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HomeMy WebLinkAboutMiscellaneous - 600 SHARPNERS POND ROAD 4/30/2018 600 SHARPNERS POND ROAD 210/090.6-0036-0000.0 _... ••••••.♦ •+ -sssr'%anaw Mr'r L.JVfiiAua f%jn f CJ1M1/ ry uv rL-Ld4 6"4&%- ~ � Y NORTH 'ANDOVER, . Mass. Date .10� BuildingPermit #t 3 �f Location 6o& 5 ha-cen P(_s 0 4 NNamee e ." !y C l y New p Renovation p Replacement Plans Submitted: Yes l7 No.❑ FIXTURES w s tc � « r s~e J M a V s s s=r 0 5 • w sw = o a a o a _t 30 i ! 2 W.� 16 X iri o i 1 °s i sue—eatwT. sAetM6HT 1 . IST FL00R I 1NOFLOOR SAO FLOOR ITN FLOOR ITH FLOOR STH FLOOR. 1THFLOOR aTH FLOOR IL Check one: Certificate Installing Company a e l T�� b 17 Corp. Address 'A r• Q•., © � p Partnership © -7 ❑Firm/Co. Business Telephone 5009, C -V07-7 .Name of Ucensed Plumber ; INSURANCE COVERAGE: Uneca 1 have a current liability Insurance policy or Its substantial equhwanL Yes No p If you have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy G' I Other typed indemnity p Bond 0 OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 d the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: SIgnOwner p Agent ❑ a urs o et a Ormet s en 1 Mreby certify that ail of the detafis and Infamatlon I have submit ad for entered)in above application are true and socrrrat*to the best of my knowasdpe and that all plumbing work and InstaNattons performed under the rmA lowed for this application will be In compilance with all pertinent provisions of alai Massachusetts Slate Plumbing Code and Chapter 142 of Vw Geral LX". By r This License u s Ctty/Town LicenseNumber " Type of Plumbing license: Master ,�' APPI'MD(OFFICE USE ONLY) Journsy'Sn 0 Date. .'� 3311 � A HORTM TOWN OF NORTH ANDOVER S Ot ,.yo .•1'1.0 Or ••tom • OT N PERMIT FOR PLUMBING 1SSACMU�th O This certifies that . . .Fa U. <.4 . . . . . . . . . . . . . . . . . . . . g has permission to perform . . . . . . . . . . . . . . . . . . . . . ti plumbing in the buildings of . /1i .4 . .!? at . . .�U S�^��1.'`L !?r. . . 1� h . . . ., North Andover, Mass. Fee. 7 .". .Lic. No..9.. .� C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F PLUMBING INSPECTOR 'f IG i WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 600 Location No. 12,4 Date „oR*M TOWN OF NORTH ANDOVER p Certificate of Occupancy $ # ` Building/Frame Permit Fee $ Foundation Permit Fee $ s�CHUSE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ _ BuildingD spector 10 79 3 04/03/97 15:56 69.0t1 I Div. Public Works PERM--T NO.& APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K40. y(� LOT NO. ) 026 2 RECORD OF OWNERSHIP iD TE BOOK ;PAGE ZONE I SUB DIV. LOT NO. I LOCATION la PURPOSE OF BUILDING OWNER'S NAME {"7 NO. OF STORIES SIZE OWNER'S ADDRESS 6j�A _BASEMENT OR SLAB - ARCHITECT'S NAME(J 7P SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME zoc SPAN -- DISTANCE TO NEAREST BUIL'tflNG DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SCI FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 42LANS MUST BE FILEglDA D APPROVED BY BUILDING INSPECTOR DATE ILED = �7 1?- 1- A� MUILDINO INSPECTOR SIG A RE tpF OWNER O THORIZED AGENT �j J Al A FEE �— OWNERTEL.✓< ( )�F� � / PERMIT GRANTED 7/o--4 < 7 CONTR.TEL.# l 19 T CONTR.LIC.# C'S 0e1Tgy-?' H.I.C.k ` �V r BUILDING RECORD I OCCUPANCY 12 SINGLE FAMILYSTORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ B t 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 1/1 3/4 FIN. ATTIC AREA _ NO B-M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D _ ASBESTOS SIDING COMAACN _ VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE 11 HIP BATH (3 FIX.) ` GAMBRELMANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I /1 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GOAS IL BstA T 13 d I NOHEATING - PER'lfff NO. Z� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP KJO. G)� LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING E/ 1t t OWNER'S NAME j. NO. OF STORIES SIZE r i _ OWNER'S ADDRESS�Q �utT �� / BASEMENT OR SLAB ARCHITECT'S NAME r SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME t V� J��• SPAN -- DISTANCE TO NEAREST BUIL ING / DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT'OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION ^ IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ����� PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER 6 FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS .PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ILED ILDINa INSPRCTOR SIG A R F OWNER 6904WITHORIZED AGENT F E E �"" OWNER TEL.# PERMIT GRANTED CONTR.TEL.# �� � 19 CONTR.LIC.# t✓S 045'9112 H.I.C.# A04'?7?- BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE BUK. PINE BRICK OR STONE HARDW D PIERS PIASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M AREA _ y, V2 l/ FIN. ATTIC AREA _ N_O 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVJ D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COIS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T ad _ ELECTRIC 1st 323NOI NO HEATING NORTjy TONNM- o _ Andover No. t 2. 4 A dover, Mass., 19 9u <. w 0 '9A. LAK COCHICH WICK^L�'�• '•�i� ED►PP`y �� S BOARD OF HEALTH Food/Kitchen Septic SystemPERMIT T D BUILDING INSPECTOR t+f THIS CERTIFIES THATD................ . . .D. / .! ................................................................. .................................... Foundation has permission to erect-..../4' .......... buildings on �..©..Q.......... jI ,R P/ Rough ........... to be occupied as..............................................k11...-a.f7 eA1...........� ............................... Chimney Provided that the person accepting this permit shall in evenrespect 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 • UNLESS CONSTRUCTION ST ELECTRICAL INSPECTOR .,.�. Rough t ... ...................................... Service LDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises Do Not Remove Rough Final 4 No Lathing or Dry Wall. To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner ` `•" Street No. Smoke Det. k' HOME 'MPROVEMENT "ONTRAC'OJR Registration 106877 - TrPe PRIVATE CORPORATION L.kmw or registration-valid for individual` i EYpiratiow 07/28/98 use o* before expuation date. If found return to:One Ashburton Place Rm 1301 BLACKOOG ?UILOERS• INC Boon Ma.02108 ,pp� David K. Bryan "`�""���ellY Rd, "10.AOMPASMMR 2 SaleQ NH 03079 i atstrietei To: it �re1Y7e to Rsss�aa a aerreot KWTW1 OF PIRIC SAFETYI �/AIIfQAY70N.J�bfl�y�� CONSTRICII01 SO/EROIS01 LICEISE - wet Cid•!:saa:.Fri�sroeatloe : Expires: etrtldate::' fiery oilys t = FAIT M„e, - �---t+a+r---«ew"ms4 4 rr i �atrietel ie: !i 37.LAMM If ; 03030 f CS 016667 0 1301M-7 00/3o/19(y office Use Only uj` �ummnwtttl lJftt9atiu9tPermit No. +13epartmeat of Public —*aftfU Occupancy&Fes Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave bank) 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 Af 1A IS_2 (M* 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 & Num r) (e 4y Owner or Tenant G' Owner's Address Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building 5,_j Utility Authorization No. -I Lir "� f c Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _� Volts Overhead ❑ Undgrnd ElNo. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. of Hot Tubs I No. of Transformers KVA No. of Lighting Fixtures I Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Air Cond. No. of Ranges I tons Initiating Devices No. of Disposals Dis No.of Heat Total Total P Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal El Other ❑ No. of Dryers ( Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: r✓J i G/Zd q-y� INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO = I have submitted valid proof of same to the Office. YES X NO _ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE X BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value Tf Electrical Work S Work to Start4 '4 lei Inspection Date Requested: Rough Final Signed under,tha Penalties of perjury: _ �j a 2 FIRM NA LIC. NO. Licensee ft�Signature L1cC. NO. q� N` Bus. Tel. No. 6O� WE3Da Address MZH IF-9X07, Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Li ensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner A nt (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x-5565 C�� "y? Date........................ ... .... ifl 8 64 of No°Tki 3? °oo� TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that .. .- .ee ear............. ' has permission to perform ........ .........)t,t/!Q4e,I............ wiring in the building of.........IV C)(�0.K . at.....4 D.Q....�4 R ptoll.00%..Y v .... .. ........... .North Andover,Mass. Fee�'d 0-ekV... Lic.No.1:-.���..��............................................................. ELECTRICAL INSPECTOR 04/15 811 . 40.04 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer s K Date. .. . . jr,1'a— of ",O R':'+ TOWN OF NORTH ANDOVER I 'Mom. PERMIT FOR PLUMBING 40 s � •"a ;,SSACMUS� This certifies that . . ./ . . ,�� t ._, . ,.� ,�..ri . . . . . . . . . . . has permission to perform A. . . . . . . . . . . . . . . ,. plumbing in the buildings of .T., -t..-/� . . . . . . . . . . . . . . . . . . at.- . . .... . .!,,.� --; forth Andover, Mass. Feed,.rw. . .Lic. P� Check # G INSPECTOR G � G "� i 5189 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) /J)11 I Mass. Date ` 1�Q 2 Permit # �/ : Building Location �a �QeNamey r�e, AType of Occupancy 15 'S+ D E I`1 ti A L_ New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ FIXTURES 2 N < Z Y N N N O Z >&U W W Y J N V < N O OCC U) Z 0 < < • ~ Z O Z N a W N 3 X V N Q f0 N W < H N Z G < 0 O .Q a x 0 W 0 O W d y cc r W y Q J Z 0 C C LL S f. F. G • 3 J ¢ F. < Y W = < 2 O Z S Y d 0 < W U. Y W s a Z Z F- O V S 1- t7 F- O H N �" Z O 0 H W < p. < < S N < < O a J J < ¢ ¢ a < O < f- 3 Y J m N10 G J 3 Y i- tl1 W O a7 < S ¢ m 0 SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR • 3RDFLOOR 4TH FLOOR r STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name fjin(rmATACM Check one: Certificate Address ? Co R t hi mA t') PJ ❑ Corporation /r C TW I'C_A) , YO A 0 r ❑ Partnership Business Telephone r9'7 1 0-rirm/Co• �- Name of Licensed Plumber `✓3FrPT jq SAfYlmr- rr•4 "INSURANCE COVERAGE: I have a current 1' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ .1 If you have checked ves, please indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity ❑ Bond ❑ 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: Owner p Agent C3Signature of Owner or Owner's Agent 1 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 ormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e and apter of the oral Laws. By "L �Pmre of Licensed Plumber Title Type of License: Master % Journeymali ❑ CitAP Rowe OFFIC US ONL License Number �3 3 5 BELOW FOR OFFICE USE ONLY FINAL__INSPECTIONS SKETCHES 1 PROGRESS INSPECTIONS FEE j NO. APPLICATION FOR PERMIT TO 00 PLUMBING i NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 PLUMBING INSPECTOR he Commonwealth Of Massachusetts •Use only _ oopemnenf or Pubs sa!_fy G U a .1 F prrtit No +, cr BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 �(J ecupar,�y a fee cheek (halve Manx] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL Ad *ma,�.,IR. ter, , TRtCAL WORK (PLEASE PRINT IN PINK Oil TYPE ALL INFORMATION +� City or town of ' 0 g Date The undersigned appy for a permit to perform the electrical work deacnbed below. To Me Ins _ poatot of W;rea: Loeatlon (Street & Numb Owner at Tenant Owner's Address _ Is this permit in conWction with a building permit ya ❑ no Qom- (Ch-•;k Purpose of Suildih Appropriate Box) Utility Authorization No. Existing Service �rnva___.J vans Overhead 0Urtdgrd ❑ Now Service � No. of Meters,, Vons Overhand El Una�,rd CiNumber of Feeders and Ampaply No. of msftm—......_., Location and Nar,e of Proposed El=rical War *r n a-►-•e��,- rf_�!J do No. of 11htin putters NO. of irW Tubs No. of Transformers TOTAL No. of ' MM Fixtures Above In KVA Swimming Pool grnd.❑ rnd❑ Generators No. of ReceotaCle outlets IVs.of Emergency KVA No. of Oa Burners ea U- lagnung No. of Switch Outlets No. of Gas Burners No.of R es No. of Air Conditioners TOTALand Of BAMS Na.of Zones TONS Initiating No. of Oisposala HEA TO Al FOTAL No. of Sounding No. Of Pumps TONS 9 Oerices KW No. of Self Contained Ivo. of pisrtwashen Soaea/Aree Meeting KIN DetectionlSounding Devices NO.of 0 rs Heading OenicesMunicipal --_ No. K1N Local C Connection ❑other No. of Water Heaters KW No.W Bal o!aita eeuLow Voltage wiring Na.of Hydre Massae Tubs No. of Motor Tatai HP OT11ER. /A' 4 INSURANCE COVERAGE: Pursuant to the requirements of Massuhusens G*neenM Laws I have a Current Liability Insurance Pokey in�ing Q aeL"Operations Cp1erage or its substantial oquivalent. vaild proot of same to this office.YES Q N0 YES Qj NCr p I heave subenivad If you have Checked�80140 indicate mo type of covegge by chocking the appropriate box. INSURANCE OTHER ❑ (Please Specify Eaamated Vatue of Elsctrka! Woks Rx-poadon Data) Wark to Start_ Signed under the penalties ofmon Date Requested: Rough 1� DeflurY Final FIRM NAM Licensee S=am I Z"IN L LIC. NO. I '�- Cf'f/L/ (.._Signature r Address ,� ,ov C VV-u'\ LEC. NO_ Bus. tel. No. OWNEA'S INSURANCE WAIVER: I am s"rp that the Liceni(ee does not have the Insurance cover Ali. Tei. No. Ma3axnusstrs Gener at(.awe 4- VIS mY f rawre a•�y�'M�:\ aae Or iLt fu6stOr►tlat eeuivN...i..,�,,:.. (T-1 R\�1 i YW7 vFM^Cilbtl`NOH�b 1Rii rogtairemene.Owe�ir wgelm tvt.ew a�+.+ex on.�L7� I� rnatYre o1 Own rD+yaAI No'~-- --- ��ues .� lei V (Sre e1 1��1Mnr1 - V� ,) Date....!..j.. ... .../�� 596 t NOR71/ "S. "1"�,� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS�CHU This certifies that ............1..... !.v ..��. ..�t......... ............ has permission to perform ..........� �..L �..�.......( �..{. ? 6;�- wiring in the building of............ at.... UU...... �. a 4(ll�l ... ....:..... ................North Andover,Mass. 1 Feel�.....W.. Lic.No. f.a 6 y............................................................ ELECTRICAL INSPECTOR 11/18/96 1 UOPAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Location i f No. Date t M�RTN TOWN OF NORTH ANDOVER 3? � •SOL F 9 i • � ; , Certificate of Occupancy $ •�,s'•"°''tom 9 Buildin /Frame Permit Fee $ s,+cNusa Foundation Permit Fee $ Other Permit Fee $ mil TOTAL Check # c:�v4 'i 7568 Building Inspe66r a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT ILPPLICATION TO CONSTRUCT WPAK RENOVATE, OR DEMOLISH A ONE OR TWO FAMELy DWELLING Z� V�ft 096 BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: BuTlWn—g Commissioner/I of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ��60 Sry1�eP��V�iti's4 NP I?� 0�/3 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Dislrid Proposed Use Lot Area Frontameft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R 'red Provide Rzcpired Provided ReqWmd Provided 1.7 water Supply M.G.L.CAO.1 54) 1.3. Flood Zone Information: Sewerage Disposal System Public ❑ Private 0 Zone Oueside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 7 F, --I.1 Owner of Record —_ DD Sr�i�RP�If 7?S �u j�'d Name(P ' t) Address for Service fSign tura Telephone 2.2 Owner of Record: Name Print Address for Service: r Signature Tel hone SECTION 3-CONSTRUCTION SERVICES S 3.1 Licensed Construction Supervisor: Not Applicable C 3 Licensed Construction Supervisor: 4 License Number Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ K//LL;Adddress G I� O i me � g� k/IC y� �C Registration Number n r Telephone Eltpnrah30 Date 2 e SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Si red affidavit Attached Yes.......0 No.......C SECTION 5 Description oiProposed Work checka ble �J New Construction ❑ Existing Building Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee 3�d Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x(b) 4 Mechanical(HVAC) 5 Fire Protection �- 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT r 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. t Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, giVANO J, IV A61y as Owner/Autherized-AgMrof 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 P ' e r / D / Si ature of /A ent Date t NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS isr2NU3 Ew SPAN DIMENSIONS OF SILLS DINvIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS ` SIZE OF FOOTING X J MATERIAL OF CIE NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL.GAS LINE NORTH Town of over X31 .No. �.: C% 0 LA E over, Mass., ,,C COCHICHEWICK RATED P" BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............. ..... Foundation has permission to erect................... .................... buildings on...4.00- 61A ...... Rough to be occupied .................. 0 ............................................ Chimney 000 **"*""**....­­...i...­­*...*""***...**'­'­­*­­*'...*'*"***"*"**** provided that the person accept g this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provIslo7of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S ELECTRICAL INSPECTOR Rough .......... Service ...................................... ...................................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove FiRough nal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT # Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE __Jl Smoke Det. TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation,_repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: �G /foo f Est. Cost 3500 Address of WorkL,-�J Owner Name: LRM/ a Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date Building not owner-occupied �,-'-Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name i 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: Nd pceeis (Location of Facility) Sign re of Permit Applicant A i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector