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Miscellaneous - 52 BANNAN DRIVE 4/30/2018 (2)
52 BANNAN DRIVE 210/038.0-0111-0000.0 J � _ -- - -- � - ---- I Location No. U� Date _ -0V NORTH TOWN OF NORTH ANDOVER F OR A Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check # X D 17161. Building Inspector J/ c TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING I NIA BUILDING PERMIT NUMBER: ��"'� DATE ISSUED: C SIGNATURE: ic —1 Building Com—A66 oner/Inspector of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1/( 1.4 Property Dimensions: V Zoning District Pr osed Use Lot Area(sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.9 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 �J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Qwner of Record r ' W CC'ylc��G v Cc, 0 C. �mu\ r Name(Prin Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Y Address for Service: Si nature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone J - a SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. -Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check au applicable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ 7tion ❑ Accessory.Bldg. +� Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beMN Completed b permit applicant � #+ 4t ' I ','� 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 AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 V g J property i Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Own er/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEMBERS 1 2 ND 3ko SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. e........-......a.-r.-■...r..■.......,.....................=..r.r.o.......0.0.00......0 APPLICANT 'a' CA `� PHONE 0MX-1$J `600 ��� �`� � � � -_:`R 01 q 9al- 9330 ASSESSORS MAP NUMBER LOT NUMBER 1 SUBDIVISION LOT NUMBER STREET ® N STREET NUMBER ...s.rs.c........rs..rs.■..■r...........s.u..■as.............a.......s..■ OFFICIAL USE ONLY ........................s........monsoon Noun..■........■mass.man....Mass....... REC M 4ENDATTONS OF TOWN AGENTS a0a0em....,...... .............r..........DATE..■....APPROVED..r..........�. ......... . � AMM � C &SERVATION ADMINIS TOR DATE REJECTED L j CONDAENTS � W 6e, FV. fu ( eX�'rir ke ih Sam 1066 �l0h _ 1cr�5� r see. 4. (e, 1 DATE APPROVED TOWN PLANNER DATE REJECTED CONIl OUM DATE APPROVED FOOD INSPECTOR-BEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-BEALTII { DATE REJECTED CONN ENTS � d PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS _7 0000 . - - - - -. RECEIVED BY BUILDING INSPECTOR DATE V4 RTjj ® ® Andover No. Seo .�....m_.� .:.�: .., lover, Mass., COCHIC MEWICK OR-ATSD BOARD OF HEALTH Food/Kitchen PERMIT T u D Septic System D10.V* /at 40 re ) . BUILDING INSPECTOR THIS CERTIFIES THAT...................................................................................... ..... Foundation has permission to erect... .............. buildings on .........wf!4.......... Rough I A.) .........� 4, d....................... ........cf ..4j*d Chimney to be occupied as........olproj.�is perm shall in every respect conform to the terms o*f'*t**h*'e***a*'p'p*li*c**a*'ti*o'*n""o*'n**f*il*e"i*n* Final provided that the person accepting k 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. 39 / 111 X ?dO slump PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMU EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU=ON SIAR Rough ...........Af....•6............................ ...........&'&�... ........... .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ' Date.. . A. 7 09....... A' NORTH °� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING SSAC14US� This certifies that, '.................................. has permission to perform ................... ... ....................................................... wiringin the building of.. ............ ........................................................ at... .. ... ,North Andover Mass. Fee'--.'................ Lic.No.. .........%3............. .. ...... . . . .. . ' ELECTRICAL NSP R Check # !�Z 8.95. 2 Commonwealth of Massachusetts official Use only Department of Fire Services Permit No. � - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank f APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00 (PLEASE PRINTININK OR TYPE ALL INFORMATION) Date: jl City or Town of: NORTH ANDOVER To the Inspe ,tor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Z —/711J Owner Owner or Tenant moi. C.y ° Telephone No. Owner's Address Is this permit in conjunction 'th a Ting permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building VI Utility Authorization No. Ezisiing 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: " Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming PoolAbove ❑ In- ❑ o.o ni-I cy ig ng d• d. Battery Units --, No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.-of Detection and Initiating Devices No.of Ranges No.of Air Cond. TonTots No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: -_.-------- ...._. Detection/Alertin Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* - No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Si s Ballasts . Data of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: �/�� Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: Estimated Value of E ectrical Work: (When required by municipal policy.) y (> Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 cove ge is in force,and has exhibited proo�tfhap e to the permit issuing o ce. CHECK ONE: INSURANCE IV BOND ❑ OTHER ❑ (Specify:) 1f,/3 Q� I certify,under the pains and penalties of perjury,that the inform o.fplu:akon is true and c mp&1e, FIRM NAME: c,/b t LIC.NOS Licensee: (J Signature LIC.NO.: Gj (If applicable, enter pt' in a cense number lineLe'.) Bus.TeL No.: / Address: �'/` *Per M.G.L c. 147,s. 57-61 securityCwork require? „ „ Alt.Tel.No.: equir Department of rubli afety S License: Lic.No. 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 Signature g Telephone No. PE p PERM FEE: � 9 ' �., . (. � � � � �3 ® � '1_ Y �. �' Date. 40RT TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING tSACHUS This certifies that . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . rA,0k has permission to perform . . . ..P. . . . . .'-. . . . . . . . . . . . . . . . . . . . ... . . . . plumbing in the buildings of . . . . C .f . . . . . . . . . . . . . .. at.5 . . . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. No. .2 6 k )- : . . . . LA. . . . North-, -Andover,'r . I Fee. . . . . . . . .Lic. No.. . . . y . . . . . . S . . . . . . PX.UMBING INSPECT"OA Check # 8161 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING at ype) =_ Y) j p LLIZ Mass. Gate 3l 2p,U Permit# G Building Locatlon_U o� �� �j Y)v Owners Name 0 T) G l Type of Occupancy_s I r> ,� a ,r New ❑ Renovation Replacement ❑ Plans Submitted: Yes❑ No ❑ FIXTURES Z � NZ Y 4 .. W (A o Z > °� W A M ).