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HomeMy WebLinkAboutMiscellaneous - 510 OSGOOD STREET 4/30/2018 510 OSGOOD STREET J 210/102.0-0004-0000.0 - -- - --- - - - -- - - - - - - ► Date. . `5.. .:�'. . . .. .. Of NO DTN 1H o� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION i e 7 • t SA US This certifies that . . . . . . .'. . .. . . . . . . . . .` -"r'` ' .. .. . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . . .r, - �. , " .`. . . . . . . . . . . . . . . . . . . . ,at .: . :: . 1 . . . . . . . . , North Andover, Mass. Fee. . . . . . . . Lic. .. . . . . . . . . . . . GAS INS%CTOR i Check# � f 41 11 =� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) �t/p,/�i�IGy4e� MA Date J'� 2063- Receipt# Permit# ��� BufldingLocation<f7e? S7" Ownees Name �C'7— S Map: Lot: Zone: Type of Occupancy S✓w��� /�i�. I New &]/ Renovation ❑ Replacement❑ Plans Submitted: Yes❑ No ❑ Fee: W JJ 2 H1 Y W ¢ N QJ W ¢ y ¢ o z 7n ¢ LU ¢ O U � � _ of O y w ~ > m = 0 ¢ Z p w ~ Q ¢ z O ¢ v m 0 r W W O c ¢ W < C7 W < 2 ~ (t7 O > w N ¢ _ () W 0 W < W r O F W W N < ¢ ¢ V. ¢ W �W V y ¢ O F 2 J r Z W W O > �' H Z Q W J Q Cr �- ~ > H m Z O 2 w O (n Q W > ¢ W O Z < < Q O O W O W w 3 c c; er e > c a t- O SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 2RD FLOOR 4TH FLOOR I I' 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR 4-H Installing Company Name EASTERN PROPANE & OIL, INC. Check one: Certificate Address 131 [MATER ST DANriERS HA' 01923 � Corporation Estimate ValueofWork: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter , %' INSURANCE COVERAGE: I have a current liaIjlity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes & No ❑ t If you have checkedems,—plea/se indicate the type coverage by checking the appropriate box. A liability insurance policy L� Other type of indemnity ❑ Band ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner El AgentO Signature of Owner or Owner's 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 knowledae and that all plumbing work and installations performed underthe permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gen La�,e�nsed By Type of License: 'Plumber Signare of Plumber or Gas Fitter Tide Gas-fitter Master License Number City/Town Journeyman APPROVED (OFFICE USE ONLY) Revised 05117/00 i I BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. i APPLICATION FOR PERMIT TO DO GASFITTING NAME 6 TYPE OF BULIDING LOCATION OF BULIDING 3 PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED i DATE 20 GASINSPECTOR L4 n / rF No. Date l° TOWN OF NORTH ANDOVER rr NORTM o p Certificate of Occupancy $ t9 : ; Building/Frame Permit Fee $ cM�SE<� Foundation Permit Fee $ -493eevermit Fee $ _ 6U Sewer Connection Fee $ Water Connection Fee $ �i TOTAL ilding inspector 7318 Div. Public Works Location,'5—,-/C (1. _i1,` No. 7 Date 3 %ORTM TOWN OF NORTH ANDOVER O� TJo 1 A Certificate of Occupancy $ Building/Frame Permit Fee $ b sACno MUs t� Foundation Permit Fee $ � - Other Permit Fee $ Sewer Connection Fee $ ._& -y Water Connection Fee TOTAL ` $ Building Inspector f 43/09/34 08:41 1.375.50 loom 7060 Div. Public Works ocation NO. �S`9 Date /& t# NORTp TOWN OF NORTH ANDOVER o?O•'t'aa •1h00A F p Certificate of Occupancy $ D 0 + • : Building/Frame Permit Fee $ Foundation Permit Fee $ 0 SACNUS Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector 14:09 150.00 RAID s _ .- 6824 Div. Public Works Location 5f0 �5 erg No. Date NORTh TOWN OF NORTH ANDOVER '•�tio0L r n Certificate of Occupancy $ Building/Frame Permit Fee $ �7s'-via't'��'' Foundation Permit Fee $ ti s�cNus Other Permit Fee $ ���� D /VD (Z-S Sewer Connection Fee $ Water Connection Fee $ i ! TOTAL 21, 4 wiidii g Inspe to'r7 12/27/93 lett 2-000'* ,Glf��y/1'� • /�i/�GEl u .e.- 6902 Div/.Pubjro Works PERAVT NO! /* APPLICATION APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.���f PAGE 1 M+AP i4 0. I LOT,NO. 2 RECORD OF OWNERSHIP DATE (BOOK ;PAGE ZONE SUB DIV. LOT NO. 7 vio LOCATION S CI-os s S�� D PURPOSE OF BUILDING OWNER'S NAME l<ZS lU NO. OF STORIES f SIZE OWNER'S ADDRESS l� 7 lkw i� I J-� �,' /J� �I BASEMENT OR SLAB �s� ��!r 7 5/�� ARCHITECT'S NAME / 1®�/1 a �( S,t,/mac N /y SIZE OF FLOOR TIMBERS IST �w.f 2ND v�cN7 3RD BUILDER'S NAME �Vl�'^! ' In I SPAN DISTANCE TO NEAREST` BUILDING / S7 DIMENSIONS OF SILLS Lf X DISTANCE FROM STREET ,r I POSTS r�� DISTANCE FROM LOT LINES-SIDES / , r REAR �/ " GIRDERS q/ AREA OF LOT / d r f? N FRONTAGE `j�a HEIGHT OF FOUNDATION ✓(Q r THICKNESS U IS BUILDING NEW y -e S SU SIZE OF FOOTING /D CJ�9- X IS BUILDING ADDITION / /i J 0 MATERIAL OF CHIMNEY < dswk IS BUILDING ALTERATION R 9 IS BUILDING ON SOLID OR F LLED LAND 47 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ��5' IS BUILDING CONNECTED TO TOWN WATER Ve s BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER V� S IS BUILDING CONNECTED TO NATURAL GAS LINE s' INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES POW y / v D EST. BLDG. Cof 9 700 o G 1, v PER PAGE 1 FILL OUT SECTIONS 1 - 3 �� Q��{A TE-���^��•..r.�-. EST. BLDG. COST PER fQ. FT. 1 PAGE 2 FILL OUT SECTIONS 1 12 �,IF FRAME PFR�4tT �-� � U EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE Fl&ED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT F E E PERMIT GRANTED OWNER TEL.# � ��/�8' PLANNING BOARD CONTR.TEL.#22 19 CONTR.LIC.#�eta 3 aQ WARD OF SELECTMEN s 0�/ � �. xz:lelff SUI INO INSPECTOR /Y BUILDING RECORD' 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES _- LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES, GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BIL K. PINE BRICK OR STONE HARDW D — PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'T AREA _ '/. 1/I FIN. ATTIC AREA N_O B M FIRE PLACES _T HEAD ROOM MODERN KITCHEN L 4 WALLS I 9 FLOORS CLAPBOARDS B I 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ r� ASPHALT SIDING HARDW'D � ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ y STUCCO ON MASONRY ll�—_ STUCCO ON FRAME .} ! * ERIC N MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME I ? Y CONC. OR CINDER BLK. STONE ON MASONRY WIRING e STONE ON FRAME _ SUPERIORPOOR _ ADEQUATE I- NONE 5 ROOF 10 PLUMBING GABLE HIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) r 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 11 HEATING WOOD JOIST PIPELESS FURNACE r 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 , IL O B'M'T 2nd _ ELECTRIC 1st ( 3rd I NO HEATING • s� s b FORM U - LOT RELEASE FORK 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: S je�T Cor Phone LOCATION: Assessor's Map Number Parcel SubdivisionPt��v� Cf-o� Lot(s) Street d e St. Number '57/b ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved r�CJ Conservation Administrator Date Rejected Comments �Q Date Approved 2 Town Planner Date Rejected Comments Date Approved Health Agent Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 1 323. 9 07iz- Y, oR�v f •moo. \ 0 107-29 : LD . #,5 o fDU�t/DAT�ON LaG4Ti0iV F�C'oiti! I 4,3 5100 `S F 0 .4,V IW UM61Mt 5N T \2R1 Y.'Y. I -A 400 0 .4C. • � 3�ZD, .-�yQ� �, .59 O 9 ov �� 8¢ 271 i S • apD L41��_LDEPARTMFNTJ �r A"60Y CE.�T/fY TO TyE T/TLE RL or RL f7 N -V ; BAN.!'T.