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HomeMy WebLinkAboutMiscellaneous - 57 COBBLESTONE CIRCLE 4/30/2018 57 COBBLESTONE CIRCLE 210/059.0-0081-0000.0 Date......7.1.!.. ./tv,............... pORTh F � TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION g$�cHuss This certifies that ......................... '.............�!............. . !i...................................... has permission for gas installation .... -�...................................... inthe buildings of................................................................................................................... at .$'....�� .... Nort1 Andover Mass. FeeJ.01 -�..... Lic. No.,P..4,Fr: !..C, ......... 1:... ...................... IiAS INSPECTOR Check# /44 . r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY j�\G'r _W ,. MA DATE ._. . .1� =PERMIT#— '144 JOBSITE ADDRESS; i5� l GES n� 1Y DOWNER'S NAME GOWNER ADDRESS ' TE _ �aS�- �6 _d1 FAX _ .. ._........_:i TPR OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIALL,i CLEARLY NEW:j._.,.:. RENOVATION:L_ REPLACEMENT: = PLANS SUBMITTED: YES[-', NO[ ' APPLIANCES Z FLOORS BSM 1 2 3 1 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER ;: t i.: ._.. .. j .�" ::::: E...::._ ..: CONVERSION BURNER -- _ . _ _. COOK STOVE (- -- v _ mm. I € t r DIRECT VENT HEATER DRYER ..._ ,. ' 1 FIREPLACE m: .,�..,�. :_� �, FRYOLATOR C.... I l' r g FURNACE GENERATOR 1r ._ GRILLE i _ -- - — T INFRARED HEATER _. LABORATORY COCKS ( "" _. MAKEUP AIR UNIT L . (_`_ ";_ _ OVEN _ � .1j i 177 __._ '.... ., POOL HEATER _ -- (�� ROOM!SPACE HEATER 1_ I ROOF TOP UNIT �-� --� - -- - -- TEST ; .. . ...... . t UNIT HEATER UNVENTED ROOM HEATER I.. �- WATER HEATERF777 — �- ............. ..... ........... ......__........ 7 f = OTHER II .... y _. _ .. 3� f 3 J Alf f INSURANCE.COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW I LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY Lj BOND Lj OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on thisermit application waives p pp this requirement, CHECK ONE ONLY: NER L-] AGENT [ ,' SIGNATURE OF OWNER OR AGENT -Thereby certify that all of the details and information I have submitted or entered regarding this application are true an ac ra to he est of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complian a th a PQki ent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER GASFITTER NAME Gregory W Stark,Jr LICENSE#I 11027 GNATURE MP E MGF[ JP JGF LPGI( CORPORATION[ # 486C _ PARTNERSHIP j# LLC # COMPANY NAME Stark&Cronk Plumbing&Heating ADDRESS Lj08 Main Street ll µ CITY Groveland _ STATE; MA -ZIP 01834 ,TEL;978-372-6981 FAX�978 374 0837 CELLEMAILgreg@starkcronk.com 1 _ ,.. 9 0 6 ; " 0. . . Date.�. .�. -. °' '4, TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,SSACNUS� This certifies that .. . . . . . . has permission to perform . .�3Ai -7 vim .. . . . l.tiv��s�� `. . . . . . plumbing in the buildings of . . . .1 5 . . C�^�.4�-- . . . . . . . . . . . at . . . North Andover, Mass. Fee Lic. No.. . PLUMBING INSPECTOR Check # 6 SS MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO DO PLUMBING6-0 I � �1 � ` __ CITYITOWN: I CJUG yAPPLICATION DATE a2.- ./ -. ' o` JOB ADDRESS t�_G�1t°�5 �, C � w= PLANS SUBMITTED: YES❑ NO❑ OCCUPANCYTYPE: COMMERCIAL❑ RESIDENTIAL � /� C-r'�s�- P NE W❑ ALTERATION❑ REPLACEMENT® REMOVAUDEMOLITION �/ I' PLUMBING: PIPING—FIXTURES-FIXED APPLIANCES—APPURTENANCES Z ENTER TOTAL AMOUNT FOR EACH SELECTION LIMITED TO FIVE 5 NUMERALS ALTERNATIVE TECHNOLOGY DISPOSER SINK: MOPLj SERVICE Li ASPIRATOR DRINKING FOUNTAIN STERILIZER DRAIN: AREAD FLOOR F1 =1 EJECTOR ❑ STORAGE TANK BACKWATER VALVE I EMBALMING F1 AUTOPSY URINAL BAPTISM:FONT171 SACRARIUM FOOD CHEST MISTING SYSTEM VACUUM DRAINAGE SYSTEM BAR SINK GLASS WASHER WATER CLOSET BATHTUBU WHIRLPOOL ICE MAKER WATER HEATER:ALL TYPES BIDET INTERCEPTOR:ALL INTERIOR WATER PIPING: CROSS CONNECTION DEVICE KITCHEN SINK l OTHER NOT LISTED Z DEDICATED: ACID WASTE SYSTEM LAUNDRY CONNECTION DEDICATED: GASIOIUSAND SYSTEM LAVATORY DEDICATED: GREASE SYSTEM PIPE RELINING WORK ONLY DEDICATED:RECLAIMED WATER ROOF DRAIN DENTAL FIXTURE/EQUIPMENTSINK: 1.2.3 BAY PREP. DISHWASHER SINK:CLINIC FLUSH RIM [ PLUMBING INSTALLER—FIRM-COMPANY INFORMATION CHECK ONE ONLY " ✓ Cor oration Business#l2486C ► NAME.°irk&Cron Plumbing, Inc 308 Main Street ❑ p ........ ADDRESS: CITY: `Groveland MA� 01834 _.. ❑Partnership Business# _.... ESTATE �. ZIP: '978-372 X6981 374-0837 W""" ❑LLC Business#� � TEL: !� _ - FAX ' EMAIL. greg@starkcronk.com �.— , .. .. DBA 1 Unincorporated NAME OF LICENSED PLUMBER: INSURANCE COVERAGE I have a current liability insurance policy or,its substantial equivalent,which meets the requirements of MGL.Ch.142 YESNO If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy❑✓ Other type of indemnity❑ Bond 11 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Signature Of OwnerCHECK ONE ONLY OWNER AGENT or Owner's Agent OWNER'S NAME:' TEL: n FAX . ,. -w.., ..,,�_... I hereby certify that all of the details and information I have submitted(or entered)regarding this permit ation is true and accurate to the best of my knowledge.I certify that all plumbing work and installations performed under the permit ssued will be in compliance with all pertinent provisions of the Massachusetts Uniform State Plumbing Code,and Chapter 142"e r (OF ICE USE ONLY) TYPE OF LICENSE: Permit# ❑Plumber f Signature o sed Plumber Inspector /1) Q Master License Number:± . 11027 Fee: ❑Journeyman I r Date./.. ...3....- �..... HOR7p °�t"`°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING comw ! 9 This certifies that ........................................1 .���///................... ............................ has permission to perform ..... IC `' e -" A, wiring in the building of........,!......................................................................... ............................. ,North Andover. ass. Fee...,� ......... Lic.No 7 f:,A ....... .. . .. ... ............ o E CAL INSPECTOR Check # a 10563 i w Commonwea&of amacLaffi Official Use Only cc�� cc77 Permit No. ---- 1JeParfinenf..o�,}ire�ervicee _ __ BOARD OF FIRE PREVENTION Occupancy and Fee Checked TION REGULATIONS r [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code EC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TY ALL JNFO TIO ) CJf ate: City or Town of: To the Inspec or of Wires: By this application the undersigned gives notic o is or her,i tention to per rm the lectrical work described below. Location(Street&Number) G Owner or Tenant Telephone No. 1 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. rd Existing Service Amps / Volts Overhead ❑ Und g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: fl e--c� O Completion o the folrowin table may be waived b the Inspector o 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- E] No.of Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and TotaInitiatin Devices No.of Ranges No.of Air Cond. Tons l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ........`...... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Other Connection No.of Dryers Heating Appliances Kms, Security Systems:* No.of Devices or E uivalent No.of Waters KW No.of No.ofHeaterData Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER < ` Attach additional detail i(delsired,or as fequiredby Ne-Inspector of Wires. Estimated Value of Electrical Work: (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 tliepains and penalties ofperjury,that the information on this application is true and complete- FIRM NAME: LIC.NO.: Oo 7� Licensee: Signatur , I .NO.: (If applicable, nt exempt"int licen�¢num ne.) Tel.No.- Address: Vyl.-I Cyt Y��( /'`I 0 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe "S"License: Lie..No. OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the liability in rance 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 kf, \ Telephone No. t L[;ZJ I 1 t PERMIT FEE. $ 0267 Date.... TOWN OF NORTH ANDOVER &imam-. PERMIT FOR WIRING Io �SS�lCMUSEt This certifies that ...... ........ ...... has permission to perform ............116� ................................................. wiring in the building of........(1140.-5.F ..................................................... at.... ...... North Andover,Mass. Fee-56. ............. Lic.No.J. .......... .. .... ELECTRICAL INSPECT71 Check # 7 Commonwealth,of Maisac4we Official Us Only c� Permit No. a LJeParEmercE o� ire servicee Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ?1'113- f City or Town of. A/o2TN �Q/I/pp,��-/i 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) S' ��,��Xn A/C (�M Ce.e= Owner or Tenant �A(/L/a C� Jam` Telephone No. 97d AY? M?I Owner's Address s/rM Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No..of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Awy /N (1/2/1/6 lf7jti A/e_4A.) ,Pq Tlt 'L X 1—,9AJ 1 AD D SLi/1 7C/-/ C1J_# /A/ 77A/O 4-16117J O✓r'7t 60-b &./Arxr /Inv Completion o the ollowin table may be waived b the InS'.ecior of Wires. F{ No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans TransNo.offormeTotal rs KVA i No.of Luminaire Outlets No.of Hot Tubs Generators KVA . No.of LuminairesSwimming Pool Above ❑ In- ❑ NFOI Emergency Lighting rnd. rnd. BatteryUnits I.No.of Receptacle Outlets' No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.-of-Defection and Initiating Devices No.of Ranges . No.of Air Cond. TotalTons No.of Alerting Devices No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals: .. .....J .......... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Other Connection No.of Dryers Heating Appliances KW Security.Systems: , No.of Devices or E'uivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts � No.of-Devices or Equivalent 1 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: ©O. (When required by municipal policy.) - - -- Work to Start: Inspections to be requested in accordance with NEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical wok 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 [3 BOND ❑ OTHER ❑ (Specify:) I'certify,under the pains andpenalties ofperjury,that the information on this applicati n is true and complete. FIRM NAME: �,r feVe 0.VAfdq CNE/LG clSE V/C C'I LIC.NO.:/7/ �9A Licensee: /17DSI,t4L-r Signature LIC.NO.: 73( (Ifapplicable,a ter"exem t"in the license number number line.) Bus.Tel.No4�a_2/9307/ Address: v. Dol D NG A Q/ Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires 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: $ 1 The Commonwealth of Massachusetts 1 • Department of Industrial Accidents ' Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Cont.-actors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): 0 , Address: City/State/Zip: RCA D(AJ G, M A. 0 f $6 07 Phone #: G E 7 71? 3011 Are you an employer?Check the appropriate box: Type of project(required): L[!9 1 am a employer with_ 4. ❑ 1 am a general contractor and i employees(full and/or part-time).* have hired the sub-contractors 6. F] New construction listed on the attached sheet. 7. ❑ remodeling 2.❑ i am a sole proprietor or partner- j ship and have no employees These sub-contractors have &. F-1 Demolition working for me in any capacity. employees and have workers' 9. E] Building addition a [No workers' comp. insurance comp. insurance.4. 5. corporation and its 10.M Electrical repairs or additions required.] ❑ We are a rP 1 officers have exercised their 4 3.❑ 1 am a homeowner doing all work i 1.❑ Plumbing repairs or additions g g p myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] r c. 152, §1(4),and we have no + l3.❑ Other employees. [No workers' i - 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 thatcheck 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 eny employees. ,below is the policy and job.site information. insurance Company Name: F_ L. s Policv#or Self-ins. Lic.#: WC 9G3 917 Expiration Date: 3 "Z0 -4z0 Job Site Address: Z?443L /UL Cf/LCLC City/State/Zip: i 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 I 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 certify under the pains andpeqaltzps o perjury that the information provided above is true and correct. I27Z"_ Si"mature: + Date: /.�_ /� — _ Phone,##: &17 71 .3 11 Official use only. Do not write in this area, to be completed by city or town ofciaL � I 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#: 1 NoFfL s63 S�G� G9 57.E shy Date —Z—f:2 i 40R,D TOWN OF NORTH ANDOVER $ 0 ; p Certificate of Occupancy $ Building/Frame Permit Fee $ ��s"^•°''��' Foundation P-rmit Fee $ s�cMusE - Other Permit Fee $ Sewer Connection Fee $ ----------``' Water Connection Fee $ �— TOTAL Building`Inspector C 'l ;•' ' 150.03 Pain - ( 5 Div. Public Works r Location to. ,�U3 Date, 1 NORTF� TOWN OF NORTH ANDOVER �._. 6 0 A Certificate of Occupancy $ • /0A l + : Building/Frame/Frame Permit Fe $ 2U Z ' t5v . , 9 p Foundation Permit Fee $ s�cMusE Jv Other Permit Fee $ 5 Sewer Connection Fee $ Water Connection Fee $ `' r TOTAL $ e Building Inspector ,JY '# Div. Public Works I Location rIo. _ Date sti i N°RTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ 41 Building/Frame Permit Fee $ Foundation Permit F e $ E s�CHuse i Other Permit Fee $ 2 •U r I Sewer Connection Fee $ Water Connection Fee $ TOTAL $ c' v cJ Building Inspector 3i3'4 15,03 20.C.^ FXD . 6362 Div. Public Works 7 �,ocation D• JSa 31 Date Id "ORT" TOWN OF NORTH ANDOVER 0. Certificate of Occupancy $ } r Building/Frame Permit Fee Foundation Permit Fee $ /,9,0 • U J Other Permit Fee $ i' Sewer Connection Fee $ -- —�l 9 Water Connection Fee $ TqJAL $ Building Inspector ` 6677 Div. Public Works Location + ,g No. Date 'v NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ * ; + Building/Frame Permit Fee $ S° °'tet`' Foundation Permit Fee $ , SAc 4 Other Permit Fee $ A1, :`%� Sewer Connection Fee $ /-173,2170 Water Connection Fee $ 9 TOTAL Building Inspector �� � R [T , -e• i ter- i — Div. Public Works I -.PER\IIT NO. 4,-.5'0.,r APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. k461' of Jt %3 3 PAGE 1 MAP 4,40. LOT NO. 2 RECORD OF OWNERSHIP !DATE BOOK !PAGE ZONE �?3 SUB DIV. LOT NO. I I LOCATION,- QPURPOSE OF BUILDING i/7 1 OWNER'S XAfAE r NO. OF STORIES SIZE OWNER'S ADDRESS Tur BASEMENT R SLAB ARCHITECT'S NAME �L! /!�Ov SIZE OF FLOOR TIMBERS IST �J�/� 2ND l^/Z 4r D 3R BUILDER'S NAME fm l ��„ _d,an7 SPAN / .S ,eNr_ If ij/� / - /6 DISTANCE TO NEAREST BUILDING !JA/`ul�Tj DIMENSIONS OF SILLS ---iG C1 DISTANCE FROM STREET 'f ll! POSTS DISTANCE FROM LOT LINES-SIDES J �C/ REAR �_n 1 GIRDERS J J AREA OF LOT y ccJJ FRONTAGEWV HEIGHT OF FOUNDATION {�r /, /�s THICKNESS �r IS BUILDING NEW L C - SIZE OF FOOTING U V p X Je// IS BUILDING ADDITION IGf1 MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING O SOLID R FILLED LAND 416 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LI S INSTRUCTIONS 3 PROPERTY INFORMATION rS b LAND COST SEE BOTH SIDES momm EST. BLDG. COST ,O O Jy fiT. BLDG. COST PER Q. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 OU E PERMIT Wig--1 D �/ T. BLDG. COST PER ROOM y SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY e ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FI I IBOARD OF HEALTH GNATURE OF OWNER OR AUTHORIZED AGENT FEE D `�v' OWNER TEL. - PLANNING BOARD PERMIT GRAN D CONTR.TEL.# 19 � CONTR.LIC.# 3 I• " BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM 1 MULTI. FAMILY oFFlces __ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES. GA- RAGES, ETC. RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION IS INTERIOR FINISH _ CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 1/1 '/t % 'FIN. ATTIC AREA _ NO B M-T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS g 1 y g DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING H4()%U:D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ 7 STUCCO ON FRAME nit - � BRICK ON MASONRY ATTIC STRS. 3 FLOOR I_ I BRICK ON FRAME -•�»�i'mf �7 CONC. OR CINDER BLK. {T STONE ON MASONRY WIRING r STONE ON FRAME •I�i _ i �� SUPERIOR POOR _ ADEQUATE I-I NONE I , 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ a ASPHALT SHINGLES >< LAVATORY s WOOD SHINGES KITCHEN SINK Yt SLATE NO PLUMBING _ TAR & GRAVEL I STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST 4k, PIPELESS FURNACE 11 FORCED HOT AIR FURN. J TIMBER BMS. 3 COLS. STEAM , STEEL BMS. d COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS a 7 NO. OF ROOMS GAS' _ OIL B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING i { i YrJ 9 1 /(i 4Y L" ' i`U✓.l,'nAT/O.c,� ��OG a''%•C.� ..I is/1• y, i ' F I i Lo-- 7 I J q COY 1993 �S f/EREBY C'E.CTIlr' TO YNE T/Te-&-IAIS6/.M-f ANO RL or R`41V TU 7,,N 8.4A,,r TygT 7;4, O- rE(Llmo IS fOG'.4TE0 ON 7WW-/T DGKS Co dFG:Piy/ /N !Y/TN >,ciE ��"'''� OF.t/O•A.v.:OvS,C 20N/N6 ,�EG�/LAT,bt<$' ' / // r /�'�6rI.P0/.t/(i JETBAGit'S F•POrI!.STPEETS� LDT L/•✓ES. 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OiP�i l'✓IV fDiP �yeiv,v O/V UN/Ty P.litlLG "�M 25 098 OGfI3 408Rc-5 T711E ✓.ori "`,�`'''`�yJ /NE.P,P/,fl,9Gf E".t/G/.c/EE.P/.1/6 SE•E"Y/G'ES.47'10,t/ 774,e6, ' Aeawf EX/ST/.f/C PECo,PpS. 6( �,Q.P,(� ST.PEET i A.t/OOrE.C, /f1�4SS.4lf/!/SETTS O/8/O FORM U -' IAT RFI TrASE FORK { INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction - have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: CA S .^- iPhone X87- LOCATION: Assessor's Map Number Parcel Subdivision roulta e=s CiMlyss 4 �. Lot(s) 7 Street .nitcl1'�- St. Number ************************Official Use Only************************ RECOMMENDAATTIONS OF TOWN AGENTS: 'l Date Approved ' Conservation Administrator Date Rejected Comments It Af 121 -V10 Date Approved Z-,21-93 00 .qgen anne Date Rejected Comments Date Approved /Z Health Agent Date Rejected Comments Public Works - sewer/water connections 2a-93 - driveway permit �� Fire Department - Received by Building Inspector Date a f. � . - NORTH Town of R < Andover 0 L No.S 9 3 0 ' ^� r dower, Mass. 19 :.� O - L A � _ 1 1 COC HIC HE WICK �t ORA7ED p'?a "`� BOARD OF HEALTH Food/Kitchen r QrA Septic System PERMIT T IL G INSPECTOR BU DIN SP THIS CERTIFIES THAT.�,.,�, .. , 'T�.l!V 94.1r,1�.r.., .M.41C..����.��.�4.4..............• Foundation r has permission to erect. 11i1 buildings on X 7essiMainAve .mimsta or? Rough to be occupied as,t►`t.111, . ' 'M.��.�I.,Qi ► i1 .. .�>�.�� �.............. Chimney the person accepting this permit shall in eve respect conform To the terms of the application on file in provided that p p g p every P Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PERMIT FOR FOUNDA PLUMBING INSPECTOR { REGULATED BY PARA. 114.8-5. �.,,. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MM4 __ � FEE PAID elf-d d UNLESS CONSTRUCTION STARTS °I d ELECTRICAL INSPECTOR Rough PERMIT FOR FRAME/BUILT" Service BUILDING INSPECTOR Final DATE: ,a ��1 FEE �ccupancy 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT CERTIFICATE OF USE & OCCUPANCY =^J y Town of North Andover Building Permit Number J 0 Date THIS CERTIFIES THAT -7 THE BUILDING LOCATED ON MAY BE OCCUPIED AS , IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. T Z/1 CERTIFICATE ISSUED TO 33 ADDRESS 2 7 CHUS Building Inspector - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - ,� NORTH Town of - 4 < Andover L No. 503 r I' yyvrt dover, Mass., 4114 at V 19 :3 T LA C'Q COC MICMEWICK AD�''ATED S H BOARD OF HEALTH { 1 PERMIT T Food/Kitchen �A Septic System j TOR THIS CERTIFIES THAT.e,.0' 0.44 'T .It.1.lr009.1AV.4.01A.A.,�)P. . R4. ...... B" ISIC%, 3y Foundation i has permission to erect.,) .LSI ... . .. .. buildings on x74400steam, !e..omay.or? Rough /d —� I � to be occupied asftAVA.49AW......Aj►.Y. ��i►.��.Q� .�.��.�x.����.............. Chimne yt-4 W :P d3 provided that the person accepting this permit shall in ever respect conform To the terms of the application on file in P P P 9 P Y P PP Final �.� j this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of _ y Buildings in the Town of North Andover. PERMIT FOR FOUNbA. PLUMBINS', INSPECTOR REGULATED BY PARA. 114.8-�. �,.,,. VIOLATION of the Zoning or Building Regulations Voids this Permit. bu 1/ in PERMIT EXPIRES IN 6 MMT1111 PAID ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Q PERMIT FOR FRAME/BU ' Its , ... .. .... ...................... ...... Service 0 .. ............................. .... BUILDING INSPECTOR Final DATE: ,a -�� FEEP GP_� 15ccupancy Permit Required to Occupy Building GAS INSPECTO r - - - - - - - - - - - - - - - Display- in-a Conspicuous Place on the Premises — Do Not Remove 1 I No Lathing or Dry Wall To Be Done FIRED PAR NT Until Inspected and Approved by the Building Inspector. / Burner PLANNING e)G ' z IAL CONSERVATIO ' �'v FL Street No. ►�1 / �jl G Smoke G 1 6 SEWER/WATER LTLJ 14-94-FINAL DRIVEWAY ENTRY PERM I IN — a94-'— ' r c)t t�tcaa OI�. Town of I i\1'I'lii\I.ti ;_'1,hlslill `:ii1•i•I •,t- NORTH ANUUV EIt BUILDING .:-•.•.�,�'' t.t:l};tiiu lura rl�:litttt to)N J:l tVA'1*1ON '"'°� I ll\•IN11 IN I IF Ili( ;I la I;; 1ii!; III:i\1:1'11 - I'i..\NNINc� PLANNING. & ('00AIAWNITY CHIMNEY AI'I'LICAHON ANO 11I311 f r. ATE /' S'G%• PEKN11'. #_ a �r e )CATION VNFR'S NAME: 1ILDER'S NAME:-* SON'S NAME: /�7LJe. LSON'S ADDRESS: '.SON'S TELEPHONE: f� �.� - o �, LI JERIAL OF CHIMNEY: !1'ERIOR CHIMNEY: ' � L'X1L'RIt)iZ CIf1hINLV: ilHER AND SIZE OF I"FLUES:_ c, II CKNESS OF HEARTIN ' /D :,U ckininey aa ().vicepCace can(joui to Mite uqu.utellt( i t.6 u( the cul/e and have :ttice.3 a►rlt :guYatiow bee11 tecebed: .TE: .GNATURE OF MASON: :RWT GRANTED: •- / -- FEE 'BERT NICETTA .ILDING INSPECTOR _ SPECTEO: • --MARKS: _ SOLID BLOCK REQUIRED THIS PERMIT" must GC VISPLAVLO 014 IIIE ITL1,11 SLS y ^ ! T I � s 9 I � r I I I I I I i � I