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HomeMy WebLinkAboutMiscellaneous - 56 SURREY DRIVE 4/30/2018 56 SURREY DRIVE 210/074.0-0040-0000.0 t i a// q�� Com.monwea{°th ol///adsac4ccsetb Offici�a/l Use Only Permit No.li� 61 e1.JePartmen�o��ire�ervice9 Occupancy and Fee Checked i BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/071 (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: City or Town of: �(>. ;�/,1�pye 2 To the In pecto of fres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner"or Tenant 15-ZZZy149kz y Telephone No. Owner's Address �'Ar^a�• Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building z-A,-7---.4y Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: T�Sii�2L p� sU�,•y� ��/7� '/p-Z�J�' E� Completion o the followingtable 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 Pool Above ❑ Emergency Lighting rnd, BattegUnits No,of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No,of Gas Burners No. eteD and InitiatingDevices No,of Ran es Na.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump I umber Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ oth er Connectron No.of Dryers Heating Appliances Security Systems:* rY KW No.of Devices or Equivalent No..of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts . No.of Devices or Equivalent Bathtubs No.of Motors Total HP Telecommunications irinl: No.Hydromassage No.of Devices or Equivalent x OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: c.52Pd (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER_❑-(Specify:) I certify, under the pains and penalties c 'ion:on this application is true and complete. LIC.NO. FIRM NAME: ELECTRICAL SERVICES /, LIC.NO.: 33 6�3 (If applicable,enter "exempt"in the license n P.O. Box 8062 Bus,Tel.No.: Address: Ward Hill,MA 01835 Alt.Tel.No.: *Per M.G.L. c. 147,s.57-61,security work iequires Department of Public Safety"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 Telephone No. PERMIT FEE: $ Date..... .-.2'...ct....r. O�NonrM,h TOWN OF NORTH ANDOVER O 9 PERMIT FOR WIRING SSACMUS� This certifies that ............................ � ./( ............... .............................................. has permission to perform .......Z.......... ..............h +.d........4G� 4 wiring in the building of........... 1 /.. f�-�L ....................... at .S. ........ ..Y. / ........................North Andover,Mass. F\ee..... .. .....Lic. No.1."e:sv� .......... . ELECTRICAL PSPECTOR Check# IZ � 127P1 v �%``<COMMON►NEQLTH OF BOAR 0 _ L E CTR I C I AS,.;:><;. ° ISSUES THE F OL L OW AS >q' G`' OURNC EYELECT-R I :> <> EW R BR EN`` .•� .� 20 MYRi 3362 A 01844-1 0`< 3 E :: 07/31 .16 3 8 32739 COMMONW EALTH Oir MASSACHUS mill IIIII ° o - ° o TTS BOA�tp L ;C:TR I C i A N S<::< ISSUES THE FOLLOWING L1C<ENSE `AS:: ' .� .. REGISTER D MASTER. ELECTRiCIRAN MA TH EW R BRI EN 'Z 20 MYRTLE Si 1� W to HLitN . 14A 01844-1 7/31:1>16:>::>::><:::> 32740 1 Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(Mf C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: la&& & City or Town of: 10 l Adorf p Q To the Inspec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) U 'r '- Owner or Tenant ^0 if f-- Telephone No. Owner's Address 4 et Is this permit in conjunction with a building permit? Yes� No ❑ (Check Appropriate Box) Purpose of Building 4ddf`jrf�!�1 Utility Authorization No. Existing Service Amps ��0 / Volts Overhead Undgrd❑ No.of Meters New Service Amps /,P4 Volts Overhead Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: - O n 4� 40 I— 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 Pool Above ❑ In- El o mergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets �� No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.o Detection and Initiating Devices No.of RangesNo.of Air Cond. TonaTotal No.of Alerting Devices A No.of Waste Disposers Heat Pump Number Tons KW No.of Sel -Contamed Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ElOther Connection No.of Dryers z Heating Appliances Key Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.o 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: vm Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of le trical Work: ��0 � (When required by municipal policy.) Work to Start: v Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V 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 coover 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 Misapplication is true and complete. FIRM NAME: / �-- LIC. NO.: Licensee: r�l c((N� //LiM �j -rte Signature LIC. NO.: (/f applicable, enter "exem ern t{ liFe�e�nu er line.) Bus.Tel. No.: Address: iCcs s Alt.Tel. No.: ' 697 *Security Sys ontractor License required Mr this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. . Owner/Agent PERMIT FEE. Signature Telephone No. l n� f �j.�-vti,,P �!C `�• - ` � -acmes /pig i I i I Date...-`....:........l?.... Air TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHUS This certifies that ... ....... .............................. has permission to perform ....... .. .....:..... wiring in the building of........... ...................................... at .............. .North Andover,Mass. 6 Fee-3%f......... Lic. �/. .............. 'R ELECTRIC •INSPEETflR ., Check # 49R7 /� IITp CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 054 (7/31/2006) Date: January 5, 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 56 Surrey Drive MAY BE OCCUPIED AS Addition of Family Suite IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Joseph Keleher 56 Surrey Drive North Andover MA 01845 Building speetor t, ,q- 4., �• 1. ..1tI .N: No. 0 o dover, Mass., 0 LA �. �J COCHICHEWICK 7 Ao'%ATED PPS` BOARD OF HEALTH Food/Kite en z?PE tem e0k610 A'.e ....... � ...................... ....... oittcation THIS CERTIFIES THAT..... .......... Shas permission to erect.. buildings on .. ' "" Raugh.. %_ . /0 0► • to be occupied as. 3.. ...........Q!�C.."h'. 1. ....:1."'i +t..... ... ......�Al.�t 1••*•�f'1........ a -'Chimney G p ay x res est conform to theterms of the application on file in ina -4 �e , n provided that the person accepting this permit shall in every P the Inspection, Alteration and Construction of �/ , this office, and to the provisions of the Codes and By-Laws relating to p PLUMBING INSPECTOR Buildings in the Town of North Andover. �,,� Zoning or Building Regulations Voids this Permit. Ohm VIOLATION Of the g 9 9 F' a � f Z��� 360&4 �' 1v�ONS PERMIT EXPIRES IN 6 ELECTRICAL INSPECT4,?ft • �� UNLESS C®NSTRLJCTIQIs S O� � ou Service N: B DAer- Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not ' Remove Final 4 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT �J Until Inspected and Approved by -the Building Inspector. Burner d' le— Street No. a ! 2 SEE REVERSE SIDE Smoke Det. - 3 �� AORT4oxo .. f *Argo C,4USti�S� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Building Permit # 0 ADDRESS/LOCATION OF PROPERTY :-56 udaw lyZ Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED ROUTING C0NSERVAT110N PLANNING DPW -WATER METER l Y164 SEWERM/ATER CONNECTION a NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW • Signature File: OC form revised 2006 C w � s CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 054(7/31/2006) Date: January 5. 2007 THIS CERTIFIES THAT THE BUILDING LOCATED ON 56 Swev Drive MAY BE OCCUPIED AS Addition of Family Suite IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Joseph Keleher 56 Surrey Drive North Andover MA 01845 -00�e Building f8picior r 1p 'A ^--._ I a - r IN No. o dover, Mass., O h-- L 1. A- COCHICHE-ICK '7 ARRA 7E D PPa` �� � BOARD OF HEALTH Food/Kitc, n iIT T PERM 11.1AL 7� �Z Se�t�5�tem THIS CERTIFIES THAT ...... ................IC t0e .�,/��......... o rife, has permission to erect........................................ buildings on ...... ...... ............... to be occupied as-x013 4...........040-..• �:w. V.. !'ii.tha ... ......�A/ .�1.*.t1........ ..Chimney n this permit shall in eve resped conform to orms of.the application on file in in � ,,• -G� provided that the person accepting p every p 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 INSPEC'T'OR VIOLATION of the Zoning or Building Regulations Voids this Permit. � � /( sopk F& 3o6&4 00W PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR OG • UNLESS CONSTRUCTION"' _ _. S ou �� ............... ......... .......... Service B D 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 cJ Until Inspected and Approved by the Building Inspector. Burner o� le— Street No. 4.joCa SEE REVERSE SIDE smoke Det. 1 2', -v P L � °s,�wu► CERTIFICATE OF t1St h OCCUPANCY TOWN. OF NORTH ANDOVER 0 7 Building Permif Number 05447/31/2006) Date: 7anu@u 5,2 p THIS CERTIF--IES WHAT THE BUILDING L.00ATED;ON 56 Susie Drlye m Y MAY BE:OCCUAP ; Second Unit Two Family F�ym y Conversion IN k . ACCORDINCE `ETRE PROVISIOISOF THE MASSACHIISE'TTfS-STATE BUILDING CODE AND SUCH Up2HER'REGULATIONS AS MAY APPLY.: lea,,a Issued toi ese�n xe�ener 56�Surrey Drive Andover 01 45.- Building spector s ; i _ .� � ,+� a'�!��Ss A c L '�"' .. w.1 v '"T 4 ,�� ,< r"�•..e r1r.. � '-' ..�¢ ._._�� {. do n�-_-o ' '� dover, N fass., �J cocmCHEW cn y1' AoRAT E D 'S BOARD OF HEALTH Food/Kite en %�� 1��•, �� r . stem • V �r � �. 7 THIS CERTIFIES THAT .......1c...................... .... .�/�. ........... o N } �ran.n has permission to erect........................................ buildings on... ..�............... u: to be occupied as.a-034...........�� C.. I' a... <. .� .. ... .. .��..*. . ...... G`kimney provided that the person accepting this permit shall in every respect conform to theterms of theapplication on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration aConstruction of in Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �g✓�/� � y PERMIT EXPIRES IN 6 MONTHS C// 01— ®C ELECTRICAL INSPE i UNLESS CC�NSTRUCTI � Is . - ou � .� ...................... ............. .... ...............B. ....D Service O !2 4 /lT 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 �oT- `J Street No. � - SEE REVERSE SIDE Smoke Det. ` Z -�� i y FROM :M.P. Roberts Insurance FAX NO. :19786833147 Nov. 06 2006 11:32AM P2 it • X03 - S�,S'�/'7p3� -•,tom-P.ea s� chusetts The Consrr"onwealth PIMA dent�c Depaolmentt ejlndr�triel _ 600 Washing(on • ,Ba4tos�Mass OZJX Wart 'ici, -Gewrat Bolsfw" LA _III . l i��yw�.i� ,. .��' '�- �. - .•..�-_.. J c 100601_ 8 - - ' � RtslagtaoUl�at/fig Embiist�ew f Oki am:role ptomdw and hs"no tae 1lifaalfteSa = Otfioe[�'�Ifas tincludia > l 13 y Autos CM) worldnt iu soy 'c Comfits at tie outer u I>m m►ftn g worlte ''comPa 'n t�or my ampby�oes , on this job Y Att1 as emplace P . e — - eWr and ItBsre hired the indepen&d coniraCWS listed Rfio have the Sal(oa S porloCB' I mole proFri . , . .• rte: . Alm IOIDD.Dp�f1laS•.__ aee 1 t� _ � _ . - Li Cr 4 , � 5 1 : 9eso• co. aDdaa 8artbn 1SAad MM 132 m had w do t ee4f , rri mo Partes of a am q0 a 31^06*nUar VMle:e����"'_"a'!� ittfbi lana M a 81'OT vNC)ItK oteDOl+ar1 a�aflyMflfl a tai■pfaicr a..� 1 tnddrataad tM a ���. 'ia rwfl a•elafl� as of f5e tnu pr earw.p�ame.wa cow.f tbb sbauret�a!'� r'a�e'i ra�a e)f11ta iii 10Maftptla tame► +i°IPr►1w7 rAat 0-IMj"=&low pra*&W tb~it ftw and eenrI 1 do AerebY Po p— Si at5ctal ate a* d.art Wfta us thb ar a a bm egwVwA by et ty er ft aMcW ' 0Ljz 6dfetD Bepartroe� city or tr+gs.._ .--- Qt tsanr�8aard ❑c6-ek if tam ab%M"m b required ❑Bm?tb tepartaaerk csAfMf �---- pboa"D"et �Otber gnmeA gyp.meq . FROM :M.P. Roberts Insurance FAX NO. :19786633147 Nov. 06 2006 11:32AM P1 M.P. Roberts Insurance Agency, Inc. 1060 Osgood Street, North Andover, MA 01845 Phone (978) 683-8073 * Fax (978) 683-31.47 To: Town of North Andover From: Cynthia L.Cyr, CSR Co: Building Dept Date: November 6,2006 Fax: 978-688-9542 Pages: 2 Ke: Knights of Columbus CC: *Attached please find form sent to our, insured from DIA—Commonwealth of MA. The Knights of Columbus has insurance for workers compensation through us with Associated Employers . Feel free to contact us if you have any questions. Thanks C is Cyr MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location �^ Date l U ��fZ-Owners Name Permit#�7! I Type of Occu ane Ke,Ie her- Amount — New Renovation` Replacement 1:1 Plans Submitted Yes No❑ FIXTURES E~ > w � x r A JIA�� RASEUM ISr KOOR Z 3M>� 4MHjOCR 51H FLOOR 6[H Fl" 71H FLOOR 91H RDCR (Print or type) ( � I Check one: Installing Company Name (1 Gk,(/1 ( �iy c;Lr Certificate Add 2 ,�y� ❑ Corp. , 'G "M/— y!`� tc/ �ti Partner. Business a ep one /I Firm/Co. Name of Licensed Plumber: a/1 9 j cl�G'<- Insurance Coverage: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy Other type of indemnity E] Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application(foes not have any one of the above three insurance 'Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)in above applicati in are nd accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issu ort s applic ion will he in •_ompliance with all pertinent provisions of the Massachus° er.imbing de and t^ 1 12 r he G- cral f-w� . By: Signa ui ci ens( >>er Title �T�ypre�of Plu�mg icense Cit .Town y rcense Numver Master ® Iourne.man APPROVED it:,FFiCE USE ONLY " Date "<O°T:'ti, TOWN OF NORTH ANDOVER 0 ,11 ' PERMIT FOR PLUMBING 41 SSACMUS� a f This certifies that L �t.�' . . .1 t !c`'JA70 . . . . . . . . . . . . has permission to perform . . . . .I�.0 w, . . . . . . . . . . . . . plumbing in the buildings of . . .k 4 . . . . . . . . . . . . . . . . . . at . . . .S. . . .sh;Y. D/'� . . . . . . . . . . . . . .(North Andover, Mass. Fee. .7 y. 'Lic. No.. .� L �. t.� . ` _ LU WING INSPECTOR Check # G 7121 MASSACHUSETTS UNIMRM APPUCATON FOR PERMIT Tp DO GAS FITTING (Type or print) Date S-e—A NORTH ANDOVER,MASSACHUSETTS Building Locations SUy ry Permit# Amount$ Owner's Name h I Je � e New❑ Renovation Replacement ❑ Plans Submitted ❑ a a o a x F 1-4 c o w F 1= w a !�- a W W z ¢ x x a w a ° W a�H x C7 F z F z F w W O O w L.._ .0 z d W x F oa z O O vFi x U i0o 12 a N o SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) `` �Q ` f ( Check one: Certificate Installing Company Name__ � �. 1 �fl i��.l CVlG�t1�' l El Corp. Addres � ����� v t � Partner. r_71 O : caC Busmess Te p one 1:1 Firm/Co. Name of Licensed Plumber or Gas Fitter ce c� j�j � -A INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes13 No❑- If you have checkedVis,please indicate the type coverage by checking the appropriate box. Liability insurance policy E3, Other type of indemnity 13 Bond 13 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 13 Agent 13 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By. Signature of Licensed Plum s Fitter Title ® Plumber City/Town ❑ Gas Fitter tcen um er Master APPROVED(OFFICE USE ONLY) ®, Journeyman uX Date.. ?1A e. . ... .. NORTH Of °,MO o= TOWN OF NORTH ANDOVER N 9 LL • PERMIT FOR GAS INSTAA N �9SSACNUSEA . This certifies that . . . . f% . . . ,e. . . . . . . . . . . . . has permission for gas installation . . . Rk." �..'. . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . ..S! r! `: . . .; . . . . . . . . , North Andover, Mass. Fee. .1//. . . . . Lic. No.. GL a"t . . . . ... . <-^— --_ . . . . . . . . GAS INSPECTOR Check# } 5734 MASSACHUSEITS UNIFORMAPPLICATONFORPIIIMUTO DO GAS FITTING (Type or print) Date A NORTH ANDOVER,MASSACHUSETTS Building Locations .� S`f /7 2 Permit# 3 Z Amount$ A-L Owner's Name Ke `�4 eeL New❑ Renovation ❑ Replacement Plans Submitted ❑ N ° w a ° ° z F w Q x w a c4 F z N z a W a W H x a z w x H Cn M z o z a o d ' o w 3 °a > SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR . 6TH .- FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) � Check one: Certificate Installing Company ( Name r �� �G` ' Corp. Address -Sy �Jy �JK-�` v ` v�`�! ❑ Partner. Business Telephone g1 7 g tog-(, Z aFirm/Co. Name of Licensed Plumber or Gas Fitter 0 & INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13---- No O If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy [ Other type of indemnity 13 Bond 13 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 F-1 Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issuey for this aplication will be in compliance with all pertinent provisions of the Massachusett e Gas Code and)hapter 142 f the G ral Laws. S' nature of Licens Plumber Or Gas By: fitter. Title Plumber City/Town ® Gas Fitter License Mmoer 13—M- aster APPROVED(OFFICE USE ONLY) [3 Journeyman Date ,,!3.�1. .... .. .. s NORTH TO N �O, F,:NORTH ANDOVER u O P t . PERMIT FOR GAS INSTALLATION h '�s,SSAC MUSE�� This certifies that . . .-. .< . . . . . . . . . . . . . . . . . . has permission for gas installation . . .JR . . . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . �at . . .)4 . .f� tR.R^.Y. . . . . . . . . . . . . . . .. North Andover, Mass. Fee. Lic. No..� - c. . . . IL GW . , ! INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 3 0 (Print or Type) _Moak AW-DO\)(t . Mass. DateJ(tL-/ , /)/��'� Permit # 7J Building Location (o S(,{ Y D t2 , Owner's Name_J0S6/'H KFl- -� NIObE7 HA I.I DOV 9Q4 HA Type of Occupancy_ New ❑ Renovation ❑ Replacement Plans Submitted: Yes❑ No❑ N Y W N N N V X cc N N N ¢ O N = FX- W J N a O V m = o CC 0 , X Q r N oQ arwa OIc m N W 2 WW VZN a h. i cc I W Vf W a Wh F- HH� a .aXZ O W OW Q Q W > a W O 2. Q rtQ a a '.= O C7 X U. n 3 c d .Qa v ¢ Y a a F o SUB—SSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET �O Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone -68.7—'1105 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9, No ❑ If you have checked ves. please indicate the type coverage by checking the appropriate box. A liability insurance policy D( Other type of indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Owners Agent Owner[] Agent ❑ hereby certify that all of the details and information I have submitted(or entered)in abo plication are true and acmate to the best of my knowledge and that all plumbing work and installations performed under the permit Iss f r this application will n m liance with all pertinent provisions of the p pe Pr a Massachusetts State Gas Code and Chapter 142 of the Gene s. Tg of license: Plumber Signature of Licensed Plumber or Gas Title Gasfitter Master License Number 3-145 City/Town Journeyman APPROVED O IC SE ONLY i. BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO -DO GASFITTiNG NAME TYPE OF 13UILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIG NO. PERMIT GRANTED DATE GAS INSPECTOR .,� r Date. ...... . r NOFTM Of ,�•o TOWN OF NORTH ANDOVER • . PERMIT FOR GAS INSTALLATION no•O',�h �,SSACHUSES This certifies that . .,1 9,Y T t d9 . .. :. . . . . . . . . . . . . . has permission for gas"iinstallation . . . . . /.. . . . . . . . . . . . . . . . . . . . . in the buildings of '. . . . . . . . . . . . . . . . . . . . . . . . . . at . . .�. . . .S .�.�"�`.� . . .!.. . . . . . . . . North Andover, Mass. Fee. A 7. . . Lic. No.. ���. . . . . . . . . . . GzNSPECTOR Check# r 5175 PERAtIT"-TO. D 7 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. �GE 1 MAP KJO. LOT NO. 2 RECORD OF OWNERSHIP JDATE (BOOK ;PAGE ZONE I SUB DIV. LOT NO. LOCATION i/ /_ PURPOSE OF BUILDING OWNER'S NAME ��Lp���/ NO. OF STORIES _i• SIZE OWNER'S ADDRESS ,� I�V,� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 2ND 3RD BUILDER'S NAME �'�aC1s L�I 1 ��IIe-S SPAN DISTANCE TO NEAREST BUILDING e 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 r MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND �`I -1 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE j� 4, IS BUILDING CONNECTED TO TOWN WATER I CI t BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH BIDES EST. BLDG. COST ���'©(.?� QC7 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER ORA THORIZED AGENT F E E PLANNING BOARD � � oC(:t� PERMIT GRANTED OWNER TEL. - cy CONTR.TEL. Is / CONTR. LIC. aC� i 7 BOARD OF SELECTMEN •� �� �� BUILDING INSPECTOR A BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY lillooll STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH _^ CONCRETE _ B 1 2 13 CONCRETE BL'K. PINE __ BRICK OR STONE HARDW D PIERS PIASTER _ DRY WALL _ UNFIN. 3 BASEMENT l AREA FULL FIN. E'M'T'-AREA Y. 1/1 '/. FIN. ATTIC AREA _ N_O 8 M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS . CLAPBOARDS B 1 22 f 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDNPJ'D _ ASBESTOS SIDING OMM0N VERT. SIDING ASPH TILE t'– — _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR POOR _ ADEQUATE ( ,-NONE 5 ROOF 10 PLUMBING GABLE HIP 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 l —HEATING - WOOD JOIST PIPELESS FURNACE ' FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2ndI ELECTRIC 3rd NO HEATING. NO HEATING Ile Location `No. Date NGRTN TOWN OF NORTH ANDOVER . ; Certificate of Occupancy $ . Building/Frame Permit Fee $ y�r Foundation Permit Fee $ Other Permit Fee $ n; Sewer Connection Fee $ 1g°�Vater Connection Fee $ F�� 2 TOTAL $ 2/• �-o Building Inspector A Div. Public Works 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 Subdivision Lot(s) Street �S ra �� �`- y St. Number ************************Official Use Only************************ V74OMMENDATIONS OF TOWN AGENTS: -Al z A 0 1 , i - P Date Approved C sexpation Ad nistrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Food Inspector-Health Date ApprovedDate Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Lo-r 3 3� ± P . 82 I P ( SET 1-LL4 ez I,� - - N. e. D. F7LAt I 9 8 x (o•Z' 5HED '� TP� ( FNp) L _ Pf�oPos�p E r4CL0 SEp Porzc.H . LoT Z3 12 I `a LoT z�A a FL— Z-1 5' 15.,6 PLAN OF LAND M LOCATION 5ce SL1rzi�E'� D�l� N O. ANiDC>\/ ER NIS PREPARED FOR rn SCALE 1u - Zo' DATE - 4 - 1(0- 95 0 S YANKEE ENGINEERS " GF MKss comic. PLLJ�yio too.a` I P. C Frio) 110 JACKSON ST. o F. roc ---- METHUEN, MA. 01844 90� 0. 0 lAN9 i1 rr Y./1l'A r r\P S S Fln-t- s s t-IL J ;�� /tea<�"' -;Cy LQ4RL"a ip ttO L �Qn�[Io �JJy'r ri 'T•74 �'OS 1 r rod CoPC re' 4rd L. Gdr,,�l Oe, colit-r-octor- ki8k-:%q- a k porch- - --_- -- -.' --- 111 to tile Bicbard L. Gilea , Ioo. 34O Audovor St . Date 0m. Andovwz/ Mm . UI845 Tel . 5O8 687-42OI Slheet No.� Prmpwaml Subm�uwd To: t�m,� �mBoPerfmnmod Au: .,LMr.s .. Joseph, Keleher Name Str'e'et_ S.�r.rey Drive 'Street same .State Date of Plans We hereby pi,opo$e to furnish the materials and perform the labor neceu!:;ary for tile completion of Consruction of a 120 14 1 screened in porch with all necessary footings and supports , framing, finish work, screening, pain,ting, el-ectrical,.iwork included; .4l,po..included is the supplying and installation of,za 61 pair pf, French doors from the living -,,­ _ ary frafaing, patching, and finish work and moving of the heat _as reqqired -.,The frame of the porch floorwill be prossure treated, wood, the deck of the porch willbe 5/4u x 6" . pressure ,.treated decking; Al-so . included will be two skylights, a ceiling fan, and asphalt There will be a set,j6f ierraced .wooden steps on .the corner of _�ho porch, there will be.- a sreened door at the top of 'the- steps . All material is guaranteed to be as specified, and the above work to be perforined in accordance with the drawings and specifications submitted for above work and completed in a SUI)StEllltiEll workmanlike manner for the sum of with payments to be made as follows: �/3 or $ 3, 533 . 34 upon signing, 1/3 or $3533 . 34 ' costs,will be exeouted only upon written otders,and will becorne an :7 upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado 4nd other necessary Insurance upon above work.Work- Per Richard LQilbsq , inc . man'O.Companution&M Public Uabifty Insurance an above work to be taken put by Note—Thia proposal may ho withdrawn by us if not accepted within days. — ---------------' I.The obove prii:es, E-pecifications and conditions are satisfactory nnd Fire YOU a[e .)L1U10rLi!d 1;o do the work as spPcified. � Payment,will bemade auoutlined above. Gigmxo/1H-Cute � TOPS | ^ qP NORTH Town of � �� over ►- .i .0 � x`ft No. 09Z * _ 1� . o� `=COCHIC , dower, Mass., AW,* 4_Vd? &* 19V Zi A0RATED P'P��H / BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR �. A THIS CERTIFIES THAT......TO...JX.00 .......�� � Foundation has permission to erect..^aat..A........ buildings on ...J.PA..... Rough to be occupied as.... .X.*.4K.jr4j.AV.Af ........ ,•Ace.4....*4 07.1.Y'V ........................... Chimn y ' e provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough Service B6 6iT 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 PLANNING FINAL c'�rCONSERVATION FINAL Street No. Smoke Det. CLIA/CD /IA/ATCD Fin1A1 �!rq �� DRIVFWAY FNTRY PERMIT__... __.— ZONE: RESIDENTIAL 4 APPROVED BY THE TOWN REQUIRED APPLICANTS LOT OF NORTH ANDOVER ZONING BOARD OF APPEALS LOT AREA 12,500 S.F. 14,714 S.F. DATE MAX. HEIGHT 35 FT 24.5 FT STREET FRONTAGE 100 FT 100 FT FRONT SETBACK 30 FT 40 FT SIDE SETBACK 15 FT 15 FT DATE OF APPLICATION REAR SETBACK DATE 30 FT 43.9 FT DATE OF HEARING REQUIRED PARKING DATE 4 4 DATE OF DECISION DATE FOR REGISTRY USE ONLY HAGEN & SANDRA LWOWSKI 124.82' } — ,� s 1 5 ' 1 4 43.9' s LOT 22 14,714± SF 1 PROPOSED ROOF PEAK TO GROUND = 24.5 FT 28.0' 15.6' 12' w a� PROPOSED ADDITION = — — — 15.0 15.6' M '? JOSEPH & LOCUS 29.5' NANCY FINN EXISTING cD DWELLING16.1' 24.0' N #56 19 0 o I I I I 34.2' ) i o CYNTHIA I I LORENTZ 40.0' I I I I J I 10 1 I I I I I I 100.00' SURREY DRIVE NOTES: 1 . REFERENCE: BOOK 1178 PAGE 82 N.E.R.D. PLAN #6380 2. ZONING DISTRICT. R4 PLOT PLAID OF LAND "I HEREBY CERTIFY THAT THE PROPERTY LINES #56 SURREY DRIVE SHOWN ON THIS PLAN ARE THE LINES DIVIDING NORTH ANDOVER, MA EXISTING OWNERSHIPS, AND THE LINES OF THE `�N OF MgsS STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC ���P q� SCALE: 1 in. = 20 ft. JOHN ti° DATE: FEBRUARY 9, 2006 OR PRIVATE STREETS OR WAYS ALREADY F . ESTABLISHED, AND THAT NO NEW LINES FOR B McpUIlK4NJR. N REV'D: MAY 10, 2006 , DIVISION OF EXISTING OWNERSHIP OR FOR NEW 9 No. 36120 ao PREPARED FOR: WAYS ARE SHOWN AND THIS PLAN CONFORMS TO THE °g Joseph and Mary Keleher RULES AND REGULATIONS OF THE REGISTRY OF DEEDSAL LaNOS° 56 Surrey Drive North Andover, MA 1 " V� ,�,.�X�• S• i a• o b PREPARED BY: J HN F. McQUILKIN JR. U DATE JM Associates 0 10 40 ap 325- Main Street North Reading, MA 01864 978-664-6668 ( IN FI$'1' 1 inch s 20 & JCB# 496-250