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Miscellaneous - 45 PEMBROOK ROAD 4/30/2018
45 PEMBROOK ROAD 2101021.0-0003-0000.0 / 1 1 tiC l.v[vlwlVty rrct>t�.t n yr�ntaax>tt,nv.vs��� �•••--��-�•�� DEPARTYVIFIVTOFPUBIlCSr MY Permit No. BOAROOFFIREPRE{�EMONREGUL4T70NM527OR120 ` v� Occupancy&Fees Checked APP TTONFOR PERMIT TO PERFORMELECMCAL WORK ALL ORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT INK OR TYPE ALL INFORMATION) Date 3 3 _a Town of North An over To the Inspector of Wires: The undersig ed a plies for a permit to perform the electrical work described below. Location(Stre t Number) Owner or Tena �O Owner's Address +/� Is this permit in conjunction with a building permit: Yes rM No (Check Appropriate Box) Purpose of Building I I Utility Authorization No' Existing Service ..1G..��� Amps LO/ Volts Overhead Underground No.of Meters l New Service AmpsVolts Overhead =1 Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures /Y) Swimming Pool Above Below Generators KVA 2mund ri No.of Receptacle Outlets / No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners m f Ranges No.of Air Cond. iotal FIRE ALARMS No.of Tones Tons t Disposals No.of Heat Total Total No.of Detection and Pumps . Tons KW Initiating Devices Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices ryers Heating Devices KW Local Municipal a Other Connections ater Heaters KW No.of No.of Signs Bailasis Massage Tubs No.of Motors Total HP Aasua[Y b dle tagtmeriafs of111a�ct1>setlS CSI®l laws liah�yhtarePa6cyin3�IgC'ort>ple� asub9arialegrivalat YES NO vafidproafof=wio heOffice YES ff)uutxmdrdWdY6,plea mdrmftt peefarimWby BOND MEEK r7 Fr=**) ?re17i0-(—rC(V //./D EkpitadonD we Estimated Vakr of1kcrordl Wak$ hgpecdonD&ReWe-4ad Rough Fmd of � pa'`=)rC �� �� ���� it�oatseNo 2-?F 2 74- &V 3tgnaaae &V �a � �� ,,//� Gy Bus=Tld.Na tr ff /�'// o>� �/ Alt Tel Na 97 y�9'-1146 OWI,WSINS(JRANCEWAVER;IamawxedmttheL`wedotsmaloeaneageailsmbgnialegivalaitascac}lWbyMamhnMCanW aws and that my sigrlbae en this permit appli abm wages du regtatemat (Please check one) Owner Agent a _ Q Telephone No. PERMTr FEE signature or Owner Of Agent .. i 9 ������ ti Y -° Date..... :.b..... .... kORTN it 1 Oqo i•1ti 3? O0 TOWN OF NORTH ANDOVER Z. PERMIT FOR WIRING CHUS This certifies that ....... j1 =-. .FrR •...................................... :. has permission to perform ......... ........... ............................. v�nnng m the building of....1. ..a�C `?r--�.... ......... ....... 41s PES 13Pooh 1e at.................................................... ......... ,North Andover,Mass. S-0 5:a- Fee �c Fee..................... Lic.No.............. .......... . ... .. ..:... ...... ..... .... .......... ELECTRICAL INSP R Check # 5885 DFPAR7MENT0FPUBLIC&4FETY Permit No. S BOARD OFFWPREVEM70NRECUI.4T10AS527CKR 12.00 J(PLEASE Occupancy&Fees Checked ��APPI�ICATTONFOR PERNIlTTo PERFORMELECTRIC U WORKALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACIiusm ELECTRICAL CODE,527 CMR 12:0pate PRINT IN INK OR TYPE ALL INFORMATION)of North Andover To the inspect of Wires: The undersigned applies for a permit to perfort 5_m the a cal wo described elow. Location Street&Numbers�� Lo ) ( Owner or Tenant re A 1 IA_ Owner's Address �'t't 4:;, Is this permit in conjunction witth'�a buiillding permit: Yes No ® (Check Appropriate Box) Purpose of Building A/r/C.e r��� Utility Authorization No. Existing Service Amps, Volts Overhead a Underground � No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total al No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Air Cond. Total FIRE ALARMS No.of Zones No.of Ranges Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Locala Municipal Other Connections No.of Water Heaters KW No.of No.of Sins Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- Laws Y Ir>staatoeCa►aag�Ptd5U3ttO1hEIBf}SHI1t3tiS lBtt��H19�1YES tha�eaamartLiabtTdylrmaatoePbkyittdtt�gCar�l�e ChAWcrEE is ttialag>ivalai Iha%eabrt badvakpiaifofsametnthe0ffm YES n NO Ifjouba%edvdwdYES,pleasec&*lhetypeafaotaWbYd glhe INSLRANCEo BOND o o Estimaoadvahrecft`7�tidWodc$ � WcrkioShat lnspacfimD* Ro* Fant Signedunda-ie%raltiescl'pffW Lioa�seNa FIRMNAME Li=wNO BI&mTel.Na AkTdNa �11L�9=�— OWNER'SMULkNM WAIVER;Ian a watethatt vLi=w—&q__,aMmtt ettteir>stratoeco►eagecrA.ssubsotdaleglWftaste*madbyNtsmdm=Can'ALam andthatmysigscreecni ispamdappliatlatwmusdnstaquaenart t J (Please ch ne) Agent QJ—Q P�ER.�MTelephone o. IT FEE DEPARMENTOFPUBLICS4MY Permit No. BOARD 0FFIREPREPEW0NRWU AT10AS527CjVR12-M Occupancy&Fees Checked �.� APPI.ICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 ---� (PLEASE PRINT IN IMC OR TYPE ALL INFORMATION) Datg ! </� �� 'v Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the a cal wo describedelow. Location Street&Number Owner or Tenant q eA t Owner's Address Is this permit in conjunction with a building E��e4 it: Yes tt� No (Check Appropriate Box) Purpose of Building /I /tZt•(J Utility Authorization No. Existing Service Amps Volts Overhead Underground No.of Meters New Service Amps��Volt Overhead Q Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA Na of Lighting Fixtures Swimming Pod Above Below Generators KVA ground around No.of Receptacle Outlets No,of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices C) No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other ID Connections No.of Water Heaters KW No.of No.of Si Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHE bmrdrloeCaaag�NasuatbilletagtitetlatafTvl�st�Gelt®haws �� Iha%eaaxmtLidAtyb UM=PCbCYidU*gCaTOft Cat Wcrits�tt�afivebt YES NO 1lme�brnAedm&piot£afmml0 hem YES Ifjmhred ed®BYES,pkmilafwdietAxofwmWbydledalgtle NRRANTCEa BOND 01FM 0 (� Est n*dValreofEbdricalWakS Wcrk>oSlat Raq x9W F'a,al S;gRredtardr3�iePt3raltiesofpajuy. IioaueNa FIRMNAME Lioalsea n LioerrseNo _ Buscr�sTd.Na �J Pe A1tTel.1% re f -- OWNER'SDVSURANCEWANEIt;Ianat+=6 t1heIw s�n0 theesuaroear a@etrassrl�tiale4d ttasiBgiaedbylviassadtlsdtst$realiauvs andftmysigoL* ern8ffipan*Wp6cWgn�esihslegrm�lat 7-3/ (Please ch ne) Ow er Agent 7 Y Y3 Telephone No. PERMIT FEE o AW-DT. (A) C�.e-��v � i�,��c►-v +jpjAfv,-7 wt, <-f t Z/z Date. . . . NORTH F TOWN N H ANDOVER • - PERMIT GAS INSTALLATION . � h �ISS ACHUSESt This certifies that r.. .._. . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . i has:perm � ission for gas i> llation in she buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i at . . . . . . . . . . . . . . . . . . . . . . , North Andover, Mass. Fee-.-A5 . .. . Lic. No.1f . . . . . . . . . . . . . . •(`aAS INS�C,�O� R Check# 5181 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) -_ - Date /�7 1 6P� S BUILDING DEPARTMENT W Permit # Owner Building o N bor �C llsc� sr Name AT: Location Fee Paid Type of Occupancy: New ❑ Renovation ❑ Replacements Plans Submitted Yes ❑ No ❑ I to a N W N st Z it . N N O 7 to = W W cc O V m f' = N C9 W Q m r/t t- Q ac 0 0 N a W = a Z tW- W Q W Q 1- th W Uj Z V W Z N W Q fL O0 a I, UJI _ W W W Q Y cc ft W W N 0. O t— Z J H Y W W O O > LL H W J H W 1 Y Q W Q it f. H > N M Z O Z W O N Z Q W > W Z Q W Q Q O O W O W i- Q = O O 1 W O (ti J U M > G C. F- O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR ' 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR s (Print or Type) ����� �A� T�� Check one : Certificate Installing Company Name 11 - 1 E] Corp. _ Address 4 074 46,tv dj- S ❑ Partnership PL-VA A44- [91-irm/Company Business Telephone 9/M'Isz, o ante of Licensed Plumber or Gasfitter I hcreby certify that all of the details and infounation 1 have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfonned under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General laws. TYPE LICENSE: By - ---- lumber. -- Title _ Gasf:itter. Signature of Licensed - City/Town: ster Plumjer or Gasfitter -------- ----- Journeyman APPROVED (OFFICE USE ONLY) License Number. e } Location No. X42- Date w/ cvv-a-s NORTIy TOWN OF NORTH ANDOVER 3? 0 AL O R ' Certificate of Occupancy $ JACNUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ { Other Permit Fee $ TOTAL $ / f Check # peels 18342 r2� 1 /' Building Inspect s i t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT EVAI RENOVAT F, O OR TWO FAMILY DWELLING DEMOLISH A ONE tt x BUILDING PERMIT NUMBER: �� DATE ISSUED: 6' ��� M 3 SIGNATURE: Ay"6C., Building Commissioner for of Buildings Date — 2 T-07 z SECTION I-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: a &Ak-\ j -— Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin Distrid Proposed Use Lot Area Fromm ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide Required Provided Reqwred Provided v 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: 1.7 Water Supply M.G.L.C.40. 54) Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ Public ❑ G. ❑ SECTION 2-PROPERTY OWNERSEMAUTHORIZEDAGENT 'i'"i'i'i= '1-tr'Ct: Yes P,10 M 2.1 O7sicA 1- Name(Print) Address for Service � t Signature 'Telephone 2.2 Owner of Record: 0 Name Print Address for Service: z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable q, Licensed Construction Supervisor. 0 w License Number an Address rw Expiration Date aw Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r r Address z Expiration Date Signature � Telephone 4 SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Pro sed Work check aH applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ P terations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beOFFtC1'AL USE ONtY Completed by permit applicant 1. Building (a) Building Permit Fee OP D , U 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. Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUMDING PERMIT I,. O � as Owner/Authorized Agent of subject property Hereby authorize to act on My beha ' ' all matters r ativ wor authorized by this building permit application. i ure f Owner 1/ �P ^ � Date 4 SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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 Print Name Sianature of Owner/Agent Date �a NO. OF STORIES SIZE r' BASEMENT OR SLAB SIZE OF FLOOR ITVIBF.RS 1 2-ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIIVINEY 1S BUILDING ON SOLID OR FILLED LAND IS BUII DING CONNECTED TO NATURAL GAS LINE %0RT1f f f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION 2 Number //Street Address f o, ��i� �" aP/LotJ HOMEOWNER O r it. 7U 68 77 Name H/om hone Work Phone PRESENT MAILING ADDRESS Xb� City/Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two 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 108.3.5.1.) DEFINITION OF HOMEOWNER 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,one or two family dwelling,attached or detached structures attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and at he/ a will comply with said procedures and requirements. ee?,'� HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL NORTH Town of W Andover No. -r7w 00ver, Mass., 0 LA E COCHICHEWICK 7,ps RATED WARD OF HEALTH Food/Kitchen PERMIT T. D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..................... ........ .............................. . ............ ............................................................... Foundation has permission to erect... uildings onyrc?..... ........................................................ Rough Chimney . . ...... 1 to be occupied as . .................................................................................. provided that the person ic-c-�Olng this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION q T ELECTRICAL INSPECTOR //%j- Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place an 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 _jl Smoke Det. r Date...:`- ........................ y yORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �SS�cMusf� _y This certifies that ....1..... j �-�-............... has permission to perform �................`".................................................. wiring in the building of .. ................................ at...`�+o..4.... ) ............... ...... .............. ,North Andover,Mass. .... Lic.NoO7. . _ ELECTRIC�NSPEC�R Check # /l/J 5664 1Im LulylLVLV1v rrrr n Ur XrL-Ionru"ULwi I U •w •� DF.PAR73IDVTOFPUBUCSAFEIY Permit No. BOARDOFFIREPREVF1MONREGUM90NS527OMl2Ba Occupancy&Fees Checked APPL 71ONFOR PERMIT TO PERFORMELECMCAL WORK ALL ORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 3—o (PLEASE PRINT INK OR TYPE ALL INFORMATION) Date Town of North An 'over To the Inspector of Wires: The undersiged a plies for a permit to perform the electrical work described below. Location(Stre t Number) Pe, Owner or Tena Cd Owner's Address Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building Utility Authorization No. ExistingService D' Amps L I� Volts Overhead Underground No.of Meters 0 New Service Amps I Volts Overhead r-1 Underground No.of Meters Number of Feeders and Ampacity al Work — Q D Location and Nature of Proposed Electric ' r�i ,S No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures /Y) Swimming Pool Above Below Generators KVA C ground and ri No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and y Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal � Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors. Total HP OTHER- Ir�ttanoeCoveage Putarantbdietegtmanais�GarralLaws . grits YES subdaiial NO IhaNeaataaYLiab>'IO.yhmaar=Ib>yC.Yinchxfr>gCornplelP Com e�rivala:t Iha-,e& triwdvafidptoafof=w1D Off=YES ffyoutimcladedYES,plea mdc*dlerypeofamaWby INSLRANICE BOND 011iER (Plea9aslw y) ?re)r6?rra IWAIWB#mlianDw EsWn*d Valreof&=cal Wcik$ wodceostst hqxc6mD&ReWeWd Rao Final ME�iei �pajtay li==Na 2—G Z2 C� lioa>sae �IJI�i� C� 6 Signa�ae Lioalsarlo 9 9 >,X �1l / �o� ��fC�//n 0 3� 7 Tet Na 7 5�`y� /r/ _ OWIgR'SINSURANCEWA1VIi;IamawarethattheLinalsedt>esmthatetheinsaaloecov Wailssubstar>tialeWwWaltasm madbyM CmffWLm and ftrat my sgl�ue on this paQrit applic�rn waives this ragtmelnat (Please check one) Owner Agent _ Telephone No. PERMIT FEE$ 26 signature of Owner or gen ,.� • NORTH ANDOVER, Mass. Oate .t p_LL 8undlt GQ ]/ )rd 7 J Permit t v l Location �� /t/� /� 't CT . qj7 Ownees Name i New p Renovatlon Replacement p Plana Submitted: Yee FIXTURES ......... w s M s � 0 el D • Y S X w s s i O t s �+ r ase • — s N■ 19 � o � � � P. a s ~ X� ase a1 = s Y ° t s Ye ° t 4 .as ,. .. el to y . . Id 42 o a F 1Ae •MT IST PLO011 ._. SM* FLOOR $11O FLOOR now _ 11MFLOOR w { - •TN 'LOOR STN FLOOR j TTM FL0OR - !j •TM FLOOR Check one: Cerllflcais Installing Company Name�AL A L—� . 1 L�. Addressjq �" 8 w �. Q C j p Partnership Business Telephone 0 g". Name of Ucensed Plumber Lo r INSURANCE COVERAGE: Ch ec one ' have a current Ilabl�Yinsurance policy or ts substantial iquWent. # i Yea O No p.— N YOU have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy_ Other type of indemnity j OWNER'S INSURANCE WAIVER : I im aware that the 11ceniee does not have the Insurance coverageprequlred by Chapter 112 of the Mass. General Laws. and That my signature an this permit applicaUon.waMes.thta. Check one: .. __ t!Reiheasll. _..... _. . _ Comer Q a urs o er or sr.s en Agan*Q - I_hnaby sanity that all of the detaMa and blormatlon I have wArn ted for entered)h above II.— dpe and that an numb aPD�allort acatrue.aad aocdralalo{tw► f th tnq�rwk and hilaJlatlona petfan�d under the pertM Itaued br We apPMeallon will be.In partinen Provisions of a Massachu's"s State Piumbing Code and Chapter 142 of tl»Oarlerai Lams oompRarlp wi,{ sA 8y t� Mie no urs of Lim C tylrown tk.nse Numb« 913 10 MP MED(OFFICE USE ONLY) Type of Plumbing License:Master Journeymart, Q Date. D of""..NORT`,��o TOWN OF NORTH ANDOVER PO p PERMIT FOR PLUMBING 'F SSACMUS� t R This certifies that . has permission to perform; .1.. . --- - . . . 7 .3 . . plumbing in th.e'bw- ldings of . at. . . . . . . . . . , North Andover, Mass. Fee&.. . . . . .Lic. No.. vk . I PLUMBING INSPECTOR 07/Z5/97 13:055. d� WHITE: App icant CANARY: ui ing PINK:Treasurer Location ` a No. //l/ Date d ZZ -!>% ,.0RT„ TOWN OF NORTH ANDOVER c?o.'...° N�aoo�. F p Certificate of Occupancy $ WIT • t Building/Frame Permit Fee $ Foundation MP ee $ s�cMust Other Permi $ I SSO 6 Sewer Connection Fee $ �� Water Connection Fee TOTAL $ .S.6) C) r" Building`Inspector e� cD�E+L1#19414:31 35.00 PAID 4 73,62�G Div. Public Works PERMIT,NO. / APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. AGE i MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE — ZONE SUB DIV. LOT NO. ✓LOCATION 1 PURPOSE OF!-BUftpttpq_ "OWNER'S NAME e/ �1 NO. OF STORIES SIZE vWNER'S ADDRESS �I0 Q a yJ• BASEMENT OR SLAB ARCHITECT'S NAME ✓ v KY SIZE OF FLOOR TIMBERS 1ST 2ND 3RD y-"-BUILDER'S NAME /Q R ,4dC– F, SPAN —DISTANCE TO NEAREST BUILDING fJ1� DIMENSIONS OF SILLS -_ --- DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES–SIDES /' REAR GIRDERS - AREA OF LOT 6z FRONTAGE HEIGHT OF FOUNDATION - THICKNESS - IS BUILDING NEW SIZE OF FOOTING X - IS BUILDING'ADDITION MATERIAL OF CHIMNEY - IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND Vyl_I.LL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST /�//,�i+►o PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. T V r EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 r� /Y C! PERMIT NO. If w ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING r - 4 APPROVED BY Iv 7 ATTACHED GARAGES MUST CONFORM S ATE FIRE_REGULATIONS PLANS–MUST BEFILEDAND APPPiRO D B BUI ING IN ECTO DATE FEL D Y BOARD OF HEALTH IGNATURE OF OWNER OR AUT IZED AG - F E E OWNER TEL.IY��3 PLANNING BOARD PERMIT GRANTED CONTR.TEL.4 t9 CONTR.LIC.#i BOARD OF SELECTMEN r BUILDING INSPECTOR . I k . y BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY SiOkIES 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 8 INTERIOR FINISH CONCRETE _ B 2 I_ CONCRETE BL K. PINE _ BRICK OR STONE P —_ —— PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. BM TAREA _ '/. 1/7 14 FIN. ATTIC AREA _ NO B M T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE ��_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING COMIACN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _41 STUCCO ON FRAME - BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBQEL MANSARD TOILET RM. (2 FIX.) _ FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER - ROLL ROOFING MODERN FIXTURES TILE FLOOR ' TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE •– ` FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM _ STEEL BMS. & COLS. HOT W'T'R OR VAPOR F WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T2nd _ ELECTRIC 1 1st 13rd I NO HEATING PLOT PLAN OF 45 PEm5Roov, Pc)A -D RT w� AKiDovEp, MASS P2ERAZED FOE CC)L f tr. V..,AQ t.,.j L A P EY nc T. (31 � 1L � � N t, ,D, @L 1 N hCQC� 2( - LOT 3 FoL)hlw.\Tto 'V- lNn W �LINx �t : 24� 27 Sot � of .4 1 C- o o,d.� e ygy k'ak Qf Al i� 4 ROBSTrs ^ ..� Q J 979.30 t e ' I ._ E 1 a l ' �.1 f S_:1 _ _>G S C: �or�Family dun. T. E}`N RIC�aN 'ARKETIN r_ G CORPORATI' x,100 ,NRICO DRIVE, MANCHESTER, CT 06040 T;_:, .(203)649-3666, "ICONSIGNED TO % \ C U M E N T L ,•4 DE IV N ` STORE 1 _ CATQ O1 ORD. NO.241 h, s A ti a vA WAREHOUSE: CTNS J i�` X ' r �r .� -� CARRIER CTNS X 7 71 �. AIA TkAtNSPORT CODE: DLL ONLY CARRIER PrP 7Si8 714 Lbr '-8X4'8 SILVER OAK f • 1$4£=S CSS—I.. WALL R 1 2-50 ,FRAM la L I 118 k 8 2 pR .d` L'IN1=R G ,i r- X581 COL Ar=A4P ALJM LAGI3ER IN PAK � - JA LS40IP I HP DE FILTER -IN PAK 00 1 Y STRAIGHT BILL OF LADING-SHORT FORM— • R•CEIVEO,"Obloct to the cleasmilat Ons and terf In affect en ill date of the I...of EMs•IR of Ead1K1 SH I P R E R . AT MANCHESTER, CT. 06040 /C 3 •' •• •1 G i..10 412 9 w FROM NORTH AMERICAN the propartdescribed CAN Y Uetl bel M pw in A . a r n RK Dp.e 1 good ode,.aKcepl a npted,00ntentl.ra Condition of oPruYnt!Of Packages ETI NG CORP. understood throughout Isis contract a meaning arty person or Ca ages unknown another Carrier on the route to said deltlalllon.II is mutual) paabOn in poassafon of the I.merke4 COnsi9—.and destined as IndlCRled below,which said carrier(the word Cartier being progeny under the Contrett)agrees to carry said its usual place OI tlelivery at saitl tleshnation.If on its rpute,otherwise to d liver to WOWnY.that eve service to be performed hart r sally ag sued•a to each Carrier of all a any a aai0 property over all a an Ihi!is a rail or a ra hwaler shipment,a(21 in the Dject to all the terms and conditions if the Uniform OdMslic Straght Bill o lading Se/fort�tt)n and as a l Frei nt',"o C as licahon m effect on the tl lath apDlfCaple mold tinier Cla 'icatlon a tarifl it thio is i mala Carrier sni h q Party at any time interested m all or any of sartl ng,Iassig s,thole on the back theraOf,sal Kath in the ClaailiCali-a tariff which rtI!IM Iran! shipment.S ipper hereby canities that he Is familiar with all the terms 10 no conditions of the sattlreo of antl his align,,(Mail or atratl Kttldrn8 of conalprtso—Fp plepssers of roM06stbe OOVe ponation of this shipment,and the said terms antl contlmons are nerebY agreed heto b the sni 1 Y pDer and accepted for himself NO 1KGS. KIND OF PACKAGE,DESCRIPTION OF ARTICLES,SPECIA( AtAR%5 AND E%QPTIONS •wE1GMT(SUB.TO COR) CIAu ,] 6-CLASS [ +l (L OR RAiF CK CIX �� L 7•.r 1 U a IS v.'.J ."i o V L A J S 65 Agenl or Cpsh:er s T,;;in _ i •N Me fhlprnenr merM between rwo parry by a KOrr�er by woMr,Me law r 3 I--rhe bill 01 Iod�nq(hall flora wheMer.I n"corrlai s ar yhr grey ` Pper'y weght.• NOTE_M'hera Me ro4 n dePeMenr on valve.yhppery ore reavred b ybb ypacnc�ell 11<horyey pe ro be prepaid,write or sbmp here. �R ,he praperh the ogeW ar declared valve o1 rhe propwry n hereby ypecdreony In wrihrg rhe agreed or declared volae Of "T be Repad." The u - y staff by rhe yh"Plier Ie be not e,ceedlnq 1 9rbw.e.here acknowledge.only Me amovn• N/ prepo�d 1 TO BE PREPAID Ch $ NORTH AMERICAN MARKETING CORP. SHIPPER.PER YoeFnstFom fast-dfke""'Res of shlyyer. 10•SAN DRIVE MA AGENT,PER 669 NCNESTED.CT.06W (Th.6.11 of bdr ne n Io be sgrred by rhe.hipper orW ogenl of the Caren.fsvm (///7/ g tame I 1_s _ A Sty. 1 Str: r' j DATE J 1 8 0 8 No. / Phone# r - r or Flamily Fun! WHOLESALE OUTLET §`C Comments SOLD TO STREET CITY'.. STATE ZIP HOME PHONE NO. -' / BUSINESS PHONE NO. PER. RATE SLIM TRN STORE LOG N0, CAT.NO. _ NO. l ACCT.NO. MISC. 8 SEVEN DIGITSFT - - OUAN. STOCK NO. DEPT. MODEL#/DESCRIPTION #CTNS. JI 71 I - r' _ i I I Sub Total I Tax Total Less Deposit J Cash ❑ Check 011 MC/Visa [I TOTAL#Ctns. Balance Due BUYER'S SIGNATURE X RECEIVED CARTONS X I HAVE READ AND-UNDERSTOOD ALL CONDITIONS ON REVERSE SIDE. PLEASE SEE REVERSE FOR STORE POLICY AND INSTALLATION CONDITIONS THIS ORDER IS CONTINGENT ON APPROVAL OF CORPORATE OFFICER. � Io. ORTpyo oover N 0 2 4 4 _ _ o ort ; dover, Mass., XWOM it Z ff 19 Vj COC NIC HE WICK AO R� ff "/ RATED r BOARD OF HEALTH r- PERMIT T D Food/Kitchen 4 � Septic System BUILDING INSPECTOR . 4 .............................................. THIS CERTIFIES THAIi.�.L..� ...... Foundation /� has permission to erect... . ..`............. buildings on ..... ..40�..... Rough to be occupied as.../ �..r .�►0.. ... .......0...0.4....d .. O........ Chimn y e r> provided that the person accepting this permit shall in every respect conform to the terml of the application on file in �. this office, and to the provisions of the Codes and By-Laws relating to the Inspe tion, Alteration and Construction of Final Buildings in the Town of North Andover. d PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR `r UNLESS CONSTRUCTION STARTS Rough ALIP, 4 ... ....... ..../ Service BUILDING INSPECTOR Final Occupancy Permit Required to Oc(-upy Building GAS INSPECTOR Rough yy. Display in a Conspicuous Place on the Premises — Do Not Remove Final =y No Lathing or Dry Wall To Be Done :.spy Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. ,ry Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT f Location No. v�� S � Date NaRTh TOWN OF NORTH ANDOVER Certificate of Occupancy $ �o a # Building/Frame Permit Fee $ � cM�SEt Foundation Permit Fee $ Ot a ee I $ -� Sewer Connection Fee $ - Water Connection Fee TOTAL // f Building Inspector c�14/44 09:16 15.00 PAID 7<3 eDiv. Public Works PER111T NO. 1:2- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. VII-A GE 1 MAP d40. I LOT NO. 2 RECORD OF OWNERSHIP IDATIE BOOK :PAGE — ZONE SUB DIV. LOT NO. LOCATION PURPOSE O IL ING h r OWNER'S NAME. Nd. O O IES I OWNER'S ADDRESS L BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME g T�(g � _ SPAN --- DISTANCE TO NEAREST BUILDING -tel/ DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAL FSFQ ATION THICKNESS IS BUILDIN 'EW S. SIZE OF FOOT114G X IS BUILDING ADDITION kLOFHAMM NEY _ IS BUILDING ALTERATION IS BUILDING ONS LID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE U N 4NNCT D TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILD CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE - INSTRUCTIONS 3 PROPERTY INFORMATION LA COST SEE BOTH SIDES EST. BLDG. COS PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST P R SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM Y SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING - . 4 APPROVED BY �l ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS f/ PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR I✓ DAT ILED I BOARD OF HEALTH SIGNATURE OFrOWkER OR AU H I- AGENT av F E E //Q�// PERMIT GRANTED OWNER TEL.#4?IC PLANNING BOARD f CONTR.TEL.#I6 rZI 7 is - ' CONTR.LIC.#O1S'fi'2L O BOARD OF SELECTMEN r ♦. f0� ll �� BUILDING INSPECTOR I , rw i BUILDING RECORD 1-J6 A OCCUPANCY, 1`� A HISSHOW EXACT DIMENSIONS OF LOT A� DISTANCE FROM APARTMENTS 1. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCI•ES. GA- APARAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH , CONCRETE d 1 2 I3 CONCRETE BL'K. PINE _ _ BRICK OR STONE HARDW-D PIERS PLASTER DRY WALL UNFIN. r 3 _� BASEMENT I - AREA'FULL' FIN. BM'TAREA ,y,i B s ( '/.- - '/1 '/, FIN. ATTIC AREA NO BMT FIRE PLACES HEAD ROOM MODERN KITCHEN - - 4 WALLS`' I 9 FLOORS CLAPBOARDS B 1 2 3- DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD+!✓D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME 0� BRICK ON ASONR I I q;kTIC STRS. & FLOOR _ BRICK ON FRAME ' CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR (� POOR r ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT- SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE -- �f FORCED HOT AIR FURN. TIMBER BMS. 8 LOLS. STEAM STEEL BMS. & COLS. HOT W T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING W- MASSACHUSETTS I BOSTON,MA 02108 _.. .,.,, w EXPIRATION DATE CONSTR.LICENSE SUPERVISOR „1- ,a ..CAUTION ll /.08/1996 EFFECTIVE DATE LIC-NO. j FOR PROTECTION AGAINST RESTRICTIONS j I THEFT, PUT RIGHT THUMB NONE 01131/1994 055484 PRINT IN APPROPRIATE 173JLO BOX ON LICENSE. ARTHUR J DUFRESNE - 87 MAPLE AVE B ING O4ATOF4 SS � 025-28-3453 N ANDOVER MA 01 845 I i MI S�INCLUDr-p PH4}r-.+ ~� gONLY) F I. J� !� ark 0.00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY I I L)4..c `- C. I J„�l Ut STAMPED-OR-SIGNATURE OF THE COMMISSIONER HEIGHT: DOB: -- !/ l 11 /08/1937 THIS DOCUMENT MUST BE CARRIED THE PERSON O ^ate`!• R F _ SIGNATURE OF LICENSEE .., E ' — THE HOLDER WHEN EN- OTHERS-RIGHT N-OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION. �Q.OMN'IOt!'iDtA1CF1 O�1 Q654C 11f,4��` ,/ DRIVER,?.8 LICENSE �e Tpar�o�na�zu l/o�✓Ifiraac�rulc�I ` e @252834 33 11 0 X983 FIW. HOME IMPROVEMENT CONTRACTOR 11-0A-37 M D� 19I44A cla-la w Registration 100621 3-BS x cp Type - .INDIVIDOAL 'aDUFRESNEf ARTHUR J JR t Expiration 06/22/34 67 MAPLE AVE N 1843-3 ANDOVER MA ; 9 Dufresne's Brush & Hammer 62 Arthur J. Dufresne :; 87 Maple Avenue EEE ADMINISTRATOR North Andover MA 01,1445 I ws tXORTtq Town of Lc over 0 N 243 .: � o. Q _^.. C gTorti dover, Mass., 19 COCMICHEWICK A0 RA7ED P"?9- ,tCJ S ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT..........40. 4jf �....Of..&.0. ........................................................................... Foundation has permission to rrt.. 44 .. buildings on ...�... fi ... .......... Rough to be occupied as.of&.04-I.At....ItOrI #*$....*... .... ....csf.............................. Chimney e provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS 1S Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ................................. . .... ......... .. ...... Service . .............. BUILDING INSPECTOR Final Ocatpancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough . Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. CFIIUFR /WATER FINAI DRIVEWAY FNTRY PERMIT Location No. Date s I NORTH TOWN OF NORTH ANDOVER . " p Certificate of Occupancy $ • .;+ Buildi�ngYFrame Permit Fee $ Foundation Permit Fee $ �— Ss�cMust Otherq Pe n t Feer Sewer Connection Fee $ _ Water Connection Fee $ TOTAL Ab e � •I I.J l�I[ � T y� Building Inspector Div. Public Works f PERMIT NO. ' � APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP 4-40. LOT NO. 12 RECORD OF OWNERSHIP IDAT�IBOOK PAGE — ZONE SUB DIV. CLOT NO. LOCATIONL,01PURPOSE OF BUILDING //�WNER'S NAME NO. OF STORIES SIZE ! J Y L-6WNER'S ADDRESS - � BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LA D COST SEE BOTH SIDES EST. BLDG. COSTpi EST. BLDG. COST PER SQ. FT. PAGE 1,FILL OUT SECTIONS 1 - 3 V EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12- SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY I ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS �I /PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR L/ DAT LED I BOARD OF HEALTH SIGN RE OF O N OR HORIZED AGENT FEE j5, 1. c2 0 OWNER TEL# �/ (] PLANNING BOARD PERMIT GRANTED CONTR.TEL.# - 19 CONTR.LIC.# BOARD OF SELECTMEN ������ w eUl INa INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY - sroRlEs 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 —� 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL Ka PINE _ BRICK OR STONE H —_ —— PIERS PLASTER _ DRY—WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'T AREA J- 1/1 1/1 3/4 FIN. ATTIC AREA _ N_O 8 M-T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW'D _ ASBESTOS SIDING COMMON _ VERT. SIDING ASPH. TILE j STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. _ STONE ON MASONRY WIRING STONE ON FRAME I - SUPERIOR I� POOR q ADEQUATE NONE , 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) }� GAMBREL MANSARD TOILET RM. 12 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK - SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 8 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING 1 1 L. i Town of North Andover BUILDING DEPARTMENT . Homeowner License Exemption (Please print) DATE JOB LOCATION j � �j'S S Number Street Address Sec i_n of town "HOMEOWNER" Name Home Phone Work Phone PRESENT MAILING ADDRESS �- � D V Lo 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 HOMEOWNER: 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 dwell- ing , attached or detached structures accessory to such use acid/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed 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 . The undersigned "homeowner" certifies that he/she understands the Town of - North 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 OF CIAL- �. Note : Three family dwellings 35 , 000 cubic feet , or larger , will be required to comply with State Building Code Section 127 .0, Construction Control . __ __.__ ; SEWERIWATER FINAL �OIEPVATIO FINAL p N , INA ,� own o < < � , 6 �� ndover No 395 PERMIT � - -- - '� � �.� ORI-VEWAY ENTRY A Ery ► er, Mass., 19 BOARD OF HEALTH PERMI LD THIS CERTIFIES THAT....D•*fM.�.�.... ..��•MIV•e& . .......................,. . BUILDING INSPECTOR has permission to erect k).1.0wo-r.w. ....13•sr.•40pilf. .,Or�It••Vr•!R7 Rough A..A e.c.: r. ... ,.. .....�..�.. .. ........, Chimney to be occupied as....... .... •••• •••• •• Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRUCTION TARTS r Service •.•• Final .... . .... . .. .. ... .. .. ..... ........ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove/ Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. 1) .? _�L.? Building Inspector PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE MAP t40. LOT NO. Cl 2 RECORD OF OWNERSHIP (DATE BOOK :PAGE �9 p V ZONE SJB DIV. LOT NO. L.L/� (`i LOCATION 1/� --�����— PURPOSE OF BUILDG�� ,�j1 c Sfd�D c�e�Ziz zlJ` OWNER'S NAME L< / �/` - NO. OF STORIES 912E S/ �/ 3� / "1 OWNER'S, ADDRESS q f/Jf'G BASEMENT OR SLAB t— GG.•.• - ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST /d 2ND 3RD BUILDER'S NAME �L -/1 SPAN X DISTANCE TO NEAREST B'-'ILDING n /J. /"DJ DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES ,idf � REAR !3d0/ GIRDERS AREA OF LOT FRONTAGEfp HEIGHT OF FOUNDATION G f THICKNESS q Ct IS BUILDING NEW l SIZE OF FOOTING - D x a '- IS BUILDING ADDITION [�� MATERIAL OF CHIMNEY VIrZ IS BUILDING ALTERATION /LLe IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE y19 BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 7 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE s B INSTRUCTIONS 3 PROPERTY INFORMATION LAND COOT SEE BOTH SIDES ' EST. BLDG. COST PAGE 1 FILL OUT SECTIONS I - 3 EST. BLDG. COST PEK-SQ. Ff. PAGE 2 FILL OUT SECTIONS I - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY S ATTACHED GARAGES MUST CONFORM TO STATE FIRE REG TIONS PLANS MUST BE FILED AND,APPR ED B LDIN NSPE DATE FILED 9 ■ LDINO INtPLCTO� SIGNATURE OF OWNER DR A T IZED AGENT ;1 2 F E E '�3 `OWNER TEL I ✓��� chi 3 �/ PERMIT GRANTEDF <—' / CONTR.TEL M � l� � � � 7- J( 2 19 'CONTR.LIC.N :..: ,. H.I.C.I a c BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY NOR'I THIS SECTION MUST SHOW-EXACT'DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY ' fF10E5 LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS.REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION E) INTERIOR FINISH �'' d �CI,R/Sj R1{G'� R �4,L� 5;01-b �0 CONCRETE _ d 1 7 13_ CONCRETE BL K. PINE �� BRICK OR STONE HAROW 0 _� _ _ 40t �- ��J� � riJ �(sT�A `T�1-•, /T(,J PIERS PLASTER ORY WALL /�7��"7 //C�/7^�//�� �/{- p C 7�Lt�� `'C -7-Al r UNFIN. �' I _ '{��Y V/ • LI a'J�11L/"'iw' J /V 3 BASEMENT AREA FULL FIN. B'M'T- AREA _ (ww��""•J�C/..Gy�rj �� v? / GLr / / zfli_ ,/M -, G /Lri //r— y, 1/1 yFIN. ATFIC AREA _ TQ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN d WALLS L 9 FLOORS CLAPBOARDS B 1 7 3 . DROP SIDING CONCRETE WOOD WOOD SHINGLES EARTH ASPHALT SIDING HARD"I'D ✓ �_ ASBESTOS SIDING COMIAUN VERT. SIDING ASPH. IILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASON Y ATTIC STR5. A FLOOR I_ _- ,_�f- .• _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING _ STONE ON FRAME SUPERIOR POOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.► _ GAMBREL MANSARD TOILET RM. 17 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE- NO PLUMBING _ °•TAR A GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOCR TILE DADO g FRAMING 1 1 HEATING c•-�- •7 - _. -• - A WOOD JOIN PIPE LESS FURNAt•E - FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WCXDD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS - GAS - - 7 No. Of ROOMS OIL .... BMT 7nd _ ELECTRIC 1�1 13rd I NO HEATING ►ORT F Town of _ jAjid o' v' ' er No. stL q * . : dover, Mass., 19 0 - LAKE �' -COCNICKEWICK ~Y',• S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT............................................Co.//.4.......... ................................................. BUILDING INSPECTOR Foundation has permission to ereet-..4. �bFJ'P........... buildings on....... .......PJB ..;o. O.. E.......X.f - Rough to be occupied as........................................................... .d.R.L�'.:(.. 'z 0/. ...................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations.Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST S Rough ............................... ...... Service ..... ... ...... ..... ....... ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F Rough gh No Lathing or Dry Wall To Be Done FIRE Until Inspected and Approved by the Building Inspector. DEPARTMENT Burner Street No. Smoke Det. i r -.PLOT PLAN Of-- 45 PEmbpoov, � DAD f NO- P-TW A MASS . PZ E PA ZED F02. q COLN CVA L4, pc-y t32,C) Lo-r S7 I F Chan 2� - LoT 3 cc i 0 ! LL Foo ttDAY(o EKis-rIR& DWELLING ts.s l .�_ 27 i �`.► — 92,5` — (2.c�' ' o Of �~ LER-r y. i i �� FORM U LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Hoards and Departments having jurisdiction. , have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. * **************Applicant fills out this section***************** APPLI : U1/ 50 Phone � a3 -251 LOCATION: Assessor's Map Number Parcel Subdivision Lots) O®o J? /Street "Mb12eV1(' Vim. Vd 1 1�/ULIL St. Number ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit F ' re Department /? ��2 U /,�i?r�-L�ctx— tee s / 3 �7 Received by Building Inspector Date BUILDING RECORD 1 OCCUPANCY I2 INGLE FAMILY s:oalES THIS SEC ION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY ' OFFICES LOT" LIN S AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH ® f s� S b CONCRETE CONCRETE BL K. I PINE Z �^,L ^� � �-c,,Q^�•}.� �'/Y6. ( e��,y?/ BRICK OR STONE HARDW 0 __� _ _ +' T✓ bV T-�r I� ` `-` ems.+- ` . PIERS PLASTER DRY WALL J��S //.�? I n 1 ` •-9.AlC� /''Ae UNF IN. — — — � � Cf F✓C /L LZ �/'vSJ�r L 5 tL A (..'ez-5r�!L' 3 BASEMENT AREA FULL 11 FIN. B'M T' AREA LC./�C•L�JV"- NO B M'T FIRE PLACES / // HEAD ROOM MODERN KITCHEi4 t 4 WALLS 9 FLOORS CLAPBOARDS B 1 22-I 3 - DROP SIDING CONCRETE —I_ WOOD SHINGLES EARTH ASPHALT SIDING HARO"j D ASBESTOS SIDING _ COMlAi;N VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME .. .. 6 I Z( N M ATTIC STRS. g FLOOR BRICK I— ON FRAME _ ` CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME , SUPERIOR POOR 11 ADEQUATE NONE $ ROOF 11 10 PLUMBING - GABLE HIP BATH 13 FIX.1 G AM84El _ MANSARD TOILET RM. 12 FIX.) FtAi SHED WATER CLOSET _ ASPHALT SHINGIES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 3 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FtOCR _ TILE DADO g FRAMING 11 HEATING WOOD JOIST PIPELESS FURNAfE . FORCED HOT AIR FURN. TIMBER BMS. 8 COLS. STEAM STEEL BMS. 6 COLS. HOT W T'R OR VAPOR W000 RAFTERS _ _ AIR CONDITIONING RADIANT H-TIG UNIT HEATERS GAS _ _... . 7 NO. OF ROOMS OIL B'M'T 2,d _ ELECTRIC - til 17rd I NO HEATING � a ' Office Use 1P u P LIIIIIIIIIIuluraith Permit No. (J` 3partmEnt of 11uhUr —%fEtq Occupancy& Fee Checked � PREVENTION REGiJ LATIONS 527 CAR 12:00 3194 (leave blank) BOARD OF FIRE PRE APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts EIectrical Cade, 527 CMR 12:.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (NX or Town of NORTH ANEVER To the Inspector of Wires: The udersigned applies for a permit top orm the electrical work described below. Location (Street & Number) Owner or Tenant z�IZ " e Owner's Address ��'�� Is this permit in conjunction with a building permit: Yes No r (Check Appropriate Box) Purocse of Building �� /��/'/�-t Utility Authorization No. Existing Service AW Amos ..l,J `/cits Overhead E-f"' Unagrnd No. of Meters New SerAce Amos --1 Voits Overhead _ Uncgrna f_ No. of Meters Numeer of Feeders anc Amcacay Lccaticn aria NatureofPrccosed Elec*nc i +vera �'�� f� 0 Dar r-47 1-,Awe-e-- c :j _ No. , 'Hot -,bs Vo. cf Transformers KVA No. of L:g^ang Outlets 1 Above— ;n- No. of Lighting Futures Swimming =1:01 grna. — grnc. I Generators KVA No. of Emergency Lighting No f cecectac a Outlets No at CilBurners ; .3acery Units No. of Swttcn Outlets No. or Gas Eurners I FIRE .ALARMS No. of Zones Total No. of Cetection and No. or Ranges I No. of Air Cana. tens Initiating Zavtces No „f Heat Total `V' No. of Sounding Dev ces No. of Discosats I purr=s Tons No. of Sad Contained No. of C•isnwasners - ScaceiArea HeatingDetect:OnrSounaing Devices I i — Munteicai Other No. of Dryers Heattna ^av:ces KW I -coat Connec::on i — ' No. ct No. of Low vottage No. of 'Vater Heaters KW i Signs Satlasts Wiring No. Hycro Massage Tubs Na of Motors Total �P OTHER: INSURANCE CCVERAGE: Pursuant to the reeutrements of massac-csecs general Laws - NO - I have a current Liaotiity Insurance Policy inctuctng Carna:etea Ocerations Coverage or ;is substantial eeuivatent. YES E _ nave suomtttea valid proof of same to the Office. YES _ NO : It you nave cnecKea `!ES. -tease inotcate the type at coverage cy cttecxtng the aoproonate Cox. INSURANCE = 3CN0 = OTHER = lP!ease Scec:ly) (Exatratton Datet Estimated Value of E!ectncal wore r+ Roti nai worx :o Start Inscecaon Data Aacuestnec: 9 Signed under the P Rtes of peg �j LIC. NO. 11r1Z.=-� F1RM NAIMEai d LIC. NO !� Licensee l S' nature Sus. Tel. NO. 7 Fjt C Alt. Tet. .^JO. Address C3� OWNER'S INSURANCE WAIVER: I am aware that the Licensee aces n t nave tris insurance coverage or is sucstantial edutvalenAt estte- auvea oy Massachusetts General Laws. Ona ;hat my signature on ^:s oermrt acpucatton waives this reaturement. Owner 9 W (P!ease cnecx ones -eteonone Na. PERMIT FE= S (Signature of Owner or Agenn 7 ..�. ` � e l r P 1 4�1, ��r= � Date /.. ..: r• 1Q84 fi TOWN OF NORTH ANDOVER 4, p PERMIT FOR WIRING SSACMUSE _ . / A 4 This certifies that �............................. . ......� ................ ................... ..: has permission to perform ............... . ... $ wiring in the building of ..... :.. ,. �-' Y .... .................... ........ at........ ..... * .:..... .................. .North Andover,Mass. Fee. ...� Lic No f ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer _ 0 k4)Location ✓ � �� �i� No. - Date ° v / t T - NORTh TOWN OF NORTH ANDOVER O 1. 16 9 • ; . Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s�cNust 9 Foundation Permit Fee $ Other Permit Fee $ �J�/ TOTAL $ Check # ✓ / 1 7696 Building Inspector s � TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIa RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: c)( icv /© /f SIGNATURE: (/ Building Commissioner/I -tor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Re4pirCd Provided ReqWred Provided � r r 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: -Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSIBP/AUTHORIZEDAGENT Historic District: Yes No Pit 2.1 Owner of Record Name(Print) Address for Service: Q . Signature Telephone 2.2 caner of Record: Me P ' t Address for Sernce: -S C,7S Pig reTele hone 90 SECTION 3-CONSTRUCTIO SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: &6 t%,&V 44 ® �®� License Number mn Address /� n Expiration Date Sig lure Telephone r o 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name [1 7 M 8--n ETA 4 r Registration Number o Address ro V ^ Expiration Date Az Si re Telephone V SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be com leted and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildingrmit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Descri tion of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition i Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: U A MAXCO C1/~ 4�t 5r^.t '�i 4A 6/4 E I SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated CostDollar to be ( ). OFFICIAL USE(NLY Mr,Completed by permit applicant- _ � � 1. Building �. (a) Building Permit Fee 0( 9 Multiplier 2 Electrical i (b) Estimated Total Cost of a Q _�- Construction F 3 PlumbingBuilding Permit fee(a)x (b) 4 Mechanical HVAC lee 5 Fire Protection 6 Total. 1+2+3+4+5 . Check Number SECTION 7a OWNER AUTHORMAT ON TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BURDING PERMIT LI, ( z &Z . as Owner/Authorized Agent of subject property I oyre au on e to act on al , n all mat r lati to work authorized by this building permit application. Si tore of OwnerV Date SECTION 7b OWNER/AUTTVCMZED AGENT DECLARATION 1, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date W -NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 RD 3 SPAN DEAENSIONS OF SILLS DEVIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON.SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4 R 1 1 i% w 1 S� rs..t',� '. 5 7 St-ry-1• �' rd� r f-.}�.// y4 r t'Jrr.6��°.3' � ,y{!$L�f. .,r rs�.'"+ .. ":�.� �t .4•�d iJ r '�f" �/(.s++'.ra .C� rU.rJ'.._...'.>° ` - _ ✓•� 7 �.rrf'i'. ,.t.s ..�f 7;Y.?C.•� >` /`'C i �.' - � '��3 -c.:i r� �� � �o!�''� �:1%i •` f.t'`` f.�.. ♦�'� ,f}r�;l�w:� • Ft / n r.'. c c t' r. li;..a;r r< .�" __•,st<?'!.� i�:!` .. . .'t '" Q ,,�� .. �...•'. i,/ �.,! r��•[ s`�,r'� ,R.r•'`�-• �! t� )7'.. y ri_ roc. _..;�� !G' �f r_:T .�.-.�'_-/J �� - � „��'�.Vie''••, x•.`'t!ti.rlr. .n,"'r' �-��,...a' '"�h.i two :ter r��r / �4 �' � . t r(fit iof IU14 m� q •s '�Ylt s lt� i} f� 1 r '�t *.-6 ,5, s_ S'•rt �0,� .:4'1},.,L !,�f r['"�% '''``�. �'(..J:� ;r1"r'. ._._ � ! _ y - l �+� ,r r?'��• +a:e'�4.''!> -,<�`} --irir't', '.., t `' /i,s'£�, f fr♦ /<."-.,._. :�s.'Gs .5�c.`:�l•''rt'G�.j moi,;": ir-:.`'--'S,. .�.�..�WJ"-�rt',�,�e`7.::/c� .�'r.s.fit.-s,.��� S','t rr; - `��, t,,, ♦ a,+-„. F { r i +f. ^ ♦.♦t' f F s 5"�rC/�`C r �i�/fes �".�•-" -^i3 g-'� iS1t9t'R'.�93aY5.Yw".:'&SrP.S_.SfP'ti,:'.,�`"'#,"10.`�c`«`�`�`-'�"•5tso:�L:.'?t?Saa+Y##•.��.ti3t±nh.•a.u•�Ji7t:,e�.X.....-4..t�!��iu.:,i;�*,a'�ey..Y�'*„a....§A Nisar �±n +-�'+._dE4�-.�5�.^..'.�f� $ ::a�"�Yfa:.! 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_ PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREET ST. NUMBER. ******** ************ *** ***OFFICIAL USE ONLY************ **** *** **** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS `} 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 9197 jm The Commonwealth of Massachusetts. M Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 �''� •'' workers`Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # 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 rrry employees working on this job. Company name: Address A4 �U Cifv: Rd& 1r1 Phone* Insurance.Co. A-/, All OF() Gay- eo Policy# 7 a/ 6?a0-•F Company name: , Address Citvc Phono# Insurance.Co. Poliev#- Faitwe to secure age as required:under Section 25A or MGL 152 can tead to the imposiHan 4 civninal PMWKM ora fine up to$1`.500:0(1 and/or one years'knolmorunent�welLmjWO40nalttes-olheSam�aS7QP afore-fAs111 m)ajdwr� aiost� 1 understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for couefage verificM.. /do hereby cerNy under the pains and penalties ofperjury that the MMMUM provided above is true and coneeL Signature date 7AD E Print n e . ",CJ Lo ff phone.# ?IV ,S f 5- Official use only do not write in this area to be completed by city or town dfiaar City or Town PeanM icensi 0 Building, Dept []Chet*Yimmediate response is requred -0 L.►certsing Board. p Salectmaws Office Contact person: Phone# E] Health Department Ei Other NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9! DEBRIS DISPOSAL FORM In accordance with the provision of MGL e 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: GedACjdwev G /� A Si fia (Location of Facility) 44 Signator of Permit Applicant D to NOTE: Demolition permit from the Town of North Andover must be obtained for this projec through the Office of the Building Inspector t. 4 114'1"N'E'1-11�OY CoMi".RNATION APPLICA."FICY'N FORM FOR UMPASE IP FAV and ADDYI]OINS -,'SG') COX Addne�:)� city"Fk�wil CA 1j,"'o 'Cinoup' 4 De, f it pi F (iAwDed to P or ?Andt mood pame bupyua yw,d nth Wah unyt "A "J-.�ou!gh EX Sol NO Win: Heying DogrevDayi A)It,) Wn Table.!52.:a: S*5.2-1b. d. U-v�6ouc' Perfurnibuce: "Tian MOM to mood ot =n? honwa Wfnp ont) unow Lone Joni Figne A W zono 12 Zone Awn AppsIx A [md hilll(, Tudy(tt Kxyhaw, if AINO: CYOTAns, .{." [ , Honie Enerp Ss f s1u sysw;a Aquh BMW unng) Nxig ApAnd (101"s lmmg mom n". to W A L T 3,R N. I 'I 10 N Ws Ana Apolk sn pJang to won, h- �Oh (.4azirig se fej up to 40% 13. Nuvy Amn 01" OL Mtn H-OhOpmog MAKI APPA" col,rh "do; mammon Mq in 1, Piny if FY 7 iA M than 40% gJazolqO 1W ond cWhuy yp on wq Knuadon Foon- 140, 7XU AIR daylA A MOM do V&ORTH TONM Of :a:_ • 4 _Andover . ...... ... No. a13 Ao , dover, Mass. O Zootic NEWICK V ' ' S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System C.611 !1� .THIS CERTIFIES THAT......... . .... ........t.44*�Y. ......................... BUILDING INSPECTORFoundation b ...... ................ Etas permission to erect. ........ buildings on ........y s ........� M� .e �a Rough t0 be occupied as...... .P PA O � m G e �Q 1/►� �i d N Sty �ti *VL44.0.646imney ................................... ............... ................. ...................................�........... ........... provided that the person accepting this permit shall in everyrespect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-p_ws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. Q 1 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ....................................... service :�. ... .... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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.