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Home My WebLink AboutMiscellaneous - 60 SHERWOOD DRIVE 4/30/2018 60 SHERWOOD DRIVE 210/105.60061-0000.0 j J Date.. ... #`L.,1.............. CF NOHT�y,� ��,• ;. ao� TOWN OF NORTH ANDOVER n PERMIT FOR WIRING • 188��5�t This certifies that ..� ....................................................................... has permission to perform ..... .r.. .........�w g Le jj .....(................. ........ .' wiring in the.building of.........TJ... . .�C`'� ............. ........ .. at ............ ...... ..................... ...,North Andover,Mass. 1 ,2: t ELECTRICAL INSPECTOR +} c # 7 B� vii -/� � '/2ZI13 0<� l r) .Q- I�� , Commonwealth wealthl ®f Massachusetts Official Use Only Department of Fire Services Permit No. I 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=C) 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 1 City or Town of: NORTH ANDOVER To the Inspecto of Wires: By this application the undersigned gives notice of his or her inten ion to perform the electrical work described below. Location(Street&Num er) s -e4e k)mW 1)12! VA Owner or Tenant Telephone No. 975 ^lv h 2 7/ -7 Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building At �elp (1AAW, Utility Authorization No. - Existing Service_ZLv Amps 12p1 Z,,ibVolts 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 /e/l� /�y[.,pt&,,/U� Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell: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- F1o.o 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: . ' ........'"..."""..... Detection/Alertin2 Devices No.of Dishwashers Space/Area Heating KW. Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of DataWiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: w Attach additional detail if desired,or as required by theAspector of Wires. Estimated Value of Electrical ork: o (When required by municipal policy.) Work to Stai L.4 Oji Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURAN O RAG : Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insur ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) ` I certify, tinder thepains andpenald ofperjury,that the inforntatio on 47111S application is tr' re complete. FIRM NAME: _ LIC.NO.: Licensee: ��tg µ,vi /(,( A Signature LTC.NO.: ��7 a (IfapplicaAddress:ble,enter "exemp "in the licensrmberhhlZe.) L Bus.Tel.No.: Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Deparhnen fPublic Safety"S"License: Lic.No. � OWNER'S INSURANCE WAVER: 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. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,the x permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166, §32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall.be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: I ***Note:Reapply for new permit❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: i PARTIAL ROUGH INSPECTION: Pass Failed Re-Inspection Required($.)❑ Inspectors Comments Inspectors Signature: Date: ROUGH INSPECTION: Pass Failed 0 Re-Inspection Required($.) ❑ r Inspectors Co ents: Ilf 1 2 Inspectors Signature: Date: FINAL,INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD TOWN OF MERRIMAC, MA. .......dweinhold@townofinerrimac.com Y w The Commonwealth of Massachusetts Department ofIndustrialAccWnts Office of Investigations 600 Washington Street Boston,MA.02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationftdividual): Address: z o CZ IA - City/State/Zip: v w 01�� Phone#: -70 Are yo employer?Check the appropriate box: Type of project(required): 1.El I am a employer with 4. ❑ I am a general contractor and I � 6. New construction employees(full and/or part-time).* have hired the sub-contractors ❑ 2.El am a sole proprietor or partner- listed on the attached sheet. 7• E]Remodeling. ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. g, E]Building addition [No workers'comp.insurance 5. El 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.❑Roofrepairs insurance required.]t employees.[No workers' 1311 Other comp.insurance required.] 'Any applicant that checks box 41 must also fill out the section bel6w showing their workers'compensation policy information. 1 Homeowners who submit this affidavit indicating they tire 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 pollcy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: 1,4/ , 7 4 tv L Expiration Date: ,n _. Job Site Address: le c:;, S��CJc.w�r,�r� Nk—, oo City/State/Zip: /I �o �'�U Atiach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL 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 certi under thepainsan pens les ofperiury that the informationprovidedabove is true and correct. - Si ature: Date: Phone#: -7 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#: Information and InstructRons Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or.written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dowelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any - applicant who has not produced.acceptable evidence of compliance'with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please till out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LL C or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial ' Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only-'submit one affidavit indicating current Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or, town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the w applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: �'he Caxn�.on�eaXt�i o�Massarl?vsetts .. Dep.artraeut ofladustdal.A,cczdonts • �Df�ee o�In��estigatxo.�s 600 Washingtoli Street Bostont MA.0.2 111 TQL#61.7-727.4100 ext 406 or 1.-877:MASSAFF, Revised 5-26-05 Fax#617-727-7749 01 4c ommonwralO of Malwar4usetts Office Use Only Department of Public Safety A3 5 Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 -- Occupancy & Fee Checke� 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the.Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of Aj Ary0au F-- To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 44 -51e ,,woe aP Or - Owner or Tenant CC)/0^ Vi�r✓�s ze Aa U -'f�/J Owner's Address Is this permit in conjunction with a buildingN permit: Yes e- o F. (Check Appropriate Box) Purpose of Building /"Gnn-e S ! Weh r aL 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 �P G.t! r r t�(� f`� Gt ►'v'�1 TOTAL No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA A oveIn- No. of Lighting Fixtures Swimming Pool grnd. ❑ rnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle 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 Tota No. of Sounding Devices.' No. of Disposals No. of Pumps Tons KW No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices. Municipal No. of Dryers Heating Devices KW Local 01 Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YESI�NO❑ !.have submitted valid proof of same to this office. YES rr'NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE LJ BOND ❑ OTHER[:] (Please Specify) p,� (Expiration Date) Estimated Value of Electrical Work$ 900 . (�G Work to Start I 9 19b Inspection Date Requested: Rough Final Signed under the penalties of perjury: d FIRM NAM&E� I1__11 VA^ 614- + /Q-11Af '1 LIC. NO. 19��tf Licensee 1C t)h-pr'tiL /� Su�h J a""�` Signature ��^ LIC. NO.-2 y�� 7`0 Addres�� M1YX,AyYJ ST` L�3w2FruC�- Bus. Tel. No.978 IMP-i y/7 Alt. Tel. No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts .General Laws, and that my signature on this permit application waives this requirement, Owner Agent (Please check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) �,N2 �"�! g 5 Date�.`��........ A M NORTH °`,�``°:•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ��SS�cMusE� This certifies that " < � :....:................................................................................... m has permission to perform ....... ............................................................ wiring in the building of..�'. ��-� •r .. �� .� :v.........�.:�:.I o at.... �.:..... :..:...`..`.:.: r ... :............... .North Andover,Mass. Fee&1 - ...... Lic.No.!VJ'C: . ELEcrRICALINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Date.l�.. .. .. .. . . . .. .. . . HORT/j pf „ao �°9tip o= TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION -� SAc MUSE�r( This certifies that . . `. .. .. .. . .. . . . . . .f . . . . . . . . . . . . . . . . . . . has permission for gas installation . ./J . . . . . . . . . . 4.4 in the buildings of . 4 (J. . . . . . . . . . . . . . . . . . . . . . . . . at °. . ._. North Andover, Mass. Fee. ,2 .?.: . Lic. No. . . ..... . . v,OR Check# 4159 MASSACHUSETTS UNIFORM APPUCATON FOR PERNUr TO DO GAS FITTING (Type or print) Date ® O NORTH ANDOVER,MASSACHUSETTS Building Locations /� �/J�� e, Permit 1# Owner's Name /Az Z�� mount$ �- New❑ Renovation ❑ Replacement i/ Plans Submitted ❑ U o zZ Ow cn F O O O w E A. x U O x Gz x w F A v z 0 H z N z H w o w w w F o 3 A C�7 a O a A a I H IO SUB -BASEM ENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6 T H F L O O R 7TH . FLOOR 8T H . F L O O R (Print or type) ' Check ne: Certificate_Installing Company Name /�/yl�.�/L �/�f�/%1/�� 1i �' Corp. Address �4 �/� ��/T �� '�• Partner. Business Te ep one 3---�R ® Finn/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I.I%ve a current liability Insurance policy or it's substantial equivalent. Yes IEF No If you have checked yes,please i dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity Bond 13 i El 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 E 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 Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Co and Chapter 142 of the ene Laws. By. Signature of Licen d Plumber Or Gas Fitter Title Plumber City/Town Gas Fitter License Numocr Master APPROVED(OFFICE USE ONLY) ❑ Journeyman K, Location No Date 611415 V►ORTh TOWN OF NORTH ANDOVER o�,,..° ,•.hyo 3? �.._ _' .• OL A Certificate of Occupancy $ ~ • a Building/Frame Permit Fee $ roo <� Foundation Permit Fee $ sACMUSt .. Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ --ar 'I TOTAL $ �- o - Building inspector \ tit 19968 Div. Public Works I Location No. 1 , Date TOWN OF NORTH ANDOVER ;. p Certificate of Occupancy $ CL AOL o Building/Frame Permit Fee $ �O�+tie•� CH�SE<� , Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ 3. Water Connection Fee $ s TOTAL $ S {� trp j}mss r� Bui Utr g Inspector X21TO 1 V V Div. Public Works rr -til Location ��'� No. 0 , Date rt moo TOWN OF NORTH ANDOVER `° r}�tioo r 0 " Certificate of Occupancy . $ L +� ,' Building/Frame Permit Fee $ g Foundation Permit Fee $ s�cMuse Other Permit Fee $ Sewer Connection Fee $ 7�6 a Water Connection Fee $ D z— ,r TOTAL $ °' ' - - j3wwing lnZ br y ` 9 25 9 Div. PuglIc&orks i� 3 PER3HT NO. ?Owe?— APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. I LOT NO. 2," RECORD OF OWNERSHIP IDATE (BOOK 'PAGE ZONA\ SUB DIV. LOT NO. �;I m8��.. ►n �, f�C iqC�� 37GQ I 9(p LOCATION �1p _o S�EPsWOOD Rhe PURPOSE OF BUILDING CX4L] �C-0 1 OWNER'S NAME Tom a�Nn /'��a„�� — NO. OF STORIES SIZE f� OWNER'S ADDRESS l O �0 x BASEMENT OR SLABjmQ� ARCHITECT'S NAME �Ct SIZE OF FLOOR TIMBERS IST QX`o 2ND,/ Xu) 3RD BUILDER'S NAME -T•1 M n V`�.n `^ _ Y1, .1, [�f^Q SPAN DISTANCE TO NEAREST BUILDING / DIMENSIONS OF SILLS -✓ �/ --_ DISTANCE FROM STREET 2�UI POSTS DISTANCE FROM LOT LINES-SIDES 3a�7^� REAR Q\ "' GIRDERS V•� �J' AREA OF LOT 35%2.4 FRONTAGE 1q.Z HEIGHT OF FOUNDATION �9'� THICKNESS off IS BUILDING NEW v SIZE OF FOOTING o �� X l�7 [/ IS BUILDING ADDITION q 1 MATERIAL OF CHIMNEY N�nl1.CF�� G• IS BUILDING ALTERATION Iv IS BUILDING ON SOLID OR FILLED,L,A1�NTD`�lJ �r O 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 y IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST o SEE BOTH SIDES EST. BLDG. COST 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 LD ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGUL TIONS q? PLANS MUST BE FILED AND APPROVED BY G INSPE - DATE FILED BUILDING INSPECTOR SIGNATURE OF OWNER OR AU ORIZED ENT FEE ?i r11A)� �-OS- OWNER TELA �� sl PERMIT GRANTED CONTR.TEL.N SOS- 'DD !v 19 mil ► ,,,,� CONTR.LIC.11 2.00 c H.I.C.M �� II 106 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY X STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY tK, 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 WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 FIN. ATTIC AREA NO BMT 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 COMMON _ VERT. SIDING ASPH.TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR _ ADEQUATE I NONE 5 - ROOF 10 PLUMBING - GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATERCLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING '" TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING I MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11. HEATING r WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. d COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR '= # �►/`�gv� WOOD RAFTERS AIR CONDITIONING �•r �,.>,,. ,j RADIANT H' f UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T2nd _ ELECTRIC ist 13rd 11 NO HEATING t�ORT. -o df over z-7A* LAKE dower, Mass., 97 19 - w A COCNICMEWICR � - - BOARD OF HEALTH I T. Food/Kitchen .�PER ' T Septic System BUILDING INSPECTOR 4.0 THIS CERTIFIES THAT .�'laF. L�1 ....... 4�l.. Foundati ................................... L. ... .5....................... p .................. building"n......�.. .-� �• has permission to erect.................... L1......... .. .. �?d..Q.....:,�.LO. Rough tobe occupied as...............................:........... _6-#46-44C........................................................:.......................:.:.. Chimney provided that the person accepting this permit sll litevery 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, AReratio �and-Wnstracti Buildings in the Town of North Andover: PERMIT FOR FOUNDATION ONLY. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B. 6gh Final PERMIT EXPIRES .IN 6 MONTH FEE PA7_9i5l ELECTRICAL.INSPECTOR UNLESS CONSTRUCTION Rough ... .... Service' B DING INSPECTOR Final 000'L6pQ11C7► Permit RP.C�uircd t0 Occupy.�Z11�11�ig GAS INSPECTOR_ Rough Display in a onspicuous Place on the .Premises Do Not Remove o ing a^ o -fie one P Y 9 >. FIRE DEPARTMIIV'r. Until Ins acted and A roved b the .8 lldin Inspector. Burner .h S treet Nq. g A. .Smoke Det it's - _.:... .s m.,..,,s-. ..............�a._. 5....,< .. .r '�- .. a.a ^cs .> ,-... �.n -.s�.., - ;�-� '.z,`�' .. �1.. •+'$ ,,.i:.:u -r s:,.. - -- .�. -_aKa.,.ai":"s`.a.rr'C:.... -;✓i '�'- "�.y'x^��>-.... �a..-M.y.au� �... � sY..h� s.�- ':a,,.. %4`�. �'p�`.. .....;...-s 0VM Of , , over No. Z7 Zo. " - dover, Mass., 1991 LAXE w 9A CO_CNICMEWICK , " ssA�T�o pPP .(y BOARD OF HEALTH PER �MIT T Food/Kitchen D . Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...:................................` .�R.�....................... Foundation ...... ........ /yi has permission to erect.................... ................. buildin ion g Cp..�?. .� 0R...400--d-0......0 ,l . �e. . Rough tobe occupied as....:..........................:.... ...... /..A)6.44C........................................................... . ...... .... . Camey provided that the person accepting this permit shall lWevery respect conform to the terms of the application on flie 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. Trough Final PERMIT EXPIRES .IN 6 MONTH ELEC'T'RICAL.INSPECTOR UNLESS CONSTRUCTION Rough ................ ... ........ .... ....................................... Service B DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR_ Display in a -Conspicuous Place on the :Premises — Do fat Remove Rough hi _ o Lar ngr DryWall ' o Be Done ,Until Inspected and A�}pcoved by the Building Inspector. VIRD ` :Burner tee.No. _ z.«z.:- - ... ,..V";.,..,.c -. -;*' .a �. <.-- :,;c...,. ...x+�:t x. -• -1..... .,,. .i. o- !w..,: "' xM.. .r ` — �:.__.:�.,,�*"_•�"'#z.�. dr.h:�s�•-..: y.Y`�. M„ _,. -„_,.�r-..,..�.c.^-tad..,-. -.. �'II&�;�s..r., �, r.vi.:..: .c,. ;azq,.. .�-3.� `ae'” _-�...,.�....n.. ,._;S....,.... -+-=.-,z.. _re ,..,..e: .. ,,.,,....aTi.....s.s1'a��v,. ,r'.•Z+.r-.�"},�,*-2rs.- -�x.e...,.:z�s�_4 rias n-a.:�w.r.' .s�F'- � � �_y�.="`'�' 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: Ro �� S` -�� Phone 393-- LOCATION: 93-LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) i Street St. Number —(PO ************************Official Use Only************************ RE NDATIONS CX TOWN AGENTS: fi 43 L� Date Approved Cons rvation Administrator Date Rejected Comments r Date Approved . 4��All own lanner Date Rejected Comments Date Approved Food Ins tor-Health Date Rejected Date Approved X, s4eic f nspector-Hea h _.. Date Rejected Comments Public Works - sewer/water connections �u) 7 - driveway permit ?7 Fire Department Received by Building Inspector Date -D--- --- -- — - - -- mv V Ac- A- R ;", - �v Al � zs S .,) r10Rh07�*4 T `- cl 5 Town of �-� �_ : Andover No. � o- s LIKE A dower, Mass., 1 '9A_COCNICNEWI C K iy'.,• '9� Dq�E DT/►PA�y �� . S` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT....................................'- 'd.. z ..L.A, .......3.4..t-10..0 Z. ....................... BUILDING INSPECTOR Foundation has permission to erect....................I.................. buildings on ...... .. .........S.f4lar. ... �. .. ...... ..[ Rough tobe occupied as............................................. .....,f..,r ,•.. ........................................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION Rough ............. .. ..... ... . ... . .. ....... .... ............ .................... B DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR_ Display in a Conspicuous Place on the Premises - Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE Until Inspected and Approved by the Building Inspector. DEPARTMENT. Burner Street No. Smoke Det. i f---- � vj ) ��,�. 5 � �; �� a� �� _� �- r i CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number7 Date a 4198 THIS CERTIFIES THAT THE BUILDING LOCATED ON & " MAY BE OCCUPIED AS fi S ZN ACCORDANCE IJ ' WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. NORT1y p� CERTIFICATE ISSUED TO 3t .•�. '• Opp ADDRESS 00, ''SACHUSBuilding Infector FT40R /,OT Town ofAndover No. - Z _ s dover, Mass., 19 O LAKE yy 'S�-COCHICHEWICK 1• 'T'SP\V E S BOARD OF HEALTH PERMIT T D Food/Kitchen /&/-�z Septic Syste B DING INSSPE OR THIS CERTIFIES THAT.................................... ....... ....................... Foundation has permission to erect....................I.................. buildington ...... .........S./&/Om...�.0.60....... tz Chimney / to be occupied as...........................................S ,��w--- .................................................................................... 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. PLUMB G R VIOLATION of the Zoning or Building Regulations Voids this Permit. RoiigF%�/v i 1 PERMIT EXPIRES IN 6 MONTH 7--LE CAL INS)f' UNLESS CONSTRUCTION - zV- -- v Rom:_ r� ; ................ ... ... .. ........ ..................................... l . B DING INSPECTOR Occupancy Permit Required to Occupy Building GAS INWJ1 Display in a Conspicuous Place on the Premises — Do Not Remove P Y P F60 C'/ ` �Q No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. ��;veu,�>� FIRE PARTMENT Burner �f treet No. '' c moke Det. % MASSACHUSETTS UNIFORM .APPLICATION'.FOR.PERMIT TO.DO°PLUM61(Z ,� (Type or Print) : . :..: NORTH ANDOVER ,Mass. ' Date: Building Location Permit I) 3 SUg ►„?: Owners Name -ft tOel(!4ND 122,'/ 0-.e V New Renovation Replacement Plans S bmitted P � FI TURES . z v� to � el O Z > W N Z N 6 ac Q h Z O _ = N a O W t` W Ql 1— (� W Y d p V' a ~ a ac n os ¢ >~ •d lW- vvi z a a t7 a _ d x �,•.. Q W O a' W Q Cl d d W 'lrl Q a J Z p •Q J Yr F. o o J ac I— d �C tr. a r,. •. < Y 1' T. Y 8 O < W tG X W Y 1' O x a 7 N F Z O G a1 2 Z W t' O V S < d = v7 N d d O d J J d a W. .< O < N Q SUB�BSMT. • BASEMENT 1ST FLOOR 2N0 FLOOR 3RD FLOOR • 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR t (Print or Type) Check one: Certificate Installing Company Name (eft/�Pm {'�df/ T �d� � Corp. Address P97-rfl J Partner. �r .lle�(� /�✓�- ' �-1 Firm/Co. Business Telephone 1f)5-f C4, Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy F-1 Other type of indemnityEl Bond Q Insurance Waiver: 1, the undersigned, have been made aware that the licensee of . this application does not have any one of the above three insuronce coverages. i . Signature of owner/agent of property Owner Agent 10 y, 1 hereby certify that all of We details and information 1 leave subsniltcd(or entered)in atsrrve application sic true and,4utate to Use bell of say —• - knowledge and that all plumbing work and installations performed under rcrsuit icsucd for this application will be in compliance with all petligept pto*.4 itdsions of the Massachusetts State Plumbing Code and chapter 142 of the General Laws , ii gy . i Title . Signature of Licensed Plumber City/Town: `� lG�P -of Plumbing License License Number Journeyman .APPROVED ZOFFICE USE ONLY) ❑ Master Journe an Building Locationt<0 Permit -- mer'a Na4 l J Name NeW Renovation p Replacement ❑ Piano Submitted: Yea Q No h t " u c N ! O ay -' a W ro. z ON ►. _ = O H 4 M ~ O ' O Z W w M C y M U Id = M 7t 1+ Q ® C Y I 4 69 sr J F H ® r< M Y C y. < ►►-- ss O ryf O O id a D �. p U 0 Y C� oUR—�aUAT. • •AeEMENT t ioT FLOoIt t , !Na FLOOR I , l aRO FLOOR 4TH FLOOR •Tk FLOOR aTH FLOOR TT14 FLOOR t oTk FLOOR Intalling Company Name 114, E1 Check one: Certbicale Address (?-o,o, b P Corp. ? Cl Partnership !� BUsiness Telephoned 7�-y D Flrm/Co, Name of Licensed Plumber or Ges Fitter INSURANCE COVERAGE: I have a eurTent liability Insurance policy or its substantial equivalent. Yescp ne NoD 11 you have checked,Yee, please Indicate the type coverage by checking the appropriate lm A liability Insurance policy ® Other typo of Indemnity O Bond D OWNER'S INSURANCE WAIVER: I am aware that te licensee does no ht have the Insurance coverage required by Chapter 142 of the Mass. General Laws.,and that my &Ipnalute on this permit application waNes this requirement. Check one: to of owner a Owner's Agont Owner ® Agent 1(laseby gltlPlr Iha@ all of the details and Information I have submitted (or entered)In above application are (rue and accurate lie itnowtadpe and Thal ani pplumbinp work and Installations performed under the permH Iswed for fhb aion are fru a d c Use best of mr P«linant provlslwm of Iha Massachusetts Stale Gas Oodo and Chapter 142 0l the Gerwal Laws. �ar�nth a� Ttof license: Title Plumber to( Ona urs o nee um er or as Mar 7a,n (IIyRpwn Master License Number •ioumewnen NTFKYvEO(orFICE USE oNL1f) r 7!7 C� 56 Date ........ NORTH " TOWN OF NORTH ANDOVER 3?ph`��ao ,e,tipL O �^ PERMIT FOR GAS INSTALLATION N A • s A �9SSACMUSES d - O This certifies that . . .4i. .r 1.!`.". . .,r: . . . . .�. . . . . . . . . . . . . . . . . . has permission for gas installation . . .!��'. !/��:. r . . . . . . . . u, in the buildings of . . . . . . . . . . . . . . . . . . . A. . at . . .G . .s/,-P Y, `: & • . . . . . • . ., North Andover, Nibs. Fee. ,-. . Lic. No../G . Y . . . . . . . . . . . . . . . . . . . . . . . . . . . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer �• ' ""� nivo run rhHMIT TO DO GASFITTING nt or Type) ? � . NORTH ANDOVER , Maas, Date Building `` ,�.,/ Locallon� 89c. Q o n Permit #_t i2-6 6 Cr •• Owner's Name c/D evgIS- New ❑ Renovation ❑ Replacement ❑ Pians Submitted:. Yes L] No p N a u z sc 'A h K N ! O at N t+ K d J N W M y III H 31 Z M JK 0 It ~ K O Q O O Y h N 11 N K N tl V r X ►� N p K < f Z M j I= rte. w tl Q � rjIL 0 J n K r et sue—a8li s�sEII�iHT : IST FLOOR , 2ND.FLOOR 1 SAD FLOOR 4TH FLOOR STH FLOOR 4TH FLOOR i 7-TH FLOOR l , aTH FLOOR ; �• .:H± Check one: Certificate Installing Company Name (�( ��/� ��- Address . �7 Corp. rCA d Partnership 11 Flrm/Co. Business Telephone_ ill �Jc�c Name of Licensed Plumber or Das Filter ��AY17 e INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent. ' Yesc❑one If you have checked yes, please INo 0 ndlcate the type coverage by checking the appropriate box A Ilat,Nlty insurance policy OOther type of hxtemrlity ❑ Bond O 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 UiMher'3 Agent Owner ❑ Agent ❑ (hereby certlfy that an of the detalls and Informatlon I have submItted(or entered)In above application are true and accurate to the best of my n kowledge and that all plumbing work and Installations performed under the permit Issued for Is application will be In compliance with all pertinent provisions of the Massachusetts Stele Gas Code and Chapter 142 of the Omer Tof Ill �--� Raster umber Title na ure o nse um of or as of aslilter �fTOWn Journeymen �n3e Number Qa Ilr'f FMED(OFFICE USE ONLY) v � 0 U '-t Date. `?,�S.,?.. . ..... ,40RTN TOWN OF NORTH ANDOVER 8 OF PERMIT FOR CAS INSTALLATION H � p s + ,SSACHUSES O This certifies that . . . .� -. .�.�?. �.�- . . . t��f. .. . . . . . . . . . . . . . . a has permission for gas installation . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . .. North Andover, Mass. Fee. .?. 12.. .-. . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . i' GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer WIAW �.nu�c a ulrlrunta Nrr�l�.al luny u t'tt. . . . Ii..D (Type or Print) ANORTH ANDOVER ,Mass. l y - ate: E 7 . ►wilding Location 6 o S Penidt # 3s v ' Owners NamA. v . New Renovation l] ' Replacement [r Plans SMbmitted II li FIXTURFS N aJ O Z z Id > a W Y J t. �• V < N a d Q AC . x a ac d _0 In cc t-. < W sn X � a �` a►' 3 K a: W wac 2 < W a x o a .o .�. w 4C - o < . In W o x. .-a 0 � 66 oe le d W fi • < > 1- o h 93CL to F' z o p ao w o v Z aL J m t! D Q J < S < J J < a: W W. O t g- o. f fAO O < 3; Ac Sub—esmT. BASEMENT 1ST FLOOR k 2ND FLOOR 9RDFLOOR ATH FLOOR 6TN FLOOR ' Gs 6TH FLOOR f. 7TH FLOOR STH FLOOR (Print or Type) ,� Check one: Cr�t'ficlte Installing Company Name e� dal. 6' p C, M—Corp. C? Address �� qO (7,U/ Partner. a.�L/ r° #LL (01 Firm/Co.-- Business Telephone 7�('- 3 7y -x` 7"'3 Name of Licensed Plumber: ) tv 6z C Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: t: Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been made aware- that the licensee of l . this application does not have any one of the above three insurance coverages. . Signature of owner/agent of property Owner Agent. I beaby eectifr that all 9(d*ic dclails and inforaalion 1 ha.c submiticd(or calcmd)in aM,.c aMicalion dot lose zaft l0 Yw bap 41 of Ihmwkdge and d at all plumbing wrk and installations im(nrmcd undcr rcimil Issucd for This a tical rp tool will M M all PplbKllt ,.tr silk=of lbs Maaaacbusolla Stale riumbiag Code and Clup/er 141 of Ute(kocial Laws. 4 i y j Title . Signature of *Licensed Plumber City/Town: � '� Tv of Plumbing License IA oog?nvFn 7OFFirF USE ONLYi License N�etltber IT-Master 1:1Journey r�,. . . Date Y- e<sT m 15. 0 / "O 6T:. Cf 14, TOWN OF NORTH ANDOVER r 3g e!'tiC -,s pL A PERMIT FOR PLUMBING - SSACMUS� _ This certifies thaY� .` fi� rh �(.' . `. ��. . . . . . . . . . . . . . l has°permission to'perform . . . A/ - , 4. . . . . . . . . . . . . . . plumbing in'the buildings of . . f`}/3.. T7.. . . . . . . . . . North Andover, Mass. Fee Lic: Noh;U� Y.I. . . . . . . . . . . . . . . . . . . . . . . . _ o PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 3911 / Date.......S..a.. .��. TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� (...{�.li /� 5 This certifies that .......f..l...... .��<�. .............1. ................................ has permission to perform ... ��:�!.... !l!.F"T S ....................L.r�.1..::..`../........... wiring in the building of.......... C................................................... at.......r. ......1. 1•! 1�.t�X�r.... � . �*'. .*...!' ,North Andover,Mass Fee..../t� Lic.No..,l No.. /./� �...... yyj ELECTRICAL INSPECTOR Check # 0 I� �i c /00?� 1 Date. �yo ?? N2 3510 NORTH TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUSE� S This certifies that . .Vv, . .��c.�:�.�� . . . . . . . . . . . . . . . . . . . . . . . . c,c has permission to perform . . Ilse .l-rf.o . ..... . . . . . . . . . . . . ... . . >ti S F a !^. c� plumbing in the buildings of :!��: i. . . . . . . . . . . . . . . . . . _z at. Uu?. . . . . . . . . . . . . . . . North Andover, Mass. Fee.390a.� Lic. No.. . . . . . . . . . . . . . . . . . ... . . . . . . . . . PLUMBING INSPECTOR 10/10/97 10:53 390.(}0 RRTD -" WHITE:Applicant CANARY: Building Dept. PINK:.Treasurer Official Use Only THE COMMONWEAL TH OF MASSACHUSETTS Permit No.--- Department o.—Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy&Fee Checked_____ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date O ;lL— To the Inspector fres: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number— ® —�J�1% -- p I Ve Owner or Tenant_—_— Owner's Address-- l a-r I.,)o r) (L4 Ue Is this permit in conjunction with a building permit Yes No (Check Appropriate Box) Purpose of Building— �� ''h�_ -- -- t Utility Authorization No. �l Existing Service Amps_— —Voits Overhead Undgrnd No.of Meters -__ New Service — --_Amps_-__—_--_Voits Overhead Undgrnd No.of Meters Number of Feeders and Ampacity—_--_ Location and Nature of Proposed Electrical Work_ I U 1D foot n e, ) v Total No.of Lighting Outlets 5 No.of Hot fuse No.of Transformers KVA Above In No.of Lighting Fixtures 5 SwimmingPool rnd rnd • Generators KVA G No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone ----------- Total No.of Detection and No.of Ranges No of Air Cord Tons Initiating Devices -----—___ Heat Total Total No.of Di osal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices • Municipal • Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = (Please Specify)------ (Expiration r ExPiration Date Estimated Value of Electrical Work$_____ _� A ----------- Work to Start Inspection Date Resquested__—_—_—_—-------__Rough-__—_—_—------Final------------------ Signed under the Penalties of perjury: FIRM NAME _ LIC.NO._—_------____ ------------ ------------------ Licensee--- /d,6J Signature NO NO.-------------------— Bus.Tel No. Address---__— _ _ Alt Tel.No._--__ —_—_ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts Gen ral aws.And that my signature on t is permit application waives this requirement. Owner Agent (Please Check one) -- — ---6 -- t/- 978 G$2 ?71-7Telephone No. _PERMIT FEE $_ '1 _W��/a— Signature of Owner or Agent) /D JIoj\w00� Location C� L� No. �' g Date Oz a -2— 'a. 'a Th TOWN OF NORTH ANDOVER 3 .t o O • s i Certificate of Occupancy $ 6-0 Building/Frame Permit Fee $ CNusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 15785 -7 Building Inspector TOWN,OF NORTH ANDOVER BUILDING DEPAl�T1dIENT. . . APPLICATION TO CONSTRUUREP RENOVA OR:DEMOLISH A ONE OR TWO FAMILY:DWELLING r,.. BUILDING PERMIT NUMBER: DATE ISSUED:CS . SIGNATURE: ic Building Commissioner/I or of B.uildin Date_._ SECTION 1-SITE INFORMATION Z 1.1 Property Address: t.2 Assessors Map and Parcel Number � )Cin /A"A)gC(_ , VIA c�191,S Mare _ ... P..I.Nnmber 1.3. Zoninginformation: 1.4 Pr Dimensions opt Zonin Distrix Proposed Use Lot Area - Fronta ft 1.6 BUILDING SETBACKS ft Front Yard .. Side.Yard Rear Yard.. R red Provide Required Provided R ed Provided .5. Flood Zone Infomtalloa _ - . 1.7 Water Supply IoLG.LC.40._ 54) � .1. ......-. ._ .. ...].8 sewerage Disposal .77--77= Public 0 Private ❑ Zone _..:Outside D Flood-Zone 0 Municipal ..0. _ On Site Disposal Syseem..0. SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2. Owner of Record :.. ,1 4AQG(,� Tf-1.c l td2 C¢Cshe r^c.Jc Nam (P.rint) Address forS�ervice �+ 7 '. 30 r Z/tiiZ ign lure Telephone 2.2 Owner of Record: Name Print Address for Service. -Signature Telephone m SECTION 3-CONSTRUCTION SERVICES go 3.1 Licensed Construction Supervisor. Not Applicable 0 Lice_,sed Construction Supervisor o y -License Number Au rens: Expiration Date Signature Telephone. r i 3.2 Registered Home Improvement Contractor 1r, Not Applicable O - Company Name _ s Registration iNumber Address. r Exptration Date Signature Telephone � . � ��- ..a �� ..,. .� _ SECTION 4-WORKERS COMPENSATION.(KG.L 0152 § 25c(6) Workers Compensation Insurance affidavit mustsbe coinpleted'and submmed with this application. Failure to provide this affidavit will result j in the denial of the issuance of the buildingpermit." Signed affidavit Attached Yes.......❑ No...r..:❑ . `' '_ i SECTION 5 Description Proposed Wo-rk check all a.. i tie New Construction ❑ E 'stingButldimg ons(s)` .fih [Addition .'Q....-. Repair(s) ❑ Alwiati Accessory Bldg. 0_ Demolition 0, Othei 11Specify Brief Description of Proposed Work: _�n is h. .b a�m��' G�4'1 � g�sh>- o�� n�"n i s�'►e-c�, @tit SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Com leted bv�bermit a licant _ 1. Building DOD (a) Building Permit Fee. Multiplier 2 Electrical (b) Estimated Total Cost of. Construction 3 Plumbing Building Permit fee(.yix(e) 4 Mechanical AC - 5 Fire Protection _.. 6 Total1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT.OR CONTRACTOR APPLIES FOR BUILDING PERMIT I> as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I> as Owner/Authorized Agent of subject 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/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS OT 2ND 3Ew 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 i i U ,� s �� FORM U - LOT RELEASE FORM eIAA eA) 4— 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT_ ARRaI� 15 _______ PHONE ----- LOCATION: Assessor's Map Number____,/ PARCEL_ SUBDIVISIONLOT(S) STREET_tQQ_ (v-x7tU _______—_ ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN—PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEGfr/� DATE APPROVED-------------- -- DATE REJECTED_________ PTIC INSPECTOR-HEALTH DATE APPROVED DATE REdEC-�-ED��} COMMENTS---��S�e�,"--^�Q c�_S_—� C°��``�'l PUBLIC WORKS- SEWERMATER CONNECTIONS DRIVEWAX PE IT_ _ 117 — -- ---- ----- ---------- FIRE DEPARTMENT_—__ 4—a RECEIVED BY BUILDING INSPECTOR_-_------—--------------------------DATE Revised 9\97 jm Town of North Andover Building Department artment 27 Charles Street 'SACH North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print . DATE `�/0'Q/0 Z JOB LOCATION L D '5he rW Oen Number �/, .� Street Address Section of Town "HOMEOWNER ac) ria O ,f u Z -7&U Number // Home Phone Work Phone PRESENT MAILING ADDRESS (00 SjnarL kxL)o U e, /_)a&r,A k �kb�zg_r- . M A 01 �q5 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 undersigned"homeowner"assumes responsibility 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 proc es: r irements and that he/she will comply with said procedures and requiremen �� 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. North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signat re of Permit Applicant &/2--? /02- Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 2T-3 5/8" m 37-2 7/8" 4' Fridge _II q N Utilities 4 �I O i. ---- ------ --- - -- -- I0 0 � — ��, 22'-3 15/16" i Storage �� I,J Water 2 � Electrical _ _ 1s'-s v1s° S 1T-9 1/2" V J 21'-3 5/8" 32'-2 7/8" 4' I' I {I � II i � i I I I Utilities I � f Y. 22'-3 15/16" I I n � o r 19'-5 1/16" 11'-s 1/2" '✓ HEARST SKETCH ADDENDUM Borrower HAROLD 8 KIMBERLY HEARST - - --- ........... ... Property Address 60 SHERWOOD DRIVE City NORTH ANDOVER County ESSEX State MA Zip Code 01845 Lender/Client SOVEREIGN BANK FIVE WHITTIER STREET SECOND FLOOR FRAMINGHAM MA. 01701 17 tAvA my -16 ^P f3 (;LSA vr' 3z 7, 3 _ �OP 10Y. � 23 3 AT. e �E 3k `1 c s AAA 4L �a NZ7 j HEARST. SKETCH ADDENDUM Borrower HAROLD B KIMBERLY HEARST Property Address 60 SHERWOOD DRIVE City NORTH ANDOVER County ESSEX State MA Zip Code 01845 Lender/Client SOVEREIGN BANK FIVE WHITTIER STREET SECOND FLOOR FRAMINGHAM MA. 01701 12/14/00 THU 11:51 FA-1 9754755222 [1002 7 n9 '�•sem. TOA 0/ Fou tdgtion D • Septic Tank F (ISOO GaB'ons) a c r , L o t 3 ^° � Lot 5 LOOM Trench system: 2 Trenches .¢6' Long , t( A f' Wide. 2' peep P•�5.-4 E s , I I I ' Lot 4 35,824 S.t 1 0.82 Acres I UP* (16 JU 4 S.F I I i f ' 3 � Cf 14S,670 >,> I ku 7S 67'. t t L=70.00' o � fir vofe — 50' Wide F NORTH own ® ^ ; .. Over TO No. � B _ - _ _ LA O dover, Mass., g - �- aaoa COCMICMEWICK �d ADRATED p`PY� S S H BOARD OF HEALTH Food/Kitchen PERMIT T D . Septic System N Old �� ' BUILDING INSPECTOR THISCERTIFIES THAT...... ................................... ... ............... ................... .................................. Foundation has permission to erect.... ................. .... ...... .. buildings on ....... . ........................................... Rough ct M11111111 P" Chimney to be occupied as.... Oct 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-Lawsr lating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. i ops 6 07 " roo ® PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough V/®/. . ................................................................................:...6040�� 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. a SEE REVERSE SIDE Smoke Det.