- V < N � d Q dl Z O Z N a O y s m a y < N z ¢ v < < 3 _ o W F F• W d O < „Wj Vr Q J O C G d ft it x d = 3 3 C Z = !C d p N < Y < W IL X W o } r- o = '� D <� < O sue—BSMT. BASEMENT •o `V/ 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STHFLOOR 6TH FLOOR TTH FLOOR 8TH FLOOR EE Installing Company NaCheck one: Certificate Address /9U 2 o L' J ❑ Corporation ❑ •Partnership Business Telephone G L 7 j— ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: 1 have a current ❑ Ifabli ty No , ice policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ( If you have checked yg, please Indicate the type coverage by checking the appropriate box. A 11"Ity Insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'ON- URANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter the a ral to , and that my signature on this pern,ft application waives this requirement. Check one: Si natur of Owner or s kentOwner CK Agent p I hereby certify that all of the&-sits 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 Installati rforrned under the permit issued for this application will be in compliance with ail pettrrtent provisions of the Massachusetts State Fi Code and Chapter 1 of the General Laws. Tme gnature of UcensedPlumber Type of License: Master ❑ Journeyman(� City/Town � Z-;' APp9A0�(or= License Number ' -ate 3 .... ... RT TOWN OF NORTH ANDOVER 0 "imaggoa PERMIT FOR WIRING This certifies that ............................41-!!!� ?.......... ..................... has permission to perform ........Re'A.171Y ....40�"-K..................... wiring in the building of....... j�oy.'.A?............................................ at........S.... ......................... .North Andover,Mass. F . Lic. .......... ................... ........ ELECTRICAL INSiEC3M Check # 5623 1 m(,VMIV1Uiv vyhauH UP[YM&"(,HUNKJ 1 N Office Use only DFPARTAIE TOFPUBLICSAMY Permit No. 3 2 BOARDOFFIREPREVEMONRFGUL4UONS5raffll2'W Occupancy&Fees Checked APPLICATTONFOR PERMIT TO ERFORMELE=CAL WORX ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE ASSACHUSSTS ELECTRICAL CODE,S2�CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date V Town of North Andover To the Insp ctor of Wires: The undersigned applies for a permit to perform the el ctrical w rk described below. Location(Street&Number) OL r Owner or Tenant (1wner's Address S Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building S .Q G Utility Authorization No. Existing Service Amps Volts Overhead ID Underground No.of Meters New Service Amps I Volts Overhead M Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Ql7 >�/kit No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures 2 Swimming Pool Above Below Generators KVA J round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units SNo.ofSwitchftfta No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones _ Tons N4.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 Municipal Other No.of Water Heaters KW No,of No.of Connections Signs Bailasis No.Hydro Massage Tubs / No.of Motors Total HP OTHER r /> h>,uuarret:.ovesage.Ruslantmthetac�marlaYs >usetts Laws Ihaveaama�tLialalAyh>s1 �oeRilicyirrhidil>gCornplete CovQragecritssubearialegtBvalat YES NO IhaNcabriedvandpFOOfOfSWI'OdrOffiM YESd1XJrgthe ffycuhavedmicedYES,plea9eirdcatetherypeof0D by W ]NSL SURANCE BOND OTHER (PleaseSpaciFy) Exp�riDnDeate alued&clical Work$ WO&O&tt kq)XliMD&Re�d Rotrgh FSI SNA EE �v 64 11offW >o. 33 UmIsee 5� �1 /�J Sigrlatiae %///� Lioa>SeNo ar �/�?ClC'�i�/�,P� /k/I susirsTelNa �3— �'3--1 A1tTUNa OWNER'SMURANCEWAIVR;IamawaredudreLiDfedtrasnothavetheir>=z=averWorits&bbrrtialegt�asragtme iMamdmcMGnxWIaws acrddratmysignahrteonthispwnitapplicatiarwaivesthisregm'mlmt (Please check one) Owner Agent Telephone No. PERMIT FEE$ signature of Owner or Agent Irm tlulmrlvty rrrril.ln yr iV1tL y1UnUJGl1J urnce use otuy DF.PARTAIEWOFPU1nUCSA= LPermit No. `� BOARDOFFIREPREVF1MONREGULMONS5VaRI2•AO ancy&Fees Checked APPLICATTONFOR PELT TO PERFORMELECMCAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 ^ EASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3 D S wn of North Andover To the Insp Ctor of Wires: undersigned applies for a permit to perform the electrical work described below. cation(Street&Number) 5-2- &I'l;M /I ner or Tenant ner's Address his permit in conjunction with a building permit: Yes No (Check Appropriate Box) y -pose of Building S j: , Utility Authorization No. Ming Service Amps �Volts Overhead Underground M No.of Meters Service AmpVolts Overhead Underground No.of Meters ber of Feeders and Ampacity ation and Nature of Proposed Electrical Work lvc�✓( of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA P.of Lighting Fixtures 2 Swimming Pool Above Below Generators KVA J round ground P.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units i.of Switch 9ettetsLl No.of Gas Burners of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons o_f Disposals No.of Heat Total _ Total _ No.of Detection and Pump . Tons KW Initiating Devices of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices of Dryers Heating Devices KW Local Municipal � Othe Connections of Water Heaters KW No.of No.of Signs Bailasis Hydro Massage Tubs No.of Motors Total HP OTHER• f� /'� /i �I rt l hmaarreCo�dge PutsuantlotheregtmerrlaiLs� Laws Ibaeeaama�tbaW yksvaarla Pbkyim]xkgComplele Cora critssr>bstriWeWivalalt YES NO Ihavesr>txrligdvatidproafof lotheOlfioa YES XyouhaNedltxdYES,ple=it thewof by LMMMJ WSURANCE BOND D GHiER F1 (PleaseSpec�}+) �` c �Z ,3 worktosm hpalionDah;Regtlesmd Hugh Vat>edac1>wWC&$ *VdurXiX Pt Mka sofpajW FIRMNAME ( rl Li=WNQ Liven 3fi��1i-1%1 �T sigt>a<tueLioffwNb !^ -_� Budr=TelNa d3' e 31 d AkTei No. OWIsWSMJRANC WAIVER;IamawaethattheLioa>sedommtlxmdm mmw crts arrial and trLmyagnahmondzpwrAapplicmmwaivesthisleczennt ��4 bYMassadu�tlsC�erlaalLaws (Please check one) Owner Agent Telephone No. PERMIT FEE$ signaw—reof Owner or AgenE ‘__ etttc_ i'- ~Yr LocationQtY1 No. Date d TOWN OF NORTH ANDOVER O }- ; Certificate of Occupancy $ Building/Frame Permit Fee $ s�cHU - - s Foundation Permit Fee $ r Other Permit Fee $ x TOTAL $ A Check # 18622 Building Inspector t t L TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIa,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. C�3, DATE ISSUED: 0//,9,9 / a� Q� l SIGNATURE: /to K-4�,t� Building Commissioner/12i or of Buildings Date Z SECTIO_ N 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: /U0 r4 i 00;,-X— Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required- Provided R red Provided v 1.7 Water Supply M.G.L.C.40. 54) �8 �P� Ys 1.5. Flood Zone Information: 1.8 Sew e 1 System: D Public ❑ Private ❑ Zone outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rlc is rlc : Yes o M 1 Owner of Record 15171JAIAR/ ZM- Name(Priv Address for Service Signature a hone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address r Expiration Date ic Signature Telephone rM 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r Address r Expiration Date ^z Signature Telephone V/ u, } SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building unit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work(check aD applicable) New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ,OFFICIA3C USE<NLY 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 AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 t property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief M •1 Print Name Signature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TB/MERS Isr 2 ND 3 PD SPAN DRVIENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHi1vINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ' FORM U - LOT RELEASE FORM C1 I[to h.2 INSTRUCTIONS: This form is used to verify that all necessary approvals/permits)rom 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 7 PHONE y?k601--S LOCATION: Assessors Map Number PARCEL SUBDIVISION LOT(S) STREET 5a- 61wNlulqN OR(vu— ST. NUMBER OFFICIAL USE ONL R CO N OFT AGENTS: C SERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS a TOWN PLANNER DATE APPROVED DATE REJECTED JAi COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED . DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 Jm �; •r ibLue Rl� oDct E N I 112c'1'/ 4 t t n 7 a ��_ � ��" '� ��� t �n i i 4 s lx --L •_ � r+ja _V`-: / t TMNr t � 4 A � sC' - - �4d'�i.bT�P A� - { 1✓L K �'�p.� f F � � k5 . t { r�' r 715 -7d W4 - f wZw7- r - ix�slt�./t crt� [ Zx3 c� trr :. f ' F '� F5, r 3v _ 3cx, '�'�•? - Lo r. Y�. •.;x. t E -^� f`� x i i - .rlt�_-F 7,d 2a� 1u.l:J.F✓� - t � r,(zQS a s, fl� •• r '•t. i �-a�TtN(T' /�µf. � STbtsE WIDEN AREA , 5 x 1� F L- n ,4 V r .. w K(STL o side h „c -t p 5 hp PADY wti►�� o��pv flaw -tD ►wt� �l►�►� u�x� fi sa LJPT r a ' u / \ow OURra N 7T) �F, 3� Ml�cX SIT. vi d�.sr5 i 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 at: .;'- /JZ is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I 0A. The debris will be disposed of in: �-��►�t f�'-�r�/2 ---- %��i Sof/�/�S��- (Location of Facili Signatur of Pe i pplicant Fire Department Sign off: Dumpster Permit Date ••< • • it of ,,ORTN � TOWN OF NORTH ANDOVER °o� OFFICE OF p BUILDING DEPARTMENT Bio * 400 Osgood Street .r.o North Andover, Massachusetts 01845 �ss+c�a►S°t D. Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: - 13AAJ J14A J Number Street Address Map/Lot HOMEOWNER DUOS CY!� i aK&Y7S *5 3 Z 3k- Name Home Phone Work Phone PRESENT MAILING ADDRESS 611-AJ Alk" Ole t l,�' Pl) City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifi%thhelshe understands the Town of North Andover Building Department minimum inspection procedures and rentL and that he/she co ly with sai rocedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL BOARD OF.\PPEALS(18&95d1 Y.\l;l'll6 X-9540 PL.\NNING(.M-)535 Date...... 4, TOWN OF NORTH ANDOVER PERMIT FOR WIRING 41 US This certifies that ............ C ........... has permission to perform ..........5 r....................... ............... . . ..................... wiring in the building of.......(.;,I... ........................................................... at......... ......7..... ...............;';X.,I North Andover,MUs. Fee.. ............ Lic.No.�...372.3.....>. ELECTRICAL INSPECTOR Check # 5083 Official Use�oDly� Permit No. V OG .�- �� Occupancy&Fee Ch ed BOARD OF FIRE PREVENTION REGULA ONS 527 CMR 12:00 APPLICATION FOR PERMIT TQ/ ERFORM ELECTRICAL WORK All work to be performed in accordance with tF>r� Massachusetts Electrical Code 527 C 12:ate t s (Please Print in ink or type all information) D 1 704 To the Inspe4r of Wires: Town of North Andover �>.•� The undersigned applies for a permit to perform the electrical work described bel Location(Street&Number Owner or Tenant Owner's Address Is this permit in conjuncti 'nhAa bui ing permit Yes u (Check Appropriate Box) Purpose of Building ✓! r'( Ility Authorize n No.o r Existing Service l O Am r"V Z Volts Overhead 0 Undgmd u No.of Meters New Service U Am Overhead 0 Und ps!W oits gand 0 No.of Meters /r Number of Feeders and Ampacity ��( ,6 Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of.Lighting Fbdures mmin Pool gmd a gmd 0 Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units Y No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices Nol of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding.Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No_of Low Voltage No.of Water Heaters KW Signs Bailases Wiring r No.Hydro Massage Tuds No.of Motors Total HP OTi-19R: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES=NO a have submitted valid prof of same to the Office YES=NO - If you have c YES the _ by checking the appropriate box. INSURANCE - BOND - OTHER - (Please Specify) O (Expiration Date) Estimated Value of.Electrical Work$ Work to Start Inspection Date Resqu ed Rough Final Signed under the Penalties of perjury: -J� FIRM NAME C/ / LIC.NO. '�� Licensee Signature / rv/�?a LIC.NO. � i / 4j- Bus.Tel No. C14 LG ✓ D��� Address C AltTel.No. OWNER'S INSURANC WAIVER: I am aware th the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ �✓ (Signature of Owner or Agent) 4 f i r 1 Date.)� �6..6 .?.... .. .. MORTIM 3�Oy„ao ,•11�OL p TOWN OF NORTH ANDOVER t - PERMIT FOR GAS INSTALLATION ACNUSE� This certifies that . . ! . -. .s. . . .1.!J:r : . . . . . . . . . . . . . . has permission for gas installation . . 4"`/'. . . . . . . . . . . in the buildings of . . C '/.lz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .. . `. .�.? .. . ..`. . . . . . . . . . . . . . . . . North Andover, Mass. Fee. .). . . . . Lic. No.). .t >... . . . . . . .� . . . . . . . . GAS INSPECTOR Check 453 ? MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ®O GASl°TTTINIQ Wrinior Type) rI t9 n d ty /C . Mass. ®ate > i 200,? _ Permit # Building Location 3 a � )9 n-n a n 0 r j-vt Owners Name 6 d 0 C ? Type of Occupancy S n New ❑ Renovations Replacement ❑ Plan Submitted: Yes❑ No❑ W z c m W J W F W m g Y A 2 O W < @' O O 0 W BPl O All WOW4 = rm H z A W W W < CC F O S W W J ®I- WA7Cc W> Cr W > W Y !L < < 00 W O ql b 9C z A A Y !6. 3 ® A J 0 > o @` b SUB--BSMT. BASEMENT 1ST FLOOR I Gi 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR aTH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name 1-07/�r cc b n cg L Check one: Certificate Address 7/ c ,9 T 4 G P A j i Corporation w >g&47�,l� nyrq ❑ Partnership Business Telephoned 6 ► .2 a y t/3 a, J ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter R , c. h A r /Le.X41- INSURANCE COVE E: I have a cuffenWWAIty Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No ❑ If you have checked Yes. please in x. Indicate the type coverage by checking the appropriate bo A liability Insurance policy 2r/ 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: Owner❑ Agent ❑ 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 knowledge'and that all plumbing work and Installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas=and Chapter 142 of the General . By Tvna.0f License: Plumber gn o cen Plumber or atter Title- Gasfitter iJoumeyman /�� / er License Number BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION FINAL INSPECTION SKETCHES FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME& TYPE OF BUILDING LOCATION OF BUILDING IS PLUMBER OR GASFITTER L )r 7 LIC. NO. PERMIT GRANTED DATE - 20 GASINSPECTOR Location ' No. =-2z-/, V Date MOeT1y TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Cn ow' Check # 1 16893 �3dingil TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. 47yi DATE ISSUED. SIGNATURE: Building ommissioner/I for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 52- 31-1NArhV 03 IF /0/// lVo 4mDo 5e Wap Number Parcel Number l� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R 'red Provide R red Provided R red Provided v 1.7 Water Supply M.G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No m 2.1 Owner of Record -00KAL-0 C 73,10�NAV >o i Name(Print) Address for Service: 1 Signature Telephone 2.2 Owner of Record: �IName Print Address for Service: O M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1. W 1 t(t A-M ky , lav t. Licensed Construction Supervisor: O �� 7 License Number iZ.Q 3 Uiurypl✓& ep K5grrt �- Mn Address � Q 3 y©&C ` ' V(7 4`� Ui L �� Expiration Date / ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 1.1100 `s Co vTrftVU1/5 ef Company Name C� 17-4- j Z q7 Wat ee j "v /7 gIj 01 g/Z/ Registration Number Address r rM ujt, W' Expiration Date xP Signature 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 rmit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check 80 applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: — Kc- AT SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed b permit a licant 1. Building (a) Building Permit Fee Q 0 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAC 0= 5 Fire Protection s 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 / ��q r', / as Owner/Authorized Agent of subject property Hereby authorize ,W t lift W W(L S6tJ to act on May h f in alre;�r,�l ive to work authorized by this building permit application.11'�-7 U 3 Signature of Owner (,� Date SECTION 7b OWNER/AUTHORIZEDAGENT DECLARATION W,I, l U(t, , 6,d 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 Cb, W t(56u Printtl� (iV/', • f 1 W (� 3 UlJ Signature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB PD SIZE OF FLOOR TINMERS 1 2 3 SPAN DIMENSIONS OF SILLS DIN ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE pRTH ovm Of Andover 0 ,Y�,V• '' No. 3 LA E 0 dover, Mass., Itp COCHICH WICK OR-ATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT.................. .... .w.................... ...............................................................................................s........ Foundation t has permission to erect. b ings on4,� Rough to be occupied a ....................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S T ELECTRICAL INSPECTOR Rough ....... 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 Lathingor D Wall To Be Done � FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 1293-Whipple Road Tewksbury, MA 01876 (598) 657-7816 May 13, 2003 - i Mr. & Mrs Donald Cyr = - r: 52 Bannar 'Ddve Nort "AnOgver,.M$ t 1848 De4�3- ar�lr Mrs Cir -4A1 u fart ereIrr ra tern i i tie amount cad fr00:00-to remodel your kitoh6._i Ork to be done is ae clto s eoe c . n abuts ��� pp1lZi b.rfi Gam_ e°usU a:;u set r €isCut open ttng'cuse t a1loW for taller andriaer cabinets to be C i-nstatled Refin3 bop ning as n�e�ded Install owner supplied cabinets and related trim ill trash tli'brts etc will bl5 removed from the sits to an_approved sanitar y rarrsfer station Ve do.not 1riGlude electrlcol .plumbng ducttorlc, counters or the cost of E the blaidin permit e are fully covered filth workmen s compensation and:general liability insurance _ Very truly yours, f i 4 7 I William W. W " - ikon M Feesident f - l I FI i I ✓7 j BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 034089 1 Birthdate: 07/21/1938 Expires:07/21/2005 Tr.no: 13372 Restricted: .00 i WILLIAM W WILSON 1293 WHIPPLE RD ( .•�,�i TEWKSBURY, MA 01876 Administrator i ( � ✓lie Vanvnw�zcuea�� o�✓Glcraaacl,,uoe�4 ` Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR ,= Registration: 109124 Expirai on: 9%2/2004 Type Private Corporation WOOD'S CONTRACTING CORP:1 William Wilson i 1293 Whipple Rd. Tewksbury,MA 01876 Administrator I l Client#:1618 WOODCON ACORD. CERTIFICATE OF LIABILITY INSURANCE 1DATE 1114o3D ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI/Hastings-Tapley Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 12 Gil)Street,Suite 5500 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 4043 Woburn,MA 01888-4043 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURERA: Central Mutual Insurance Co. Wood's Contracting Corp. INSURER B: Arbella Protection Insurance Co. Attn:Bill Wilson wsura:R c: 1293 Whipple Road INSURER 0: Tewksbury,MA 01876.3824 INSURER F. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REGUI REMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATEMAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER D UCY EFFEOTIVE PODLICY EXPIRATION ATE IMMMD" LIMITS A GENERAL LIABILITY DOP7834136 05/20/03 05/20/04 EACH OCCURRENCE $1 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO Iml $100000 CLAIMS MADE 51OCCUR MED EXP Arty one person) $5000 PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE00O 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 52 OOO OOO POLICY PRO- JECT LOC B AUTOMOBILE LIABILITY 5337740000 05/20103 05120104 COMBINED SINGLE LIMIT ANY AUTO (E8 app) S ALL OWNED AUTOS - BODILY INJURY SCHEDULED AUTOS (Par Persop) 5500,000 X HIRED AUTOS BODILY INJURY NON•OWNEDAUTOS (Pereeeideno $SOO,ODO PROPERTY IOAMAGE $100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S a ANY AUTO OTHERTHAN EA ACC S AUTO ONLY: AGG S A EXCESSNMBRELLA LIABILITY SOP7834136 05/20/03 05120/04 EACH OCCURRENCE $ OCCUR FiCLAIMS MADE AGGREGATE $ i DEDUCTIBLE WSSM00.000 RETENTION S A WORKERS COMPENSATION AND WC.785772911 05/20/03 05120104 WC S ATU• OTH- EMPLOYERS'LIABILITY EL EACH ACCIDENT $100000 ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEUREREXCLUDED9 - E.L.DISEASE-EA EMPLOYEEIf yesdesalbeuntler PECIAL PROVISIONS below El.DISEASE-POLICY LIMtT OTHER • DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Evidence of Insurance in respects to Kitchen rernodeling work to be done for Mr&Mrs Cyr. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of N.Andover DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 110_ DAYS WRITTEN 27 Charles.St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO$MALL N.Andover,MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #10793 XLCN a ACORD CORPORATION 1988 Z •d 0162 :60 Co bT AOW NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9! 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 properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this projec through the Office of the Building Inspector _ a The Commonwealth of Massachusetts u M d Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers-'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity• I am an employer providing workers'compensation for my employeep working on this job. Company name: O��S Cd ti'►2�'�'t Pj 0C)4p, Address ,P� r1 Q Cfir 'I^ J I�S / I V I ` Phone#:. 14:97_79i p Insurance:Co. Policy# Company name: C - alf rV 41— Addrees�`Dy S( wp"noq� `--, tnL +16yGV I P 590 l?o gaxyvy3 til a 13>ev M4 01 /—E-M -891z a Insurance Co. Policy# Faihme to secure coverage as requiredurKW section 25A or MGL gar can leadto the imposition oforini&rat p or.a,floe up to$t;3ot and/or one years'imprisormeQt_as_ fine-fj-aAgah2stme: i understand that a copy of this statement may b forwarded to the Office of Investigations of"DIA for coverage ver�frci ation. do hereby cmW under&a pa#w and pemffies ofpegmy Nam Nae infonnef w provided above is true and correct Signature pate l(—(7`-4 3 Print name w c [ t. (g�ilf Phone.# 7 d" ✓�]��j�e Official use only do not write in this area to be complied by city or town officiar City oR Town Pe, >iW. t. f �' Btrtld/ngDopt:: [[C beds r wwwhafe response is m qured -0 EAGt'R3/ Boar . 0 Selectman's 0 Contact person: Phone# Health Deparin Other MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print orrn Type) f Ill. LISy k , Mass. Date �l ('C 1996 Permit # Building Location �� lac-,A,R� — Owner's Name�,64yl o C'I f d? Type of Occupancy Q lei New ❑ Renovation ❑ Replacements Plans Submitted: Yes ❑ No,,P-- FIXTURES 2 2 (n 2 X N a N 0 0 2 > N WLU W Y J N Q . Fa. N O H C O W t- W ¢ _ ¢ N Z O z N F U Y a cn U N Q m N X OC } Q F- N 2 ¢ d O Q - < X 2 0 M Q W Q Q F, 0W _ o a y 2 a a ac a LL W = a = O z = Y a 0O H Q Y d W k Y W F- U F- O X IL 0 2 O O 0 = x W F O Q 2 a ~ l a x 2 a a 0 Q J J a M X a Q 0 a r 3 Y J 0'1 N D D J 3 S N 0 W 0 n n cc m O SUB—BSMT, BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name Q V tk,a.,TAC Check one: Certificate Address 6 ©S� Corporation t L' d g ❑ Partnership Business Telephone_ �' b� 'o�J�s g ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes_,O--- No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy�� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner El Agent El 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code-jnd Chapter 142 f the neral Laws. By c Signature of Lic sed P mber Title Type of License: Mas er r Journeyman City/Town / CO APPROVED(OFFICE USE ONLY) License Number- f BELOW FOR OFFICE USE ONLY ob P f c�; e FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE_ ic�x- If NO. APPLICATION FOR PERMIT TO DO PLUMBING I NAME &TYPE OF BUILDING t LOCATION OF BUILDING ' v PLUMBER �- V, �\A PERMIT GRANTED DATE 99 i PLUMBING INSPECTOR _r Date. N" 2814 NORTM ot,,,•D •1"o TOWN OF NORTH ANDOVER 3? a OL PERMIT FOR PLUMBING SA us This certifies that . . . . . .� has permission to perform . . . .'Q 0 i !Evj �' e" 7 plumbing in the buildings of . . .e0.Q}le?.f! .f yr2. . . . . . . . . . . . . . . . �-Z. . . .6 q")I. C)?` . Dr . .. . . . . . . . . . , North Andover, Mass. at. . . 5 Fee. .�. �1�. .Lic. No..fOQ1 . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . PLUMBING INSPECTOR C coz /%- 12.47 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File r! � Town of North Andover Office of the Conservation Department Community Development and Services Division 27 Charles Street �s$ACHU North Andover,Massachusetts 01845 Alison McKay Telephone(978)688-9530 Conservation Associate Fax(978)688-9542 September 25, 2003 Donald Cyr 52 Bannon Drive North Andover, MA 01845 RE: Violation of the Massachusetts Wetland Protection Act(M.G.L. C.131 S.40)and The North Andover Wetlands Protection Bylaw(C. 178 of the Code of North Andover). Dear Mr. Cyr: On 9/24/03,this department received notification that tree cutting activities and the placement of a shed had occurred within a wetland resource area behind your property. Upon a subsequent inspection,it was observed from the road that this appeared to be true. The North Andover Wetlands Protection Bylaw strictly prohibits any activity, including vegetation clearing,within 25 feet of a wetland resourcearea and any construction or placement of a structure,including sheds,within 50 feet of such protected resource area(section 3.4). Unpermitted activities conducted within a wetland resource area are not only a violation of the local Bylaw, but the Massachusetts Wetlands Protection Act. Please be aware that any land altering activities proposed or conducted within 100 feet of a Bordering Vegetated Wetland is subject to a Request for Determination of Applicability or a Notice of Intent filing with the North Andover Conservation Commission(Sections V and VI of the North Andover Regulations). Section II(b),of the North Andover Wetlands Protection Bylaw,states that an"alteration"includes,but is not limited to,the destruction of plant life, including mowing,and the cutting and removal of trees and shrubs. Furthermore,no building permit had been issued for the construction of the shed. The Building Department requires such a permit for any proposed structures,including sheds. Therefore,the shed is also in violation with the Building Department. Please contact me immediately at(978) 688-9530 to set up an inspection so that this department may accurately determine the extent of wetland resource area disturbance and appropriate mitigation procedures. Failure to comply with the above mentioned request may result in additional penalties and/or fines of up to $300/day starting from the initial observation pursuant to the North Andover Wetlands Protection Bylaw, Section 178.10(A)(Page 8). Thank you for your anticipated cooperation. Sincerely, Alison E. McKay Conservation Associate BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 t' Cc: NACC Julie Parrino, Conservation Administrator Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector Heidi Griffin, Community Development Director DEP File Town of North Andover a tAo RTH a R6A OO Office of the Conservation Department - O p Community Development and Services Division 27 Charles Street �9SSac kus�� Alison McKay North Andover,Massachusetts 01845 Telephone (978) 688-9530 Conservation Associate Fax (978) 688-9542 December 3, 2003 Mr. &Mrs. Donald Cyr 52 Bannon Drive North Andover,MA 01.845 RE: Violation Follow-up#2 Dear Mr. Cyr: In conjunction with two previous letters sent to you in regards to the removal of a shed within the 50-foot no- build zone on your property and a subsequent phone conversation,revealing new information, the Conservation Department has determined the following. The new shed can remain in its location only because you had informed me that the old shed will be removed. The Conservation Department will allow the replacement of the existing shed only. As stated in subsequent letters,the Conservation Department prohibits any new structure within 50 feet of a wetland resource area. However, if a structure has existed within the 50-foot no-build zone prior this Bylaw regulation or is not discovered as a violation within three years,the structure can remain. No further expansion or change in size of this structure may be allowed under this provision. During our phone conversation,you had also discussed that you would plant enhancement plantings within the vicinity of the shed and the disturbed area. Enhancement plantings are strongly encouraged and would create additional buffer zone protection to the wetland resource area. To ensure indigenous(native) plantings, please submit a planting plan to the Conservation Department by April 2,2004 for spring 2004 implementation. Lastly, please be reminded that a building permit is still necessary for the shed as required by the Building Department. You may wish to contact them directly at 978-688-9545. Thank you again for your anticipated cooperation. Sinc ely, C; A ison E. McKay Conservation Associat Cc: NACC Julie Parrino, Conservation Administrator Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector Heidi Griffin, Community Development Director DEP File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Date.//-. ,,ORTH .'� TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING r: ,SSACHUS� This certifies that . . . . . . . . . . . . . has permission to perform . . .R c.1-1 \ :." plumbing in the buildings of . . .C. . . . . . . . . . . . . . . . . . . . .. . . . at . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. ?/G �. . . . . . .�. : . �. . . . 1Y... . . . . . . . . PLUMBING INSPECTOR Check # £� 1 5804 MASSACHUSETTS UNIFORM /APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) i Mass. Date /i,//2 0 2p a 3 Permit * _ a Building location S2 R )9 n ng h, r0 r l Owner's Name 6 o n c, Type of Occupancy, New p Renovatl" Replacement ❑ Plans Submitted: Yes❑ No ❑ FIXTURES . 2 Z N 4 N Z Y F- V7 O Z Z W O W > V Q N rzCC Z N < Cr ¢ _ ~ N Z 0 Z Z a ¢ u. 2 M- N W N � W Q ~, 0 W N Y a C7 < d t. X (� Z 0 y W Y H W = C < N , a tL 0 W � W 1�' tr W < to C �. < J N G J Z O ¢ C F- < Y W = < _ 3 O Z S Y d 0 .( W LL Y W I.- U y F O = tL � y = 0 0 y Z Z W .�' O tU .Y < F" < < = H < < O < J J < Cr. Cr a < 0 < t- 3 Y J V1 G t] J 3 = F- in 1L V t] Q 3 rr in O SUR—BS MT. BASEMENT IST FLOOR 2ND FLOOR .3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STK FLOOR Installing Company Name L1 h i / rYdze h 6 r7 F+�C Check one: Certificate Address %! c, qTP LP 0 Corporation f.J'Vt Partnership Business Telephone _ a a y `/3/a ❑ Firm/Co. Name of Licensed Plumber A c. h A 1 /. A L INSURANCE COVERAGE: I have a cufr nt liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked ygg, please indicate the type coverage by checking the appropriate box. A liablltty insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this pem,tt application waives this requirement: Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's ent 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 the permit issued for this application will be in compliance with all Pertinent provisions of the Massachusetts State Plum t„n and Chapte 142 of the General La BY nat ocen um r Title Type of License: Master Journeyman❑ City/Town APPRUVW(OFFICEUSE OALVf Uoense Number / act i "LOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE APPLICATION FOR PERMIT TO DO PLUMBING NAME i TYPE OF BUILDING LOCATION OF BUILDING PLUMBER. PERMIT GRANTED DATE 2p PLUMBING INSPECTOR Town of North Andover Ok �oY RM Office of the Conservation Department Community Development and Services Division - Ao'O w•.ra �Y ,�o 27 Charles Street �5�=K„5f Alison McKay North Andover,Massachusetts 01845 Telephone(978)688-9530 Conservation Associate Fax(978)688-9542 November 18, 2003 Mr. &_Mrs. Donald_ Cyr ' S2 Bannon Drive North Andover,MA 01845 RE: Violation Follow-up Dear Mr. Cyr: On October 2, 2003 I met with both of you to determine whether the newly installed shed was in violation to the 25' no-disturbance and the 50' no-disturbance areas pursuant to the North Andover Wetlands Protection Bylaw. Upon review of the shed location, it was determined that the shed was approximately 20—50 feet from the wetland resource area and is in a location that is prohibited under the Bylaw. Unfortunately,although possible mitigation strategies were discussed on site due to the property limitations of alternative placement(e.i. planting enhancements),the Conservation Commission strongly feels that the shed needs to be relocated outside of the 50-foot No-Build zone even in this case. The Commission has been very consistent in not allowing waivers of the 50-Foot No-Build,therefore no alternatives are available that would allow the shed to remain. Please remove the new shed to a location outside of the 50-foot no-build by later than December 19,2003. I would also advise that a building permit is necessary for the shed as required by the Building Department. Please feel free to contact me at any time if you have any further questions or concerns in this regard. Failure to comply with the above mentioned request may result in additional penalties and/or fines of up to$300/day starting from the initial observation pursuant to the North Andover Wetlands Protection Bylaw, Section 178.10 (A)(Page 8). Thank you for your anticipated cooperation. Sin,7rely, Alison E. McKay Conservation Assoc'ate Cc: NACC Julie Parrino, Conservation Administrator Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector Heidi Griffin, Community Development Director DEP File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North Andover x� Yh ' d also .e 9r Office of the Conservation Department A Community Development and Services Division - 'ti �a..Xo wrp'q4h 27 Charles Street Alison McKay North Andover,Massachusetts 01845 Telephone(978)688-9530 Conservation Associate Fax(978)688-9542 September 25, 2003 Donald Cyr 52 Bannon Drive North Andover, MA 01845 RE: Violation of the Massachusetts Wetland Protection Act(M.G.L. C.131 S.40)and The North Andover Wetlands Protection Bylaw(C. 178 of the Code of North Andover). Dear Mr. Cyr: On 9/24/03,this department received notification that tree cutting activities and the placement of a shed had occurred within a wetland resource area behind your property. Upon a subsequent inspection,it was observed from the road that this appeared to be true. The North Andover Wetlands Protection Bylaw strictly prohibits any activity,including vegetation clearing,within 25 feet of a wetland resource area and any construction or placement of a structure,including sheds,within 50 feet of such protected resource area(section 3.4). Unpermitted activities conducted within a wetland resource area are not only a violation of the local Bylaw, but the Massachusetts Wetlands Protection Act. Please be aware that any land altering activities proposed or conducted within 100 feet of a Bordering Vegetated Wetland is subject to a Request for Determination of Applicability or a Notice of Intent filing with the North Andover Conservation Commission(Sections.V and VI of the North Andover Regulations). Section II(b),of the-North Andover Wetlands Protection Bylaw, states that an"alteration"includes,but is not limited to,the destruction of plant life,including mowing,and the cutting and removal of trees and shrubs. Furthermore,no building permit had been issued for the construction of the shed. The Building Department requires such a permit for any proposed structures,including sheds. Therefore,the shed is also in violation with the Building Department. Please contact me immediately at(978)688-9530 to set up an inspection so that this department may accurately determine the extent of wetland resource area disturbance and appropriate mitigation procedures. Failure to comply with the above mentioned request may result in additional penalties and/or fines of up to $300/day starting from the initial observation pursuant to the North Andover Wetlands Protection Bylaw, Section 178.10(A)(Page 8). Thank you for your anticipated cooperation. Sincerely, Alison E. McKay Conservation Associate BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Cc: NACC Julie Parrino, Conservation Administrator Bob Nicetta, Building Commissioner Michael McGuire, Building Inspector Heidi Griffin, Community Development Director DEP File -' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (�P,rilnt orType) — 1�► " U'T`n�tlU�I�' �O // Mass. Date a19�D Permit Building Location Owner's Name_'\M CA J C—Y dL y" Type of Occupancy_ 1L e New ❑ Renovation ❑ ReplacemenW Plans Submitted: Yes❑ No N H Q Y W � N N V Z rt N N N Q O N = W J 0cc W O V m t- _ 'Jf Z F Q Z O 0 F- W Q m N H �yQj Cr O O O cc W a �; V) a °� Q - W 0 W N J =1 Q S a: N W cc cc W 1.1 FO- G x cc 3 Y a W =� Q C h I-- N O: > U. H W J h W 1 Q 0 1w- W W Z. < ¢ Q q O O W a: 0 to S It Z O M Y W 7 3 O Cy J V Y Q :a N O S68—BSMT. F k BASEMENT � E s ° 1STsFLOOR r i 2N%D FLOOR i I } i 3RDFLOOR ! 4TH FLOOR i I •� STH FLOOR 3 r . -t 6T4FLOOR ! 7TH'FLOOR STH FLOOR r t Installing Company NameJ(tilc Qi �V tM �C x Check one: Certificate Address �� _ � Corporation tMA �1° ❑ Partnership Business Telephone Sod WT^ A5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter 66L 0, INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy,2___*, 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 knowiedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of t4General Laws. T e of Ucense:Title Plumber of ensed um or Gas Fitter Gasfitter J City/Town aster Ucense Number (OCA APPRO OF !C S_ONL Jotlrneyman BELOW FOR OFFICE USE ONLY. FINAL INSPECTION SKETCHES - - PROGRESS INSPECTION FEE i N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME do TYPE OF BUILDING LOCATION OF BUILDING x - PLUMBER OR GASFITTER LIG NO. t y PERMIT GRANTED " DATE 19 GAS INSPECTOR �a*3..+r'.;�.aq,,iey�•'4ij"..r+�lr��2M'X:..c�..d»-�..y_.. _ +�+.+.s'}ti.�'-".rt'c--..�-� cyc.....a`�,,,'"7^'1�� i . Date.. . s ?- 29.{ 7 s NORTH TOWN OF NORTH ANDOVER .6 A ',. PERMIT FOR GAS INSTALLATION , f 9SSACNUSES . This certifies that . . . .4 � '. . . . .� v c. . has permission for gas installation . . i . . �.�. . . . . . . . . . . . . . . . in the buildings of : O.t! C�. tQ. . . . r�. . . . . . . . . . . . . . . . . . . . . at . . . .F�. ���%o.''u`' �. : . . . . , North Andover, Massy . Fee. .A. :00. Lic. No./o.0-5- . . . . . . . . . . . . . . . . . . . . . . . . . . {` /-77�(��/JJ GAS INSPECTOR WHITE:Applicant( { CANARY�Building Dept. PINK:Treasurer GOLD:File r r f � office use Cnty c T G,hr gIIriiIII.IIIIIIiz:ii± III fRas5 'rt^ Permit No. a O�� � B� CI �uf:iic �.'� ^ C�pancy dr Fee C`eckad (leaveflank) BOASO OF FRE FRE a lICN RFIULMCNS =5 7 C."'R 1=0 APPLICATION FOR PERMIT TO -PERFORM -ELECTRICAL WORK All work to be performed in ac Vrdance with t e Massacausetts E:ec:ricai Cade. 527 CmR 12: (PLEASE PRINT IN INK OR-TYPE AL INFO RLI.ATION) Date (Z-)� or Town of NORTH A 4r10V1',-R To the Insp c: 'r of wires: The ucersigned applies for a permit to p arm tr:e etec:ncal wcrk cesc:ibed below. Lccancrt Street & Number) j Cwr•er or Tenant C•.vrer's Adc:ess Ana Is nIs permit in cpnjur en with' a =uiidirs -erntt: Yes _ No m (C`ec., App-rocnate °cx) r,.:r=csa of suiicir.c S Utility Aumcrization No. =eriics l00 Amcs Cverre-_ Uncg rc ! No. or Meters Nevi =ernce amps `ictts Cvernea_ _ Ur. r.ar No. of Meters Nu•. car ;.r Feecers ar.c Am--ac::y _c s.. .. ar.c Na----re _. =razi:sec `+e. _. _.grar.g ..:els �• -. -= —_= i Nc. _. -ans:orrr.ers a, .;ems rr I No. :r _s-ting =x,—.;res Ganeramrs KVA No. :r =mergency :Gntmg . Nc. ____:ac_ Cuvets `lc. _. a __.vers -a-er.� 'lntts >4c. :. s-imn Cutlets NC. :. Sas 9_.-_-_ I =c ALAFNIS No. at Cenes NC. _ar_c-= are No. _. ?.anges NC. :. air c. f C'.S in:faUngZavicaS _ I NC.C:�ea: NC. :f =isccsats - --S �.. I No. :4 scurcing Zevtces -No. Cr Sart ContatneC - No. :t Cisnwasners �cacef�rea —__.-- Cetec::cnrSounetng Cevlces sa C �eatn^ Cevees C:r _xat Nuntc:cat ^—C:ner Ne. cr rvers 5 I Connec=m _:w 'rcttage No. :t '.Vater heaters - <':J ..Sims Ba;:—sr Wimm= NC. _ -:-a; f No. =•+pro �.tassace – as ....._._ C.— . . SNS;;�AvC= ^?ACac. ?•�rsuant:o :re recr::rernen.s =. .:assacn"a-s ;er.erat taws i nava a current •l:aetii.ty Insurance ?cttc; nC:x:ns C---eteC C=era:cns C,;verage cr ::s sacs:antral eeutva:ent. YES _ NO nave sucmtnea vatic O...et et same :o :'e C:•ica. YES _ NO _ •' ycu-nave cnecxec Y==. ,^,tease Inetcate m9-ryFe Ct .-overaSe 7y ecrtng :ne c^rccnate oox. INSL'PANCZ� 3CN0 = OTYE3 = tP'ease 5=ecc=!t C y �� (Exetrattcn a:et _s.:Tatea Value at Gat'Nortc S =nai 'Afem :o Starz •0 o Insce�en a:a =re::as:e _ .S• S;gnea uneer:ne er. »es ot -ertury: I t uc. Nc. =PIA NAME :cense• t 5:g'a-• L. NC. iVfl g�J Sus. :at. No. y92 qa`t�7 i`3i'2__ ACeress aIt- tai. No. CWNE:a'S INSUPANCc'NAiVE-q: t am aware o'•az ^e _cxsee _ees roc rave :ne .nsurares Coverage or its sucarannal eaurvalenAt as te• outrtsa 7y Mas"Criuserm General laws. ana -- ..at s:s-a.�re Cn _.:s =erT..:t aca:tcsttcn waives :nts reawrement CwnK g ;P'eass cnec>< oner 's.eCrons No. P_."MIT F=_=– 3 i5gnattus of Cwmer:r.'.sent %r.a. g Date. .,2... ......... 28? TOWN OF NORTH ANDOVER A' O 9 - PERMIT FOR WIRIyNG SACHUS This certifies that l' .... 4 has permission to perform .: .... .. .. . t �-:.. :° wiring in the building of :...... .....{.. ...1.. .,,. ............................... .� CU .. at...:. ,. .. %' ':t 4-... - ,North Andover,Mass. .,... ..... L<c.N .. � . ....... a EL R CAL Is Treasurer GOLD: File W j1 TE:Applicant"" _CANARY: Building Dept. .. PINK: i .. P,�:v }4r.�.sH_S�.i1.aR;'.:'i Y» _!L.�Ci.b. �n-^� i`€J.?.` �_. ....- ...., 5 .tR-- 9n.. L_.- ,- 5...s M. -.-. �.,�• �?A i My alV r?, Location "Yo. Date D t &ORTN TOWN OF NORTH ANDOVER •. O AL F S Certificate of Occupancy $ sCMUs Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ // .�-- Check # f3 i /Yt«'1 { 1 8 0 1 8 ✓ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: ryp DATE ISSUED: 117—o�C A"SIGNATURE: -"I BuMng Conunissioner/IngWor of Buildings Date SECTION t-SITE INFORMATION Io 1.1 Property Address: 1.2 Assessors Map and Parcel Number: z -(�ANVA O DIe e LOP/ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronta ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide ReqWred —+ Provided Re red Provided 1.7 Water SupplyM.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public 0 Private ❑ Zona Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT )iSt(lCt: P`l7 rn 2.1 Owner of Record N k4� bol.fftLo vee G 2 k14 k) Pct ,ftPDOV C Name(Print) Address for Service 1 Signature Telephone (/C� 2.2 Owneir of Record: Name Print Address for Service: 4 z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction1 Supervis r: Not Applicable ❑ C� ( I IS ui , t Licensed Construction Supervisor: 0 License Number P t Z �3 (t1 Pit. �� Address -T-a y '" `_0 Expiration Date Signature 1 Telephone U) U : 0 9�v& S7-qkr( 3.2 Register6d Home Improvement Contrac� r Not Applicable 0 A ©o Q'5 CO O e 6W01 Company Name M t2. 9,'2-:, W4, PPLc ,p p -�-�K-S g,v� L H Lk7� Registration Number r j Address I l' r �_Z `Q� t Expiration Date Signature Telephone .r a a SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Descri tion of Proposed Work check as applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: cjQr74f c1 , C6JSAN ✓tie_) �,•t' c 7-U( C4,111- 4-6( 4,111- td-G( Afaz) C 5 e-r- Z)ed2R «r d F 5aa lc-C SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCL IJ USE ONLY Completed by permit applicant 1. Building /0./ &00. 00 (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 AGENT O�QR�CONTRACTOR APPLIES FOR BUILDING PERMIT I, V V C ` t/ W but CSI(1 as Owner/Authorized Agent of subject property Hereby authorize k/ t 16 4-" W, Lbt,(Sd2/ to act on M in11,m�tXg relative to work authorized by this building permit application. �,�J (,CJ 2--1 7-D5- Signature of Owner Date n SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owner/Authorized Agent of subject `f property Hereby declare that the statements and information on the foregoing application are Lrue and accurate,to the best of my knowledge and belief Print Name Signature of Owner/Agent Date =Eli NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS h7 2Nu 3 RD SPAN DIMENSIONS OF S.1LLS DIMENSIONS OF POSTS DEVIENSIONS OF GMDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY 1S 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 c 11, S 150 A. The debris will be disposed of in: (Location of Facility) ; Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector a Afie �anvrnoozuiea a�✓�aaouc«ivaelta R Board of Building Regulations and Standards HOME IMRROVEMENT CONTRACTOR atr Re9_ . isf a�& 109124 YEx Bratton µe2006 ype ate Corporation Z IT WOOD'S CONT ' NO<rARLL� € y, William Wilson . 1293 Whipple Rd Tewksbury,MA 01876 Administrator A.i�anvrr�o�zcueai o�,/�aevac�ivaelfd�j g BOARD OF BUILDING REGULATIONS License CONSTRUCTION SUPERVISOR 034089; f E " Birthdate 07/21!1938 Expires.07/21/2905 Tr.no: 13372 Restricted OQ WILLIAM W WILSON 1293 WHIPPLE 116",',' ../`' (.•EA»o�► TEWKSBURY, MA 01876 Administrator I I September 18,2004 Mr. & Mrs. Donald Cyr 52 Bannan Drive North Andover, Ma. 01845 Dear Mr. & Mrs. Cyr: We submit herein our estimate in the amount of$10,600.00 to re-hab your second floor bathroom. Work to be done is as follows: Remove existing vanity, sink, toilet, shower stall, flooring, wall between shower and closet, and closet door. Install new shower base approximately 42" wide X 36" deep. Relocate drain and water lines to accommodate new configuration. Install blocking in long shower wall to provide proper anchoring for new grab bar. Line shower walls with %2" durock and cover floor with '/4" durock . Install sheetrock to new wall inside closet. Reframe closet door opening and install new bi-fold doors. Install new ceramic tile to shower walls and bathroom floor. Install vanity, counter top and sink, faucet, toilet, medicine cabinet and accessories such as towel bars etc. We would also suggest a new exhaust fan be considered at this time. The following items are to be supplied by you: Vanity, counter top, sink, faucet, medicine cabinet, fan, accessories, floor and wall tile, knobs for closet doors and an Electrician. Also shower doors which are usually supplied and installed by the glass company. M We are fully covered with workman's compensation and general liability insurance. Very truly yours, William W. Wilson President www/cw FORTH Town of JILI4. Andover 0 No. r7� s7 •/,—o?��S low0 L.CA.K E over, Mew., C 0 C. E RATED % BOA"OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... 0...... Foundation . .......Www-. buildings on.....jS 4 m N,4*V has permission to erect..... ... .... . ............ .................................... ...... Rough '14 -, VW to be occupied as.............. .. .......M .............1. ........ 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 previsions of the Codes and By-Laws rplsting to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. 430//// PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR CONSTRU S T Rough ...... .. ......... ... ....... ......................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. BurnerFIRE DEPARTMENT Street No. 1�_SEE REVERSE SIDE Smoke Det.