3� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI N STARTS ELECTRICAL INSPECTOR C Rough ........... .. .. ... 40# ./#......... ................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR ' Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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. MASch k ec COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 Checked by/Date CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 8-28-2002 DATE OF PLANS: 8-28-02 TITLE: PROJECT INFORMATION: Gamble lot 1 Osgood St NORTH ANDOVER, MA 01845 COMPANY INFORMATION: WILLIAM BARRETT HOMES 1049 TURNPIKE ST NORTH ANDOVER, MA 01845 COMPLIANCE: PASSES Required UA = 364 Your Home = 350 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 992 30 .0 3 .0 32 WALLS: Wood Frame, 16" O.C. 1776 13 .0 3 .0 127 GLAZING: Windows or Doors 266 0 .500 133 DOORS 40 0 .350 14 FLOORS: Over Unconditioned Space 936 19 .0 44 HVAC EFFICIENCY: Furnace, 86 .0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building g shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder/Designer Date Ir 1 3 In-a GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUH.DING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. xNga A2 G I; �� at,r,hl — c��ca ad S t- 10 C1-3 Permit Applicant Property address Map/Parcel 97A —Ly 8(9 - 155-7 Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw.I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit.Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building_ permit application and associated attachments,complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw,provided that no additional residential unit is created. The lot(s)was/were created prior to May 6,1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. _V This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a onetime exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. N C4W x S Sof 2A)6'2-- APPLICANTS 2)02APPLICANTS SIGNA DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity �I am an employer providing workers' compensation for my employees working on this job. companyname: .l W i n M U C-f-C P,Alt H n,nn e S Address City r )O A a d oJe r Phone#: Q 7 F-'to RA a3 an Insurance Co. rN o ry la^d G` a 5ua l fv CO. Policy# U.V G Q 5 S 3 7 L 17 O y Company name: Address City Phone#: Insurance Co Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under p d pena/tief perj�thnatthe intbrmation provided above is true and correct Signature x Date x g Printname Uj i r k i o-rv\ 6c-A t•r e,-' _Phone# (P UA -o130 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION i i Town' of North Andover NoRT�o h o *► do Building Department o 27 Charles Street ~ 70 North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 SSACHUS� DEBRIS DISPOSAL FORM i In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, s150a. The debris will be disposed of in/at: r e- N C T7 , Facility location X nature of Applicant At, _"L� Zo �_.. Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ✓�e �amz-nzon�ueall� o��:�'aarac��ide BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 052241 Birthdate: 10/10/1952 Expires: 10/10/2003 Tr.no: 9092 Restricted: 00 WILLIAM K BARRETT 1049 TURNPIKE ST ,» N ANDOVER, MA 01845 Administrator Workers Compensation and Employers Liability Insurance Policv ZURICH NIARYLAND CASUALTY COMPANY Information Page NCCI Company No.: 10545 ACCOUNTNUMBER: M006138531-o0t-00001 Branch Policy Number Producer lode ! Previous Policy Number RENEWAL \'A AUBURN WC 95837697 04 02090918 I TCI 95937697O3 Branch Address: 15 MIDSTATE DRIVE- AUBURN MAO 1501 ITEM 1. Named Insured and Nlaiiing Address Producer Name and Mailing Address COLONIAL DEVELOPMENT CORP.DBA TARPEY INSURANCE GROUP.INC. WILLIAM BARRETT HOMES PO BOX 567 1049 TURNPIKE ROAD WAKEFIELD MA 01880-4667 NORTH ANDOVER MA 01845-6109 (781)246-2677 This Information Page,with policy provisions and endorsements,if any,completes this policy. Insured is: CORPORATION Risk I.D. No.: F.E.I.N.: 043201987 Other Workplaces Not Shown Above: SEE SCHEDULE OF INSUREDS AND LOCATIONS ITEM 2. Policy Period: From: 03/24!2002 To: 03/24/2003 12:01 a.m. Standard Time at the Insured's Mailine Address ITENI 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: VIA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident S 100.000 Each Accident Bodily Injury by Disease S 500.000 Policy Limit Bodily Injury by Disease S 101000 Each Employee C. Other States Insurance: Pan Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND.OH.WA,WV.WY.NV AND THOSE LISTED IN 3A D. This policv includes these endorsements and schedules: SEE FORMS AND ENDORSEMENTS APPLICABLE LIST ITEM 4. 'rile premium for this policy will be determined by our manuals of rules,classifications,rates and rating plans. All information required on the following Classification Schedule(s)is subject to verification and change by audit. SEE CLASSIFICATION- SCHEDULE Total Estimated Standard Premium S 1,660.00 If indicated below,adjustments of premium shall be made: Premium Discount S Q Annually Expense Constant S 244.00 ❑ Semi-Annually Premium for Endorsements S C1 Quarterly Taxes and Surcharges S 78.00 Cl Monthly Total Estimated Annual Premium S 1,982.00 /Minimum Premium S _`00.00 Deposit Premium S 1,982.00 •7 r sue Date: 02/19/2002 INSURED COPY Cduntaisigned By Authorized Representative { . C 00 on n t A 1 Ca !n.uoN i-..........:.. ;oa-v...:,.__i�...._..:,.._r-....._.._._.:.._ 1 831 APPLICATION FOR SEWER SERVICE CONNECTION Zoo2- North Andover, Mass. C 19-- Application by the undersigned is hereby made to connect with the town sewer main in Street, subject to the rules and regulations of the Division of Public Works. The premises a e own a r known No. � Street s or subdivision lot no. Owner Address Contractor Addr s AApplicant's Signature PERMIT TO CONNECT WITIA SEWER MAIN The Division of Public Works hereby grants permission to ^L/C & to make a connection with the sewer main at Street subject to the rules and regulations of the Division of Public Works.. p Division of P blic Works By Inspected by Date See back for rules and regulations 1191 APPLICATION FOR WATER SERVICE CONNECTION ZWZ North Andover, Mass. T�1� Application by the undersigned is hereby made to connect with the town water main in Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. Street or subdivision to no. Owner Address Contractor Address Q�&Z�N V pplicant's Signature C" 2 S PERMIT TO CONNECT WITH WATER M IN The Board of Public Works hereby grants permission to to make a connection with the water main atStreet subject to the rules and regulations of the Division of Public Works. Boa of Publ' Works BY Inspected by Col- Date See back for rules and regulations DPW 7 1 5 Date ......` '�' ' OF NORTI�,� TOWN OF NORTH ANDOVER FO 9 RECEIPT (1 SSACHU5� This certifies that .... ... .. ...k`"L1CGZ. ... •••—`.�rL'- ................ has paid . ....... ........... oo.r.G�d..................................... ..... for ..... ��.... ... rw. X..... .... . Received b Li% '`''. . .....� 1.Gf. .:.......................... Department ..............................1....f, ,l.116...... ).4?/�2.............. WHITE: Applicant CANARY:Department PINK:Treasurer P TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)655-095L, DIRECTOR Fax(978)688-9573 HORT►j 9 O ttto ,6`N 32 ee O G qi(O PP,,�S 9SSAc►PUstit DRIVEWAY PERMIT DATE _ 2 LOCATION BUILDER phone OWNER 4, " phone 6,62-2 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. X A FP L L CA N i r5 S/GNA'Y�e� L i IiI i v O O z I _ � OD❑ I I i I i ! i C - L -- S Z � Z Q z0 ...vm ��VA WILL IAM 13Af?p�1'`I" pyo cr,�r��: GAMI3�� `�1 g� .1 ,�� 16128102 sir: 13UI�b�pl Or FINS NOM�5 qf�rfln�: FnMwNR: JIM FAPO t?ON1' 110N I I i ! ! I ! i ! 1 I ! 3 EM I =1 ........... ........... ................... FRI LLJl : IF71=1LLQ=11 o , --- i r ! C II I O I II I ! I II iiI i L�- i i ppoj�cf fllU: SCALA; TPAI sf�r,WILLIAM GAM� I/ 8 -1 '-0 / 28/ 0 13U1LP� P,, OF I'M NOMAS I?�At? ��VA�ION n�wrvr�Y, JIM F*\o A2 i N CCS C-CC Q b L — i 0 0 00 NEI I I I I I I 11111111111111111 1911mi i ........ ......N... 7Q S1 rCc Q) Z m d I ppOJ�C1'TI11.E; SCALA; nA�; �� 1'1' GAMS 1 1 r 1 WILLIAM I3A � (/ g � Q 6128102 ,..� l3UILPW OF FINS NOMAS s �r��: 5M FL�M TION5 npavv�r�Y; .JIM FAI?0 notes, Main alterations to plans as supplied by 13111(3arret, I,floo-plan mirror imaged , 2,Garage&Bonus room lencAened 3' (from 24'to 2T) 3,entrance to bursas room from 2nd floor N cc ridoor O 4,Stairs from 2nd floor to attic 0� 5.Fireplace removed,I cundatioi fcr CV fireplace to remain Q"z n O 11 � 18'-10" 3'-5" 4'-9" 38'-0" — 00 0 -- ,del - ---- -- — — — -- 1 O"x 8'Concrete WPI — 1 I —_—__— — -- On 10"x 24"Cantdnias Keyed FFOOUN �--- it N 0 LO u0 ; 31/2"Dia.I.all Cd. 4'Concrete Slab I y <4)31/2"Dia.Lally Cd. 'O" xx 12 P wd,On Concrete 30"x30"x 12"Ccna e�� FooUngp 7'-2" 8'-0" 8'-0" 6'-7" 6'-7- 1 N - L---J �� N 4-1 3/-4 x l l (4)2 x 12 Nilt-lip O beam Fkt. Center beam L °' 1L 1 N >v i STV Concrete Filled Pwrek O O 27'-0" 38'-0" � z FOUNDATION PLAN O V 1 38'-0" 8'-0" 15'-0" 4'-0" 7'-0' 11'-0" 13'-0" 7'-0" \ n c — ol KITCHEN M n 10001 � — � o � o DINING BOOM 0 1 I iV z 3'- r� I N 1 F,717 � PAWFY G p00M `V LIVIN � O GAPAG� It 6'-0' 4'-3" 7'-9' o n � Go 1 1 c u o O ° 0 12'-0" o' 4'-0" 1 8._ a I o 14'-0' a v O 8'-0' 8'-0' 3'-0" 6'-10' 9'-2' 9'-2' 6'-10" S-0- 27'-0' 38'-0" O S FR5T FL00P PLAN � O N co 27'-0" 38'-0" \ 7'_6" 9'-74" 7'-101" 6'-3" 11'-0" 6'-7" 8'-2" 6'-0" clu1 5t pOOM CC) �FLAWOOM (D I t7N 6'-4j" 9'_7j" o o W0mt200M 5t r DOWN N N MA5tF OfIXOOM 11 o � O R 1 R � � o 0 POY5 t2vOOM 16'-0" 8'-0 14'-0" Nil v � o 5'-0" 6'-0" 5'-0" 5'-6" 3'-0" 6'-10" 9'-2" 9'-2" 6'-10" 13'-0' 27'-0" 38'-0" O 5FCONP FI.00V PLAN / � z � o �,vowe wir :)4NMMdQ NIW J� d1� MOD15 �sdl� 51WOH ANW �o diQ'ino zo /9z 191110-11-119 /1 ,1-,1-�`cic �l W`�i'11-1IM 114.6 �avd :Ilex d illll��Odd 2 X 10 FLOOR JOISTS AT 16" O.C. 2 X 10 FLOOR JOISTS AT 16" O.C. N x �tG,KING At Ib 'AN 0 (QCKI G Af Alr1 YAN 0 fl z D3 CKIN At MI 5f' o OCKING At M111 X11 '0'0 "9l lb SiS10t' aOOIj Ol X Z 0 ro z z o. o �Id',W 1M!9N V owe wir :A9lwyQ NVIJ �NIW Jd food � DI,N .�ujj;j .r, 51WOH INU �O diciino 9 v' zo l z /9Q 1 10-i 1-1 1n /1 ��INd� ,.I-..��ddb'�1 INdI '1'I1M 2 X 10 RAFTERS AT 16" O.C. 2'-0" SHED DORMER O n z O O I "0'0 "9 L 1V SLSIOP 3UIV OL X Z O u wd-A inn MWJ� Hnn z WN:io 1A1 mmW Tij ..Z/16X..b/41 Cb) O I I N O v Q N cc N CONMIIa5 p1176M VMNT �O Q 1'.00rINI COMP 151 I � MP 9fATNING 2 X 12 @ 16" 0,"-, POOF IN5ULA11ON P,-','O — " 11 1'-6' CONI1NJOU5 ava VMW FIOONNF- 0� FLU91 FPAhler _ rit7GM C3M1Mh 171NpG �C:OO,ING 5f ATN N . — 2X12@I6" C � FASCIA ,AYMn CMILING p-� p00F INSULA110N I • 5OFFIr WITH VENTING 5MCONP FLP\ rJl OMCA J0I5f5 @2-4" 0� CMI 1% ! 27707@ 16"O.C. WCr,'P.00M • CMILIN WAI IN5U.A110N i CD 2 X 10 V.C. 5M6,AIC?6APOW �A'NING �AP'Op 6AP�IEt; FLOOF, I/2 W&MVP INSULA110N FL00 2 X A @ 16" O.C.�2 X 6 @ib" OL, r2NX �}'�ER'1-ZING oD VAPOp�Al2CZIMf? �/�„ INSULATION,VAPM(3Ar'fMEP WALL 10 @ 12" OL 1/2" WALL13OAFIp /2" V'JALL60ARP 51VIN6,Alp GAFNEP,5f IN%U A110N 2X10@12" 0. . IN5ULA110N 2 X q@ 16" O,C.Op 2 X 6 @I6"O,C, U NP, IN5ULA11ON,VAPOp 6A1�.'IEP Sr FLp 51LL 1/2" WALL60APP a 2A2 r�ui�r raw 77X 6 P.T., 1-2 X 6 U?, a-202 OULf Ur fEAM COW NUOU5 515ME 5 1/2 171A,X 2 LG,ANCNOP,Paf5 3 v z"PIA,M�v ca, @ 6'-O" O.C,(MAX) 31/z"PA.L&Y ca. GAp.AGM SILL 4" CONCP;TM 5LA6 FOUNCA11ON 1-2 X 6 P,T„ -2X 6 K.17. " CONcrETM w&L / 8'-O" POUT\C+,") CONTINUOU5 5LL 5AL 10" f7MMP X 20"WIt7M CONI1NUOU5 F0011NG 4'' CONCf TM 9A31/2" PIA,X 12" LG,.ANCNOP,Pa PAMPPPOOF MXTMQOp 5UP.FACM @ 6'-O" O,C,C MAX; �— �UI�niNG 5C&L 1/8 - I'-C' GA�� 5�C1'ION = 1 z � O NORTH • ry f eo ? t �SSICHU5fi� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number /S 1/ Date c2 -/ D� THIS CERTIFIES THAT THE BUILDING LOCATED ON Af '3 �1-13 6 ®SG O D2) S4, . MAYBE OCCUPIED AS ��,aa �� ,a Sia l� A Ac(�� 51/b (� pS��t�, IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO 5;og of `� e! y (� M l�- � (-- Building Iaspector NORTH E c ® ® f over 0� �oC„;�� dover, Mass., 7�ADRATED P? Cl S H E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System ou 40 A.- BUILDING INSPECTOR THIS CERTIFIES THAT. I. � �. q.., ....GV C .'.................... Foundation� � (1 ' iD ..�� Rough has permission to erect................ ....................... bui mgs on ...... ............ ............. ......... ....................:........ g C �c to be occupied as.q.RbDlh�.a/.' ......./... ..J 4ANG ...:! i�V� .... �3� imn�' 1 - provided that the person accepting this permit shall in every respect conform to the terms of the application on fele in Final 7-0-3 this office, and to the provisions of the Codes and B -Laws rel ing to the Inspection, Alteration and Construction of 'Y►�� Buildings in the Town of North Andover. �0��3 Al C2244PLUMBING INSPECT VIOLATION of the Zoning or Building Regulations Voids this Permit. 6;� 1---c> PERMIT EXPIRES IN 6 MONTHS On of Z"a°�.�.� UNLESS CONSTRUCTI N STARTS EL IN c ........ .,/.. ........C.. .................................... Se Rough ( ._ BUILDING INSPECTOR Lai (� Occupancy Permit Required to Occupy Building GAS INSPEC oR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Fg\6� 2' No Lathing or Dry Wall To Be Done DP r�` FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSEID Smoke Det. REVERSESIDE Town of North Andover O� OORT}�Building Department �1.1%.10.1`t0 »`•,o 27 Charles Street o w �, North Andover, Massachusetts 01845 4 (978) 688-9545 Fax (978) 688-9542 4 9-0 cxroc«wncw� AGHU5 APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIlvffi FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE �JQ 1 1Q OFFICIAL USE ONLY ROUTING CONSERVATION DATE PLANNING DATE �d O D.P.W. —WATER METE 24 c� DATE D� D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED OR O INSPECTION QUEST DATE. SIG ATURE/DPW AUTHORIZATION � r r I NORTH a06 Arr.aD 4 �Ha . 't1 'OvnnD✓>.r� ASSACHUf''1 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Date a -/® a-T03 THIS CERTIFIES THAT THE BUILDING LOCATED ON A9-I'3 ®SG O Dj- cS / . MAY BE OCCUPIED AS 7 &A/a'Ja 8A a S14 11 MAck,,�� Si tig(e IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO r/i�Q o1 14- e�ly �e7 M l K- � xu Building Inspector NORTH Town of �_ /E �. Andover i O 16-ct 00 °� COCH,CNK6 over, Mass., t/8ww0l �•9 A°RATED p ,�5 S H � BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT A111.43.�...(J!��r .�'0� �¢.., 'j'`�!!�G Gal/M 6 /'� ) V ........................................... Foundation�,� IA Rough has permission to erect................I..................... bui mgs on ...... ... AA ....... .........to be OCCupied as. .��Vr rJ/.�� .......I... ........... ...: I��....�� imnG� 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 andB -Laws rel ing to the Inspection, Alteration and Construction of � Buildings in the Town of North. Andover. �0��3 Al 1,1 4Q PLUMBING INSPECT VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS On 4 2,,.-r"° UNLESS CONSTRUCTI N STARTS EL IN c t Rough ....... ..J..R�......... .... ................... SeOf BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPEC OR Rough Display in a Conspicuous Place on the Premises — Do Not Remove RRough 2' ��,�•, No Lathing or Dry Wall To Be Done F& Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner - Street No. ( �j SEE REVERSE SIDE Smoke Det. / Date./.. : .s.... .`..... .. OF NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION � 9 � �,SSAC NUSEt 9 This certifies that . . .(f l.H.�,!::i. . ./.�!. .�'� has permission for gas installation . . . . . }:k4 . J r.t: . I. . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . %. sus.f :. .r. . . . . . . . . . .. North Andover, Mass. Fee.7,?. Lic. No.. /GAS INSPECTOR Check# 4228 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FI I TING ,, (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations L13 ti i S 6 a Permit# q-41� 2- Amount Amount$ Owner's Name New[a Renovation ❑ Replacement ❑ Plans Submitted wa C v O W C O O W E a 94 10 vOi SUB-BA SEM ENT BASEMENT ( p 1ST. FLOUR t 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR STH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR EL (Print or type) ` one: Certificate Installing Company Name l`1�► .1 hT / C Corp. Address ❑ Partner. Business Telephone _ 3 t/'_ 7 y j 1:1 Firm/Co. Name of Licensed Plumber or Gas Fitter !4jTr,--jzF 64aAJ-L i' INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you?Rave checked ye—s please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed der Permit Is ed for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas C90 an "pterthe General Laws. BY: ignature of Licensed Plumber Gas Fittr Title Plumber City/Town ❑ Gas Fitter LiCeWe NuMber MFaster APPROVED(OFFICE USE ONLY) ❑ Joumeyman 4253 Date.... ....... ... 4 TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4K US This certifies that ..... ........................................... .................................................. has permission to perform .... ........ ......� wiring in the building of..... ZI.,':� ,4zRt.......................... .................... .......................... ..North Andover,Mass. Fee. .............. T—ic.No.............. ( e, f�............................ ELECTRICAL INSPECTOR Check # THECOMMOArRE LTHOFAWSACHUSETTS Office Use only DEPARTMEAT0FPUAUCS4FVY Permit No. 41--5 3 BOARDOFFIREPREVE1 7YONREGUI,WONS52 7CMRI2.VO uv� ccupancy&Fees Checked APPUCATIONFOR PERMIT TO PERFORMELECITZICAZ, WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover The undersigned applies for a permit to perform the electrical work described below. To the Inspector of Wires: Location(Street&Number) LI 0156 600 Owner or Tenant tAJ I t 41,' Owner's Address Io Zl Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building _ 1 4 �I'1I I L y 4!) lir[Lr Nb l) Utility Authorization No. /4l Existing Service Amps Volts Overhead Underground �� tn' No. of Meters New Service Amps J�o / o Volts Overhead Under 'round g No.of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work SAiy�y� Jd eIAlb ro[ 1U I'd) No.of Lighting Outlets No of Hot Tubs No.of Transformers Total No.of Lighting Fixtures Swimming Pool Above Below KVA Generators round ound No.of Receptacle Outlets No.of Oil Burners KVA No.of Emergency Lighting Battery Uni[s No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS Tons No.of zones —�� No.of Disposals No.of Heat Total Total No.of Detection and No.of Pumps Tons KW Initiating Devices Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained _ No.of Dryers Heating Devices KW Detection/Sounding Devices Local Municipal Other' Vo.of Water Heaters KW No.ofNo.of Connections Signs Bailasis Jo.Hydro Massage Tubs No.of Motors Total HP CHER. � trW0eCoverage;RmmfftotberegtritmiewofNb%aduMGardj_aws w aam hied abdpfo pbn the Olt CoveraW Grits wbftM equivalalt ves<>bnm�dvalidpioofofsarnetotheOffice YES YNO �g� box ff}ouhav�edled�dYl�,ple�ethetypeofmveragzbY URANCEBOND F1 OU7ffR speffY) ExiratimDale UD StartD* Valieof bctacal Wodc$ AundertTrarlaltiesofigt .. Roles Final dNAME (�-o--M AS DmwNo. ' / r IicermNo IN Q L J i r ` B Tel.No.��,f V6'A Alt Tel No. 11 SINSURANCEWAIVETt,IamawarethatdieLicensedoesnothavethenianatremveraggoritss bUitial ecpvalff it atMYS190tueonthispwritapplication waivesthisregrtitranetlt as �bY�Gel>etalLaws se check one) Owner ® Aaent Telephone No. cti Igna ure o caner or gen PERMIT FEE$ �p �� u The Commonwealth of Massachusetts d Department of Industrial Accidents i Office of Investigations Boston, Mass. 02111 °+M Sia Workers'Compensation Insurance Affidavit Name Please Print Name: l-4n M /I Location: City WA1, Al Phone # 7$ /) 7G I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone# Insurance.Co. Policy# Company name: Address City: Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment_as_weD_as_civi1.penattiesjnlbelmn4-a_STOP.WORK ORDFR nd..a.fine.cl.($1DDM)�riay.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do ty by certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town PermiULicI . [:]Check,f immediate response is mEl Building Deptired a Licensing Board p Selectman's Office Contact person: Phone#: F1 Health Department Other Location % 3 6 C),5 No. �S Date m 1-:�5 A- 7 NORTh TOWN OF NORTH ANDOVER o AL ' 9 Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s�cM9 use Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ,; 30 Check # Li -3 15952 Building IrApector 10/24/2002 14:39 9782839253 COUNTY LAND SURVEYS PAGE 01 TOWN OF NORTH ANDOVER ti 1 O . LARSON 32.5 LOT 1 69,454 S. F. v� L �kd? 55.2 (.\ TOWN OF ioe.a r� NORTH ANDOVER o0 �►�'w�u�st o0 HARD C9Q �I v,1 S/ /Z LJ li TTURE LOCATION PLAN I CERTii Y THAT rH£ PRIMARY STRUCTURC 514OWN CONFORMS '0 _ _._.—._._._._—..__ ._,.._.. ....._........ . .._ . THE NORIZONTAI 5CrsacK RCOUIREMCNr5 or rHE LOCAL - .__....... -- APPLICAOLC ZONING SY-LAWS IN EFFECT WHEN CON5rRUCTED. (THIS CLRT!FICAII0N DOCS NOT CONSIDER ANY OTHER �/f L RESTRICTIONS SUCH AS ('OVFNANTS, WFT(ANOS, FASFwFNrS, CL I E N T: h/ /fir ORO£P,S OF CONOrnoNS. ETC.) (/ THIS DRAWING SNAI I NOT RF IJSFn 9Y rHE CI/ENT FOR ANY THIS CERTIFICATION 1S MADE ANO I.1A41TE0 PURPOSE OTHCR THAN THAT OLIrLINCD ABOVE, EXCEPT WITH THL rO THE ABOVE CLIENT. wRlrrF.N PERMISSION OF COUNTY LAND SURVEYS INC, COUNTY LAND SUPVEr5 INC. rAKfS NO RE5PONSI6ILITY FOR THE UNAUTHORIZCO USE OF THIS DRAWING OR ANY INFORMATION LOCA TION: CONTAINCO HCRCON. BASED ON 5CAL£D DATA ONLY rHE Pp/MARY SrP(JCTURE SHOWN IS NOT 0CArEO IN A FLOOD HAZARD ZONE AS SHOIyN ON FCMA rLOOO INSI/RANCC RATC MAP: SCALE: DATE: +� Q COMMUNI rY N0,'4,6 Ob (C7'� DA rC: 4- d ZDNE. (Ir APPLICAHLC) � C'UIIN'I'Y LAND �S'UHVF;YS, INC. Prokmional Land Slu-coy rr*PO Box 54.E Gloucwtar,MA 01931-05A,R'(978118'2-0443 U W I 1 No. 0 10 yy ndover, Mass., O LAKE �, r COC HICHEWICK ADRATED IT FOR EXCAVATION AND FOUNDAIION U410� THIS CERTIFIES THAT .. ��1 �•►. !.....�.r P 'P .............................. .Q� III.......f......... has permission to excavate and pour foundation at ..� '....................../,34 ....,3........4 jP 5 ,6 a CO ... ....................................................... for the purpose of... .P®Oh'1�.. � 9/4 ,� !��/, /1C/ r"� '� ' (a Rip4Ideswe ... !. s.... .................. The person accepting this permit must return to the office of the Building In ctor a certified plot plan show of building thereon before Foundation will be inspected. ��/� �►�'®�"� VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. FEIiM. FES hE., Fl)I Fu.-_4. . . ., ......... .:....:..... ..... ......... ............................. DUE FRAME PERMIT$ c>— BUILDING INSPECTOR a Date ".0o7;�a TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 41 This certifies that . . . . . . . . . has permission to perform 14 I. '. 1, . . . . . . . . plumbing in the buildings Z4'—'e�. : — . . . . . . . . . . . . at . . . . . ..,1. . ., North Andover, Mass. ,v Fee . . Lic. No.. . . . . . . . . ... . . . . . . . . PLUIVtBINPIYS TOR Check # �� v 5457 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (� (Print orType) Pl I� �1�c_�if�1000 ,MA DateZ4 i7 200,2-Receipt# Permit# '1� Building Location y 45 (/p� S7 Owner's Name Map: Lot: Zone: Type of Oartpancy�`� * �/ .