�qT T.✓EOn'ELL/�tC/S GOCATEO O.V T//E Lo7'els S.ft7A►'N AND T/G4T?ODES GO,diGtPAf //(/ If !Y/T// Y.S�E T4W� OF i(/O�Tf�/I/VQJ�ER20N/NG ,�E6�/LAT.bt/S " �dvI�CO/.VYs JETQgC.t'.S F-�O.f!ST.PEc'rTS�LOT L/.�ES.'' iYD,�Ty ,gv�DY�� /,�j,�S LOLgTEO/iS/ T ETFE�AG FiCG1O0 �TiO OSA.PE o7- �P/��/V FOiP' 25 o 0 98 Q0o3 STF'l/E•t,�$ C',�'OSS/,t/�- 1>c ezo x&vrCDS, A.4725 Boavv.PS� 4 Bo�,vo.oet�ir/,�o,P�ss- �E��P/ryllGt'E".vGivEE.P/•[i6 SE.PI�/�'ES AT/O(/ TA,t'E.y F,coy� Ex/ST/NG .PE'G'o,POS. GG �'q.P,(� .ST.rEET A.t/OOYE.� /17'4S.S.4�iY!/SE`TlS O/8/O l NORTtj ` ` F 4. < T0 of 0 No. 596 : 5� t'��*' O LA E b dower, Mass., 19 tat cocWCMEWICK V 0RATE0 P? C, 11 H s4 BOARD OF HEALTH Uff PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...5.,/.!.. O .� t�►. 4114 Foundation has permission to erect.fif/.."##*jMg buildings ............. Rough to be occupied ass iftV.&A.09 0roms, !� 1�� �.............. Chimney provided that the person accepting this permit all 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 Ins �d struction of Buildings in the Town of North Andover. 50108 !ONLY g REGULATED BY PARA. 114.8-S. B.C. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough u PERMIT EXPIRES IN 6 M�9R y FEE PAIII/ 01-101-1-U '�' Final �G�z .U � UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough PERMIT FOR FRAME/BUILDING ..... ... ..... .. .... .. ..................................... Service BUILDING INSPECTOR Final DATE: FEE P 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 PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT M Ct4ORTH0 0R over 0 a 4010000 fit No. . A4 . - LA E rdover, Mass., 19' o r COCMICMEWICK V y A0RATED pPa\ ,�C .35 - S BOARD OF HEALTH PERM IT T D Food/Kitchen Septic System BUILDING INSPECTOR =r ' THIS CERTIFIES THA ... •&%S...#X1 . �••• Foundation .k ie has permission to erec .... . buildin s on .�.�Q.. �0�.... .. ..... ...�� Rough s g to be occupied asS��(. .+i�..'.. ....... Chimney h rm' shall�h ever res act corm to t terms of the li on on file provided that the arson aC�e t s e it s a pp F P P P g P Y P 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 PERMIT FOR FOUNDATION Ove VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough } PERMIT EXPIRES IN 6 MOND Final "z� FEE PAID IDG. UNLESS CONSTRUCTIO S TS Rough Q� 5z• w ELECTRICAL INSPECTOR r PERMIT FOR FRAME/BUILDING service . .. ........ BUIL SP Final DATE:3a29 q FE13AID• 13"7 5 ccu ermit 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 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 Evergreen.Management Corp. 733 Turnpike Street • Suite 311-• North Andover,Massachussetts 01845 • Office 508-975-1420 • Fax 508-681-8447 o June 10, 1994 Robert Nicetta Town of North Andover 120 Main Street North Andover, MA 01845 RE: Stevens_Crossing Lot 3 Dear Bob, As the project manager for Stevens Crossing Development Corporation, I, Richard Tobin, am certifying that the framing of Lot 3 at Stevens Crossing conforms with the,Massachusetts State Building Code. The premises was inspected by me personally prior to drywalling and insulation. Thank you for your time. Sincerely, Richard Tobin Project Manager for Stevens Crossing Development Corporation ii JUN 1 0 1994 r nicettal Phillips Common• Meadowood • Stevens Crossing•Cobblestone Crossing• F6xwood CERTIFICATE OF USE & OCCUPANCY 1 Town of North Andover Building Permit Number 596 (1993) Date JUNE 10, 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 510 OSGOOD STREET (Lot #3) - Type F MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR GARAGE IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. oy°r'" CERTIFICATE ISSUED TO Stevens Crossing Dev. Corp. Q �'° ; qbo F�•`r °p 733 Turnpike S t. ADDRESS North Andr%w . ;�y: Building Inspector T0VM Of =pdpverv:. 44 : # i •:ar• 3 No7,"J* I . sf6 t t O _ L A E dower, Mass., COCHICHEWICK A0RATE0 BOARD OF HEALTH PE.RM IT T D Food/Kitchen Septic System ��� � �� � � BUILDING INSPECTOR THIS CERTIFIES THA .... . ... Foundation has permission to ereci� .... . buildin son .5.�Q.. 0�.... .. .....�... Rough Chimney 6 to be occupied as.1#N. .... ,. ! ....� A..�.. 9 r n his ermlt shall ever res ec�rm tot terms of the a li on on file provided that the a so a t P P p 9 P Y P PP Final (�C this office, and to the provisions of the Codes and By-Laws relating to theJnspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBI INSPECT PERMIT FOR FOUNDATION ONt_I �•� VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough 14'01 I� pp PERMIT EXPIRES IN 6 MON^ Final �3(,,� pp�JL-_L_7-q3_FEE PAID f oG, ��v ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S' TS °i�` �' Rough r� PERMIT FOR FRAME/BUILDING = Ser�ic F .......................... .. ............. .... ..... ....... ... k�4 _ BUIL SPECTOUR Final ' �^ DATE-3 a�FE AID• ►3"7 5 5� Occupancy Permit Required to Occupy Building GAS IN, Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y A Final No Lathing or Dry Wall To Be Done il Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT urner lqt PLANNING I`� N6L CONSERVATION MO F AL til Xtreet No. (J ///--- _/ �' � Smoke Det. 7 _�niFR i IATFR f� NAL DRIVEWAY ENTRY PERMIT Location F � i No. Date 1,�•3 NCR, TOWN OF NORTH ANDOVER Ot^"IC N. p Certificate of Occupancy $ Building/Frame Permit Fee $ ss'^•�° Foundation rmit Fee $ �cHuse Other P i ee $ S ^ dy Sewer Connection Fee $ Water Connection Fee $ TOTAL $ AN / 12j�2 Building Inspector E �a 7387(/ Div. Public Works "ITICHS OF: Town of I rd;H11 APPEALS .. . TAI ANDONTLIt N, if I "a 11 11 J\ f-1 NOR (:.:()NSI-.1 WATION 71.1 RV -17 7! I Il;ill I PLANNING & COMAWNITY DI' VI'LOPAIi.-N-1. 1:AHFJ4 11.11. NIA.-S( )N. I )II WC 1( M CHIMNEY APPLICAIJON ANO ITRAff f ATE. . J # .00ATION,566410 7) :LINER'S NAME: LIA J4/V JILVER'S NAME: — kSON'S NAME: ASON'S ADDRESS: �.SON'S TELEPHONE: JERIAL OF CHIMNEY:_ IFERIOR CHIMNEY: EXILIZIOR C11HINE-y:c�/ 11WER AND SIZE OF FLUES: .1ICKNESS OF HEARTH.- ,,U cfv, lney an. () Atptacc con(Imin to 4ILe. V() Vle Code and have "tuce.6 alld �gutatiojiz been AeceZved: =dA2 J,E: 'GNk'rURE OF MASON: 't GRANTED: F'EE i.3 I-R T NICETTA H.DING INSPECTOR iIECTEU: N RKS: 26 SOLID BLOCK REQUIRED 2,S THIS PERMIT MUSF GE VISI LAYLI 014 JHE ITLAUSES Location D �s 0 D t No. Date MORTh TOWN OF NORTH ANDOVER O.�t.•e y�ti0 F? �. • AL Certificate of Occupancy $ ;�J'•^°E<�' Building/Frame Permit Fee $ aU �cHus Foundation Permit Fee $ Other Permit Fee $ { TOTAL $ 1 v Check # 6 4 6 � jAl( (,�_ �� ' 'Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. 4r-;.31 DATE ISSUED. X SIGNATURE: zmf .�.� Building Commissioner/I or of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -�U ®l ® ^ Al /I y� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sjD Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Regaired Provided ReqWred Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record 11-�94blu-1 Name(rint) Address for Servi i Signature Telephone +Q vV 2.2 Owner of Record: Name Print Address for Service: O c rn Si natu6e Telephone M SECTIiON 3-CONSTRUCTION SERVICES i0 3.1 Licens Construction Supervisor: Not Applicable ❑ taW w'd Lice sed Construction upervisor: O 6„Q , License Number on iQ( f r s 1, p Addres D O;:�Y�7 Expiration Date u i natTele hone g P r 3.2 Registered Home Improvement Contractor Not Applicable ❑ r / -I1 Company Name rn Registration Number r i I ddres /�/ i' Expiration Date ^� i n ture Telephone Y• 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) 7177d!tion ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Wo teldl-elf'1� r i ice I- ki SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE ONLY Completed by permit applicant 1. Building 2 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number D SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGErJT OR CONTRACTOR APPLIEWFOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pennit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED 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 i and belief r Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB ND PD SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS r DIMENSIONS OF POSTS DtTIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE { ✓�.e {�ammzanuieczll� a�✓��ir ��a�E7� BOARD OF BUILDING REGULATIONS b License: CONSTRUCTION SUPERVISOR Number: CS 064384 a Birthdate: 04/24/1957 t Expires:04/24/2004 Tr,no: 20986 Restricted: 00 1 , i KEVIN M BROUILLARD SR r 59 PELHAM ST C4 METHUEN, MA 01844 Administrator u Board of Building Regulations and Standards NOME IMPROVEMENT CONTRACTOR tr Registration: 137695 Expiration: 12/19/2004 Type: Individual KEVIN M BROUILLARD KEVIN BROUILLARD SR. 59 PELHAM ST, ; M>rTHUEN,MA 01844 Administrator 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: (I- cation of Facility) 4 ature of PermiqA4pficant- I 4—Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector. u o D The Commonwealth of Massachusetts Department of Industrial Accidents 1 Office of Investigations Boston, Mass. 02911 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' co pen n pf,my employees working on this job. m an name: C7 lA Address City: A), /7 d�2i Phone* `l ' 794/-60- ,i- Insurance.Co. Policv# Company name: Address Ciiy: 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$1,500.00 and/or one years'imprisonment_as_well_as_civilAaenattiesin-thelorm-fa-STOP..._ORK ORDER..and_afine-f-($]110.00)-ajday.againstnw— I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. i do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' City or Town Permittl icensing Building Dept E]Check,f immediate response is required E] licensing Board p Selectman's Office Contact person: Phone A El Health Department Other PROPOSAL — CONTRACT Reliable PROPOSAL BROUILLARD SATISFIED Service CUSTOMERS INTERIOR-EXTERIOR•REMODELING are Our best SHEET NO: Kitchens - Decks - Additions ADS DATER, �q �J3 COMPLETE DRYWALL SERVICE 978-794-0247 lu /� Proposal Submitted To Work To Be Performed At Name �/ Street /'-- m 10 � s Street city- Date City Date of Plans State Architect Telephone Number 7 o We hereby propose to furnish all the materials and perform all the labor necessary for the completion of.� i/c 4 Sa/I 00 01 . ' o R_o � ' O G ' 2 D 'o W i df O t,C i I!V4 ' Lo 'e ` All material is guaranteed to be as specified, and the above work to be perormed in accordance with the drawings and specifications submitted for above work and completed in a,/�ubstantial rkman ike anner for the sum of /3•�aUWeelz- 7 S/g�AT2//Lr0 �n�)1lors ($// 7,39,0"g with payments to be made as follows:99/3913 A u�All�i r9•r► ce,l,/�G Of Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. Owner to carry fire, tornado and other necessary insurance upon above work. Respectfully submitted Lic. # 064384 Note—This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Accepted Date _ / ' �J «</// Signature • LITHO IN U. 6. A. NORTIy E over Town of � . No. Co 3 111L - - •• - OCCHIC � L dover, Mass., � ORATED P? C2 S H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System -.-?ddoL + BUILDING INSPECTOR THIS CERTIFIES THAT.................. .� .. ....................4S. /+.A�....O..N .: ..................... Foundation ................................................. . has permission to erect... 01y.�.... buildings on ..... la......... . .S.G S f Rough .S 0 21 y DAP P. r c w/ N w s Chimney to be occupied as...,3........ .............................................................................................. y . ........................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. )D Z/ ';,O PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this rmit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR f Rough 00*11:10................................................................ ............................... Service BUILDING INSPECTOR Final Occupancy Permit Required t0 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. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING . rn BUILDING PERMIT NUMBER: DATE ISSUED X / � - E SIGNATURE: -"0 Building Commissioner/In or of'Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 19 1�p T 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 Reqwred Provided Re uired Provided 1.7 Water Supply M.G.L.C.40.5 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 _J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record . (� Name rint) Address for Servi v Signature Telephone t� VV 2.2 Owner of Record: Name Print Address for Service: o _ m Signature Tel hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Lice sed Construction upervisor' moi/ . 0 �J License Number UvV1 � 1 y Add res / js 1 ) ,6.-),y Expiration Date ignatu Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 t Company Name rn — / Registration Number Addres Expiration Date ^ i'n ture 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 permit. Signed affidavit Attached Yes........❑ No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Wo ro <S I A �)lde , SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building. (a) Building Permit Fee Multiplier 2. Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical(HVAC) -- 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGErYT OR CONTRACTOR APPLIEWFOR BUILDING PERMIT 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 o1'O'mier 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 beliel, Print Name Signature of O\+ner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR ITVIBERS I 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DiMENSIONS OF GIRDERS HEIG1-fI'OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH Town of dover 0 No. 0 t-L ,�, dover, Mass., COCHIC0RATEO S H E BOARD OF HEALTH Food/Kitchen Septic System PERMIT T to BUILDING INSPECTOR THIS CERTIFIES THAT............0.. ..... ... . .....................L it e + �/� ti ti Q ........................................................... Foundation has permission to erect... ..�y.�.... buildings on ..... .�� O.S.G.. ..D yON p. c w w . Rough 14V ' Chimney tobe occupied as.... .... ........ . r............................. ...............................................................S.............. . ... 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. 0 Z/ O PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this rmit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR ,/............................ 001r., Ir 11 %also Rough 000 0000 0001 ...'1000000*4 ............................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. v SEE REVERSE SIDE Smoke Det. Date if ...............`............. I t t10RTH, S3:;•t�"` TOWN OF NORTH ANDOVER - p PERMIT FOR WIRING ,SgACHUSEt This certifies that ... . .. „ v has permission to perform .... ...... wiring in the building ofd `` —4e...............................................' at .. r . ,North Andover,Mass. U ! Fee:- ............... Lic.No../Al ..... .., ::: - - ...................... ELECTRICAL INSPECTOR Check # �� 4637 ( ommonwea[lk of Maseachuiell<t Official Use Only 2c� c� eparinrenl o� }ire SerPermit No:— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ' (Rev. 11/99] Icave 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 (PLCASE,Pi?IiVT IN INK OR TYPE-ALL INFORM TION) Date: 2117J2t . City or Town of: AndclvFR . To the Inspector of 6Vires: By this application the undersigned lives notice of his or her intention to perform the electrical work described below. Location(Street &Number) �j1p f)�0®o �Q -� Owner or Tenant �jp'p �C Wn1cN1 Telephone No. Owner's Address C'5AYY)1' Act Is this permit in conjunction with a building perntil? Yes ® No ❑ (Check Appropriate Box) 1'urposc of Building �� SEAStwN ?OC-4\ iUtility AuthorizatioNo. Existing Service 2.00 Amps 12o / Zqo 1'olts Overhead ❑ Undgrd No.of illeters' New Service Amps / Volts Overhead❑ Undard b ❑ No.of Meters., Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Si%fl Q+,t �cat�ln ,(1� et �►©rr,� Completion oftie iolloninetable ora be icaived bytlrc In, cctor-oi1VL-es. No.of Recessed Fixtures y No.of Ccil.-Susp.(Paddle)Fats No.of Total Transfo nicrs KVA No. of Lighting Outlets I - No.of Ilot Tubs Generators KVA No.of Lighting Fixtures Sivimnlirig Pool Above ❑ In- El o Emergency Lighting nid. rnd. Batteg Units No.of Receptacle OutletsNo.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesNo.of Gas Burners No.of Detection and Initiating Devices tt Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Eons KW _ No.016elf-Contained 1 Totals: Detectiov/Alerting Devices No. of Dishivaslters S ace/Area Heating KW Local Municipal p g Connection Other No.of Dryers Heating Appliances KWSecurity Systems: . No.of Devices or Equivalent No.of Nater KW Ballasts of No.of Gala 1Viriug• HeatersSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of tllotors Total IIP l'elecommunica(ions Wiring: No.of Devices or Equivalent OTHER: Attach addiiional detail if desired,or as required by the Inspector of lVires. 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 ❑ I3OND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Elcclrical Work: J oo (When required by municipal policy.) Work to Start: 116/7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,•, under the pains anti penalties of perjury;that the information on this application is true and complete. FIIZt�I \ARIL: �. L�lV1c.� Flr-464AI lf6n+rAGTinu t..l!0. LIC.NO.:,Ai�'��f� Licensee: y�ArnES LIC.NO.: (If applicable,enter "emupt-in tic license numbe/LbL&ftk inc.) Bus.Tel.No.: gl$"y�JB'%393 Address: 1ta PirnE tr.EE� Svd �.$ . AjA o06Si Alt.Tel.No.:q_7$-9OZ-M&$ O1VNEWS INSUIZANCE WAIVEIZ: I am aware that the Licensee floes nol have the liabilily insurance coverage normally required by law. B\- my si,,natw-e belo«, l hereby%vai�'c tlpis requirement. I am the(check one) ❑ owticr ❑ oNN•ncr's atent. Ower/A"ent Signature Telephone Nu. j'I'RiIIIT FEE: ✓