Loading...
HomeMy WebLinkAboutMiscellaneous - 67 SHERWOOD DRIVE 4/30/2018 r 67 SHERWOOD DRIVE J 210/105.C-0073-0000.0 N° 9602 Date. "OR :1�a TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING cHu- This certifies that !! . .. . . . . . . . . . . . . . . . . . . . . has permission to perform . . ._X ?� . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . .. . . . . . . . . . . . . . . . . . . . . at. . .[P . .Jkee ^o4 . . . . . . . . . . . .. North Avriddoever, Mass. Fee.T7. . . . .Lic. No 4361.4I. . . . 1-14. . . . . PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer r ' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITYop (L �j MA DATE ( PERMIT#af 4D JOBSITE ADDRESScSr w OWNER'S NAMEv POWNER ADDRESS �Pt"wC T _ `a : �� TEL � � FAX — / TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIALa. PRINT CLEARLY NEW: ! RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES 0 NO01 FIXTURES 7 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12' 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM I ( 1 ._-„_! _... _,l _. _._.1 ! .......-_ ._,_.__ DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM ! DEDICATED WATER RECYCLE SYSTEM DISHWASHER € J _._.---_( DRINKING FOUNTAIN € --__-._.( a_____ .._-.___€ __. __€ _.___1 . .___._! ___(= FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) T ! _-..,...__! _ _i __..__I _...___1 KITCHEN SINK _ ! ____.._..I 1 __..__! _...—____( ..-__1 ___-__l _____.._l -_........_..( __..___I .__ ( _-_I _.._..__._! ! LAVATORY _._ I -- _l .----___1 ..—..-( ____._) _._._._._. _._._-_! ! l .___..__.1 ._:..___._.I � ( ROOF DRAIN (" ! ! ____f _.___l _------_l _-_-I SHOWER STALL SERVICE/MOP SINK TOILET URINALl .....__..-_! -_-___l _—..__i __-___1 .__.___.1 _.__.._-� .-_ I _... _! € :...___._l .........! .-- t ' ' WASHING MACHINE CONNECTION __f —__l _J ___ _ = _ _._ I ___ l WATER HEATER ALL TYPES WATER PIPING !I= OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO IF YOU CHECKED YES,PLEASE INDICATE TH E OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY t OTHER TYPE OF INDEMNITY D BOND Q 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 0 AGENT 0 SIGNATURE OF OWNER OR AGENT S hereby certify that all of the details and information I have submitted or entered regarding this application are tr nd 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 co plia ce ith all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 1,4 PLUMBER'S NAME . �lQi SI vi(1Q-►•�h ,p P IILICENSE# Cr�/ . ! SIGNATURE MN JP ( CORPORATION 0# �,PARTNERSHIP1# ; LLC ED# COMPANY NAMEff 91VADDRESS 0 �11-F►> cS �S _/yam, p p,clZ�,F,_ CITY 1STATE ZIP (�L (o All TEL l— FAX CELL �.: 9.- MAIL %fOf ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL.INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# V PLAN REVIEW NOTES T. C �1 tiL The Commonwealth of Massachusetts Department of Industrial Accidents 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/Organization/Individual): �' Q(LiK)i3i rl�1 {--4,,ez4 1/1ct Address: L r> City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2�I am a sole proprietor or partner- listed on the attached sheet.1 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs'or additions 3.❑ 1 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 l2.❑Roof repairs insurance required.] 1 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. P 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 their workers'comp.policy information. i am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. [assurance Company Name: —� ?olicy#or Self-ins.Lic.#: Expiration Date:_ lob Site Address: – City/State/Zip attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ?ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a .'Lase 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 )f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. do hereby certify under tl p ' s an IIties of perjury that the information provided above is trite and correct. ii nature: Date: `2 'hone#: Official use only. Do not writ ' 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#: i Information and Instructions 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 dwelling 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)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 LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be 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 pen-nit/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 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 burn 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 021.11 Tel.# 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass,gov/dna COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTERS r t LICENSED AS,A MASTER PLUMBER ISSUES THE ABOVE.LICENSE I k _ µ, 5 CHRISTOPHER T FLICKJAGE `8 1/2 WH4,TNEY ~ST r -1 e SA;UGUS• , MA •'0190bx 432 { _,. 13`641 05/01/14 237959 MUETM• ?;, • t _ 'COMMONWEALTH OF MASSACHUSETTS --PLUMBERS AND GASFITTERS: i LICENSED AS A,JOURNEYMAN TLUM9. ISSUES THE ABOVE LICENSE TO ,.a x CHRIS T,}�Fl ICKINGER x 17 GREENW00D AVE i <: SAUCUS <M,A 01906 2'827 E j 425584 05/01714 235101 f 0 COMMONWEALTHOF MASSACHUSETTS KIM,M1211 t , -'pL,MBERS ANDGASFITTERS L-"lCENSED AS,A�MASTER PLUMBER ISSUE$THE ABOVELICENSE TO r t CHRISTOPrH-ER T FLI-CK`.INGER i 8 al/2 WHITEY sT i t SAUGUS MAA1906 432 ' 1364 .05/01/14 x23795:9 � COMMONWEALTH OF MASSACHUSETTS t. A yq f I i` PLUMBERS AND GASFITTERS! r E U;LIGENSFD AS A,JOURNEYMAN PLUMB r ` T 1SSUES THE ABOVE IL"CENSE TO ',CHRIS 7.�E,.UIGKII 17 GREE14W00D -A'U.E �=r 4 �a5Al1GUS fMA ;0190G 2-827 , 25584 05/.01714 235101 YD • i r 1 � Policy No./Sales Code: TBD Carrier: SAFETY INS CO LIABILITY INSURANCE BINDER Massachusetts LiabilityInsurance Coverage Has Been Bound As Follows: Name of Insured: Christopher Flickinger Address: 242 Park St. City, State, Zip: North Reading, MA 01864 Business Liability Coverage $10001000 Medical Expenses $ 10,000 Fire Legal Liability $ 10,000 Polocy Period 09/27/2012 to 09/27/2013 Annual Premium: 1497. Down Payment yment $300. Effective Date of Binder: 09/27/2012 Agents Name: Kenneth H. Grant Agents Signature: Kenneth H. Grant Insurance Agency 200 Walnut St. Ste 2-E Saugus, MA 01906 781-231-4916 Fax 781-231-4906 a PAID RECEIPT „Uro NOME ❑ KENNET1i I. GRANT INSURANCE AGENCY _ OTHER 200 WALNUT ST. SAUGUS. MA 01904 d RECEIVED FROM �j fLjAT IC� 1)A 11. o 4KENIT 11 CRW( 54- Z-,-,�F On := E Permit Na. r"'` 'rrt/£ e0711�1>'0?2Z�/�JLz.L°7ir►/�?1Lrf$Sr�rert�ll5�?75 Occupancy&Fee Checked Dc�wetwad o6�aef(Le Sa6rry t BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:0 (Please Print in ink or type all information) Date To the Inspect6r 4 Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. j Location(Street&Number / b ��,f/±Ly T Owner or Tenant OL- IS Ar , Ir n u!c A-6 I 1/ 1 LAS Owner's Address Is this permit in conjunction with a building permit Yes es No ❑ (Check Appropriate Box) Purpose of Building 5-NO L I- r—A-M 14 IUWt- u NIV Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity. I / Location and Nature of Proposed Electrical Work �6 l�IV r!.C�� o-)� 2 � P-6 �e [�el t1,/vb e-i Total No.of Lighteng Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool gmd G gmd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Bumers Battery Units No.of Switch Outlets No of Gas Bumers FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Soace/Area Hearing 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 1 have a Current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = Y lease indicate the a of coverage b checking the appropriate box have submitted valid proof of same to the Office YES NO If you have checked ES p type 9 Y INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Works Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of erjury: FIRM NAME f Z G LIC.NO. Llcen-11:11-L W&N—ItySignature LIC.NO. /x `J , U �Ib G�tT C Q�// bP[�/!✓ Bus.Tel No. Address r Alt Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage r its substantial equ valent as requiYAI ,6E/�,C) sachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT F (Signature of Owner or Agent) 6 Date... .. ...... " 0 N2 i TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING -7 C14us This certifies that ... . .PM c, ...... . ........................ ..................................x has permission to perform ...Co.v-n,444......... ................... 7" wiring in the building of..r.6)... .................. UIj at...... ........................... .North Andover,M* Fee ....... Lic.No.�Rd.l� .............................................................. ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer « w� CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date--S Y 98 THIS CERTIFIES TH/ATT���. `` THE BUILDING LOCATED ON Co SAZ&5 eJ O O 7 MAY BE OCCUPIED AS &/A.) G I-4F q X IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Of ",.. . CERTIFICATE ISSUED TO _ < /-&6;�Cl-pGt�h x-* ADDRESS /U P • s • • Js�`""s� Bui ding nspector t _ ;+°..�•. y�-���x.U.�f:- .���Yr"�..�:�. ���x� ,.� .I''r` .. � �O _ .. t:;,.r...,-a �o �� ��i.,,��,.. ieA `•��"���T t. rr /—'G/'�" r5• 6�'y -4 '�..��r4 " r rn :F' r .- •-Fy.y. d ',.� .'w .�: Y""i ?Y�/�`R �s L�� S���/ ��ir!`��F yi y ,,.� ,.+� s\ F jC r.�'•^t�}•��'`'�.ua" -t�,, .i '"q' �:yJ-''�"' �r -4f;M - dormer ass. ' ± i LAKE 'yy` 1 M 9A_COCNICNE WICK '�• r - - - y A A �p BOARD OF HEALTH Food/Kitchen c - _ Septic Systemi5:� o? BUILDING INSPECTOR THIS CERTIFIES THAT.......................... lf`��s. ............ .. ....... � .................. Foundation has permission to erect.................... f!P buildings on ..... �f�, ��Lit/(� ....: .•••.••,:..• 'cel iV G // . to be occupied as................................... ... �� (�� .. ..:............................................... Chimney _ provided that the person accepting this permit shall in every respect conform to the t rms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of ina _. Buildings in the Town of North Andover. _ PLUMBING INSPECTOR,- VIOLATION of the Zoning or Building Regulations Voids this Permit. G©i PERMIT EXPIRES IN, 6 MENTI-IS ` a UNLESS CONSTRUCTION S S ELECT5AL7SPECTU /'� �j - ..................................... .... ................ .. ......................................... Service / l r BUIL ING INSPECTOR Occupancy Permit Required to OCCUPY Building 1 GASINSPE _Ri, S _ • hDisplay in a Conspicuous Place on the Premises — Do Not Remolathing or Dra Wall-.To oneiiouagI 1 8' Be, FIRE DEPART - _ n "r.t. - '+3 r`' •-r�I" �,'t' "S ;+ t,n p�' .L -"t:.,e_. .- r... +t+>siro-,^--`. ;:.: •� �?-a'fr 11�,�'`.Y,) pd'•p- t _ ''.,^"a- +:ki `'�. �.,:f'" � ,• � - 5 .i .rta i ���}s�.,r.y e ,1 °z 'z � rr LLiner n ", � �,G�`. "�.�S F:y.Y,"" * . .+++� ,y FA K 'a d 1.. 4 �� 1 Y' •'71�. R, 'S., t } i l�e , y : + ti ::��x tY:'�� " ,. :: - ;S, Tyx✓3 Fdl tF �iz'�, v.,.�a-���Kv �O� �:..ST,.,�x+. < - t-� �' �`� `'�"� ." � .. �s. .- - ��x Ix:�, 4�,�q r a ;�. :a•n.t t �txYg. t� i��� .�:,.' - '' I_ �.«. `' ,°a''Ss;.,,:�C; r .T h•X *.Pj:31p''' kr.�`Lt ti N�l�' ?>�" azc " ''t`•3 'u''`S�i1�TR '•d:'L r*. 1r 3r, '6.` ! -l%:P. xt t yq, §...zy :::i• '«. ro. ro 0 i,- • ,, ,_ Ny..- r: 4 �. a •S » rz `.�� �," * 'r'+`fi`..'d.' ,S r' �x'e, �7r• �•x,'_.�; ct d� :f >•: a:�;�:•,.,:,,w ��y�; ��'�''„_.. �... X• .r �+,� .r * �w. .s tk{y,,,dpw, i + F j,,'9., T 7,. .y` .s,A-s,:'i.' .yn, Ce Tet gh• :y�w��. �.,M• ,py€ L. tr r ga,:. .,. .-::. _. ., .�:.et.a,•.,c..L. .$a Location No. Date sm ` 40RTN TOWN OF NORTH ANDOVER '� `` Of �.ae ,•1ti 3� �'., .. • OOL Certificate of Occupancy $ Building/Frame Permit Fee $ cM�SE� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL ti° 1 Building Ingpector 2 q/0457411:42 1,402.00 PAID Div. Public Works i PERJiIT NO. lJy APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP h-40. © � * LOT NO. 1t� 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. I t I �� MBC EkLA0 buu0 IgQCp I ��q� 2'1 CATION �� S1r, wcxo� 'IP �uf= PURPOSE OF BUILDING OWNER'S NAME =�S NO. OF STORIES SrZE OWNER'S ADDRESS O� "1Cn 1U, , ,'^�W " �,`, n BASEMENT OR SLAB F A) ^ ARCHITECT'S NAME '���•�� 7 �✓` SIZE OF FLOOR TIMBERS 1STQx 1" 2ND X I�` 3RD BUILDER'S NAME ;��n lam^ n ,..,.,C SPAN V V DISTANCE TO NEAREST BUILDINGrt� j DIMENSIONS OF SILLS �/ CS DISTANCE FROM STREET (oz F 1. POSTS �✓`V2- p•0L(- �'JZ DISTANCE FROM LOT LINES-SIDES 3�T � REAR g� GIRDERS I !7 vY � 5 AREA OF LOT I _ 3 ��£� i�13 QR`O SAGE HEIGHT OF FOUNDATION40 6` CTXHIC^KNESS /o// IS BUILDING NEW YF L+J SIZE OF FOOTING 3011 X 12 // t IS BUILDING ADDITION Y /r", MATERIAL OF CHIMNEY 1M pr SOt3 A 2 IS BUILDING ALTERATION NlAt IS BUILDING ON SOLID OR FILLED LAND c)L, �✓ WILL BUILDING CONFORM TO REQUIREMENTS OF CODE J YF C IS BUILDING CONNECTED TO TOWN WATER /E BOARD OF APPEALS ACTION. IF ANY N/� T L:_. IS BUILDING CONNECTED TO TOWN SEWER A)Q IS BUILDING CONNECTED TO NATURAL GAS LINE � FS INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST -VI +50 K qq SEE BOTH SIDES EST. BLDG. COST `� L/! PAGE 1 FILL OUT SECTIONS 1 - 3 - EST. BLDG. COST PER SQ. FT. JC JC' d PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 12 Q ffW SUILDING INSPBCTOR iiGNATUP.PW OWNEX OR AUTHORIZED AGENT F E E OWNER TEL.# Sog- 3�3 PERMIT GRANTED 77 CONTR.TEL.# (1003 - X32'(30(20A1 9 CONTR.LIC.# 13Z�7t. - - CLEC 2 1996 i BUILDING RECORb 1 OCCUPANCY 12 S q SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM i MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS - RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION I 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE __ _ BRICK OR STONE HARDW'D — _ PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT I ♦J AREA FULL FIN. B'M'T' AREA _ 1/1 1/1 1/1 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 HARDWID _ ASBESTOS SIDING _ COMMCN JC VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRI K ON MAS NRY -ATTIC STRS. & FLOOR I_ ! BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME Ly SUPERIOR –tI POOR _ ADEQUATE k I NONE 5 ROOF 10 PLUMBING F GABLE HIP BATH (3 FIX.) Z 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 I MODERN FIXTURES j TILE FLOOR TILE DADO t 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM } STEEL BMS. & COLS. HOT W'T'R OR VAPOR 4 WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ I ELECTRIC 1st 13rd NO HEATING w 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***************** q APPLICANT: R ObEe. SA1JUS2 Phone 60t. 373- 75.3 / LOCATION: Assessor' s Map Number ULP 4, Parcel 4_+ EVE Subdivision Lot(s) Street -St.'s Number � ********************* *Official Use 'Only************************ RECO NDAT ONS T . AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved 41q -t-- 4 Town Planner Date Rejected Comments Date Approved Food Inspector- alth Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments s V Public Works sewer/water connections - driveway permit Fire Department Received by Building Inspector Date DEC 2 ! 199% _ NU, (74269`7 rt 02 I}' 'R ��e? -CaW)d.�1Jln'!!!0^ar!f�r, 4,,•�,� � ' L��UMM OF ���fi SR�3f� CQA6rRULIOR SSPRfivjSoR bICiASg !` C5 '> 9 ?I1t X311$/195 �3!l3/29ab ;o f 'TARO WAR' •x °•r XF 23933 ,y MI , }' TO- WIN' OF NORTH .ANDOVER, i.,ASSACHUSET T S DIVISION OF PUBLIC WORKS 384 OSGOOD STREET. 01:845 GEORGE P _;t!-,A Telephone(508)685-0950 DIRECTOR Fax(508)688-9573 \_ o 4SSHCHUS' - DRIVEWAY PERMIT Date: LOCATION. u(��w ✓e BUILDER: phone: OWNER: ���P�� �� y-� phone: 3 - 7� The North Andover Superintendent of Highway Utilities&Operations MUST be notified of the grade and set-back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Remarks: Approval: 1 . ! d j ::.f .J r Na 678 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. ZZ 19 g� Application by the undersigned is hereby made to connect with the town water main in / ���X /� 2-r SKcet,-- subject to the rules and regulations of the Division of Public Works. a The premises are known as No. 1 � - or subdivision lot no. -77-5 �o6P/� Owner Address Contractor Address Xplicant's Signature PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main atf�'4��� ��� Street subject to the rules and regulations of the Division of Public Works. Board of Public Works By Inspected by Date See back for rules and regulations r x RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES 1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town of North Andover without a valid permit from the Division of Public Works. 2. All water services shall be installed a minimum of five feet below the finish grade. 3. No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964. 4. Service connections shall be 1" type k copper tubing. 5. All fittings shall be brass flange type Mueller or equal H 15202 Corporations H 15212 Curb stops H 15402 Three part unions H 8185 stop and waste valves 6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 4Yz foot rod and brass plug type cover. a ,r FORM J I LOT RELEASE The undersigned, being a majority of the Planning Board of the Town of North Andover, Massachusetts, hereby certify that: t a. The requirements. for ".the - construction of ways and municipal services called for the Performance Bond or Surety and dated 19 and/or by the Covenant dated 19 --and recorded in District Deeds, Book _ Page or registered in Land Registry District as Document No. and noted on Certificate of Title No. in Registration Book Page has been completed/partially completed, to the - satisfaction of the Planning Board to adequately serve the enumerated lots shown on Plan entitled " . � f " Section Sheets Plan dated i"✓_ 3 2, 19 � recorded by the ,Rl-d7-,YD,�r.c,L Registry of Deeds, Pian Book /2rour , or registered in said Land Registry District, Plan Book Plan _ , and said lots are hereby released from the restriction as to sale and building specified thereon. '' Lots designated on said Plan as follows . Lot Number s and street (s) ) ( b. (To be attested by a Registered Land Surveyor) T hereby certify that lot number (s) on Street(s) do conform to Layout as shown on Definitive Plan entitled Section S eet (s) i ++ Regi t rNkslMn. urveyor 4 0)$al"p* ® F�`�►Wj LAND LL 1 of i DEC 2 199 f�- � r ' � a.�_'t'�,t Board, holder or a Ferrornance its duly organlnzed planning Boar1 19 and/or Bond or Surety ' dated 1,9 from Cov ,dated Of the City/Town Of Aw County, Massachusetts recorded with District Deeds , Book YV9 Page the en', No A,' �,o try District as Docum or registered in La nd Reg i s in and noted an Certificate of Title NO• acknowledges Registration Book, __, __, Page I satisfaction of the termsereof ana-�hereby releases its right, title and interest in the lots designated on said plan as follows: day of october II EXECUTED a-Is a sealed. instruMent this majority of the planning Board of t!".e Town of North Andover COMMONWEALTH OF MASSACHUSETTS LssexOctober 1 1996 ss -,hen personally appeared Joseph .v. maluney one of the above mezbers of the Planning Board of thin of North Andover, Massachusetts and acknowledged the foregoing instrument to be the free act and deed of said Planning Board, before -me. Of NAta Public My Cozmiffsio�Exipies 2 of 2 P.O. BOX 907 TIMBERLAND BUILDERS NORTH ANDOVER MA. 01845 STEPHEN R. KARETA TO THE BUILDING INSPECTOR, DUE TO RECENT CHANGES IN OUR ORGANIZATION WE WOULD LIKE TO CHANGE ALL OF THE BUILDING PERMITS CURRENTLY OUT WITH TIMBERLAND BUILDERS TO REFLECT THAT ROBERT INNIS IS THE CONSTRUCTION SUPERVISOR ON ALL OF OUR PERMITS AND WORK SITES. ROBERT INNIS HAS A MASSACHUSETTS CONSTRUCTION SUPERVISORS LICENSE # 05883 THE PROPERTIES AFFECTED ARE; 158 FOREST ST. PERMIT NO# 604 10 JERAD PLACE LOT15A PERMIT NO# 444 44 SHERWOOD AVE LOT 2 PERMIT NO# 560 96 SHERWOOD AVE LOT 7 PERMIT NO# ffN j 93 SHERWOOD AVE LOT 13 PERMIT NO# 90 6�SHERW_0OD-_AVE:LOT"16__� PERMIT NO# 6-0.3- IF YOU HAVE ANY QUESTIONS OR COMMENTS PLEASE DO NOT HESITATE TO CONTACT ME AT 508-557-5531 THANK- STEPH N R. KARETA sAAP 2 5 - . a � • : ••``•" j•••••�•• �.. v4e4r%jnM Ar r u%.#^ssum run r=mi su uv s'L+rwruuw S` (Print w type) �W F 0 NORTH ANDOVER, Mees. Gale .10, Build k>d Permit # 3 Locatto __. �_ 7�cu ooh Owner's Name !'113 �9►- New t Renovation ❑ Replacement ❑ Plans Submitted: Yes[p No.