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Home My WebLink AboutMiscellaneous - 48 PATTON LANE 4/30/2018 48 PATTON LANE 210/106-A-0165-0000.0 Date........'...t. .... i i17 NORTH TOWN OF NORTH ANDOVER pF��to ,t 1ti0 0 '• • pp PERMIT FOR GAS INSTALLATION SS^CHOSE i p 1 r 4 f u7 This certifies that . . . .. . . . . . j: has permission for gas installation�^ ,. !!: . . . . . . . . . . .. . . .. in the buildings of �.x. at . . . .. e . ., North Andover, Mass. Fee. . .' Lic. Nod:!.I..N1.. . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR N WHITE:Applicant 'CANARY: Building Dept. PINK:Treasurer GOLD: F6id' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER Mass. Date 02 -W 14uilding Location �4�9 f/�� Z wor- Permit # .� Owners Name • New . 7 Renovation Replacement Plans Submitted D FIXTUP=c m < a Y W N z s as U) Q 0 R .p :2 .N = F W o: Q o v m r s N m w us, a N a CC W N m N a W :. m ,� a q c > W W W m -1 z d s a � o a w r. W z c� s �_ H z a. r W m ° 7 0 ~ W o uFi z 2 d W G a —' G1 Q u y r= W Z14 c 4 q O O W O W I— z O > a a t— o Sua_BS IAT. t I BASEk1EPiT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR (Print or Type) �+ >� / Check one: Certificate Installing Company Name �Dy s� ll2e �� Q Corp. Address e Partner. ��f jC� lis �Fi rm/Co. Business Telephone: ` 111'k Name of Licensed Plumber or Gas Fitter ��/UC%/Q '(�,' lzt Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Q Insurance Waiver: I , the undersigned, have been made aware that the licensee or this application does not have any one of the above three insurance coverages. r Signature of owner/agent of property Owner Q Agent Q I hereby certify that ail of(he details and information 1 have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing wort and anstaUations pctfomtcd under Permit iuued fo: this spplintion will be in compliance with all pertiaent provisions of the hiarsachusetis Slate Gar Code and Cl.apter J42 of the General Laws. By TYPE LICENSE: PS��X lumber Title Glumberer Signature of Licensed Master Plumber or Gasfitter City/Town: MA4- Journeyman APPROVED (OFFrci_ USE ONLY) License I umber TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . ./V . . . . . .�l/ L. s /has permission to perform . . J'C=per wiring in the building of . . . . S.r .2/.41.6' ' . . . . . . . . . . . . . . . . at . . . . . .Y3. . P��?7770,kQ. . �'-4�. . . . ,NqA Andover, Mass Fee,'Z-�� .'. Lic. No. ( . . . . . . . . . . . 1'. ELECTRICAL INSPECTOR 762.YC1465 M% Check# r� 11004 . < 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 §Rule 8 In accordance-with the provisions of M.G.L.c.143,§3L,the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed J el the prescribed form.After a permit application liar been accepted.by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.C.143,§3L. Permits shall-be limited as to the time of..ongoing construction activity,and may be.deemed-by.the.lnspector_of_Wires abandoned-arid-invalid-if he—__. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or-the installing entity stated on the permit application. . EJ The Permit Extension Act was created by Section 173 of Chapter 240 ofthe Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending'through August 15,2012. Permit/Date Closed: * Note:Rea jpply for new permit 0 Permit Extension Act—Permit/Date Closed: (.o►xmonwealth o�cc/I/a�aclu�elfa Official Use Only r 2.Partnunt 013i.Jervice, Permit No. b QT BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07) leave blank)_ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRINT)INK OR TRE ALL INFORMATIOl9 Date: a /a/ � , City or Town of: To the Inspector of Wires: By this application the undersigned gives notice of his or her fntention to perform the electrical work described below. Location(Street&Number) Owner or Tenant rQ Telephone No. IT-7-4-79 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install residential security system Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans o.oTotal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ n-. ❑ o.o mergency Lighting rnd. nd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o,o etection an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers eat Pump I,..,.um•..er ons o.oSelf-Contained Totals: _ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal❑ Municipal [--] Other Connection No.of Dryers Heating Appliances KW Security ystems: No.of Devices or Equivalent No.of Water , o.o o.o Data Wiring: Heaters signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.)k Work to Start: a ( 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE X❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: NI htwatch Protection Inc. LIC.No.: 70240 Licensee: Paul Delsignor Signature LIC.NO.:70240 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:888-722-9282 Address: 22 Briarwood Drive, Westford. MA 01886 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SS-001696 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)Ej owner El owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): i\1 1 h wCl l ?fAe4lonC Address ( A _Lo t,J e-S f- t(l _p r q City/State/Zip: SQUM Jif 0 30 ,�� Phone#: U��` 7 va a- q oa 8 a Are you an employer?Check the appropriate box: Type of project(required): l X I am an employer with 5 4. ❑ 1 am a general contractor and I 6. ❑New construction employees full and/or art time).* have hired th ( P the sub-contractors 2. ❑ 1 am a sole proprietor or partner) listed on the attached sheet. ?• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. $ required] 5.❑ We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑Plumbing repairs or additions myself [No workers'comp. right of exemption perm MGL insurance required]t c. 152, § 1(4),and we have no 12. ❑Roof repairs employees. [no workers' 13.Pther_, Cru f j comp.insurance required.] *Any ��w mot-4�ge *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: �i)E Expiration Date: o ' Job Site Address: y9 a 4 z?n .n City/State/Zip:bl_)dn AMM- gj 15 J Attach'a copy of the workers' compensation policy declaration page(showing the policy number and expiration(date). Failure,to secure coverage as required under Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cerdfv under the pains and penalties of perjury that the information provided above is true and correct. Signature: 5� Date: )ah a Print Name: C Phone#: U0 ` Official use only Do not write in this area to be completed by city or town official City or Town: Permit/license#: Issuing Authority(circle one): 1.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: R Commonwealth of Massachusetts Department of Public Safety I Sceuri( 1Nacm.-S I.iccn.r + / License: SS-001696 . :., I LIN ,max a PAUL DELSIGX6R 22 BRIARWQOD J)X t t Westford MK 018$b'. J.�.- c�E.t`� Expiration: Commissioner 01/25/2014 Fold,Then Detach Abng AN Peftratlon• ALTH OF MAS$ BOARD '— LECTRICIA S FA EAI�E TYPE -C ON D rory,ei•M 0 85.6028 • Fold,Then Detach Abng All P•Raatldn• ®Aunolmmm Nightwatch oEAm' 'Protection, Inc. ; 50A Northwestern Dr.,Suite 9- Salem,NH 03079 Kevin Gilli an 15 Holly St.,Sub 208 9 Scarborough,ME 04074 President toll free(888)722-9282 021 kg®nlghtwatchprotectlon.com www.nlghtwatchprotection.com 9910 Date..... ........................... NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4L This certifies that .....................4..... ./.................................................. has permission to perform :........ .GU.......E- .. .....I/..I ......../Y -S wiring in the building of........... S-�tllr/ ..... . ................................................. at........ .... .Wort Andover,Mass. W ................. Fee.!� Lic.No..Zr/ .................... ELECTRICAL INSPECTOR Check # Cn pp�// //ommonwaaCth ol Ra69achttsatb Official Use Only 1n cc//� nn Permit No,.-----�-7y �1Jafiart`rnent olJira Jervicas Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 9 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: X), /4T.4674-e4, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner*or Tenant 0 r, /%nc�Ea,,` Telephon No. �C1 &I Owner's Address U . Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps _ / Volts Overhead ❑ Undgrd❑ No.of Meters New Service .Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity .Location and Nature of Proposed Electrical Work: 21b6 k, o 6C o�7 C4.t r t� Sqam Completion of the following table may be waived by,the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp•(Paddle)Fans FNo.of Total. Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above F-1In- ❑ n.of mergency Lighting g rnd. nd. Battery.Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Gas Burners o. Initiating and No,of Switches Initiatin Devices No.of Ranges No.of Air Cond. Total No,of Alerting Devices g Tons No.of Waste Disposers eat Pump Number Tons KW No, of elf-Contained _ Totals: T Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other p g Connection yonnection No.of Dryers Heating Appliances KW SecNotyf Devi es or Equivalent No.of Water No.of No. of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No. HydromassagEo e Bathtubs No.of Motors Total HP Telecommunications Wiringg: No.of Devices or uivalent OTHER: DUO/ Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �fj� - (When required by municipal policy.) Work to.Start: 0446Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA Unless nless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE yX BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information.on this application is true and complete.''// FIRM NAME: ('1 Se _ LIC.NO.: Licensee: i L G Signator LIC.NO.a O L7 (If applicable,enter "exernp 'in the license number lin /l Bus.Tel.No.:��. Address: 1 ��L /��] t 1)I� #0 1s .=X)* 1094(19 Alt.Tel.No.: *Per M.G.L. c. 147, s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 000 b / OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑ owner's agent. Owner/Agent PERMIT FEB: $ Signature __Telephone No. _ COMMONWEALTH OF MASSACHUSETTS ELECTRICIA^IS A .REGISTFiScu, SYSTEM TECHNICIAN ISSUES THE r18CVE LICENSE T01 1 ARTHUR W P?ERc C 1 UPHAM ST SALEM MA 1024 C1S7G -2516 � 07/31/13 874092- D • - - Y • J!!P. (/10'/ILIlK3liGlIQ�'^"` d�`-�I ZJ,NY./ " + DEPARTPAENTOF PU3LIC SAFETY Cts ficate of Clearance — 000517 Number, SS CC . - Tr.no: 91.0 F_spires:OS13012012 S-License: ADT 1. _ ARTHUR W PIERCE 18 CLINTON DR /% HOLLIS, NH 03049 Commissioner {ilr ...c irt,t a I ..) .. ., + ... v F • ..... .. ,.... At. ��..5 '�$'. f-{ h a _w S"Y: � I{+ Date..!�/-.7111-6.............. NORTH.4,6, TOWN OF NORTH ANDOVER 6 6 0 1&,W0jgft PERMIT FOR WIRING US Z4 This certifies that-.., ......... .................. has permission to perform- .................................................. wiring in thebuilding of.........t:...... ................................................... at.14.. .......................... yorth Andover,Mass. Fee--45�........ Lic.NAA$43:� .........t ELECTR3CALINSPECTOR Check # SA1 9 M Commonwealth of Massachusetts Official Use Only Permit No. is uj Z. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTIV IONS [Rev. 11/99] (leave blankAPPLICATION FOR PERFORM ELECTRICAL WORK All work to be performed in accordansetts Electrical Code( EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO Date: _ O SCity or Town of: �Of'rh G,tTo the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) �/ �' PC(770 La Ale Owner or Tenant VoyAlcL Ca SCS Lot 6 A-1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Rf-11 iOe-A(C a Utility Authorization No. Existing Service 2 0 v Amps 120 / 2 o Volts Overhead❑ Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /` `-CA, VeC Completion o the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of CeilSusp.(Paddle)Fans No.of Total : Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above EiN-5.ot Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches C No.of Gas Burners No.o Detection an 1 Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump I.NumbiTons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kit SecuNo of Devices or Equivalent No.of Water Kit No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE eBOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: r 3 l _Q .57 Inspections to be requested in accordance with MEC Rule 10,and upon completion. 1 certify,under the pains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME: eD l– 0 0 e+✓ &61CM LIC.NO.: 10 �S Licensee: 15?7-& - 00 U f-f 0c P-i-- Signature LIC.NO.: 0 OS•r (If applicable,enter "exe t"in the li ense number-line.) / Bus.Tel.No.: int 7 e�9 �� Address: 79 eall 57" ea�i(+�A ✓t44 0/F�2 Alt.Tel.No.:2 6�t 51V Z(330 OWNER'S INSURANCE WAIVER: I am aware that th icensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's age Owner/Agent ] Signature Telephone No. PERMIT FEE: $ f Commonwealth of Massachusetts Official Use Only Permit No. lSy/2Z ., Department of Fire Services �:w Occupancy and Fee Checked �� BOARD OF FIRE PREVENTIO REGU IONS [Rev. 11/991 (leave blank APPLICATION FOR PER IT TO ERFORM ELECTRICAL WORK All work to be performed in accordance ith the ssachusetts Electrical Code( EC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TI N) Date: 0 S City or Town of: NP r'rh 64.) To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 7 F /'C(7-70 I J Lot Ale- Owner leOwner or Tenant 00AJAICL CA Sof/I ek/ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 10�- No ❑ (Check Appropriate Box) Purpose of Building kesl IDC'/i/Ce Utility Authorization No. Existing Service o v Amps 1.2U / 2 Vo Volts Overhead❑ Undgrd 19--�No.of Meters New Service Amp l, i, Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Am ac�tyrl Location and Nature of Proposed Electrical Work: A-1 1 rCAe,-J Completion of the follo4ing table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ o.of Emergency Lighting rnd. grnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches C No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW. No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers S ace/Area Heating KW Local ❑ Municipal ❑ Other P g Connection No.of Dryers Heating Appliances Kit Sec No of Devnces or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent— No. uivalentNo.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: Y g No.of Devices or Equivalent OTHER: ' Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L� BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 5-- 13/ _Q 57 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: EeDfr 1)C� en1 rL CJ6'CTnLIC.NO.: /O FS�S Licensee: ReZ-19/' OCt ue,44o r — Signature r LIC.NO.: D�S-s (If applicable,en er "exe t"in the li ense number-line.) / Bus.Tel.No.: Sr/ 7 sff 9 .y6 Address: 9 7W/Z 57- e4 A L,l`q .tit q D/ gi(2 Alt.Tel.No.: )8/ 2-vy`Q3 6,7 00 OWNER'S INSURANCE WAIVER: I am aware that th icensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's a ent. Owner/Agent �✓ Signature Telephone No. PERMIT FEE: $ fl6 FORM U - LO ��ELEASE FORM IIN T—MUCTIONS: This form is used to uerl fy that all nec.-ssary approvals/permits from- Eoards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/er landowner from compliance with any applicable or requirements. "APPLICANT FILLS OUT THIS SLCTIC r� PHONE APFL!C;.,`a T/7cN�Ja -t LO ��r1 v n/ LOCA T ION: 1im2p I\lur fiber /D FAFCE_ �I� SUEDIVISION LOT (S) STREH7 Ilk i-9A lTdn! Lk/ . ST. NU10EER_y�[ h*** OFFICIAL USE ONLY"'`-. .tt - RECOMMENDA'IONq OF TOWN AGENTS: 1 `}�lly 3 �ea3oK �orc.l. 9pf ep lc t'v 56U�M CO —ERVATICN ADMINISTRATOR DATE APPROVED Zit DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED c . TCI PECTOR-HEALTH DATE APPROVED DATE REJECTED_3 /ay/vu COMMENTS D�S G�Zc� %^ IJ ro�o��- io�a'��-...s '7[•� .S<.a �r e�- -tom.-v a"Aa PUELIC WORKS -SE-NERIWA T ER CONNECTIONS DRIVEWAY PERMITMAR n 2 2 2000 FIFE DEPARTME,"IT RECEIVED EY EUILDiNG ii ISPECTCF DATE Re,osed m 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: L a u viti), Phone(Scok) -"X-)_'V- LOCATION: %-)_y-LOCATION: Assessor' s Map Number 1(�& A Parcel Subdivision Lot(s) .� Street A IL•ti 1_,g1V St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved 1r 2 Conservation Administrator Date Rejected Comments 0 1A Date Approved l 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 C. Fire Department � �QL��_ � ✓C �, r�^l�I^acyu'CCc°C� y,tir -I�� ;=~ _ -% %%`/ ` V Received by Building Inspector Date Location '�� aGt f ''1 Lo -, 51— No. ie1sz-- No. Date / t MOR, TOWN OF NORTH ANDOVER � : 9 Certificate of Occupancy $ �'�b''••°''�t�' Building/Frame Permit Fee $ ,SSAC IN Foundation Permit Fee $ Other Permit Fee $ TOTAL $ hG� Check # Z(�L 13753 Building Inspector ,r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .., � • ,txa,,ter� � .�� '�..��1t•.�� i��.� _ ax�A i.; -'�'t� ��a:BUILDING PERMIT NUMBER. DATE ISSUED: ® C �s SIGNATURE: '00pr .6"Owoa� BuildinCommissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: qSr /fin tiA)0 AAuejcqyz,1 /V Map Number Pyr/lhS 1.3 Zoning Information: 1.4 Property Dimensions: :S.(00� ZoningDistrict Proposed Use Lot Arm s Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Sapply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public R�Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System V SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record C),-gQA)A 4 Ei3 � Sel ARAj y� RA n-&Aj div Ah 4A)Anj Pk Name(Print) Address for Service: Signature Telephone IF 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTIONS-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ T2El�Pa"c AAPn&/Awz,-)y Licensed Construction Supervisor: License Number:— �� 7j �3 j2r1..�ty�►� ,1 At�� /UB /��Jc�.�yet2 Addres �S �2 Expiration 25ate 0 rgnature. Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ !� 2t �1 tr, 5 Company Name . / Registration Number '�/ �32m'GL1�ra,lt�d c' .4y� ,/+1d/�.yCdVe✓Z, � P' Address � �� ` i— ..,""m"°r /0 1 tsi lll.1-SING DEW, '�i1�v�t. �'� Expi—h Dat �y Sj nature Tel hone !J/ ti 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 i Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: /Y X/ to 3 Se-4svu c "-90 2 C d /,JJ/' 7--A/ Y/b P7'01�C V So A). Tv e S � /3P�a,,� c�2,� �e X;s--' "'VC q a r U SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be QFFICIAL USE QNLY Completed by permit applicant ' 1. Building (a) Building Permit Fee Multiplier 2 Electrical J o p (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 0, 0 0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorizeto act on My behalf,in all matters relative to Vork authorized by this building permit applicatio i. Apt i nature of Owner Dat 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 i � Signature of Owner/A ent Date MEMO- NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF,FOUNDATION THICKNESS SIZE OF 100TING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE BUILDING DEPARTiY1�1i T DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number —3 Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: %RAA)K. CdSPi IZ' 4 -SQ k) =Q ?"✓tL] r' Location of Facility Signa of Permit Applicant yi y i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i i .The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone F-1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity dam an employer providing workers'compensation for my employees working on this job. Company name: /�Z _ , u, l j eyZ s f S pi-II-e-V, Address 2�Z 4410 L)JG City: /4)0, AA) nvn✓t -4A- Phone#: Insurance Co. ' n L)r+n-n Policy# A2 1, C n _2` a.-) 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. 1 do herby certify under t ains and penalties of perjury that the information provided above is true and correct. Signature Date Print name /' ��✓a )t4A P9 4 Phone# 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 A ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION r THECHARLES STARK DRAPER SHEET sLABORATORY,INC. CAMBRIDGE,MASS.02139 OF PREPARED BY- DATE: �LQQA • I U Ey � o r I x; ',r; or 7P S720 THS I I I S EF? CHARLES STARK DRAPER LABORATORY,INC. CAMBRIDGE,MASS.02139 PREPARED BY: i DATE: -Ia 1/0 o _14 ---=- F I Ei Ea1'n4 vi TC 4- CG G i AVP -- 0000 1& __ e - 7c, T I dx NIS < i 1 -- �1s JV C _ f I Aligning Your Print Cartridges Align your print cartridges every time you replace a print cartridge - even if you can't see any misalignment. This gives you the best possible print quality. 1. Examine the following set of horizontal bars. Using the [-] and [+] buttons on the product front panel, select the number below the best aligned bars and press the Select/Resume button. I � I 1 2 3 4 5 6 7 8 9 10 11 ............................................................................................................................................. 2. Examine the following set of vertical bars. Using the [-] and [+] buttons on the product front panel, select the letter below the best aligned bars and press the Select/Resume button. A B C D E F G H I J K A page will print from the product to confirm the alignment. HOHE'IHPROV Registration NT.ENENNTRA T.OCON TYPe .-:DBA- - � .ExPiration� -� 1 _42-02-10vol j PRO-BUILbERS K DESI6N CO ' FREDRICK A, x` RI6HfiW00D AVELARDO ATOR f M. ANDOVER NA 01845 I J 921� BOF OARD + License: BUIL CDING REGU ON Number.Num CS STRUCTION SUPER R 3:r 063173 Birthdate: 01/21/1966 Expires:01/21/2002 Resacted To: 00 Tr.no: 15958 ' i FREDERICK A P App 71 BRIGH7WOOD VE ALARDO N ANDOVER. MA 01845 + Administrator 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. tF�* ** " *ttAFI'LICANT FILLS OUT THIS APPLICANT T DtbA)ti)A 4 C-Z _04SSdj A/ PHONE-6 �,S'a LOCATION: AsSessces Mao Number to PARCEL SUBDIVISION LOT (S) STREET 1?4 Ma Al LA/. ST. NUMEER �[ * �`" OFrICIAL USE ONLY*`*-**'-k—' * RECOMMENDATION OF TOWN AGENTS: 1 ' ) (e T�or,,_k 1 �'`I� oP�►�D �" . 5��m CO ..ERVATION ADMINISTRATOR DATE APPROVED 3 ZGt A1 L� J DATE REJECTED COMMENTS �� 4� �1 ��✓T/`S cr-'I� 1QU TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED 4 11/194 S.EeT C 1 ?ECTOR-HEALTH DATE APPROVED DATE REJECTED 40, COMMENTS D�S C�,T� ::•� l�rc�oasc� /vc a �•.s A PUELIC WORKS -SEVNER/WATER CONNECTIONS SWAY PERMIT 1 0 DRIVEWAY , MM 2 2 2000 ,' FIRE DEPARTMENT 1 REcEiVED, EY EUILDING I�ISPEC T OR DAT_ 1UILDING DEP Ass a iIEN. Revised 9i57 im �p P E� I `(p 1 ere w New 0P.nCN�iON �bXyM vs.cv. �Jk� 49.d)` YVI e a!� tr 4 �EP_.tLC...:fA.N�1. •t-..1� x.13.0 x__Pa..R_t.i�L.y._..G_t%Y.�.o.C/��E..Ij_._ COM40N`� !� o w m a� ➢ ` r O . S11- 0 �0 O 5a 9�i 9N S113S�� ° 10� . I �0 3 t 1 �. -o a �L• �f?,�r_c._f alk_. .... AORTH Town of _ 0 6ALndover No. 133 - � o dower, Mass., d O N r = L'CA. , GOG HIC HE wICH �t� ADRATED P -`C S 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System IN a Cd Se )'de0VBUILDING INSPECTOR THIS CERTIFIES THAT.... .QN....... ........... .................. ............. .... ........................................... Foundation has permission to erectR� .p��V�buildings on ...4.8.....V. .... 1. ..................... Rough to be occupied as.1.'1., !..........a....S. 4i40N.......'SPI...cls......'Ir....`0.14.....0109N...D F-1-:K.....: 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. D *MA d L1 S k VC( O N j&tV p W/ drw'lrlr PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough to PERMIT EXPIRES IN 6 MONTHS Final G E L E CTRICAL INSPECTOR UNLESS CONSTRUC ON Rough S... . Service.........� . .....l. BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 1 a 1 La ation �/� -• _ �. No. Date NORTo, TOWN OF NORTH ANDOVER O?0•jaw—t•`•O '•,�00� A Certificate of Occupancy $ / — ` Building/Frame Permit Fee $ 2f 0 Foundation Permit Fee $ s�CHus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector "i 11;29/93 14:07 x,65 PAID 6?5 4 Div. Public Works `Location No. / Date "CRT" TOWN OF NORTH ANDOVER Oft� o �1ti O? + •eC� F p Certificate of Occupancy $ 0 a + . Building/Frame Permit-Fee $ ,SSACHUSE� Foundation Permit dee $ - 'esy Other Permit Fee $ Sewer Connection Fee $ Water Connectio" TOTAL $ ,� 5- ',1 A J l� Building Inspector `� 6691 Div. Public Works PER-1tiT NO: S�/ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS./",',/ /PAGE 1 MAP i4O. iQbA LOT NO. - 2 RECORD OF OWNERSHIP PATE (BOOK PAGE — cZONE Q I SUB DIV. LOT NO. LOCATION LSC, PpT70N 1-41v& /Y AryQOVE/Z PURPOSE OF BUILDINGAb A ) OWNER'S NAME ki)LzRQ.A A 00AWA CASCL&Al NO. OF STORIES SIZE 2. � X 221 OWNER'S ADDRESS Li& pA77CVLl ,,� C/ /y„ � N� BASEMENT OR SLAB ��b .54A66 ARCHITECT'S NAME J 2• SIZE OF FLOOR TIMBERS `IST 2ND 3RD BUILDER'S NAME '� Rucl+>rn SPAN DISTANCE TO NEAREST BUILDING oyi1, CLCI!_�,I DIMENSIONS OF SILLS DISTANCE FROM STREET y�®I 3 ,0 1 •' POSTS ZxY l<1) LJALL _ DISTANCE FROM LOT LINESv-SIDES 1 0 q?,7/p/ REAR 95 •' " GIRDERS c�V6 Kb RA471c2J S AREA OF LOT 3,i _o .1 51 F. !� 7 ( FRONTAGE 150 HEIGHT OF FOUNDATION LJ`�I THICKNESS 10 4I IS BUILDING NEW 161'+J� SIZE OF FOOTING a�� X 1 e IS BUILDING ADDITION C5 qR�� MATERIAL OF CHIMNEY 00 IS BUILDING ALTERATION J�l�C�UQA!(xfS�1/uj /_'YIQ Yw.�`Qw,tIS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yl� IS BUILDING CONNECTED TO TOWN WATER p�t' BOARD OF APPEALS ACTION. IF ANY { IS BUILDING CONNECTED TO TOWN SEWER hS® IS BUILDING CONNECTED TO NATURAL GAS LINE �d INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES fPi�BE+ a EST. BLDG. COST Li, =y 0-0 PAGE 1 FILL OUT SECTIONS 1 - 3 MA U v v EST. BLDG. COST PER SQ. FT. Ll'?ICC? Irc , ��`�,�n EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. 1 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING a 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED / 3 &&TKI (,GK.P/L, BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE Q�j2 �j C/ I PLANNINQ BOARD PERMIT GRANTED OWNER TEL.# g CONTR.TEL.# .5Y-D/9& 3 is /3 CONTR.LIC.# MN 0657 2 f BOARD OF SELECTMEN INQ INSPECTOR i BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILY I DC STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA _ 14 1/2 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM '-(D 47 MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS X B 1 2 3 DROP SIDING CONCRETE Y. �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD!d'D _ ASBESTOS SIDING COMMON DL VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING + r , STONE ON FRAME SUPERIOR I� POOR AD _ EQUATE NONE l 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES J4 LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELE55 FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS Ol l B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING f r' FORM U - IAT 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: 'iso6f.rzri A. Pox_t-tgA Phone( LOCATION: Assessor's Map Number JO& A Parcel /&5' Subdivision Lot(s) .3 Street TA7-Ni ,CANS St. Number JVR ************************Official Use Only************************ RECOMMENDATIIOONSS OF TOWN AGENTS: Date Approved �i 2 Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected / 4 4 ' 1 1 Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit .-- Gc%f.�Dl� /Z I Fire Department �A Received by Building Inspector Date L �C> Foci u AF1T1 o u i-j Il 12143 Sc••o--r----r L.. G t L.E.S >z..(_,.S. til oTZ-rk-t A t ,n ov rc.� , MASS. 43, Got SF a1 T U � dl r N Ew s-r 2 ��• �•76 #48 RreP. 37 3 I � 22.5 � od 0 +i ' V PAT 'TO S GE--2T1>~y 'T•1iAT o�FSt✓TS S+-Iaw t..J ATZ.,� "F-oTL TEtE. _�'� ` gp4 Of T�FdE. oF'FSrcTs USE oF' TH•Frc. SUtt.�t►.16 =t-+SPt�CTp .�d�4�Z Si-•takjk-1 CAMPt_y Ot.1�Y ASD SvGH USrG l S �'ai� $" gGt GAJ CT-" THE. ZA►,it ��e.TE✓2t-�l�u ATtot.� oF' �.o� t�..iG '� 1LAS �1 Sy L.A�t(S o�' Cro u F o2 t�tT'�' oTZ 1`1 0 Go►.j Fo2+M- 0. 13972 a iL(o.4:k ��/��SMA \TY k 1 H E,wJl Go L-1 to �f61STE�Ed L Ldot bcl4►E.v fit,..)t t_.T �� 1241 tl IZ143 COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF 1010 COMMONWEALTH AVE. Vv MASSACHUSETTS BOSTON, MA 02215 LICENSE CAUTION EXPIRATION DATE CONST R. SUPERVISOR f FOR PROTECTION AGAINST AWAJ�101 t94 EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB NON (�NE _ I,._t' o1Q/31 /'1992 052721 PRINT IN APPROPRIATE o BOX ON LICENSE. 6 JZRO$ERT A i30UCHER z BLASTING OPERATORS G12 SHELLY DR SS 4 011-44-2948 mPELHAM N}1 03 176 MUST INCLUDE PHOTO. m y PHOTO(BLASTING OPR ONLY) FEE: 100.00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED-OR-SIGNATURE OF THE COMMISSIONER I r HEIGHT: .�� DOB: F 5/28/1958 /rn /f /cam r THIS DOCUMENT MUST BE J— SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF ,, SIGNATURE OF LICENSEE (!"{y.``'( 'J�•/I�;?Il THE HOLDER WHEN EN- T PRINT GAGED IN THIS OCCUPATION. COMMISSIONER I. EW4 MPSHIRR I e /re �arrrrn�vu�en�ll o�.. ��unc�n�rl/e �- .*4)RJERUCENSE CONTRACTOR �GYtER 1 !A''$OLC HE R _ r �2''SMELLV DRIVE k-a SLla.�on 1U466� PELMAm NH . NSEMENiyGe - iiCA '�LASSiEDORT ,I 0 3 O I lS kOP.ERATOR cxpiraticn 07/1 /3 4 .f LICENSE NUMBER - UCENSF FXPIRFS 058RR58282 05-28-94 ' SOCA SEC,NO. BIRTH DAl'F- �. `.y 3 . i poucile I-iii .� 94805-28-58 1 HT WI SF i IYI•E Robe,t A. EouchEI C ''' 5-10 190 LIOE s AURE —Q— . ..—_-. iL fT0ilSjildlTi.�ticct ADMINISTRATOR Lown;i i MA Oi'J52 °PER-MIt NO.k APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS PAGE 1 MAP 1,40. LOT NO. 2 RECORD OF OWNERSHIP (DATE ].]BOOK 'PAGE — ZONE I SUB DIV. LOT NO. LOCATION1`7pN -qnlC7t/PaVG 7Z PURPOSE OF BUILDING��l) la(/lyC UK �X�`fill�l AR u /' ` OWNER'S NAME kDWAOotofoA 15CL C NO. OF STORIES SIZE G-:7 X � OWNER'S ADDRESS TTC AHG 'd rl� 'V� BASEMENT OR SLAB CG/K -CTL L ARCHITECT'S NAME )NG i5/2/5tl)&W SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME te)UlcL)LkS SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET �j• +U POSTSDISTANCE FROM FROM LOT LINES-SIDES)-. L4 Y. REAR Y " GIRDERS278 AREA OF LOT �� FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING U X 10 IS BUILDING ADDITION 9 �jLAK- Ar=A�C MATERIAL OF CHIMNEY V IS BUILDING ALTERATION G' /U CiCIS71 ' �f f-/dM. ��' 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 sic IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION J J LAND COST SEE BOTH SIDES i 1 EST. BLDG. COST1(i( PAGE 1 FILL OUT SECTIONS 1 - 3 L )J 1 EST. BLDG. COST PER SQ. FT. j PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG.COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS , PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ��' ✓' / 3 f ic4l -1/ X J [il-0-1 , BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT mrd. c PLANNING BOARD PERMIT GRANTED 19 BOARD OF SELECTMEN / BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I_ STORIES 71 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. E _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA RAGES. RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE 81.K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/4 1/2 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM 7' MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD\VD ASBESTOS SIDING _ COMMCN ;K OL _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER ELK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT 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 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS �i AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'MT2nd I_ ELECTRIC 1st � 5d NO HEATING GEST"l�1 EO �oV U vlATt o u �_A�.,i c ` L.oGATEt� 1►J ��r'�-+ A�-.tno�r�T��MA. ' It 121gT— cJco-rZ' &JorZTH 44uflovE,t� �t�ASS. pew 3 �J T U � h Q1 � N4- oq N �7 4.8 3 I o � 11�26�g3 22:5 dl I I � P A T T o 2 91993 � G�2TIF� THAT o P'FSt✓T5 S+•tdw►..1 Ai�.E 1=02. THE, 1N of THt� c�F"FStcTs USE. oF' Tt4CE- BVtt.,nt�.aCE, Z6-JZ> S K a k.!►...� C.oMPC.y O/J t,�y A�fl �uG H VSE+ l S �a S�� `�r� �G GAJ Cr H 'z`-H E.ZAt.11 1�rc.T t✓2 til t wJ AT l o tJ o �.o�► t tiJ G. ILES H C.o►.t F cat t�tT y oTZ. ►`b a t..l Go►._i Fo 't- 0.13972 t.�o. ��rE.>✓,MA \ t''� f~-tt=,w_t GCs ►J ST 2.0 GT E.D. �F�1STE�E� 4L LA001 S Vc141��1 �v t t.�'T tt 12,E 93 Q 1-2-4 [q,3 . r t%ORTf� � 0 o f I �� Andover 0 �o� A 'ort dower, Mass., A)# f/• 3 1923 COC HIC HE WICK �� Ao"YATED P?�\ '�C, �S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.... BUILDING INSPECTOR .0.. .� ... 1�.E .. ow................................ �"'o Foundation has permission to erect. b ...... buildings on ... .. .. ... Rough to be occupied as.&*.Oovothvlase sk !t . . .. . .. Ar AVirr w ...or 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 Inspecti#lERWjftp" ftLPf Buildings in the Town of North Andover.,(","4( TO � ��B�R& 114.$-S. B.C. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough DATE. PAM n Final PERMIT EXPIRES IN 6 MONTHS4 —� UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough PERMIT FOR FRAMUBUILDINGservice ..... ........... .. .. ....... ..... ... . . .. ................. BUILDING INSPECTOR DATE: �' r FEE PAUL- 4"0-.2 Final Occupancy Permit Required to Occupy Buildiilg GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 516 (1993) Date MAY 25, 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 48 PATTON LANE MAY BE OCCUPIED AS ADD GARAGE & CHANGE EXISTING GARAGE TOIN ACCORDANCE FAMILY ROOM WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. rf� . oT CERTIFICATE ISSUED TO Edward & Donna Caselden 48 Patton Ln. �",`$ �e� ADDRESS North Andover, MA -��- Buildrng Inspector !(j;' F1 T f own o ;off over No516 orth dover, Mass., —1923 0 'ftV'q 'n Of?/\T F 0 4�. B 4 BOARD OF HEALTH Food/Kitchen 4PERMIT To UILD Septic System BUILDING INSPECTOR THIS CERTIFIES THAIr .... ... O#w................................ has permission to erect.*#*f1b&...... buildin Ats... orroo.00"A ............. buildups on . Rough Chimney to be occupied aslookawAls....40.. r vA Ar fvo a P.#Aw i... P 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 Inspecti0ERW#ftIftNbMppftqf Buildings in the Town of North Andover. AWAPId 70 J*#V4ft.*, ULATED BY FAFOL 114.8-S. B.C. PLUMBING ID4SPECT 0 VIOLATION of the Zoning or Building Regulations Voids this Permit. 19 DATE PAI PERMIT EXPIRES IN 6 MON FIS 7 ELECtRIdAL INSPECTOR UNLESS ow Rough PERMIT FOR FRAME/BUILDING ZM i A ................ Service BUILDING INSPECTOR FinaI6 PAID DAT E FEE Occupa?icy Perinit Rc-_qti?vd U) Occztjp'y Bi�(ildzllg GAS I PECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT. Burner Street No. PLANNING FINAL CONSERVATION FINAL Smoke Det. j l 1 SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT q <� - COW Tj 61dvhl Location No. Date TOWN OF NORTH ANDOVER � o� 'fit -•- , °°� p Certificate of Occupancy $•: �, • .,��* Build ing/Frame'Permit Fee $ ,SSAG US Et Foundation Permit Fee $ Other Permit Fee /P�U� $ Sewer Connection Fee Water Connection Fee $ dv 20 6iT L $ OG X99 c�� _ I Building Inspector �`�+ Div. Public Works PERMIT eb. ;L,(oz) APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 12 RECORD OF OWNERSHIP IDATE (BOOK iPAGE ZONE I SUB DIV. LOT NO. LOCATION �- PURPOSE OF BUILDING _ S11 Pei- v X _ ,� ��(fid u� ® a L l -KAo' vOWNER'S NAME `nA o L�,a p U je j) C. S�,C L NO. OF STORIES SIZE /OWNER'S ADDRE�SSSJ CCS //f{�I� ZL- fV l - BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD rILDER'S NAME ,_„p �-- `�� L SPAN r- 6 42 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 ISVUILDING 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 s PROPERTY INFORMATION INSTRUCTIONS LAND COST SEE BOTH SIDES EST. BLDG. COST 1/,?, 600 , PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY !y ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS r PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DAT IL D l r BOARD OF HEALTH NATURE OF OWNER OR AUTHORIZED AUENT -6WNER TEL.#(I. (o w PCONTR.TEL. FEE 4ONTR.LIC.#19 9a PLANNING BOARD PERMIT GRANTED .i 1�A/e- BOARD OF SELECTMEN BUILDIN3 INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYSTORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTSRAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8. INTERIOR FINISH CONCRETE a 1 2 'I CONCRETE BL'K. PINE DRY WALL BRICK OR STONE HARDW D PIERS PLASTER _ UNFIN. 3 BASEMENT I• AREA FULL FIN. B M'TAREA _ '4 1/2 'h FIN. ATTIC AREA _ NO BMT FIRE PLACES _ H„AD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS DV1APBOARDS B 1 2 3 P SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D —II_ ASBESTOS SIDING _ COMMON — VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORPOOR _ ADEQUATE I- 1 NONE 5 ROOF 10 PLUMBING .- GABLE I HIP BATH 13 FIX.) _ GAMBRELMANSARD TOILET RM. )2 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHI'iUGLES 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 WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC j _ 1st 13rd I NO HEATING \ 3 111 . ..�. N 0 R 9 ....*.,.. TTT�� o 6 0 AcToldoverOtAft 0 No 260 er, Mass., s&Aa& Ab 199 C MI KEWICK oR ?� ERMITBOARD OF HEALTH r THIS CERTIFIES THAT................. D....w... 111... �. .................. BUILDING INSPECTOR has permission to erect .. ................. . s on ....:4M. ....R� #v moeAW11C Rough Chimney to be occupied as.P.`' .... d....� C.��.... �..,,�...................... 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 MONT ELECTRICAL INSPECTOR NLES ONST TS serve /�j 4J AJ a . Final LAM s i��. .. ... ... ....... ......... . ........ ........ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building RO1gh Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner STREWN0. No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector - „ !.-A W.«•-•r-f .r .._a• w...\. _ _ -w.awwa <•..a ..a ar_e •<•... -� .t 1.� _ 1 r-•era G•.r-.••• •awo •_A- _ �.._ .-- _ _ �o �OA 1�a �! <.•.•(.- rer0 4l�~ OL <1•)t..a lJ•t• ••. •e c.e••ft_%vs it l �w 7 at Q.aA.c.r.•ft W^vt - rlf t•wwa.J:A'0.c.taw.ATs ._ - • aaa+-rt-• .. • • w .. - ..._- ___. a g+•la••\ti - r) •ML CC-•-a.•.T•\rA,Vf . . �� -'c+• •r• wa fa wr A7C. w.wi 7 - \' _ c ar�•a' �trt •.• wltt ary wT'C Wwari {6f .-C aaY-�:• • • .I� 11 AT. / •ao _ l '�. ••r wit taw•A•C '•wat .--_- - t• �- I ' � -•sT•ra .. Alarw •••i\.�f. ' . � av( ... AaT/■I•,�[ _s � - I era. . 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O r••/.WHa . 0•W.r••, •K••w t• ♦yYR1.•. r a A-4...a !� --•t1—..._.-._..�.:.�. J-._L•�.- •_��lt lfl:lT:.:il1►•r/. Ca A•[ r ASTc.aa Aat •^ 1 I •-�«d cKf%T At Y•T[. _ 1 S-, .. sV•IAGCC • M•• t..t - _--•-. ; eaA1M A•/wY •f0•i�PO�-Aal :Z=I've '. . 45 j 7 ' JwCTNw a•a :•• IIANCa I< TN( .'•a -� 1f>5 ..wsea.'•-c� j 4 � Plan view ` •arrT v.c.< • - -� {% �IYAIY DAA/M �r ,1 VAat .• V 1 I'. LONGITUDINAL POOL. "'CT\ON • Tii/v1SYERSAt POOL SECTION 1• - `�r't NYOw+LTAI/l ft[a•GI • n - ■' i rAL-P At TCR Mf•at.. • F - �Eb=PA< CONSTRUC710N I\.TES . �- SVI NAa NOTI �•� ••••T IM A%tCAS OCs•Gf•A1C0OW4'reMTAt•lC• t—i GENEPAL Relr\forClrq Steri . •t 6wwolwC o.«9604 A a1TDwu SN••TIC .. .. waster +Alva SftAll •a .•ltwll(o - • a•rf •w is 7•wM -.AAw a.r•••••< To • f{:4TOw N«G ltc<. t.A.a l.r•....t• p,C.T-M. ca a••+lT•.vt a-vv A-/t .1aIT •f 0-16. l SA/aTv t•f.r STAN"Allof. L.0 • •A•r...... •' J• Gaw.-<7••L - _ • ;.•:.V. 101 Rt YGT •LR6r•T[Y •• a"Ovlt Le.. 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Ca•\V lwl Vu.•at►a.-Ir AtY WTw.Ls qe•lCulA 6'.666: reM IOV4 Go.lSc CyTNC DwVS 64WO04%064. • �•, �� - a ,I. -3 0. ••A7•lft i•A4_•a w� I00� q_w"'c -. • t••<•wa •• VCCCC. =t•..•.•<a..; •..tea ;• w +a _ ' � ' • .M cA Sa<6.._ fa.r• -Ira q f t••.T�JAa c• vt,• [tea•... r.c<.. •< • ✓• •<c•..-.a(<.--•••^w•4 r x G•r r ••Kr « a••r.we r +• .•aa L l••.wa.A.•• ftf•V•f 1.✓r1• •r,••4 TO fl•..I►AICr f •- I .a•. • • aa••T r•:AL t. <••••�.a T• �.aAa 11 .c.• A aq l..r 3r4.o.no sw...•.•.0 rpol t0'r "A.. pw.a.a -•ra W u Co. • t•AL .•ay - .. It 9109•.T••w•.aT I ' ' -- 1 CUSTOM QUALITY POOLS ' K." : 1 16 JYMAN 80!10 31LLFCIC!1, !LASS. , 01821 oIt SKurr lER. FLLSPCtJT OCTAIL••• - [set naso oLrAe••eo Pt Or nA,. oaA•+we] t i:,.: +�71.,E l{n.. �� ' �"(�'tiY in r"1� � {� {•1 •$' + f• y x C4 J03 �9 75, al V o _ r d 4 J 01 U 1� Lb•�b a � 19 u IL V1 FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSIGNED BY D.P.W. i/STREET �k S 772A l &/APPLICANT C C� G PHONE i r pZATE OF APPLICATION EZZ --'� TOWN USE BELOW THIS LINE PLANNING BOARD DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION -� DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED HEALTH SA TARIAN .sem P�d�1 i3.� DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT N� SEWER/WATER CONNECTIONS JV /� FIRE DEPT. K_ RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Date. . . . . . . . . . . . ... . . . .. . . « . 3 l �! HaRTH TOWN OF NORTH ANDOVER QttT QED �6q�0 V Ji F� ry...: a op PERMIgIT FOR GAS INSTALLATION QDq�TED nPP��S �9SSACHUSEt a This certifies that .I.: 1 S.J ./: ".q./ell f . . , . . . . . . . has permission for gas installation I in the buildings of . . . . . ../ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .17 ..44� .A) . . . . . . ., North Andover, Mass. Fee.,A)'. . ' Lic. No.. �tJ_?� -. . . . . . . . . . . ;... GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File nivii (Print or Type) L fi NORTH ANDOVER, Mass. Date1 . ( v 19 Building Permit # -732— Owner's 32Owner's NameZ- New O Renovation p Replacement O Plans Submitted: Yes p No Cl R.. h X h N r O N = tl .I a �. Z aC !+ a: 7 w F� it A st 0 0 0 d M p 30 w t a i w p w s r ac a orfX F � a L q ac ss 0 O 0 r' r r 's O d Iii. :9 �, O J !gy p d O 1 1 sus—asMT. 0AIRMINT LIST FLOOR 1110.FLOOR I !RD FLOOR 4TH FLOOR aTHFLOOR ! 0tH FLOOR 7THFLOOR T-H 0TH FLOOR Check one: Certificate Installing Company Name_ ,,,,—T, S,4�ei-W4 4�e 41-1 f�7 Corp. Address 11 vac Kd 2 S T d Partnership '7'1 f4- -,44/Q/0 P d Firm/Co. Business Telephone C9 F60$ y � Name of Licensed Plumber or Gas Filter-� 5Allo, INSURANCE COVERAGE: Check on 1 have a current liability Insurance policy or its substantial equivalent. Yes W9 No O if you have checked yes. please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Other type of Indemnity O Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: % O nature of Owner or Owner's Agent Owner L1 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 knowled a and that all pIumbin work and Installations performed under the rmit I ad for this appikallon II be compliance with all D h 9 pertinent provisions of a Massachusetts State Gas Code and Chapter 142 of the al ws i ey Type tatkonse: Titleumber 9na ute o nse um et or as er Ll Galfilter aster License Number CIty/Town Journeyman APPnOVED(OFFICE USE ONLY) /o y7® 7 Say State Gas Company GAS INSTALLATION AUTHORIZATION y Date , Issued to Yoa "-gee, a 64,�Aow Address VEArned 1 t AQum For Installation of: BTU Input , 3a✓ �D Restrictions BSG Representative PERMIT ISSUED -BY •_ _*•-r^., _INSPECTOR - - This Portion of Authorization To Be Returned to BSG. Inspection Has Been Made of the Following Gas Equipment: ❑ Heating System (BTU Input ) ❑ Range ❑ Water Heater ❑ Clothes Dryer ❑ Room Heater Location All Work Has Been Done In Accordance With The Massachusetts State Gas Code And Is Ready For Use. INSPECTOR ---- ----- ---- -- ----- --- - ------- -__ .,.._, _- --- --- --- - -- - - . NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY CARD FIRST CLASS PERMIT NO.721 LAWRENCE,MA POSTAGE WILL BE PAID BY ADDRESSEE BAY STATE GAS COMPANY ATTN: SALES DEPT. 55 Marston Street Lawrence, MA 01840 N2 2297 Date....��7/%. ,,1 d�'..... NORTH'9 TOWN OF NORTH ANDOVER °L p PERMIT FOR WIRING SA us This certifies that .... 1.4.r w.......�=:..�.f..� .t.C......./ .!n.�................. has permission to perform .... .....5. .5(J!^....... v 1.......................... c( -e o wiring m the building of.....�.........................!�1............................................. ffv h / at....... ..�..........e ....................... .. .......... ,North An-over` , ass. ;,Fee.. ........:...o Lic.No.�f! S/ J..... ........./-�4 ....... .. .................... LECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer TM60MM0NWE4LTH0FM4SSACHUS= OfficUI UV4 DEPARDI VTOFPUBIICS4MY Permit No. 6BOARDOFFIREPREVF.N770NREGMTIONS527CMR IZV Occupancy&Fees Checked PPLICATION FOR PERAff TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAcHussTS ELECTRICAL CODE,527 CMR 12:00 `//q a (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DatL. Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) tl� Pohm L_1!,-/- Owner or Tenant Dome f- Ed Owner's Address Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) Purpose of Building )Vjdtj N,% Utility Authorization No. Existing Service .� AmYs Volts Overhead 1:3 Underground No.of Meters New Service Amps�� Volts Overhead r--J Underground Q No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work ' htu) 3 on o= No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA _ and ound No.FJ 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 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 Municipala Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.F;ydro Massage Tubs No.of Motors Total HP 0TH>R - - - h r&=Co ge Rcsuantbthececgritanatfisoflyl sdtsGa�aalLnvs ItocaaratLxbtldyhmr&=PcbcyQrh&gCc CoVagecrilssubst3MeWiVdiMI YES r7f NO Iha%esthnftdvalidptodc antetothe0ffi=YES r7 Ify uha%edxckedYFS,plea9 mdc*thetMxcfmaaWbydwdatgthe INSURANCE © BOND OMER (Pl=Spo fy) J t r Fsti� Vakr Wuk$ WolktaStart y(/� hVemml teRe ed Rao 11616t Final FIRMNAMEC(n1 t. I /G' LioalseNa IYJ-13 A Licaua /Y)i/11c� .) /Y eSigtr�Iue a;v/ LioalseNo 12�J .� I Busi=TdNT(x y)9- A ^, / ��, r Ah.TdNh OWNUVSINSURANCEW amawmdz tftLi awdon�lheit ratoeawaworis9hUtd eWhdentasmqukWbyNtnmdws&CardLaws andimtmyslgt>attaealftpwnkappbcmmwaitsthisleW,wTn t (Please check one) Owner Agent S !Iv Telephone No. PERMIT FEE$ v Date� y7 ".O R7 �+ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 4g SSAGMUS� This certifies that,., . . . . . ...!1!. . . . . . . . . . . . . e has permission to plumbing in-th;e buildings of . . . . . . . . . ''.". . . . . . . . . . . 411 . y at . . . . . . . . . .. . North Andover, Mass. Fee ? .'. .Lic. No�'�`� . . . ! - / . . . . . . . . . . . . L t� -PL-U1jB J'NSPECTOR Check d �G (� 6466 MASSACHUSETTS UNIM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS S Date Building Location cn's'�v Name C >\1Permit# Amount kd° S- le of Occupancy New Renovatio Replacement Plans Submitted Yes No �® ❑ ❑ ❑ FIXTURES W. S�BaVIC 1ST FIDQt Za FLOOR �FIDQt 41H HDM SIH H" 6M FL" =� 7MFHM 91H FL0 R ti (Print or type) Check one: Certificate Installing Company Name El Corp. Address CA W�`�� Q-0�7��t�g � " Partner. r-1 Business Telephone (.Q — Firm/Co. Name of Licensed Plumber: C� Insurance Coverage: Indicate thetype of insurance coverage by checking the appropriate box: Liability insurance policy 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 r 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 e compliance with all pertinent provisions of the Massachusetts t P um ' g Co a d Chapter 142 of the General Laws. By: Signature Of icense um e Type of Plumbing License Title 9qjq City/Town icense lNumSer Mas Journeyman ❑ APPROVED(OFFICE USE ONLY f r Date.�'. .. . r. �!":. OF NORTH F� °A TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION 9SgACHUSE� Gl�This certifies that . . . . . . . . . ... . . . . . . . . . . . . . . . . . . has permission for gas installation? .. . . . . . t in the buildings of . . . . . . . at -�,� . &!V. . . . . . . . , North Andover, Mass. oT Fee . . . . . Lic. No.. l.�/ �� -. . . . . . . . . . INS,p,��R Check# 5123 MASSACHUSETTS UNIFORM "TON FOR PERMIT TO DO GAS FrITT NG (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations L v '�� L• Permit# � Amount$ � Owner's Name G —aotJ New❑ Renovate Replacement ❑ Plans Submitted ❑ U � � G 0 a &0 x F 02 F Z z m EaW+ O 0. O W F GZ W9 E y PteW: 0 O O W F F O SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR i (Print or type) n � �� Check❑ Corp.Certificate Installing Company Name. Address '7 \a'l m� ❑ Partner. usmess Te ep one G�1=77 7-7 Lo '© Firm/Co. Name of Licensed Plumber or Gas Fitter �� /� \ �1 \01-,� INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked. es,please indicate the type coverage by checking the appropriate box. ❑ Liability insurance po i Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information 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 a plication will be in compliance with all pertinent provisions of the Massachusetts State Gas e an hapter 42 o e r 1 Laws. Signature of Licensed Plumber Or Gas Fitter By: ❑ Plumber 91014 Title City/Town ❑ Gas Fitter [cense Number \❑ Master APPROVED(OMCE USE ONLY) ❑ Journeyman Location Yg No. Date a3,3 , 01 �oRTh TOWN OF NORTH ANDOVER � A Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ �SSACMust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /b Check # 18234 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATF2 OR DEMOLISH A ONE OR TWO FAMILY DWELLING _. BUELDING PERMIT NUMBER DATE ISSUED: -- SIGNATURE: Building Commissioner/ or of Buildings Date 0 SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number- Map umberMap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District hogmsed Use LA Area Fr ft 1.6 BUILDING SETBACKS-M) \ Front Yard Side Yard Rear Yard ReqWred Provide ReqWred Provided ReqWred Provided Q 1.7 Wam supply M.G.L.C.40.§54) 1.3. Flood Zone lefonnatioa: 1.: Seweo p Dirposai System: �1 publk ❑ Private ❑ zmw outside Flood Zoae ❑ Municipal ❑ on Site Disposal System ❑ .! SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT t r' ' ",�ol 1t% 'i=t(ICt: 2.1 Owner of Record L , / V Name(Print) /f Address for Service: Signature Telephone VV qVL� r , 2.2 Owner of Record: I Name Print Address for Service: k IT Si ature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ..1 Licensed Constructio7Z, rvisor: _� �.,d�g J C / License Number Address /0-0 Jc Exptrahon Date a ignature Telephone r' .2 Registered Home Ion rovement Contractor Not Applicable ❑ Company Name M Registration Number rM Address a23 D� Expiration Date G) Signature Telephone , 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 unit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work checkas a w New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 --[ Accessory Bldg. ❑ Demolition ❑ Aff !�Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building l_ (a) Building Permit Fee (p Multiplier 2 Electrical / (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(+)x(e) 4 Mechanical HVAC 1. 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 as Owner/A orized Agent o subject property Hereby authorize to act on My alf,in all matters1phyive to wpr uthorized by this builduig permit application. —Signature of Owner Date 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 Si tune of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS I 2 NU3 SPAN DIIIENSIONS OF SILLS DIMENSIONS OF POSTS 1 DR ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector a The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations •` Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: Ci D3t23�' Phone # I am a hom er performing all work myself. I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers' compensation for my employees working on this job. Comoany name: Address Citv Phone#. Insurance Co. Po licv# Company name: c Address r r Ci 6.36 ,P- Phone* ��Y3�•5 Insurance Co. Poflof# Failure to secure coverage as r wired under Section 251A or MGL 152 can lead to the imposition of criminal penalties af,a fine up to x1,500.00 andfor one years'imprisonment-as meu.as_civil..penatflesin theform cfa..STOP W-ORK_ORDER.and_a flne of.($1D0.OD)arfay agalnst-me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signatu Date Print name c e Phone# —��_j Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensi []Check if immediate response is required Building Dept ❑ Licensing Board Contact person: Phone#. p Selectman's Office n Health Department Other `z — --- 148-1...... .��'v� z✓f�t,�'pc� I W123 ! �-- i ; V1 033 i W3033 ,3L_.. i w 'j O t I VV381524 3 K� 24. SHVV . B2412B— 821L -lr fl 01 ,x ! 55 A.,, -- i 01 N a I f T4�3q T24 �, i All dirnexisions-slae designations given are = This is an original design and must not be Designed: 5/3 " subject.to verification on job site and rEc��a}oroG�as`~ release or copied urkless Wficable Tee Printed: t/12/ "`� adjustment to fit job conditionshas been paid or jots order planed. ;1BD4.5 C:A;SF_.L.DER RESIDENCE KIT 4-15-04 Floor Plan Drawi= _ 91teow Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration rnoil {X Registration: 124592 _ Type: DBA MCD Z McNeil Builders Expiration: 7/23/2005 WA W �� Mike McNeil --- - -- °° o 1 R PHILLIP RD. _ S; 0 ` DERRY, NH 03038 o p c,.°o o - - - — ----- ,� NG ;a2 r.t Update Address and return card.Mark reason for change. -4 0 rn 0 , 1 Address ❑ Renewal Employment I_] Lost Card N p 3 a z �/ze i�ornrreoizcurall� a /�awac/u�aelt6 - Ci a C M F ; -= Board of Building Regulations and Standards m G) — License or registration valid for individul use only o o C _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -4 cn — Registration: 124592 Board of Building Regulations and Standards w Expiration One Ashburton Place Rm 1301 C)- (a • 7/23/2005 Boston,Ma.02108 ...��.,,.a..� _ Type: DBA McNeil Builders Mike McNeil 1R PHILLIP RD. DERRY,NH 03038 --- �------ --- Administrator Not valid without signature NORTH Town of 4 over L A E dover, Mass., •� O COCMICKEwICK V 7 ADRATED P'P�` BOARD OF HEALTH PERMIT T Food/Kitchen Septic System N:D O IV THIS CERTIFIES THAT......... ........ BUILDING INSPECTOR ....... ..l ........ .d................................................................ Foundation has permission to erect..... ........ ! #0/4 *1G4I � N• ....... ........... buildings on.............................................................................................. Trough to be occupied as ' �... "oAJ / ^0 �r j ��4 � 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. '00 i X/ ,& PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Trough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S ARTS Rough ....... ....... .......... ...... Service ... . . .. .................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F ugh al 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. Location 8 ' ` #uu') /,"-`' No. Date 7 - 4-j - 0_3 ,.oR•M TOWN OF NORTH ANDOVER ?o��...° , �yo f � w A Certificate of Occupancy $ a �°'Eta Building/Frame Permit Fee $ 8 �cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 8 Check # & I 16285 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP §WVATL OR DEMOLISH A ONE OR TWO FAMILY DWSLLMG WELDING PERMIT NUMBER. < DATE ISSUED: � ry 3 SIGNATURE: Builth Commissioner of Buildin Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assesses Map and Parod Number. i-1 Ir k&iIna.1 Capt /06 , Ores Map Number Paroei Number 1.3 Zminglofommtim: 1.4 PtapedyDimeasims: Zonis District Proposed Use Lot Area Fronts ft 1.6 WELDING SETBACKS R Front Yard Side Yard Rear Yard !22±ed Provide Provided ReqWred Provided 1.7 Water SuppVMnL.CAD.1 341 1.1 1.8 Se-V Disj-1 S}stsm: RUC 0 14ivab a Zane 0uWWe Flow zoo a Masic pit D On SGe Disposal System 11 SECTION 2-PROPERTY OWNERSWIAUTBORIM AGENT 2.1 Owner of Record - ona CaSCtefevt yf A*-��on �-&t'nx— No. �kclovc p /Adddrress for Service:[' Signa Telephone Owner of Record: Name Print A.ddress for Servlet: z 4 � f•� 85'• SSL 111 Si stare Tel boat SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor. Not Applicable ❑ Licensed Construction Supervisor 0 License Number Address r Expiration Date Signature Telephone 3.2 116istered Home Improvement Contractor - -- - - Not Applicable ❑ @s aG Company Name M Registration Number r Address r Expiration Date /) Si azure !MOM YI SECTION 4-WORKERS COMPENSATION(M.G L C 152 §25c( 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 it. Signed affidavit Attached Yes......D No.......0 SECTION'S IWscrigeLionorI m6 ed Workd#,eckan_ w New Cortmetion'❑ Existing Building ❑ Re*gs) 0 Alterations(S) ❑ Addition ❑ Accessory Bldg. ❑ Demolition D Other 0 Specify Brief Description of Proposed Work-, SECTION 6-ESTIMATED CONSTRUCTION COSTS . Item Estimated Cost(Dollar)to bet0 `tlFlilCiA;USE1 x Completed t applicant st. I. Building (a) Building Permit Fee S / , 000 Multiher 2 Electrical 3. 5..0 0 (b) Estimated Total Cost of -Construction 3 Pltqnb• g Building Permit fee(.)..(e) 4 Mechanical AC / 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 PERM T as Owner/Authorized Agent of subject property Hereby authorize : to act on My behalf,in all matters relative to work authorized by this building permit application Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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 -- - Signature of OwnerIARent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF•SILIS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION T19CKNESS- SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLD OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I 1 � .. . ._.._r_ :-_......... _...._.. ---- -_ CUMM�N`y o � y o In �i D rn �) S113S� 9 1 r .16'oo 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 C�wai�� c.�n� C&S ��dgPl }41' 10NE_7n-4d ', 5- $"Z LOCATION: Assessor's Map Number o PARCEL__1�2_J SUBDIVISION ' LOT(S) STREET— ST. NUMBER ************************************OFFICIAL USE ONLY********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED—_ DATE REJECTED —_ COMMENTS— TOWN OMMENTS,TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS — _— FOOD INSPECTOR-HEALTH DATE APPROVED l i DATE REJECTED--------- -- SEPT_IC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED --- —_-- COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS_ DRIVEWAY PERMIT FIRE DEPARTMENT _— RECEIVED BY BUILDING INSPECTOR _ _ —_—__--DATE—__-- Revised 9197 jm To: Town of North Andover From: Ed Caselden 48 Patton Lane Re: Building permit Date: 3/21/2003 Sirs, Attached are a building permit ap, form u , and floor plan sketches of our house. We would like to finish the exterior walls of our basement with insulation and sheetrock, a dropped ceiling and possibly carpet. The utility room area will remain unfinished. Two small closets and a wine room closet will be added in the finished area. There will be no bedrooms, bathrooms, sinks or any plumbing added. There will be no changes on any other floors of the house. Please call with any questions. 5cer y Ed 5r Caselden 97 -685-7552 NORTH 0 0 E over � o� LA d®ver, Mass., AORATED P' CJ 4 y H BOARD OF HEALTH l Food/Kitchen ti Septic System /1 BUILDING INSPECTOR THIS CERTIFIES THAT.. ....4... 1.�64'° 6•... .,�. . .Q�*% ........ ............................................ Foundation has permission to erect..AFAV6. .............. buildings on ....y.0....p�4 .q...4l..y.�............. Rough to be occupied as ..a.e � .. j6JS*M ry*Ar!W.... '.....ROC.I'�. L................... 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 rel ting to the Inspection, fteration and Construction of Buildings in the Town of North Andover. /OJ� /46 c �80 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. •7 Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STNS ELECTRICAL INSPECTOR / e Rough ........ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Cry Wali To Be Cone FIRE DEPARTMENT Until inspected and Approved by the Building inspector. Burner Street No. EE REVERSE SIDE snl"k e °e1 . ; B er,� /opo5eZ (f /,,LanI aS � 16eL 5� `�f' /v 1 Gc vh )v ✓15 � S, el AC-51 �el T'I�riao✓+�5 P�uPa P it (fixc elo L'++(;f-Y Zoom . C ✓e u+e w i vt e 5ToRajz 3. C r e u-{e 2 �f;sf' n� rare �y Rocirr-� �✓ea5-M�lt��le �® ACJ av✓S 1 clv , eo 5. �1 S oMe i ;5 ti+s CN - arc 5 w1^e✓e i LUiN Sf0Yct�le 1 17 6• -Tn 5 T CC l j N C ct✓p Lf ,�1 a �en`fr4/ S +ccivwczy 6//W op'k- Room k VAC- ung-{. �o PLANS MAY BE MODIFIED AT UILDERS DISCRETION Ft�� v , Hu STarctjE, � � it- a � Lt 1 w o✓iol� - - - - - ISLlkL,L,� stagy✓5, Vose h4'-p ' I 63'-D'r I j o i\J :-_f} V ' �u I r!c�2a cl �7<< 5 1 1 ✓t 3� ce 5� Yh-2✓l, ��c� �tr/ °v� U �''� U 3 o i to N C f O • � i N O ' r s �o PLANS MAY BE MODIFIED AT BUILDERS DISCRETION r- W _ f I FDIJN DA-7 t0A1 �A ��'�'p® se4 Ick--�`� a� I uiP c N -T)otjn I �, N � � ni �tg LP vIvt5 Roo � �o o✓h ! 1 PLANS MAY BE MODIFIED AT BUILDERS DISCRETION Oz ac i FOL)NC A. � � Fea,✓t � Flo®� V �t 1l l 6` 3\1_7 r--. CI om J ex [ILI t eo CD 00 I = N i I� -0-0Q- 0 aJ Od 1 \.- PLANS MAY BE MODIFIED AT 1UILDERS DISCRETION � KI i x FOUti Dr-710 4 04 TOWN OF NORTH ANDOVER PERMIT FOR WIRING wwqw --- Thiscertifies that .... ................................ ............................ has permission to perform ... ...... .................. wirinf in the building of..... . e.......................... ... North Ando at....It".4T. ........................................... 06 / /—, 7r ..... ..... ., Fee..?,r.......... Lic.No/ ........ ....... . .................. ELECMCAL'INSPEMR Check # 45 , 9 THE COMMONWEALTH OF AWSACHUSETTS DEPARTiYlEt T0FPUBLfCS4FETY Office Use on] r BOARDOFFIREPREVIMONRELA RONS527Ct1V12.g9 Permit No. (j Occupancy&Fees Checked "PLICATTONFOR PERM1r1'To PERFORMELECMCAL ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00WORK 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) Owner or Tenant C�S Owner's Address �J Is this permit in conjunction�a building permit: Yes No (Check Appropriate Box) Purpose of Building + Or L— Utility Authorization No. Existing Service Amps / Volts Overhead UndergroundM No. of Meters New Service Amps / Volts Overhead Underground � No. of Meters —rte Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of UgL ft Outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures t / Swimming Pool Above KV 4 � I kj Below Generators � round round KVA No.of Receptacle Outlets `Q 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 Tons _ No.of Disposals No.of ZonesNo.of Heat Total Total No.of Detection and No.of Dishwashers Pum s Tons KW Initiating Devices Space Area Heating KW No.of Sounding Devices No.of Self Contained _ No.of Dryers Detection/sounding Devices Heating Devices KW Local Municipal � Other No.of Water rleaters KW No.of No.of Connections Si ns Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- irnaanoeCovwage,REAM 1r)theiawhmewofM CiffrdLaws haw aamaitLi*khmuu=P011c},1r CbmpjM-1OMMOmCOveWorffiRtzilleggivalat havemhnhtedvandproofofsametothe011ice YES YES NO igthe box IfYmhaveched edYES,plea9eirxli&thetypeofmveWby VSURANCEE BOA OIHER ( Spw y) EVitalimDale VoikIDStait — 2. r Fstirn dVahieofE7ectndWodc$'` Z_ D ignedtuxler epulaymof 1WmfionD*Receed Rough RMNAME W L 1.1 A Lioa�erTo. ti ?�� ar> t ut.A�,�►��' (' Sigtahue 9:L. ---1 I1=wNo l LRe, ko plr�:-e BusOffmTel.No. a 7 `'(296,-73CX2) ANXS INSURANCE W jnut 'Ah.Tel No. ANII2;Iamawarethatthe ukefledoesnothavetheirLmaricecoverageoritsaibstarttialecltlivalentasie4wedbyMa thGemalLaws 3thatnrysigr><�ttueonthispeurritapp)��i�� lease check one) Owner Agent ❑ 0 CJ Telephone No. PERMIT FEE igna re o caner or gen