�lyPi/�I�� New Renovation ❑ Replacement❑ Plans Submitted: Yes Q. No ❑ Fee: m ! W ¢ N y W 5 W N y N U Z F- 2 W a W R o w < ¢ S = _ _ ¢ m W H w W O O D. O w N ¢ LU a — �- ¢ > _ O w Z v7 LU w m ur a w ¢ � w ¢ c � - (� H Z F- w w f7 O ? w U J N W Q w N a w > x w Z < ¢ a a o o w o - LU w Z 3 0 -j U ¢ > n a r- a SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR r 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Campany Name EASTERN PROPANE & OIL, INC. Check ane: Certificate Address 131 WATER ST DANDERS 2,fA 01923 Corporation Estimate Valueof Work: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. t Name of Licensed Plumber or Gas Fitter , g Aft Z 'u INSURANCE COVERAGE: I have a current I*oility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes. please indicate the type coverage by checking the appropriate box. A liability insurance policy t Other type of indemnity Cl 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. Checkone: Owner❑ AgentCl Signature of Owner or Owners Agent S. I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the bestof tj my knowledge and that all plumbing work and instailations performed underthe penmitissued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Cade and Chapter 142 of the Gral /s � By Type of License: Title Plumber Sign re o 'censed Plum r or Gas Fitter Gaslitter Master License Number City/Town �Joumeyman APPROVED (OFFICE USE ONLY) Rens ell, V BELOW FOH OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FON PERMIT TO DO GASFITTING NAME 6 TYPE OF BULIDING • ' LOCATION OF BULIDING s. PLUMBER OH GASFITTER - LIC. NO. PERMIT GRANTED DATE ZD GAS INSPECTOR Date/�. �.. .`. `. . 0,140RTh,,MO TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING • � a ,SSACNus� This certifies that . . . . . . . . . . . . . . . has permission to perform . . . y . .`.`. . ... . . . . . . . . . . . . . plumbing in the buildings of . . . . .D.6"!'6. . . -. . . . . . . . . . . . . . . at. . .4/?. 6!�7 . `. . . . . . . . . . . . . . . North Andover, Mass. 1 < Fee.b 14 ;. :. .Lic. No..4 . .7 :! . . . . . . . . . . . !..-. . . :*��.:-�. . . . . . . . PLUMBING INSPECTOR Check # 7 /� ? 5448 MASSACHUSETTS_UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) ` NORTH ANDOVER,MASSACHUSETTS nn �Date Building Location 43.l Owners Name Permit# Amount Type of Occupancy , New Renovation Replacement Plans Submitted Yes 0 No ❑ FIXTURES z H a o E~ a a w w x o a cc xCnx a ¢ 3 H A x rA z A �' a x 3 a � SMBM — � � >�FIDCR 1 1 ► I � �I1>HIsornZ1 y Z 3Id�FIDOR 4M MOOR MHAGM 6M Hf= 7M FLOOR SIH FLOOR (Print or type) Check one: Certificate Installing Company Name Corp. (�(� ,nj'Corp. Address - 7a Partner. 3/ Business Te ep one y� �j ) _ �� 0 Firm/Co. Name of Licensed Plumber: S-�—Ls(G 61 11�S6C� Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policyET Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts St P bing od and Chapter 142 of the General Laws. By igna ure�rLsiwnsea Plumoer Title ��(��i Type_of Pur�bing License i City/Town License um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY I