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HomeMy WebLinkAboutMiscellaneous - 58 SETTLERS RIDGE ROAD 4/30/2018 58 SETTLERS RIDGE ROAD / 210/061.0-0111-0000.0 Date.......i ... ................ CF r►ORTh,� TOWN OF NORTH ANDOVER N 9 " w"= PERMIT FOR GAS INSTALLATION '�s�cMus� This certifies that .�Vl-.... '4 rrro has pe mission for gas installation .v .. ................................................. snthe buildings o ....... f'...�......................................................................................... .'-ems......C... ..... North Andover,Mass. IPee...... U--..... Lic. No. ?Y�'1...... �. ..............................:......................... GAS INSPECTOR Check#�_ y � pt1 " f.N- MASSACHUSETTS UNIFORM A PLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY: �� j MA. DATE: l �i PERMIT#I JOBSITE ADDRESS: s$ Ie.�S' �e. OWNER'S NAME: 0 1 Let- GOWNER ADDRESS: TEL:(P«-3 WS N- WX. TYPE OR OCCUPANCY TYPE: COMMERCIAL EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW: RENOVATION:❑ REPLAG�EMENT:❑ PLANS SUBMITTED: YES❑ NO APPLIANCESZ FLOORS Bsmt 1 2 3; 4 5 6 7 8 9 10 11 12 13 14, BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCK MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER i ata - \ i INSURANCE COVERAGE 1 have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES q0 El If you have checked YES,please indicate the type of coverage)by checking the appropriate box below. LIABILITY INSURANCE POLICY { OTHER TYPE INDEMNITY ❑ BOND ❑ 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. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT G hereby certify that all of the details and information I have submittdd(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance all Pertinent provision of the Massachusetts State Plumbing Code and Chapter142 of the General Laws. PLUMBER/GASFITTER NAME: a f J ,Ltd LICENSE# 1 lJ55 51GNATLTRE COMPANY NAME: ADDRESS: T" CITY: t STATE A ZIP: 6L.C14 FAX: TEL:$ 836--Z/ 9 3 CELL X936' Z/ S 13 EMAIL: MASTER[JOURNEYMAN❑ LP INSTALLER❑ CORPORATION 1�# a—J PARTNERSHIP❑# LLC❑# 1 Department of Industrial Accidents PF Office of Investigations 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aunlicant Information Please Print Legibly Name(Business/Organization/Individual): I"1 A Cy-OJ 11E Address: City/State/Zip: j'\!,,J f J-e.4' o -� Phone#: �'���"" &-3C- Z 15 3 Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with .3 4• ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6• El New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet, 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. $ 9. E] Building addition required.] 5. ❑ We are a corporation and its 10.El 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 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no I � � 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. I 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. ll Insurance Company Name:_ �YcJ� Policy#or Self-ins.Lie.# RAJ 0 7 6 Expiration Date: 3/d Y If Job Site Address: S-Y sc-JtA'P- / e oa (L Qb�aA 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 cern under the airs and enalties o e is that thein ormation provided above is true and correct Signature:- - . . ,Date ZQ l-�5---- -- Phone R.3 6 ' 2/r7 3 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#: THdS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY:AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: it the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu Of such endorsement(s). PRODUCER CONTACT Bernadette M. Davis CPCU EA Stevens Company, Inc, PHONE ' 389 Main St. . (781)322-2324F, No):(781)397-7672 -MAIL ADD P• 0. 8070 188 bernadetted@eastevensins.com R S: Malden MA 02148 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Hartford Fire Insurance Com an 19682 MAGNIFICO BROTHERS PLUMBING INSURFRR-Safa+v Ins 9454 HEATING & GAS FITTING LLC INSURER C:Twin City Fire 9459 31 FOREST STREET INSURER D: MIDDLETON MA 01949 INSURER E: COVERAGESINSURER F CERTIFICATE NUMBERXaster 2014-15 THIS IS TO CERTIFY THAT THE POLICIEREVISION NUMBER: S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCEINSR J= POLICY NUMBERPOLICY EFF POLICY P GENERAL LUIBIUTY (MMIDRIYYYYI LIMITS B COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ACLAIMS•MADE $OCCUR DBSBAUQ5370 /24/2014 /24/2015 PREMISES Ea occurrence S 300,000 MED EXP(Any one penton) $ 10,000 PERSONAL 8 ADV INJURY $ 110001000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 x POLICY PRO PRODUCTS-COMP/OP AGG $ 2,000,000 LOC AUTOMOBILE LIABILITY $ COM IN SI GL MIT BJHIRED NY AUTO Ea dent S 1,000,000 LL OWNED SCHEDULED BODILY INJURY(Per person) $ UTOS B AUTOS N-OWNED 053635 /24/2014 /24/2015 BODILY INJURY(Per accident) $ AUTOS g AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAR $ OCCUR A EXCESS LIAR CLAIMS MADE EACH OCCURRENCE $ 1,000,000 DED X RETENTION$ 10,00 8SHAU 5370 AGGREGATE $ 1L,000,000 Q /24/2014 /24/2015 C WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY v WC STATU- OTH- ANY PROPRIETORIPARTNERIEXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? ❑ N/A E1-EACH ACCIDENT $ 500 000 (Mandatory in NH) SMCRJ9050 /24/2014 /24/2015 If yyees,describe under E.L.DISEASE-EA EMPLOYE S 500 000 DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hartford Fire Insurance Company ACCORDANCE WITH THE POLICY PROVISIONS. One Hartford Plaza Hartford, CT 06155 AUTHORIZED REPRESENTATIVE Thomas Cares, Jr/NII, � ..e. ACORD 25(201 W05) ©1988-2010 ACORD CORPORATION. All rights reserved. (NRI195 r2ntnnsi m Thn ef'_nQrl neme en'I Inn^ere renicfaMA Mori'.-f ar nnn r rye.. i C�OMMONWEALTHM -- CHUSETTSAS BOARD PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING LICENSE REGISTERED AS A PLUMBING CORP t,- i a. MARK MAGN I F I CO MAGNIFICO BROS PLB&HGT,GAS FITTI 'W 31 FOREST ST M I DDLETON MA 01949-201Nv ' - _326.6 05/01/16 204666 — �ir -- N „COMMONWEALTH OF M , �. MASSACHUSETTS BOARD OF PLUMBERS AND GASFITTERS ISSUES THE FOLLOWING LICENSE LICENSED AS A MASTER PLUMBER MARK B MAGNIFICO 31 FOREST STREET `'z KI DDLETON MA 01949-2015 13559 05/01/16 � ------ -_, 204667 CO_MMON F C7 MASSA � CH� s'�TTS ` S }# ..- _._ •V ` ! BOARD OF'- PLUMBERS AND GASFITTERS " ISSUES THE FOLLOWING LICENSE ' LICENSED AS A JOURNEYMAN PLUMBER E , MARK, B MAGN I F I CO ° rA� L j 31 FOREST ST zv MIDDLETON MA 01949-2015 25002 05/01/16 204668 , a wr ,y . sr LkY, ice} P` i M. u LQIIIIIUt1Imalth of I85 Em Permit No 1It>prm ntttt of Public fafttq Occupancy A Fee Cite k*4=— :t w 3190 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 b.' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ffl' All work to be performed in accordance with the Massacnusetts Electrical Code, 527 CMR 12:00 Y (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date q�jxr or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant WlG(Lp� Owner's Address CCS c / Is this permit in conjunction with a buil Ing permit: Yes E No ❑ (Check Appropriate Box) � Purpose of Building I S� Aot, e-�-ra-t_ �6 4!,— Utility Authorization No. 0M X n Existing Service Amps _J Volts Overhead Undgrnd C No. of Meters New Service 7CO Amps 1 Q / Volts Overhead Undgrno C No. of Meters ( ' Number of Feeders ano Ampacity Location and Nature of Proposed Electrical Work W �-� cJS {.• Total J7 No. of Lighting Outlets ZS I No. of Hot T,:cs I No. of Transformers KVA Y, 3 A_. �4a," Z I Above_— In— No. of Lighting Fixtures Swimming Pcoi grr.o. crno. _ I Generators KVA No. of Emergency Lighting, i+�tt.-• No. of Receotacie OutletsO I No. of Oil ourners I Battery Units �r. No. of Switch Outlets 4'b I No. or Gas 3urr.ers FIRE ALARMS No. of Zones Totai No. of Detection and No. of Ranges No. of Air C_,r.c. I :cns Initiating Devices s No. of Disoosais I No.of Heat To:ai Totai Purnos Tons K%J No. of Sounding Devices 3 °a No. of Self Contained No. ofwasne s i h r ScacerArea Heatira KVJ Detection/Souncing Devices N' D s � No. of Dryers I Heating Devices KW Local _ Municipal I Other Connection • ` No. of No. of Low Voltage No. of Water Heaters KW I Signs ?ai asts Wiring No. Hydro Massage Tubs No. of Motors Total HP '� '`• A' OTHER: >< INSURANCE CCVERAGE: Pursuant :o the reouirements of mass-mac-users general Laws M,9-0--_ I have a current Liability Insurance Policy including Comc et cerations Coverage or its substantial equivalent. YES t .i •�' ' have suomitted valid proof of same to the Office. YES _ NO _ If you have checked YES. please indicate the type of coverage Dy, Checking the appproo tate Dox. 3,y' INSURANCE jC BONO = OTHER = (Please Scec:��) (Exoiration Oatel Estimated valueofE!ectncal Work S Work to Start Insoecaon Date Racues;ec: Rough Gam— Final .r'x• Signeo under the Penalties of penury: FIRM NAME c _ UC. NO. :. t: Licensee � n� Sigr.a:ure /� Bus. Tel. No.-Ar-)-3 b Z- Address -tet•`�w�c'7 ,J S i flt 5�••� �'� 055 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the t_:censee toes not nave the insurance coverage or its suostantial egwvalant as fill, dtured by Massachusetts General Laws. ano that my signature on :his aermit aopiicauon waives this requirement. Owner Agent (Please chacx ones- Teieonone No. PERMIT FEE S (Signature of Owner or Agent) xaSSbS;� H89 NORTI{ "0 TOWN OF NORTH ANDOVER 3? O�.P • ..a OL p PERMIT FOR WIRING �,SSACNUS�� " This certifies that ../,.,3t1 has permission to perform,. Z� ...... — �i - wiring in the building of....,�-�-�.:. /// ........................ .North Andover,Mass. Few`, „"!�...'r Lic.No'4' .'✓.'4 ............................................................... ELECTRICAL INSPECTOR 09/29/91 13:16 273.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer PERMIT APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP K40. (o r LOT NO. ., 42 RECORD OF OWNERSHIP IDATE IBOOK :PAGE ZONE SUB DIV. LOT NO. IZ�Z 6677#-3 LOCATION / rt,/)�' Q r j�� PURPOSE OF BUILDING �� D J OWNER'S NAME ! 19'9��J �v J✓ 1\vrq - NO. OF STORIES S,IZ�1EE �7 �C OWNER'S ADDRESS BASEMENT OR SLAB C. ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST ?:�/x 2NDZe)Z? 3RD BUILDER'S NAME � � A�1djx J, .\�J i /'ee SPAN -mss—C L, _ �.�c DISTANCE TO NEAREST BUIL✓D`INCG, �Lofr/.Ll�i/� C.CJK DIMENSIONSOF SILLS; 1 '9 L / p"r, DISTANCE FROM STREET «7�/ POSTS DISTANCE FROM LOT LINES- SIDES REAR GIRDERS,/'Y) � L.✓1 �A AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING L' �J X ✓' C9 IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION A IrG' IS BUILDING ON SOLID OR FILLED LAND -'s WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER { BOARD OF APPEALS ACTION. IF ANY A � / IS BUILDING CONNECTED TO TOWN SEWER YUy> !v IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST l 046-� SEE BOTH SIDES EST. BLDG. COST � 6. oO Q FT COST PER SQ BLDG.. . . PAGE 1 FILL OUT SECTIONS 1 - 3 EST6S -- PAGE 2 FILL OUT SECTIONS 1 - 12 " EST. BLDG. COST PER ROOM TT 7 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 ANP APPROVED BY BUILDING INSPECTOR d' DATE FILED BUILDING INGPECTOR 8l&WA--TyJI,E OF OWNER ORAGENT FEE OWNER TEL./t �_ �� PERMIT GRANTED CONTR.TEL.# 19 CONTR.LIC.✓< H.I.C.# i0� b�9 /L ra. - tBU1LDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY srORIEs THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D __ PIERS PLASTER %/ _ DRY VJALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 3/ FIN. ATTIC AREA _ N_O B M T FIRE PLACES 1 HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDIWD _ ASBESTOS SIDING COMMON V, _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR ADEQUATE ONE 5 R OF 10 PLUMBING GABLE I HIP BATH (3 FIX.) Zi GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER j ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST 3Z PIPELESS FURNACE FORCED HOT AIR FURN. TIMBEROMS.—MCOLS. STEAM STEEL B COL HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING - .` '~ t RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS G0IL B'M'T 2nd ELECTRIC 1st �I 3rd I NO HEATING TAORTy Town of h _ _ Andover No. 0 s dover, Mass.; 19 �7 LAKE i '9 LOCH ICHEWICK 1` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System y� `} BUILDING INSPECTOR THIS CERTIFIES THAT...................................... .�. .�'-�-A&A........ ..........4-�?. .t��........ .. J. ....... Foundation P g .. ............ ..l..F...�».:. �.r..........� .C.L� has permission to erect...................... ................. buildings ..... Rough to be occupied as................................................... �.�. rr' ............i ..MJ... .. .. chimney . .. . . . . ........ ... .. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS � ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST Rough ...................................... . ...... ..... . . ........ ................................. Service /B LD G INSPECTOR Final Occupancy Permit Required to Ocudding GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No.. Smoke Det. FORM U - VERIFICATION 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: fes, Le;l �A .ylt4� ,J - Phone 697-Z,6 � 3S LOCATION: Assessor's Map Number Parcel J - Subdivision (-s 91& Lot(s) l 8 - Street l (-x RI St. Number rJ *********************** O icial Use RECO DATIO � OF GENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved 11/l c/ 7 own Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections 7/9, / - driveway permit Fire partment ( r4Y �e.C .�it, t0Az /97 eceived bUy ilding Inspector Date � ETTLPRS I�R4Pd�i � `� ►TE FLAN SLp,LE' D hTE La/z a/9 7 Tara Leigh Development Corp. 185 Hickory Hill Rd. N. .Andover, MA 01845 - - miff LVV,J( � `r- ' ]� 240 1 2 16 -t ' ' N��, _ - � 2 - r #164 P171 ----7 - J TWO 18 RCP` INV = 219.00 228 - X163F0 "CR a T 1F. yam, 7+qo OMt� 0 162 W - W d CERTIFIED PLOT PLAN LOCATED INNORTH ANDOVER, MASS. ' SCALE 1"=40' DA TE:7/29/97 Scott L. Giles R.P.L.S. 50 Deer Meadow Road North AndoVer, Mass. _ opo N , A o \ gym\ �p o \� 00 9 1 0101 1 �Jo 0, �� I 1 p #166 / 16g m U cP ' ZONE . 1�1 Off, I CERTIFY THAT - - • OFFSETS SHOWN AREFOR THE USE THE OFFSETS OF THE BUILDING INSPECT.OR ONLY SHOWN COMPLY o� �y AND SUCH USE IS FOR THE WITH THE ZONING H DETERMINATION OF ZONING' ; -13972BYLAWS OF CONFORkITY OR NON-CONFORMITY. A RE NORTH ANDOVER �kt�°TKO WHEN BUILT WHEN CONSTRUCTED. . R y` CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 3 6 6 Date October 29 , 190 7 THIS CERTIFIES THAT THE BUILDING LOCATED ON 58 Settlers R i d e e R D MAY BE OCCUPIED AS single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. �;,"• �T:'ya CERTIFICATE ISSUED TO T a r a L e i g h D e v Corp O p ADDRESS 185 H i c k o H ' 1 Andover MA CHUS B ilding Inspector k NORThI 0VM Of _ over No. . dover, Mass., 19 97 LAKE iY1A CCCN1CMEWICK �•�S Dqq E DpP`y E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......................................i--AkA....... .......... �.�......... ..n. Foundation / 01 has permission to erect...................... ... buildings on ..... YWto be occupied as...................................................,. ...; .� ' ............ r .. ...!..��/......................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms,of the application on file in Fin j 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. PLUMB INPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. •��> PERMIT EXPIRES IN 6 MONTHS fes_ 1 y - ELECTRICAL INSPECTOR j UNLESS CONSTRUCTION ST ,' � _.�,... - Rough 1Y7 ,,° , ..�.. ,�... .....�...... ...,. .......... BUILD&G INSPECTOR Occupancy Permit Required to Ocaq?y-Building G7� w' SP C.TOI u Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done • RE DEPAR ENT Until Inspected and Approved by the Building Inspector. Burner 7 Street NQ_ i Smoke Det: > ok( �Jql - ... A 4f ASSACHUSETTS UNIFORM APPLICATION:FOR.PERMIT<'i'0 :PLUMB11 G (Type or Print) NORTH ANDOVER ,Mass. � • . Date:" 'off S' ', k, Building Locations�:Se, - 3 ''t� .� �T Permit # 3LAV3 t Owners Name A •: L - New Renovation Replacement Q Plans Submitted � ' u FI TURES I z 0 °' of O Z z a i z o Z a a n O W h W Ol h V X Q alZ Z h V lQ tR q 0 a !. Q h to Z CC 0. t7 Q Or .x. Q W O 7 0' Q g Q W .�1 L] cc J z W Z �• O z X Y a 0� F- Q lC Q Alla k cc ' Q ' Platt - 34 ul Y N O N N O to f- Z O G v1 Z Z yl t' O V Z . d Q X Q Q O Q -1 J Q cc Cc to < O < F •r' 3 'c J m .0 c o J 3 7- t- N tZ a 0 a t 3 tr In o sus—esti Y ' j BASEMENT ) i 1ST FLOOR 2ND FLOOR e� ` 3RD FLOOR i 4TH FLOOR ' STH FLOOR tr 6TH FLOOR TTH FLOOR < F STH FLOOR i (Print or Type) Check one: Certificate Installing Company Name �PW-LIL e 00 Y-file Corp. Address Id- 61.-C,16066 1e.d Partner. /tJe�: Firm/Ca. Business Telephone Ltd 3 3 P-a 7 ,9a l Name of Licensed Plumber: Insurance Coverage: Indicate the type- of insurance coverage by checking the appropriate box: ` Liability insurance policy EKOther type of indemnity BondED Insurance Waiver: I, the undersigned, have been made aware that the licensee of . this application does not have any one of the above three insurance coverages. 4 Signature of owner/agent of property Owner El Agen.t`\ o I hereby certify tint all of die details and information i loavc subarittcd lot entered)in above application are ltue an011 late to We beat of my —• - knowledge and that all plumbing work and installations lrcefnrmcd under rcemit itsucd for this application will be in compliance with sll pottinept pto•.d risiona of the Massadsusetl:State Plumbing Code and Ciupler l42 of the(:cn al Laws. By Title . Signature of Licensed Plumber City/Town: C,:, Ty of Plumbing License APPROVED ZOFFICE USE ONLY) License Number ICS Master 0 journeyman f ti o Date.,r--. � NOR7M 3? <��•°;�.',�o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING F 9 t � I SSACMUS�� s 3 This certifies .� . . . . . . . . . . . . . . ' that has permission to perform . plumbing in t e buildings of .7 `r^-! .I �. . ,;�.►�t;�� . , , , � 1 at. . . � . . . . . . .. North Andover Mass. 1 Feer. . . .Lic. No. 4(."w. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE:Applicant CANARY: EMim DePhIQ PINK:Treasurer 09/29/97 13:11 Ct�lSS (print or Type) ArrLIVA I(t,TN FOR PERMIT TO DO QASFITTINQ NORTH ANDOVER , Maas. Date Building ST Location S e 71 r`e K s �� Permit # �.D 7— Owner'! f Name kf Lei �•e✓, New Renovation ❑ Replacemen} L7 Plan! Submitted:. Yea El No p >< R w w M e O M M tl J M w V a! ; M b M !- Int p o h w O — O s a 0 1 > 31 H J Z M Tfl x s wF F' w tl O U. .w i i = odd " �. o � 0tv . !ue-aIMT. • aAlEM�•fIT / � e 1!T FLOOR !NO FLOOR SHDFLOOR ,TH FLOOR STHFLOOR !TH FLOOR i 7TH FLOOR 1 !TH FLOOR Instaning Company Name Check one: Certificate e. 7��J Address . Q Corp. EJ Partnership Business Telephone�� 3 3��a2 ��� ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Ve INSURANCE COVERAGE: I have a current liability Insurance pollcy or Its substantias equivalent. Yeeckk o If You have checked yes, ple`aseIndlcate the type coverage by checking the appropriate box A liability insurance policy L3/• Other ' type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required b Chapter 142 of the Mass. General Laws, and that my signature on this q y permit application waives this requirement. % Check one: nature o Owner or U)"er•s Agent Owner ❑ Agent ❑ 1 hereby cerilfy that ail of the details and Information I have submitted(or entered)in above apDlicallon are true and accurate to the best o knowledge and that all plumbing work and Installallons rformed under the permit Is tat this appl ion will be M compliance with all Pertinent provisions of l e Massachusetts State 083=6 aril Chapter 142 of the lay T nse: al Larva. • Title umber a urs o nae Gasfitter um er or as of gty/T aster license Nurnber QJoumeyman APPDO lED(OFFICE USE ONLY) Date. � 1�..,. ./.... A NORTH TOWN OF NORTH ANDOVER A 0 � `p PERMIT FOR GAS INSTALLATIOW ,SSACMUgEt M This certifies that ra .....-.. . . . .. . . . `. . . . . . . • . • • • . • • • • I- has permission for gas,installation,. . /- /4�::' I• • • • • • • - in the buildings of . . . :: . . . . - .: - �'. . • . • • • . . .. . . . . . . . . . • • • • • at . . . . . . . <. : . .`^. n::y • . . . . . •, North Andover, Mass. Fee r/`. . .. . . Lic. No. . . . . . . . . . . . . . . . . . . . . . . . . . . . E ^G� GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer