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Home My WebLink AboutMiscellaneous - 55 PILGRIM STREET 4/30/2018 55 PILGRIM STREET 210/031.0-00440000.0 I Date........ ..................... TOWN OF NORTH ANDOVER 9 PERMIT FOR WIRING CHU5�S z This certifies that ........`` `n'.`....... �"' ......................................................................... has permission to perform .�(64--\C) .........c' ..!n`,. - ............. 1 wiring in the building of.... ��. .. ................................................................ at .............. .........f�...!.cr1. �,�n...:........................................,North Andover,Mass. Fee ..........Lic.Nod b%2- .................................................................................... ELECTRICAL INSPECTOR_ Check#12904—/ 7— (� ,n Iolei I 4 ,-^ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: V� City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Q , r`..M Owner or Tenant ��,/t C��,�Q(``l Telephone No. -�� j-) 61) Owner's Address �S � � S Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 00 Amps \010 /a-\,P 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: Q— oL9 cp�-�-t mcn ein, 3z--- Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires `, No.of Ceil:Susp.(Paddle)Fans No.of Total l Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In ❑ o.o Emergency Lighting rnd. rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 22 No.of Gas Burners No.of Detection and J Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices i Heat Pump I.Ny.m..b.e.r I TonsKW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW ,. �j Local❑ Con Munis tion El al Other No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of WaterKms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: j Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Wor : Z.� l7 , (When required by municipal policy.) Work to Start: `\—2� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) - I certify,under the—pains andpenalties of perjury,that the information on this application is true and complete. o FIRM NAME: (L�.t LIC.NO.O o Q) Z. Licensee: ,o Signature (Ifapplicable,enter "exempt"Jq the license num er li ` Bus.Tel.No.• Address: \ b r Alt.Tel.No.:�'14, bA 3��2 *Per M.G.L c. 147,s.57-61,security work requires Department Pu is Safety 1"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 a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No. �. t. ' �. �,. The Commonwealth of Massachusetts Department of Industrial Accidents — Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 Please Print Legibly Name (Business/Organization/Individual): Address: --� City/State/Zip: 1 Phone #: Are yo an employer? c0he appropriate box: Type of project(required): 1. I am a employer with �L 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. F] New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [2T�emodeling ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' insurance.: 9. E] Building addition [No workers comp.comp. insurance required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. {� Insurance Company Name: Policy#or Self-ins. Lic. #: �� — �� Expiration Date: Job Site Address: Ss i Aq r�r� . City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer 'y under th�pains a d penalties of perjury that the information provided above is true and correct. Si nature: Date: I Phone#: �' ZZ�o`5�wo Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: °a NdN9ONV11iLTt O>b`MASACHU$ET 'S OAOMMONpYEal,TH OF Mi4$3k�HUSETTS. .. Baa�a DFoa�ta aWF ��" to a Ir CTR 1 C i ANS:: f ti�. CTR I-c ISSUES 7H FOLLOWINO t f�ElSE 1$$llES THE EOLLO.WI;NG AS A RSO 'JOUR 1 )+CTRIC-4- N . : REG tS7REb Ati{1STE NER ELECTRIC 1{N F 'a KE1/ttV` A ESCOTT A'. ESO TT i0 GOOL�I7GE DRIVE ° 'ice i.D COOL'i BOE -OR TYNGS•aOROUGIi f'A 01879 259 '�,# TYNOSbOFt0 h4A,01$79 -124 9 �0,8z8 07'/31/k -3,-29- 208:2 A. 073�J16.: 503?8 Date. 7. , ",O RT:1�o TOWN OF NORTH ANDOVER " s PERMIT FOR PLUMNG SSACMUSE� This certifies that . . . ... .J: . . . has permission to perform . . . ,s.I X --.� . ... . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . C.P P.<-n 4"4. x.. . . . . . . . . . . . . at ...3. �� ./.?�.+`.� ./? . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee. .3. . . . . . . . >. �. .Lic. No.. p.t.+ . . . . . . . . . � . C .-ra�.�-� )PLUMBING INSPECTOR Check # />> 7377 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location ` 12e t-.,�.` O / Date Owners Name *l lac i�r w tZ Permit# 7 7 ? Amount 3.) TypeofOccupancy New Renovation Replacement ED---- Plans Submitted Yes No FIXTURES ra SIBEME A RMAW ra FLOCR 3MRaR 4 5119MM 6M 7M F10CR . . .... gm FLOM ' t or e ) _ Check one: Certificate Installing Company Name L �i i �/ �'`�L�l� {��—G� � Corp. Address _ S ) b J x r—L)n ' , J , U Al- y v..0 �'1 .r❑ Partner.' Business Telephone []--Firm/Co. Name of Licensed Plumber- Insurance lumberInsurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy LQ-`� Other type of indemnity 11 Bond El Insurance Waiver I,the undersigned,have been made aware that the licensee of three insurance this application does not have any one of the above Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and install ' iisperfimned under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach P umbin Code and apt 42 of the General Laws. By: Signature o kens wu er Title Type of Plumbing License City/Town I ►cense um er Master Journeyman APPROVED(OFFICE USE ONLY Dat .s�. .:�!`�. .... .. Date. NORTH pf 4.,,•0 ,°,ti0 TOWN OF NORTH ANDOVER p N 1M P ti • - PERMIT FOR GAS INSTALLAI ION . 9 Y 1s,SSACMUSEt< This certifies that . . . . . . .. . . . ... ... has permission for gas installation . .+P.e f! "e. . . . . . . . . . . . . . . . �j ^ p R- in the buildings of . . . . . .�.�?. . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . North Andover, Mass. �r Fee. . . . . . . . . Lic. No.. .�. . . . . . . � . . . . . . . GAS'INSPECTOR Check# �r v �J c9 / 9 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,fMASSACHUSETTS Building Locations n I t / f�' Permit# S^ c7 Amount$ �— ....Owner's Name Cy 0.`/ f New Renovation 0 Replacement Plans Submitted w o� z G r viw o p O a 8 Z V V x � E. `� C a > 44 z cc Z z SUB-BASEM ENT w BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) C C Name—. AA-17' k one: Certificate Installing Company � ) � �� ' ` Corp. Address CZ �� !' cS /� ��1 Partner. usmess Telephone 7 Q (D -6 2 irm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. YeS 0— No� If you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy 0/ Other type of indemnity Bond ED Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work apd install 'ons pe need under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach�s State as Co and ter 142 of a Gener aws. By: S* 1pature of Licensed P ber Or Gas Fitter Title lumber City/Town Gas Fitter LicenseI um er aster APPROVED(OFFICE USE ONLY) Journeyman Date... ............................. Ib r p� Np RTM TOWN OF NORTH ANDOVER E PERMIT FOR WIRING CAL.-- ^ • 't!9 �� SSACMUS� - 4. 'I This certifies that X.�. t ' has permission to perform .......... ........ ............................................... ....... C' CG ylq,Q d wiring in the building of...............! ................................................................ 01WOW.at........ .... 57..................... ,North Andover,Mass. Fee..................... Lic.NoJ.lq.!77:., ...............��...... , ............��.... . '� � ELL�CTRICAL INSPECTOR 2 )pO j 4 Check # ! , 7376 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �a Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TOPERF RM O ELECTRICAL WORK RK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -%Y d 7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) -,� L bra yh $, /er,4 Owner or Tenant s � '—sok. S Ila JCd V Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps fad /090 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: odLC �r I - Completion of the folio ing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans N No.of Total Transformers KVA 1 No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- E] o.o mergency ig ing rnd. rnd. Batter Units No. of Outlets Receptacle No. of Oil Burners FIRE ALARMS No.of Zones P C� No.of Switches 6 No.of Gas Burners o.of Detection and Initiating Devices No. of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No. of Waste Disposers Heat Pump I NumberTons KW No.o el -Contained Totals: Detection/Alerting Devices No.of Dishwashers / Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kms, Security Systems:* No.of Devices or Equivalent No.of Water Kms, No.o No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecom f Device o Wiring: o r„ No.of Devices or E uivalent ` OTHER: i r Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Elect ical Work: (When required by municipal policy.) Work to Start: O Inspec 'ons to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V AGE: 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 BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: A' w TlEry�p7g--v Ehell,e— LIC. NO.: -13 Licensee: O�! -17 c- Signature �� LIC. NO.: /t't/ • % (If applicable, nter "exempt"in the license number lin .) Bus. Tel. No.:y'7� Address: �� d/ Alt.Tel. No.: 91?36d S`a 73 *Security System Contractor License required for this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: 1 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 Telephone No. PERMIT FEE: $ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations uv� 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information g Please Print Leibly Name (Business/Organization/Individual):-"VA h/ !✓Z `770w� Address: /,7 hc) ..3 )L,<, _ City/State/Zip: rc�XJ Q /�3 67— Phone Pe9 72 Are you an employer?Check the appropriate box: Type of project(required): 1.❑�amato er with 4. ❑ I am a general contractor and IY 6. ❑New construction (full and/or part-time).* have hired the sub-contractors 2. 1 am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling P P ship and have no employees These sub-contractors have 8. ❑ Demolition insurance.comp. working comp. insurance rking for me in any capacity. workers' p 9. E]Building addition [No 5. ❑ We are a corporation and its required.] officers have exercised their 10.[:] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.[:] Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby c ify der the_pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: � 1y a / Phone#: !2 ��-- 3 -9 S�2 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of.Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Date. .. .a r w NORTH TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SA US This certifies that —t has permission to perform . . . A.�K. Ff v ,r+ . S` ?.r S i-.e—, plumbing in the buildings of . .CA /./✓t !-k !1 14AO. . . . . . . . . . . . . . . �5. Pr n at . . . . . . . . . . . . . . . . . . . .`. . . . . . . . . . . . . . . . , North Andover, Mass. . . . . . . . . . . «. PLUMBING INSPECTOR �}. Check # �a�a 6 b 4 0 i �, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date��, Building Locatio 1%' s� Owners Name ��/�„P�� Permit# I � Amount j Type of Occupancy i New)4 Renovation Replacement Plans Submitted Yes No F1 i FIXTURES d Cn Cn a C x x x F x j A O SmBgm RASEM[ r ISL FLOOR ZD HOQR 3M FLOOR 4M FIOOR M HOOR 6M FLOCR 7M R" SIH HOOR (Print or type) Chec one: ificate Installing Company Name �.� Corp. e Address Partner. a Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: In 'cate th ype o insurance coverage by checking the appropriate box: Liabilityins r u ance policy Other t e of indemnity Y ❑ Bond ❑ i Insurance Waiver: I, a undersigned, ve been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and ins tions performed u der ed for this application will be in compliance with all pertinent provisionsof the assac is Sat mbi Co ter 142 of the eneral Laws. By: nature icense u e TType of PI ing License Title �ity/Town icense um er Master Journeyman APPROVED(or-FtcE USE ONLY Date. . . . �a. l.©. a• NORT�y TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION 5 �9SSACH 5 .. This certifies that . . .isvN�"� has permission for gas installation . . .59!. .r.:' . . . . . . . . . in the buildings of . . . .«. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .- .�� . . .P !A.. . . . . . . . . . . . .. Northndover, Mass. Fee. . .3 . . . . Lic. NoA lt:4 k G. . , 1)1. . . . .1 . . . ��t. .. . . GAS INSPE TOR A.Check# xf '4751 Date.....41..."..../ NORTH TOWN OF NORTH ANDOVER FO A PERMIT FOR WIRING ,SSACHUS� This certifies that ....... has permission to perform .........1-fC.�..'t t. I................. ................... wiring in the building of .......... 1 pr...�. .�u^ ejRorth Andover,Mass. . ...... ... U 7 Fee.... .�...... Lic.No/ .!.!?�............... :..../ , ... G nLECIRICAL INSPECTOR Check # / !� / 5257 i 7hECOMMOATHEALTHOFA SSACHESETj'S' Office Use only DEPARTAJY V7WOFPUBLICSAFETY Permit No. BOARD OFFIREPREVE[V170NREGULA770NS527CAR I2 00 Occupancy&Fees APPLICATTONFOR PERMIT TO PERFORM ELEC,LTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRAT IN INK OR TYPE ALL INFORMATION) Date O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes MNo (Check Appropriate Box) Purpose of Building Oe'S 117>0!-4-4-7 JIL ADD/7)10A—,J Utility Authorization No. Existing Service In O Ampsfa / olts Overhead ED•fiJnderground M No.of Meters New Servic 2219 Amps/ ! O Volts OverheadL�- nderground rI No.of Meters Number of Feeders and Ampacity ' Location and Nature of Proposed Electrical Work gT)D/770A./ 7—V R es/Dt•-�CEs-- >p No.ofLigliting Outlets / No.of Hot Tubs No.of Transformers Total KVA No.of Lighd,ng Fixtures Swimming Pool Above Below Generators KVA round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No:of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW Nq.•of Sounding Devices No"of Self Contained Detiction/Sounding Devices �tNo.of Ayers Heating Devices KW Local Municipal � Other ., Connections No.of'Nater Heaters KW No.of No.of i Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• ft%R7rceCoWrdg-- PtuatantlDthe wW=Tn&ofMasswhusMGer nal iaws [have aommLiabflltyhimrmmPbhcyinchxhngComplt Coveiageoritsatsla alegtuvalert YES NO (haw,gft 2dvandpfoofofsametotheOffim YES Ifyoubavt;cllecl<DdYES,pkmmdcab tdr peofoo by :lig the ff ropuate,box NSURANCE BOND f--J OTH M (Please Specify) F�riraati�onDaTE EstimatedVahleofEbctricalWolk$ No&toStatt O kipecttmD&Regu-1tDd Rough Y��L Final (N/L t Cp4I- iigrledurlder�ie ofperjury. 1RMNAME ��o�� A �— 6-� LicemeNo. ,mme A-4-D w.��LLf3TeQ� Signahue Lioff&No �o C-1 IV BusilessTel.No. (o Q'7-/ ,ddrecc -7 ��D�� L'iT L! '�/�L �/ t"12 Alt Tel No. )WNER'SINSURANCEWAIVER;Iamawaretbatdrl-ioiwdoesnothavethemstuancecowiageoritsstilbstmdalegxvalentasctqmPdbyMassachusettsGeneral Lam xl dlat my signa m on thispeurvt apphcadon waives this Iegrme<ro t J 'lease check one) Owner ® Agent Telephone No. PERMIT FEE$ Igna ure oT Owner or Agellf _ The Commonwealth of Massachusetts ss chusetts d Department of Industrial Accidents Office of investigations Boston; Mass. 02111 Workers'Compensation insurance Affidavit Name Please Print Name: ` Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: �+ Address R: City: Phone#: Insurance.Co. Policv# Company name: Address City: Phone#: Insurance Co. Policy# .� Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment-as_well_as_civil.penaltiesin.fheform iof-a..STOP WORK.ORDER..and_a.fine_of_(.$1.00.DD)_a day against-me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. l do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name P.hone.# official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing E-1 Building Dept ❑Check if immediate response is required I] Licensing Board F1 Selectman's Office Contact persona Phone#: Health Department F1 Other s MASSACHUSEIIS UNIFORMAPPUCATON FOR PERMTr TO DO GAS FITTING (Type or print) Datej NORTH ANDOVER,MASSACHUSETTS Building Location � Permit# i Amount$ Owner's'N✓amei New❑ Renovation Replacement Plans Submitted � W cn co� U .Wl � W OC4 E. O M F W &0� z � F O O O O W EW W F p. Wd z W W W F A F S G zW W .. < Q4 z W O U WF z WF z F EW. W O O z U p a x O x A C7 a UU 09 L1 00. F O SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . F L O O R 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 16TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print ort XChecone: Certificate Installing Company Name Corp. Address Partner. Business Te ep on- Firm/Co. u ,Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance p9icy or it's substantial equivalent. Yes ❑ No If you have checked Les, ease i cate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity Bond Owner's Insurance Waive�Iam'aware a-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 13 Agent l 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 installatio performed under Permit Iss ed f this 1c' t' ill be in compliance with all pertinent provisions of the Massa set apte 1 W2 e al Laws. Signature of Licensed P b Or Gas Fitter By. Title Plumber City/Town Gas Fitter =se um erum er Master AY' ROVED(OFFICE USE ONLY) Journeyman Location ' No. �_� Date Of NORTH TOWN OF NORTH ANDOVER � 41 F w 9 ' Certificate of Occupancy $ CMuSEBuilding/Frame Permit Fee $ ooc) Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ ! 190 � Check # 17199 `C�--- Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. Q5 -91 0 DATE ISSUED. SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 55 Pi L G KI N 5r 31 41 Al. filf D 0 V EZ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: �� COTUua t2 LOT .� 5.FWWO' 7250 90.8' AA10 1(,.Zs ' Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required I Provide Repired Provided R 'red Provided 1.7 Water Supply M.GL.C.40, 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public X Private 0 � P� Ys Zone Outside Flood Zone ❑ municipal On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record f00N CRLLPO)ARD 55 P/L621M Ji Name �nt) Address for Service 1 Si a Telephone 2.2 Owner of Record: t 4• Name Print Address for Service: 0 k Y M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ NRREtJ MAXTIA/0 CS 0� t� Licensed Construction Supervisor: 49 I 910/fOld AVE E-�T „wonvev License Number Mn Address 97F-(,F 5-3037 ?-/57;20657 CQe#1?7F- 902-33190 Expiration Date Si afore Telephone ,�12 Registered Home Improvement Contractor Not Applicable ❑ DAUaJ MAZF11Vo Company Name /� 9� e,e / q nD pl rw ^-,V % ^„ ��// Registration Number Address t7 /��/ ?7F/�v F5-X ,7 N �Iy �--Cgt47ephone F- OZ- 3d'tl E iration D��— Zoo��Sin a C SECTION 4-,WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ - Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: a,Q,' A001776AJ 4001M. ,4 egM-10-Y 7ZdaA 7-D /ff Alco AUD A- A&MOA P V)` SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be EM 'ICCom leted b ermit a licant , _ M. , 1. Building d a v (a) Building Permit Fee Z 4D/ Multiplier 2 Electrical 0,1157 � (b) Estimated Total Cost of Construction 3 Plumbing c' SL Building Permit fee tel X (b) 4 Mechanical(HVAC) ®� 5 Fire Protection 6 Total 1+2+3+4+5 Q Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 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 1, ZAM-V A2/I"Zr1/W as Owner/ thorized Agent f subject property sr Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief T-MRLAJ ft?Ag�nAA _PftfftName i e of Owner/ et t Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2YJ6 12w,04 2 0 1e3LV.r1 SPAN 5 y DM ENSIONS OF SILLS • 'Z DEVIENSIONS OF POSTS DIlvIENSIONS OF GIRDERS ` HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING ` Q X Q w MATERIAL OF CHIMNEY ` IS BUILDING O R FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U — LOT RELEASE FORM ` 'O s INSTRUCT IONS: This form is used.to verify that all-necessary approval/permits from i Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. •s■asrssaasssas■aa-sassassa■as■■ss.aesaasa■■ass■■saaassaas■ss.sss■sasa:asaaa=mom APPLICANT+)A2+-,C-N 44lZT AJO PHONE 9'7,P-902-3,390 ASSESSORS MAP NUMBER 4�t' LOT NUMBER I SUBDIVISI?O�N n LOT NUMBER STREET !-- G/c�� c�T STREET NUMBER asaapse:sa .■ssssas■■-sas.aaasasssa.ss■•aaaamseaasassawesamamas■sssssss ssasaasa■ OFFICIAL USE ONLY ■ass■-saon*s,aasaaaaaaass aanamaaaanoon sa-asaa ass ananew.s■aaassaaa■aaaa.aaamaa:a-sa■ REC MA ENDATIONS OF TOWN AGENTS s■a sasasas■saa .■ ■ .■■as ■■a■aas■aasassaas�a■asasaassaas■ma■ on ■sass-asa■ J` DATE APPROVED O - CONSERVATION ADMR; TOR DATE REJECTED COMMENTS s DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORDS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Town of North Andover o! t+a oT" 1� Office of the Zoning Board of Appeals }? Community Development and Services Division 4.1 - 27 s27 Charles Street x ' � °+ten°�•(°� North Andover,Massachusetts 01845 'SS�cHUS�t D. Robert Nicetta Telephdne(978)688-9541 Fax(978)688-9542 Building Conmdssioner This is to certify that twenty(20)days have elapsed from date of decision,filed vrithout filing of appeal. Dat Joyce A.Bradshaw Notice of Decision Any appeal shall be filed Town Clerk within(20)days after the Year 2003 - date of filing of this notice in the office of the Town Clerk. Property at: 55 Pilgrim Street �!s AME John Callamaro HEARING DATE:December 9,2003(_ PETITION: 2003-042 _ ADDRESS: 55 Pilgrim Street TYPING DATE: 12/11/03 North Andover,MA 01845 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,December§ 2003 at 7:30 PM upon the application of John Callamaro,55 Pilgrim Street,North Andover,MA, requesting a Variance from Section 7,Paragraph 73 and Table 2 for a side setback,and a Special Perm-a) from Section 9,Paragraph 9.2 of the Zoning Bylaw to extend a non-conforming,pre-existing structure a non-conforming lot iti order to add a family room and a bulkhead.The said premise affected is property t!t with frontage on the North side of Pilgrim Street within the-R4 zoning district. Published in the Eagle_47-_ Tribune on November 3& 10,2003. Only the legal notice was heard at the November 18,2003 meeting. The following members were present: John M.Pallone,Ellen P McIntyre,Joseph D.LaGrasse,Joe E. Smith,and Richard J.Byers. William J.Sullivan chaired but did not vote. 0 Upon a motion by John M.Pallone and 2'a by Ellen P.McIntyre,the Board voted to GRANT a Variance 0 from Section 7.3 and Table 2 for relief of 1'on the north side setback,6' from the rear setback,and 3' from the front setback;and GRANT a Special Permit from Section 9,Paragraph 9.2 of the Zoning Bylaw in op order to construct a family room,and a ground-level bulkhead on a pre-existing,non-conforming structure J on a non-conforming lot per Plan of Land location 55 Pilgrim Street,North Andover,MA prepared for John Callamaro,Date:October 8,2003,[by]Frank S.Giles II;P.L.S.#49793,Scott L.Giles Frank S.Giles Surveying,50 Deermeadow Road,North Andover,MA 01845 and Renovations to 55 Pilgrim Street North Andover,Massachusetts,9.23.2003 A2 Schematic,7.19.2003 A3 Draft,and 7.19.2003 A6 Draft on the following condition: 1. The proposed addition's height will be no greater than the existing dwelling's 18'height. Voting in favor: John M.Pallone,Ellen P.McIntyre,Joseph D.LaGrasse,Joe E. Smith,and Richard J. Byers. The Board finds that the applicant has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning - Bylaw and that the granting of this Variance will not adversely affect the neighborhood or derogate the intent and purpose of the Zoning Bylaw because the proposed addition requires 1' of Variance;and _ satisfied the provisions of Section 9,Paragraph 9.2 of the Zoning Bylaw that such change,extensions-6r _ alteration shall not be substantially more detrimental than the existing structure to the neighborhood.; ATTEST: Pagel of2 A True Copy own Clerk Board of Appeals 978-638-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-633-9540 Plaruiing 978-683-9?35 Town of North Andover t NORTH 1 Office of the Zoning Board of Appeals ? Community Developmefif% 2Services Division s 27 Charles Street . '; North Andover, Massachusetts 01845 �,S'^'•° <'t5 SgCNUSE D. Robert Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Furthermore,if the rights authorized by the Variance are not exercised within one(1)year of the date of the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice,and a new hearing. Town of North Andover Board of Appeals, William I ullivan,Chairman Decision 2003-042 M3 I P44. Page 2 of 2 Board of Appeals 978-688-9541 Building 979-688-9545 Conservation 978-688-9530 Health 97R-(,'RR_U:dn w ,° I i Essex North County Registry of Deeds 381 Common Street Lawrence, Massachusetts 01840 03/11/04 JOHN CkLMARO CTI 91.5Y I �ib01 d 3 Rec: Type PL 50.00 DOC. 9870 C. P. 20.00 9!SA, R. D. 5.00 d 4 Rec: Type CERT 50.00 DOC. 9871 C. P. 20.00 R. D. 5.00 Total 150.00 # 5 Payment Cash 150.00 THMK YOU! Thomas J. Burke Register of Deeds Town of North Andover �oRTM oto«.• ..�� Office of the Zoning Board of Appeals ;: •s' ''' Community Development and Services Division i 27 Charles Street North Andover,Massachusetts 01845N i D. Robert Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Date: p c, l 7, 2,00 Dear: —Mf, 4- Vf,5, Co//a W a(d As you know,the Zoning Board of Appeals granted your application for a Variance and/or Special Permit or Finding for premises located at: S y;W Your 20-day appeal period will have passed on the following date: 7 C 1. Once the appeal period has passed,please pick up your Town Clerk-certified copy of the Zoning Board of Appeals decision, and your ZBA Board-signed Mylar(if a Mylar was required) from the Town Clerk's office located at 120 Main Street, North Andover, MA 01845 (978-688-9501). 2. Please make a paper copy of the ZBA M Board-signed lar. g Y 3. Please bring the Town Clerk-certified copy of the decision& the signed Mylar to the North Essex Registry of Deeds, 381 Common Street, Lawrence,MA 01840(978-683-2745),as the decision and Mylar must be filed at the Registry of Deeds as soon as possible. 4. Once this is completed,please bring:A. copy of the certified decision, B. a paper copy made from the ZBA Board-signed Mylar, & C.the Registry of Deeds receipt to the Building Department,which is located at 27 Charles Street,North Andover,MA 01845. Failure to file the decision and Mylar with the Registry of Deeds will result in your inability to exercise your variance and/or special permit and your ulab ty too aui a b�uiing perrili j c "Furthermore,if the rights authorized by the variance are not exercised within one(1)year of the date of the grant,they shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,they shall lapse and may be re-established only after notice and a new hearing." If you have any questions,please feel free to call (978-688-9541)or fax(978-688- 9542), Monday through Thursday, 9:00 AM to 2:00 PM. Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-088-9530 Health 978-688-9540 Planning 978-688-9535 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 i Number is that the debris resulting from this work shall be , disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) 14 Signat re 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 The Commonwealth of Massachusetts Department of Industrial Accidents W Office Investigations a ner atio s < / Boston, Mass. 02111 Workers'Compensation.lnsuranceA>fidavit I - Name 7 Please Print Name: pARXEN MAZT/NO Location: 65 P/LG-EJM ST City Phone # 02 ?e_fU I am a homeowner performing all work myself_ li I am a sole proprietor and have no one worldng in any capacity . I am an employer providing workers'c ompensalim for my employees working on this job. Comnanv name: Address City Phone . Insurance.Co. Eqw# Comoanv name: Address . MOM Insurance Co. Pokeyc-#. Fdkwie to sec twe coverage as requiredu nder Secoon 26A cr A4GL t x2 cmilesdtoltho no,iiiO ion of erbrrrwt pe 11210 S crf a fihe s ;S7 and/or one year 'irnprisorrr�eot.asp-V�[.ass�4i.- Oa�llesb�hefam��fa understand that a copy of#ft statement may be forwarded to the Otfioe of Iia ligations cls the DIA toc C&A age verfikwon. /dDhereby ce rby unc ler&&paiis a F7dp esofPwl,ry HastVAP infamiat provided above isfteand c ffeet Signature,11-7) Print name_ Ptns97�-9QZ-33 (1 Officfai use only do not write in this area to be caWleted by city or town dkiar City wt Town _ ". ,.: �:P�enm�tiGertsina.. BrUu?+obngt C]Check l nmredkib nnpanw is mquked S4)ec*)aWC contact person: Phone# Heafth Lip, Other - �-�` ✓rte >°�� } BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 066342 Birthdate: 08/15/1971 Expires: 08/15/2005 Tr.no: 1770 Restricted: 00 DARREN MARTINO �- 44 ADDISON AVE EXT `► METHUEN, MA 01844 Administrator i i Jrie L�amr�rwivae¢/,f� a�✓2�:uuru.�aeda Board of Building Regulati6ons and Standards HOME IMPROVEMENT CONTRACTOR Registration: 124961 Expiration: 9/17/2005 Type: Individual DARREN MARTINO Darren MARTINO 44 ADDISON AVE.EXT. 1z-- METHUEN,MA 01844 � Administrator lift, DM Construction Building with the QUALITY and Character of yesteryear. 44 Addison Ave Ext. Methuen, MA 01844 (978) 685-3037 Estimate Submitted To: John and Donna Callamaro 55 Pilgrim Street N.Andover,MA 01841 We hereby purpose to furnish the materials indicated and perform the labor necessary for the completion of: Addition and miscellaneous home improvements.(See specifications sheet) All material is guaranteed to be as specified,and the above work to be performed in accordance with the drawings and specifications submitted for above work and completion in a substantial workmanlike manner in the sum of One hundred four thousand fifty dollars-$104050.00 Payments to be made as follows: $15000.00 when work begins. Remainingpayments as p y work progresses. Respectfully submitted: Darren Martino Any alteration or deviation from the above specifications involving extra costs will be executed only upon written order,and will become an extra charge over and above the estimate. All agreements contingent upon accidents, or delays beyond our control. Note-This proposal may be withdrawn if not accepted within 10 days. Proposal Date 02/16/04 ACCEPTANCE OF PROPOSAL The above prices, specifications,and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date: Signature: " ' Callamaro Addition and Renovation ahon Specifications Sheet Scope of work: Construction of an addition providinga amil room on the 1 S` oor a bedroom f y � �a on the secondfloor. Miscellaneous nexus home improvements including upgrading the heating and electrical systems. Permits-The price of the following permits required is included in this quote:Building, electrical, and plumbing. Demolition Demolition will be as outlined in submitted drawings. DM Construction is responsible for all debris generated A container will be placed on site to assure a clean work site. Excavation-The site will be excavated for a full foundation and bulkhead as outlined in submitted drawings. Fill will be removed from the site as deemed necessary. The driveway pavement will be cutback shortening the existing driveway. The foundation will be backfilled and the area graded will loam. This estimate does not include any landscaping including,fine grading, seeded, shrubs, mulch etc. Foundation-A full concrete foundation will poured as outlined in submitted drawings. I Cellar Floor-A 4"thick concrete floor will be poured to a smooth finish. Frame-The addition and interior renovations will be framed according to submitted drawings. jChanges from the submitted design may incur extra cost. Siding-The addition will receive new cedar shingles to match the existing house. Shingles on the main house will be staggered back as necessary to tie in the addition seamlessly. y Roof-The addition will receive 25 year shingles to match the existing house. The rear roof will be staggered back as necessary to tie in the new addition seamlessly. Ice and water shield will installed on the roof as deemed necessary. Due to age, the elements, and different lots, there will possibly be a difference in color of new and old shingles. Insulation-Walls and floors R-19. Ceilings R-30 Drywall New addition walls and " ceiling to receive /� sheet rock Ceilings receive ecerve a smooth or random sand swirl finish. Drywall will be installed as necessary in Max's room, the upstairs hallway, and the new open loft area. Callamaro Addition and Renovation Specifications Sheet Interior Painting-New walls to receive a prime and 2 coats offinish(Benjamin Moore or California-color to be determined). New trim to receive a prime and 2 coats offinish(Benjamin Moore or California-color to be determined). Walls in Max's room, hallway, and loft area to be painted Painting of kitchen and dining area walls not included in this estimate. Exterior Painting Addition to receive 2 coats of paint to match existing house color. Rear deck-All composite materials left to weather. All wood materials to be primed and painted 2 coats to match existing o trim color Finish New interior door units will be 6-panel-solid core-masonite-smooth finish. New casing and baseboard to match existing trim. 15 light french doors to be installed between the family room and the dining area Oak newel post, oak handrail, and painted balusters to be installed at loft landing. All custom finish including, built-ins-window seats-etc is covered under an allowance. Heating-Removal and disposal of the existing boiler. Installation of a new Burnham natural gas boiler, sufficient for heating the existing house and addition. New boiler to vent at existing location. The new boiler will have a new S zone relay to service the S zones each with their own circulators and flow checks. Installation of 4 new Honeywell t-stats. Installation of a 40 gallon Superstorer. Zone 1-existing]-floor Zone 2-existing 2"d floor. Zone 3-Family Room. Zone 4- New bedroom and loft area. Zone S-Superstorer. Baseboard heat will be removed as necessary for construction. New baseboard heat will be installed in the addition as deemed necessary. Baseboard will be installed as deemed necessary in rooms where it has been removed or altered. Electrical-Demolition of all wiring deemed necessary. Existing service to a be upgraded to a 200 amp/42 circuit panel. Wire boiler and Superstorer as necessary. Installation of standard receptacles as required by code. Install cable at 2 locations in family room and l location in new bedroom. Install l phone jack in family room and 1 phone jack in new bedroom. Take down and reinstall existing ceiling fixtures as deemed necessary. Upgrade existing smoke detectors in compliance with new codes and add 4 additional smoke detectors in compliance with new codes. Provide porcelain light fixtures in new basement area. Provide and install l spotlight set up for rear of house. Installation of coach lights.(The cost of all lighting is covered under an allowance. Note:Installation of recess lighting is covered under the electrical fixture allowance. i CaDamaro Addition and Renovation Specifications Sheet Tile Installation of 4'x 16'strip of tile at the rear of the family room.(The cost of the tile is covered under an allowance.) Rear Porch-Frame constructed from pressure treated lumber. Decking to be composite decking(TREX-Color to be determined.) PVC lattice to be installed Posts and trim boards to be primed pine. Handrails and balusters to be cedar or far. Ceiling to be beaded t&g fir. Miscellaneous Installation of a precast concrete bulk head to access the new addition. i Cut a 3'wide hole in the existing foundation to access the addition basement. Installation of white aluminum gutters and down spouts on addition. Remove counter top and brackets as outlined in submitted drawings. This estimate does not include any fences or arbors shown on plans. I ALLOWANCES The following allowances are included in this estimate. The allowances exist to cover the purchase of materials only, unless otherwise specified. Any amount in excess of an allowance will incur extra cost. Any amount less than an allowance will warrant a credit. Upon completion of the project any extra costs or credits will be issued. Windows/Exterior Door units-$5000.00 This allowance includes all windows(including screens, hardware, grills, ext jambs, specialty trim, etc), exterior door units, and screen doors. Electrical Fixtures-$1500.00 This allowance includes all light fixtures, specialty switches(dimmer, timer,etc), coach lights, ceiling fixtures, and recess lighting. The cost of installation of recess lighting is also covered under this allowance. 5"recess lights-complete w/white trim, white baffle, halogen bulb, on slide dimmers. New construction$115.00 per light Old work$130.00 per light. Flooring-$5000.00 This allowance includes the cost of materials and labor for installation of carpeting. This allowance includes the cost of materials and labor for installation and sanding of hardwood flooring(Floors are sanded and receive 3 coats ofpolyurethane-) Custom Built-ins-$2500.00 This allowance covers that cost of materials, labor, and painting of any custom built-ins including, window seats, benches, units built in to knee walls, etc. Callamaro Addition and Renovation Room by Room Syecifications I. Family Room A. Walls-painted. B. Trim-painted. C. Ceiling-sand swirl or smooth finish. D. Flooring-Hardwood and slate.(Allowance) E. Cable outlets-2 locations. F. Phone jack. G. Recess lighting.(Allowance) U. Kitchen/Dining Area A. New trim painted to match existing. B. Remove counter top and brackets. C. Remove and patch in old exterior door unit. D. No paint of walls. E. Archway to family room.(Kitchen) F. French doors to family room.(Dining area) III. Stair way/hall way/loft area A. Walls painted. B. New trim painted. C. Installation of new railings. D. Flooring-carpeting.(Allowance) E. Custom built-ins.(Allowance) IV. Max's Room A. Walls painted. B. New trim painted. C. New closet location. D. New ceiling. E. New ca etin . rp g(Allowance) V. Emma's Room A. Walls painted. B. Trim painted. C. Ceiling-sand swirl or smooth finish. D. Flooring-carpeting.(Allowance) E. Cable outlet. F. Phone jack. G. Custom built-ins.(Allowance) H. Ceiling fixture(Allowance) ENERGY CONSERVAT[ON APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J (effective 3/1/98) Applicant Name: A4912EN /-A�//Vo Site Address: Jr PjLCsRI/ Applicant Address: 40 AAD1Jog 141,E Exy-- City/Town: /V m4aV_-- /I�ETI�u i M4- _ Use Group: JZ11_1:71rAOC-AI77,j4L _ Date of Application: -,5-30-0 Ll Applicant Phone: q'7f-U6`3037 Applicant Signature: _ Compliance Path(check one Q Prescriptive Package (Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package.(A through KK from Table J5.2.Ib): _ Heating Degree Days(HDDm) from Table J5.2.1a: (For items d.through i., fill in all values that apply from Table 15.2.Ib:) a. Gross Wall Area sq.ft f. .Wall R-value R- b. Glazing Area' �sq.ft. g. Floor R-value R- c. Glazing% (100 x b a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter e. Ceiling R-value R- j. Heating AFUE [7 Component Performancei "Manual Trade-Oir" (Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) [7 Zone 12 72one 13 Zone 14 Attach Trade-Off Worksheet from Appendix J, [and�YVAC Trade-Off Worksheet, if applicable] [] MAScheck Software Attach Compliance Report and Inspection Checklist?rintouts. ® Systems Analysis OR Renewable Energy Sources Attach Mass Registered Architect of Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a. Gross WallCeiling Area L05L sq.ft. b. Glazing Area` /30 sq.ft. c. Glazing% (100 x b a) _% 7 ADDITION with Glazing % (c.)up to 40% m,,:y use 780 CMR Table J1.1?3.I below: MAXIMUM U-value 1Ni1NUM R-Values Fenestration Ceiline Wall Floor Basement Wall Slab Perimeter,Depth _ 039 R-37 R-13 R-19 R-10 R-10,4 ft 1 Glazing Area may be either Rough Opening or Unit dimensions. Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e..not compressed over exterior walls, and including any access openings.) [� "SUNROOM" addition (greater than 40% glazing-to-wall and ceiling gross area) ep Attach "Consumer Information Form"from 780 CTYM Appendix B. Official's Name: Official's Signature: Application Approved Denied F-1 Date of Approval/Denial: Reasons) for Denial: (provide additional details as.needed on back side) RTfy Town ® ` ' 4 Andover 0 No. s8` 0 dover, Mass.,/3-otoD COC HICHEWICK V� "ted C AD/?ATED PPa,C� sSACHu5� FOR EXCAVATION AND FOUNDATION . THIS CERTIFIES THAT .... P..^ ..... �A .�.......��............... .................................. ................ ... .., ..... has permission to excavate and our foundation at P P xj� NtrK s A �� s�0/9e .*4.a✓.o*% " .�.Alsors forthe purpose of..... ............... ..... ....�................................ ... _ ................................... The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. �3��,y y � � 0 q sk aom3—my�. IL - n— Di VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The-holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. SEE REVERSE SIDE BUILDING INSPECTOR N®RT#q TONM of over And 0 . ....... No,, B �p _ C, LA K dover, Mass., `0 a �l COC M ICMEWICK ORATED F`Pa,`�� S U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.................0..hAJ..........C.A.1jp...M.A. BUILDING INSPECTOR Foundation :. has permission to erect.....4.0. abuildinLson...... r. . Rough . to be occupied as... . .� �� r Ao�o�i�I 0�................................................. Chimney ,� .........................................x........................................ provided that the persori'accepting this permit shall in every aspect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and y-Laws relating to the nspection, Alteration and Construction of 3 Buildings in the Town of North Andover. 1 ;y � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 2 �� A�proua PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR s 3 �JNLESS CONSTRUCTION STARTS Rough l .. . ....................... 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. �R AV n : ! Ts On M I 4 gyp,,.# 5� s.8 � Ilk .�� i 4 ^ . Ln j 1 i YEN } . -► 3- 1 F 5 } yy {{pppF'' iY. rn � Tai rn � a ( a F 1 • DRAWNC Al TITLE PAC A\MNG L15T f+ A2 DEMOLITION F2 R° i� J epi i LAYOUTS PARTITION / , ♦ , FIRST FLOOR A4 PARTITION LAYOUT—SECOND FLOO A5 ELECTRIC/REFLECTED CEILING— FIRST FLOOR AO ELECTRIC/REFLECTED CEILING- SECOND FLOOR A7 EXTERIOR ELEVATION WS !Z A6 INTERIOR SECTION/ELEVATIONS A_q INTERIOR SECTION/ELEVATIONS A10 INTERIOR SECTION/ELEVA71ONS pp Nr- ell +Jr r r .y - ��:�p�'7y !�.��k"°'�� +' �•yFa '��R"at" FJP^"". _ ° � r �" `.� �';��' �,. S �+� �+ ., �� a�, �s � •p" �i!.'a�r a ZOA aj'. p;' � •Ari�`.1 , Jim �!w IRS �,�. -f-�� is S�': j � P '32 ai� � ,f •'# r i.r i 4 •.� • 16'-0" 00 l= RELOCATED EXISTING — — — — — — — — — — — — ry TO EDGE OF EXISTING HOUSEI SERVICE METER AND KEY & NOTES u HOSE BIB. p N BOOT BENCH- NOT IN CONTRACT (NIC) - SUPPLIED BY OWNER _ _ _ _v - - - - - - - — -i _ O ADD ALTERNATE:- BUILT-IN WOOD TRIMMED CLOSET WITH CEILING AND ,y z 2 DOOR. N O PROVIDE NEW BASEBOARD HEATING IN ALL NEW ROOMS- VERIFY QUANTITY co AND LOCATION WITH OWNER. VERIFY CAPACITY OF EXISTING HEALING UNIT. f�J SLATE TILE FLOOR AT ENTRY WITH SMOOTH FLUSH JOINT. I EQ C EQ O EQUAL EQUAL CDO INSULATED WOOD FRENCH DOOR WITH SEPARATE WOOD SCREEN DOOR- Ln OOR- DINING SEE ELEVATIONS. PROVIDE ADDITIONAL WEATHERSTRIPPING. O WOOD FLOOR WITH EDGE BAND OF SAME MATERIAL ALL AROUND 1 ` 10 A7 o O7 RELOCATED REFRIGERATOR- PROVIDE NEW DEDICATED OUTLET. z Cr DOUBLE HUNG WINDOWS WITH SCREENS AT DEEP WOOD WINDOW SILL. O J FAMILY ROOM O u- O 9 DOUBLE FRENCH DOORS WITH TRUE DIVIDED LITES- PAINTED WOOD. ONE. 17- 6 O DOOR WITH FLUSH BOLT TO FLOOR AND CEILING. 0 Q[ (� 10 Ui NEW WOOD FLOOR IN FAMILY ROOM- SOLID WOOD THRESHOLD AT 0 11 A8 [A9]2 O DOORWAY TO KITCHEN AND DINING, FLUSH WITH FLOOR. N 11 NEW FIXED TRANSOM WINDOW- 4 EQUAL WINDOWS. REFER TO ELEVATIONS 0 2 A10 1 , O WOOD PORCH, RAILS, AND STAIR OF WEATHER RESISTANT WOOD WITH 2 w z W uj � 12 COATS TRANSPARENT STAIN ALL SURFACESEj 13 PROVIDE ADD ALTERNATE- PAINTED WOOD WINDOW SEAT WITH OPENINGS Q Q °C a -, ME] °i 10 AT BASE FRONT AND SIDES FOR HEATING UNIT- (SIM. TO EXISTING LIVING KITCHEN 3 �, O ROOM BOOKCASE AT FIREPLACE)- SAME HEIGHT, 18" DEEP TOTAL TO WINDOW FRAME. ' -. —WRAP BASE- COPE ENDS R 44 FROM OPENING MIN 0 2 1. ALL DOORS SS TO HAVE MATCHING HARDWARE OR APPROVED EQUAL TO `D EXTENT OF STONE FLOOR EXISTING, AS IN LOCAL CODES. HOSE BIB ti , , - --- EX ST WITH N 2. ALL WINDOWS TO HAVE INSULATED GLASS AND REMOVEABLE SCREEN � QUAL 5 E.QUA UNIT WHERE OPERABLE. ------- - --_-- O ACES, TYP. LE: 2 COATS 3 ALL ROOMS TO BE FULLY FINISHED ALL SURF PAINT ON PRIMER, TYP. UNLESS OTHERWISE NOTED. ALL ADJACENT � �" SURFACES TO BE PAINTED TO MATCH TO COMPLETE FINISH OR COLOR ON N PORCH12 I A PER ROOM BASIS. - - - - - - - - - - - - - - - - - 4. BASEMENT: LOCATE FLOOR DRAIN(S), LIGHT FIXTURES (2 CEILING CD EQ EQ " MIN. i MOUNTED ON SWITCHES- FLUORESCENT STRIPS 4LONG) ELECTRICAL - 10^f I OUTLETS (1 MIN. EACH NEW WALL, 42 A.F.F.- ADDITIONAL AS PER CODE) - - - - - - - - - 5. SIZE CAPACITY OF BOILER/ LOCATE NEW AND EXISTING TO BE RELOCATED HEATING FLOOR BOARD UNITS. ,n DRAWING SHEET NUMBER .O Ag 2 INTERIOR ELEVATION NUMBER _ C 8'-0" t INDICATES NEW WALL CONSTRUCTION ,n INDICATES EXISTING WALLS TO REMAIN z i o o W m TL_ • KEY & NOTES EXISTING ROOF O 36" HIGH WOOD GUARD RAIL WITH BALUSTER AND NEWEL POST- VERTICAL BALUSTERS TO MATCH ADJACENT STAIR RAILS. SOLID WOOD ROOF FLOOR CAP 3/4" ABOVE FINISHED FLOOR TO ACCEPT CARPET- SEE SECTION/ ELEVATION NOTES. 4'-0" O CABINET DOORS WITH FRAME TO MATCH TYPICAL DOOR FRAME. BUILT-IN SHELVING- 3' MIN. HEIGHT 3 PROVIDE NEW BASEBOARD HEATING ALL NEW ROMS- VERIFY QUANTITY 0 O AND LOCATION WITH OWNER. VERIFY CAPACITY OF EXISTING HEATING UNIT. 4 NEW DOOR AND FRAME AT REMOVED WINDOW-CARPET TO CARPET 0 OO O TRANSITION. zILL O2 5 BUILT-IN WOOD TRIMMED DRYWALL CLOSET WITH CEILING AND DOOR- O Q 3 10 O REFER TO ELEVATIONS (PROVIDE SEPARATE PRICE) - z .,...: � NEW DOUGLE HUNG WINDOW/ SCREEN ASSEMBLY TO MATCH EXISTING OPEN AREA O WINDOWS- SEE ELEVATION. O o EDGE OF SLOPED CEILING 1 7 DOUBLE CLOSET DOORS TO MATCH TYPICAL UPSTAIRS SOLID CORE < W - - - - - - - - - - - DOORS- CLOSET SHELF AND POLE. 1 I ❑ 1 8 DOUBLE HUNG WINDOWS WITH SCREENS ASSEMBLY 011 - O O `` 6 [A8] A9 2 9 NEW CARPETING THROUGHOUT- TERMINATE AT BOTTOM OF STAIRS AND g W a v O W ui BEDROOM/ BATHROOM DOORS. w z E- 2 FOEMMA'S BEDROOM 10 PATCH AND REPAIR FLOOR AS REQUIRED FOR NEW CARPETING. a } � � 1 O < mDa A7 3'-4" 3'-0"t EQ EQ 3'-0"f MAX'S ROOM GENERAL NOTES: Ul 2' no. 1. ALL DOORS TO HAVE MATCHING HARDWARE OR APPROVED EQUAL TO EXISTING, AS WITHIN LOCAL CODES. CLOSE O A9 O 2. ALL WINDOWS TO.HAVE INSULATED GLASS AND REMOVEABLE SCREEN (p C14 UNIT WHERE OPERABLE. CLO E 3. ALL ROOMS TO BE FULLY FINISHED .ALL SURFACES, TYP. I.E: 2 COATS s PAINT ON PRIMER, TYP. UNLESS OTHERWISE NOTED. ALL ADJACENT U MIN. SURFACES TO BE PAINTED TO MATCH TO COMPLETE FINISH OR COLOR ON O O A PER ROOM BASIS. N 4. ALL WOOD TRIM/ DOORS/ WINDOWS TO MATCH EXISTING IN FINISH � AND COLOR UNLESS OTHERWISE NOTED. ROOF L � O EDGE OF NEW E 1 -0 DORMER OVER EDGE OF EXISTING ROOF INDICATES NEW WALL CONSTRUCTION C �� DORMER - S INDICATES EXISTING WALLS TO REMAIN t nZ 1 F � o GENERAL SCOPE NOTES p w 1. ADDITION DORMER SHOULD SEAMLESSLY MATCH EXISTING 0 HOUSE DORMER. ALL EXTERIOR WOOD TRIM, FASCIAS, CLAPBOARDS, ROOFING AND TRIM OR ACCESSORIES, EXPOSED ESTABLISH NEW RIDGE POINT LOCATION, COORDINATE WITH NEW AND FOUNDATION,TO MATCH AND ALIGN WITH SAME AT EXISTING EXISTING DORMER AND NEW AND EXISTING ROOF PITCHES TO CONFIRM HOUSE. INTERIOR CEILING TO BE REFINISHED IN BACK (MAX'S) SMOOTH TRANSITION BETWEEN NEW STRUCTURE AND EXISTING, BEDROOM FOR INVISIBLE JOINT TO NEW DORMER. INCLUDING ALIGNMENT OF ROOF EDGES, 2ND FLOOR WINDOW SILLS, NEW DOOR AND TRIM AT SECOND FLOOR CLEARANCES. 2. ALL NEW CONSTRUCTION IS TO CONFORM TO STATE AND PROVIDE CONTINUOUS RIDGE VENT, _ LOCAL BUILDING, ENERGY, FIRE AND ANY APPLICABLE CODES. TYP. 3. PRIOR TO CONSTRUCTION CONFIRM THAT NEW ADDITION NEW ATTIC LOUVER ROOF ASSEMBLY CLEARS NEW DOOR OPENING TO ADDITION AS SHOWN. 4. NEW DORMER WINDOW HEADS AND SILLS TO ALIGN WITH Z EXISTING 2ND STORY WINDOWS. MAINTAIN MIN. 8" FROM WINDOW DETERMINE NEW ROOF SLOPE IN 0 .SASH TO TOP OF ROOF SHINGLES. LD 12 EO Q 5. PROVIDE R-30 INSULATION AT ROOF AND R19 AT WALLS. t 19 W USE METHOD SUCH .AS APPROVED SPRAY-ON FOAM INSULATIONLl PROVIDE NEW RAIN W THAT PROVIDES 7'-3" FINISHED CEILING HEIGHT AND GIVES GUTTERS BUILT- IN AT 6 –1 FLUSH CEILING AT EXISTING REAR BEDROOM CLOSET TO EDGE OF ROOF TO MATCH w HH ' REMAINING BEDROOM. 12 EXISTING (NOT SHOWN HERE FOR CLARITY) = � 6. MATCH ALL ADJACENT BUILDING ELEVATIONS INCLUDING BUT 10 VIF W �� g Z W E NOT LIMITED TO ROOF PITCH, EXTERIOR OVERHANG TRIM AND NEW ROOF PITCH AT }} SHINGLES AND TRIM TO SHUTTERS TOREAR TO ACHEIVE PORCH GUTTERS, WINDOW HEADS AND SILLS, DORMER PITCH, EXPOSED < _ FOUNDATION LINE UNLESS OTHERWISE NOTED. MATCH EXISTING HOUSE, MATCH EXISTING, OVERHANG- ALIGN Q 4 a TYP. UNLESS OTHERWISE TYP. BOTTOM OF ROOF EDGE G. 1 OD D a NOTED. WITH BOTTOM OF 7. MATCH ALL EXTERIOR AND INTERIOR ADJACENT FINISHES EXISTING ROOF EDGES. AND COLOR UNLESS OTHERWISE NOTED. BOX BEAM ALL AROUND l!1 8. ALL FIRST FLOOR INTERIOR MILLWORK TRIM TO MATCH OUTSIDE FACE OF PORCH EXISTING TRIM AT WINDOWS AT NEW LIVING ROOM FIRST LEVEL. El TO COLUMNS NEW BASE TO BE 6" WITH PROFILE TO BE SELECTED BY OWNER. Ul BULKHEAD 9. SECOND FLOOR TRIM TO MATCH EXISTING TRIM AND SECOND V FLOOR, STAIR TO MATCH EXISTING STAIR DETAILS. HOSE BIB N ZBASEMENT WINDOWS, VERIFY/ ADJUST 10. PATCH AND REPAIR SURFACES TO PROVIDE CONTINUOUS — TYPT-PROVIDI<2— GRADE AT FINISH AT ALL EXISTING TO REMAIN SURFACES ADJACENT TO EACH SIDE BOTTOM OF NEW WORK FOR COMPLETE NEW FINISH WITHIN A ROOM. STAIR 11. LANDSCAPING 4- N 0 T E: REFER TO PLAN FOR OUTLET AND LIGHT {�- E 0_EAST ELEVATION LOCATION, TYP. C t nZ 0 10" TN Y'PUt1CLED COVIN-F-ETE Ll Q SN oL �. t ii LL- O J � o o C7 F r , �t.L „01 U` �1N> i r t7ri!1ql�-- H- i33A of nN ole � U N Trii �- k r j 71 x ` C77M�rr\G �A%'Vvi Q�- ►�CM 0) C7`6-: ;.j 10'6, O Z N °rick Zoning Bylaw Review Form Town Of North Andover Building Department 27 Charles St. North Andover, MA: 01845 Phonblg.M=688-9545 Street:. . Ma /Lot• A licant: C.. Request: - Date: a.� C -off Please be Advised�that after review of your Application and Plans that your Application is DENIED for the f 11 ---ing Zo rtngwBylaw..reasonsa Zoning — ., ItemNotes A Lot Area ' , Item Notes _ F -Frontage 1 Lot area Insufficient , �1 _ 1 Frontage lnsufficie.nt 2 Lot Area.Preexlsting tl r S 2 Frontage Complies 3 Lot Area Complies « 3_ Preexisting ffo.ntage 4 Insufficient Inftyrfnation 4 Insufficient Information g Use _ 5 No-access over Frontage 1 Allowed t 4 !s Contiguous Building.Area 2 No't Allowed - "'' 1 Insufficient Area ,3 Use P,reexistin.�.. . `; 2 Com Ties 4 Special-Permit-Required 3 Preexisting CBA S 5 Insufficient Information 74 Insufficient Information C Setback H Building Height 1 All setbacks-co m l 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side -Insufficient-- 3 Preexisting Height e 5 4 Right Side Insufficient -_ 4 Insufficient Information 5 Rear"Insufficient Building Coverage 6 Preexisting,.seiback s M4lnsuEicientlnfoffnarion2 Coverage exceeds maximum 7 Insufficient Information D Watershed— �- Coverage.Complies. Coverage Preexisting S 1 Not in Watershed In WatershedSign 3 Lot prior.to...1.0/24/94-4 Zone to be determinedSign not allowed Sign Complies 5 'Insufficient Information 3 Insufficient Information E Historic District K Parking _ . ... 1 In District review required 1 More Parking_Required 2 Not in district._... .._ .- s2s�- - 2 Parking Corn lies 3 Insufficient Information 3 Insufficient information 4 Pre-existin Parkin RemedY for the aboveis.checked below. Item # Special Permits Plannirr Board------- - -Item # Variance Site Plan Review Special Permit Access other than_Fronta e S ecial Permit Setback Variance. Fronta a Exce tion Lot S ecial Permit Parkin Variance. Common Drivewa :$ .ecial..Permit -- -- _Lot Area Variance Con re ate Housin eciai Permit - Hei ht Variance Continuing Care.Retirement Special Permit Variance for SUM Inde endent Elden' 'Housin S .ecial Permit S ecial Permits Zoning Board _S ecial Permit Non-Conformin Use ZBA Lar e,Estate,,Condo S ecial Permit "` Planned Develo meat District S ecial Permit Earth Removal S ecial.Permit ZBA S ecial Permit Use not Listed but Similar Planned Residential-S ecial Permit R-6 Density SpecialPermit S ecial Permit for Si n Special permit for preexisting Watershed S ecial Permit -� nonconformin The above review and attached explanation of such is based on the plans and information submitted, No definitive review and or advice shall be based on verbal explanations by.the applicant rW'shall such verbal explanations by the applicant serve to Provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached docume by reference: The building tlent..titled"Plan Review, Will ll tie attached hereto and incorporated herein partmeht will retain alf,plans and documentation for the'above file.You must file a new permit application form and,begin the peltnittin- process; #=i ii : a...._ - t �3 wilding Department Official-Signa d3 Application eceived Appl'cation Denied Plan Review Narrative The following narrative is provided to further explain1he:reasons for DENIALfor the APPLICATION for the property indicated on the reverse side: t 7�A,of C� , � . .. A9C� S 7` de- LA C,k-, IA/de i' S PCT�Gti!'/- 7 7,-4 � ..r , li 4l.RS=f . .. ..li •tel' • . Y �qi Referred To: , r Fire Y Police Health Conservation Zonih Board Plannin De artment of Public Works Other Historical Commission •, Buildin De artment The Commonwealth of Massachusetts —'� NDOVER State Board of Building Regulations and TOWN OF NORTH A Standards BUILDING DEPARTMENT Massachusetts State Building code 780 CMR y RENOVATE,CHANGE E USE OF OCCUPANCY OF,OR DEMOLISH APPLICATION TO CONSTRUCT REPAIR,RENO , BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Building Permit Number: Y-IVA A4 Date Issued: Si ature: Date Buildin Commissioner/Ins �eo �in SECTION 1-SITE INFORMATION 1.2 Assessors Map and Parcel Number: 1.1 Property Address: e.15 11Map Number Parcel Number 1..3 Zoning Information: 1.4 Property Dimensions: Lot Area(sq) Frontage(ft) Zonin District Pro sed Use 1.6 Buildin Setback ft. Side Yard Rear Yard Front Yard Required Provided Required Provides Required Provided 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: 107 Water Supply 9M.G.L.C.40.4 54� �"� Outside Flood Zone 0 Municipal On Site Disposal System Public a Pr vate Zone 2.1 Owner of Record Name(Print) Address: Signature Telephone p 2.2 Autho ze Agent: Name(Print Address Signature Telephone SECTION 3 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Not Applicable Q 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: License Number Expiration Date Address Signature Telephone Not Applicable Q 3.2 Registered Home Improvement Contractor: Company Name Registration Number Expiration Date Address Signature Telephone Revised 1997 JMC SECTION 6-DESCRLPTION OF PROPOSED WORK check all applicable) New Construction Q 1 Existing Building ❑ I Repairs ❑ Alterations Addition ❑ Accessory Bldg. ❑ 1 Demolition Q 1 Other (3 S eci Brief Description of Proposed : 4 C L. rl SECTION 7 - USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly A-1 A-2 A-3 IA ❑ A-4 A-5 113 ❑ B Business ❑ 2A Q E Educational Q 213 Q F Factory ❑ F-I F-2 2C ❑ H High Hazard Q 3A ❑ 1 Institutional ❑ 1-1 1-2 1-3 3B ❑ M Mercantile ❑ 4 Q R Residential ❑ R-1 R-2 R-3 5A ❑ S Storage Q S-1 S-2 5B 13 U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index (780 CMR 34) Proposed Hazard Index(780 CMR 34) SECTION 8-Buildin-Height and Area BUILDING AREA Existing(if applicable) Proposed Number of Floors or stories include basement levels Floor Area per Floor(sf) Total Area(sf) Total Height.(ft) SECTION 9-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes ❑ No Q SECTION I 0 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AJIENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT .I� 1, As Owner of subject property hereby ut rize to act on my b 1al , in all matters relative to work authorized by this building permit application. Signature of Owner Date revised bldg form/state JMC Au1 24 02 10: 16a BFIILLIE&COMPANY MORTGAGE INSPECTION PLAN Q DoT 7 c) ~I I 3 1 d a r L.0-r 9 U\ o � C � +t � 30 THIS PLAN IS BASED ON A TAPE SURVEY(NOT AN INSTRUMENT SURVEY)AND IS TO BE USED FOR MORTAQE PURPOSES ONLY. THEREFORE.THE OFFSETS AS SHOWN SHOULD NOT BE USED TO ESTABLISH PROPERTY LINES. 5S E x COUNTY PLAN OF LAND DEED REFERENCE: PLAN REFERENCE: P L.No, 2.101 IN BK. 3(07-( PG' 289 PL.BK. PL. CERT. NO. BK PG. N O�T L--I ,�N D D ,1 -- I hereby certify that the existing building is located approximately as shown and was not in violation of the zoning bylaws at the time of PREPARED FOR: construction. This building is not located in a Flood Hazard Area. M,0 r4 V kke r- IAoKryAyf� C a ` FLOOD HAZARD COMMUNITY NO, Z50AP 99 SoHN & poNN A -ALLA JNA;LO BOUNDARY MAP NO. 0003G EFFECTIVE ZJJN93 STH OF � SCALE: 1 IN.= Z 0 FEET `F9 THOMAS y" BAILLIE & COMPANY C. o RS �-� BAILLiL �' CIVIL ENGINEERS S� LAND SURVEYORS _ No.11111 33 HOWARD STREET REGISTERED LAND SURVEYOR -9 0".E READING, MA 01867 DATE: / 2� Z'7 "9—] a� (6i 7) 944-2767 Jul 24 02 10: 16a BAILLIE&COMPANY (781 ) 944-6112 p. 2 MORTGAGE INSPECTION PLAN 7 �'- 94.6.0 --I . A 3 �, 2S0 5rl a d o 2t N 1 THIS PLAN IS BASED ON A TAPE SURVEY(NOT AN INSTRUMENT SURVEY)AND IS TO BE USED FOR MORTAQ E PURPOSES ONLY. THEREFORE.THE OFFSETS AS SHOWN SHOULD NOT BE USED TO ESTABLISH PROPERTY LIKES. trSSEA COUNTY p� DEED REFERENCE: PLAN REFERENCE: PLAN OF LAND BK. 3(0l q PG- 289 PL.BK. PL. IN CERT. NO. BK. PG. NU�TrI I hereby certify that the existing building is located approximately as shown and was not in violation of the zoning bylaws at the time of PREPARED FOR: construction. This building is not located in a Flood Hazard Area. Mar V MErCT Ntc%T"yA70' G a FLOOD HAZARD COMMUNITY NO, 25EJC7 go So>�N s, & GONN A CAS LA lV1A}Y(� BOUNDARY MAP NO. 0003G EFFECTIVE Z0u1413 ��•�� OFs�0` SCALE C IN.= 2 D FEET �m THOMIAS o C. BAILLIE & COMPANY - -- BAILLiE CIVIL ENGINEERS & LAND SURVEYORS o No 36032 \ 33 HOWARD STREET REGISTERED LAND SURVEYOR 90�ESsto�� READING, MA 01867 DATE: / 2--27 —` -7 ��SUB140ep (61 7) 944-2767 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING b , BUILDING PERMIT NUNvXIIER. J DATE ISSUED. SIGNATURE: BuildinF SECTION 1-SITE INF Location 1.1 Property Address: r o. RV s3r � 1.3 Zoninglnfor f° _ y� TpWN pF ate 4 o, nlpR V b•-. h qN Zonin Distrid 7 ,4 i p 1.6 BUILDING F sJ�ctiusEtt� ertificat AND VER \I Front euildi e Of Occupa Requires' ,,c F n9/Frame p ncY $ oundation per I nit Fee $ 1.Mater S�iyr a tither per mit Fee Public ❑ P r0-r mit Fee $ ` system ❑ •� SECTION 2 Cheek # ` A� $ ` No M 2.1 Owner o' —40--0,y 0�/ Name(Pri 1 5y Sign re C v/ Q _ eui/did 2.1 Owner of Record: - 9/osp�ctor Name Print Address for Service: A M Si nature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: p License Number Address Expiration Date Signature Telephone i 3.2 Registered Home Improvement Contractor Not Applicable ❑ Co pany Name M Registration Number Address r Expiration Date ^ Signature Telephone !!) SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check a0 applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be � gOFFICIALTSEJONLY Completed by permit applicant 1. Building C� (a) Building Permit Fee 2 S�� Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)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, �a � C . wo,•�G••,it,i� as Owner/Authorized Agent of subject property Hereby au a to act on My behal al ers relative to work authorized by this building permit application. i a e of er Date SEC IO 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A Ient Date NO.OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TIlvIBERS 1 2 3 SPAN DIMENSIONS OF SILLS '• DIMENSIONS 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 NORTH O t wo Town of North Andover a, Building Department - '� : �-M--• x 27 Charles Street ��SSACHUSES North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE��®� JOB LOCATIONs5 SIr444 rv©•,A4L0QQk Number Street Address Section of Town „HOMEOWNER 5S- Pptt oar 1.-% 011 GP4 &S& Number e� Home Phone Work Phone PRESENT MAILING ADDRESS 5,S' t"ol��s.� ��- No. MWc, NAA 1 City Town State Zip Code The current exemption for"Homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a, two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The ns'undersigned"homeowner"assumes responsibility po ability for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requi m -A/ HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. i e ' � 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 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) o� 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 No. - o� �o� L a �� dover, Mass., AERATED '9S H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... ...... .. ............ .. ....' .. ... ... .. .0..................................... Foundation S 50 has permission to erect............ ..................... buildings on ......... ....... �. ... .!.... ..............IL........ Rough %to be occupied as....... . ........ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on fi n Final this office, and to the provisions of the Codes and By-Laws relati to the Inspection, A oration and Construction of Buildings in the Town of North Andover. 3 ' momPLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ......... ....... . ........... .......................... ........................ Service BUILDING INSPECTOR Final Occupancy Permit Required 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. Z V V i i V i 1 i . 0 � o��,� � dover, Mass., ba g 0 3 � hof' TED PPGt�� 1 v H 4` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........��.._.D....4.N............C...d....11.8...ow.....0.. 0..................................... Foundation has permission to erect............ .... buildings on .........� A ... .�...... ......... ................... buildin .... ... ....... IL....... Rough to be occupied as....... r w .........I �!�/ ... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on fil n Final this office, and to the provisions of the Codes and By-Laws relatinq to the Inspection, A eration and Construction of Buildings in the Town of North Andover. 43 yy �� — PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ... . .. . . ... ... ..,.. Service 1100 BUILDING INSPECTOR Final Occupancy Per nit 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. Location sI L 6Q.1 YV� No,; t13 Date 0 ,oRTM TOWN OF NORTH ANDOVER c • �r F p Certificate of Occupancy $ t f � 4 > _ Building/Frame Permit Fee $ i � ; .. •oma. i' s �ss�cM�st� Foundation Permit Fee $ Other Permit Feej UUoy $ 10 Sewer Connection Fee $ Water Connection Fee $ M TOTAL „ 1 X81 ` - uilding Inspector •d y - 7852 . Div. Public Works PERMIT NO. l� ` � APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. f LOT NO. G 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. LOCATION `��LL�i�1 PURPOSE OF BUILDING OWNER'S NAME R NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME G, e x �/Y `J �I vi7� SPAN _— DISTANCE TO NEAREST BUILDING �L DIMENSIONS OF SILLS DISTANCE FROM STREET "" POSTS DISTANCE FROM LOT LINES-SIDES REAR "' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY �fD IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES T d� EST. BLDG. COST . PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER 914. FT. - EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F D BUILDING INSPECTOR SIGNATU F ERF:W6THOA IZED AGENT F E E i OWNER TEL.# AaPERMIT GRANTED CONTR.TEL.# T:l 13 19 CONTR.LIC./t. C-r)= C*) � H.I.C.# `-d _ 35 C.J� BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICESLOT 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 Z--1 3 CONCRETE BIK. PINE BRICK OR STONE HARDW-D PIERS PLASTER .�%\/�� + �� `� �'V-'A g\ _ DRY WALL $ BASEMENT I UNFIN. — — — ��(�l10 V��'i��•� C?�L �� l �M`CSt'�+�O \�VvM AREA FULL FIN. B M TAREA _ FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �— WOOD SHINGLES EARTH ASPHALT SIDING HARDW D —�— ASBESTOS SIDING COMMCN _ VERT. SIDING ASPH. TILE STUCCO ON MASONRY �— STUCCO ON FRAME ' BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIORI� POOR — ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) — GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER - ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. _ STEAM V STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GOAL B=M 'T 13 d I NOCHEATING Town of over C7 No. 013 � -ort ndover, Mass., C9A1JA `t 13 19 g s � e ry` 0 '_ LAKE COC`+ICNEWICK ALJ�qoR r ePPP' GJ � BOARD OF HEALTH Food/Kitchen MIT T D Septic System PER ,t BUILDING INSPECTOR C l.i-t talct+JSor{....................................................................................................... THIS CERTIFIES THAT.............................. Foundation i has permission to emet...�d.4 ................... buildings on .. PI�,.62�w� Rough N .... .... �, S..�c.....L�~E �a ......a.. ...F �z Chimney to be occupied as....1�1a... tom... • e provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. � aZ (. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS" ' U -IS'FAQ` T Rough ............................ ..................... Service BUILDING INS CTOR 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 PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY tol�YGs�map aaarrent` OFfc?ilurLr � � - MASSACHUSETTS ONE ASHBORTON PLACE DEPAR ® atsv@tt$tdteBuild.inp BOSTON,MA 02108 ode�saa thts/t� �t orrerp� D�, f ] EXPIRATION DATE �, 7 C0 NSORT RLISUPERVIS !2/13/1 995 CAUTION RESTRICTIONS EFFECTIVE NONE DATE LIC-N0. FOR PROTECTION AGAINST %+, `f= 66/30/1993 005,57,3THEFT, PUT RIGHT THUMB Iff i O "{ GARY o PRINT IN APPROPRIATE SS 027-4�-545$ _° 53 TE{�KSi3URY BOX ON LICENSE. ANDOVER ° MA m O 181 G BLASTING OPERATORS PHOTO(BLASTING f;=.�,-.',... ra, OPR ONLY) m MUST F INCLUDE PHOTO. f6 O.o O ✓Pi''y ^-'-_^":i, NOT VALID UNTIL SIGNED BY LICENSEE AND' - HEIGHT: STAMPED-OR,SIGNATURE OF THE COMMISSIONER OFFICIALLY DOB: 12/13/1951 THIS DOCUMENT MUST RE y^ r v ,�• CARRIED ON THE PERSON OF THE HOLDER WHEN EN- SIGN NAME IN FULL ABOVE SIGNATURE LINE t ;y , 1�{ OTHERS-RIGHT THUMB PRINT GAGEDIN THIS OCCUPATION. ICENSEE I '� :✓ COMMISSIONER ?`� 7 •� � - -=vim.+-.+r+r.r;cad'v�.esaW.c.�'+xi:�+�..+.�... - .�..�.i�.e.w=t'>^�,.Sasi'!'�.'SiL v3a�.s.�..-.vri^.:dw*:a-.�.�..�. �...,-�.. .�- __•__._...,__.._--._--.-.. ____...... .._' ___ 'r `f ✓ d`l '��` �1G� '� �t��1��i(r��QQQiC��%�uXi(iL�! � 4 y { 9 HOME IMPROVEMENT CONTRACTORS REGISTRATION j Board of Building Regulations and Standardsi r One Ashburton Place - Room 1301 Boston , Massachusetts 02108 y HOME IMPROVEMENT CONTRACTOR 1 Registration 102738 Expiration 07/02/96 1 �..�.;:,:�. :.,• ;,,,_� - . Type - DBA .r: HOME IMPROVEMENT CONTRACTOR f: I Registration 102138 EmErwm ,r 7 G .E .& E .N . Hall Builders 1 Type - DBA Gary E . Hall 1 Expiration 07/02/96 53 Tewksbury St . 1 Andover MA 01810 1 G.E.& E.N. Hall Builders -:. j Gary E. Hall I G� �o `3 Tewksbury St. ADMINISTRATOR Andover MA 01810 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Phone LOCATION: Assessor's Map Number Parcel 4-4 Subdivision Lot(s) Street ILz eky, '�p St. Number ss— ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit ire Department Received by Building Inspector Date The Commonwealth of Massachusetts Office Use only L ao63 Permit NO Com:•._ Department of Public Safety c� r t: V BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 occupancy & Fee Checked -•-- /' 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AN work to be paAormaO N aecortlaroa cairn Dia Masaaenuaaro Elaeu cai Cow.527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date y y City or Town of - i9�✓(la icG� To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) k- �J 6 %/ �v iwr %C Owner or Tenant Cr/C AJ Owner's Address J/9-1-9 Is this permit in conjunction with a building permit yes 12 no ❑ (Ch^•;k Appropriate Box) N / / Purpose of Building l vl S 1)12 Utility Authorization No. i Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead " Undgrd ❑ No. of Meters Number of Feeders and Ampacity / y/ Location and Nat-•e of Proposed Electrical Work L— 3 ivc ✓ � e lYe�aa. f /�•'�/ Gj No. of li Mina Outlets If TOTAL No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures SwimmingAbove Pool rnd.❑In rnd LJrl Generators KVA No. of Emergency Lighting No. of Receotacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones TOTAL No. of Detection and No. of Ranges No. of Air Conditioners TONS Initiating Devices HEAT TOTAL TOTAL No. of Sounding Devices No. of Disposals No. of Pumos TONS KW No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices 1 No. of DryMunicipal ers Heating Devices KW Local ❑ Connection Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No, of Hydro Massae Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES C NO I haave submitted valid proof of same to this office. YES C NO Q� If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough (^" /g/I Final Signed under the penalties of perjury: FIRM NAM LIC. NO. Licensee 4--A✓ tS v // Signature UC. NO. C Addresse f/cvh,( /?'J/Zi U /rY 3 Uo � Bus. tel- No. 3^ 22-e Alt. Tel, No. OWNER'S NSURANC RIVapawaat the Licensee does not have the insurance coverage or its substantial equivalent as requiMassac setts Gener awsture on this application waives this requirement. Owner Agent (Please check one)nt Telephone No. J -/ 7•® �� _ __ PERMIT FEE S_ Date.....j........................... .por+rM TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ACNUS� f This certifies that ............................................................................................. has permission to perform ............:..:t..`.:............ ..:..............t ./..................r! wiring in the building of .. J" ........ ,..... o at...................................... ............ ,North Andover,Mass. j Fee.....f........" Lic. No. ' ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File