❑ 2 « 3T 1< A r ./ M • t « _ « s • at o ° • o Yn re to s « e at Ir o a at w i P y o a j s o $ b 0 101 a 0 1 s e'si i i i °s r, eA09UGHT J) 8"D FLOOR eTN FLOOR r ; , { k ' . •TN FLOOR r�, , ..tI1�M_iwl4t1011, ITN 'LO011 .x tiTN FLOOR qCheck one: Certificate• In.-,.Compirty Name 1t /A�1 e d7d /` �t I7�Cp ❑Corp. t ilress�/d1Z_ r9tTT�rJ �ii7 ❑Partnership ❑Firm/Co. s uaiAL Telephone ,_ S' � X 67 • IWho of))aimed Plumber ANSURANCE COVERAGE: _MeEll one r,yf have s current liability Insurance policy or No substantial equivalent. Yes 0 No ❑ 14 you have checked yam, please Indicate the type cove'n0e by checking the appropriate box. L ! IIs�rIN urar'to PdicY Other type,of kxiemnity ❑ Bond ❑ = VI�NLaR'S iAiyCE WAIVER: I am aware that the licensee does not have the Insurance coverage required b er 142 at the Mass. General-Laws. and that m sl nature on thin permit application waives this requirement.,Y y a P° PPI Check one: Owner ❑ Agent p f. a urs o ' ar`UNnIff s AGInt "het+by bstllty that a#of the dotdo and Information i haw a dmnitted for entered)in talbe" Application we 4ee and&=Rate to the bait of my pe and that ail binq wwk and InstaDalions performed under the pend laued for We wileation will be in omvilance with ail Ir►Mt provisions of the MasaachusaMa State Phrmbhq Code end ChapterIi 2 of go ssanar F na we 1 q Type of PWmbktg Lkense: Master ❑ D IOFFICL:USE ONLY) Type a Date. �/e ?. . C. .. 340 AORA 3?0 °7 '+ TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING 8 This certifies that . Lk. -. . .1 . . . . . . . . . . . . . . . . . . . . . has permission'to.perform . . .P,t. . . . . . . . . . . . . . . . . `a m plumbing in the buildings of . .4'" .�. . . .� . . . . . . . . . . . . . . c ry< at. . ` r . c'f�. .Z'°.`� , North Andover, Mass. g Fee—).f7:°: ':Lic. No..) .(. !� Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer T f MASSAGI-tUScTTS UNIFORM APPLICATION FOR PERMIT TO DO GASFI%TING lJ� (Print at Te) 't, 1l 17hjlyVQjp , Mass. Date Ona,j, 19 Permit 4t-,2 to Hugd(nq Location ' owner's Name Lod1 bpi i YR L Type of Qccupancy, _I&A, New Renovation ❑ Replacement ❑ , Plans Submitted; Yes(] ' No `I t 443' Ui U3 Y H N U ij�vYr H C N o 'N 'G7. 41 <- ..1 ut to 6. C 0 w — V w N w '< W 4 W W W O Q r_ < W > C W < C < .� O O Itt O IY SUB-CLS MT. 0ASBMENT, ( . ► ( 1 ( I I i I I I I i I I I 1 r IST FLOOR I I I i i I I I I I I I I 1 1 I • ( I aHO FLOOR I I I I I ( • ( I I I I I I ( I -.I I I I. I '.`I i I I .. 'w � `,' '•3 j SRO FLOOR: .4TH FLOOR FLOOR s;H FLOOR Ns 4,1'wKr 6TH FLOOR 8TH FLOOR I I �� Ins.'altfng Company Name dGAS FITTING INC. Check one: Ce:-lcate — Address- SAI ILA MA ^4=_A86G1-- ! Corporation 50 8)x'444149 C '<' I >�-3�6=8bT;i—' ❑ Partnership �� Business Telephone ❑ Firm/Co. „ NamG ot;Lte-rtised Plumber or Gas Fitter • ` 1rizuRANC8.COVERAGE: I haYa a`current ltabatty Insurance policy or its substantial equlvatent which meets the requirements o!MGL Ch. 14Z h tt, ci� tR�*YC3 .,:NO E3r Uyoue eheckedyes,please Indicate the type coverage by.checldng the approp havriate bcx a girt °yk"+.� t r A IlsabtlIty insvcanea pclfry ( other type of Indemnity❑ ', Band ,x tr,.xy k OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage tequlred by. »� Chapter 1d2 0l the Mass. General Laws, and that my signature on'this permit application waives,this requitement. . Check on �gnaltue al Owner of Owners awnert] Agent ❑ � Agent . hereby C161111V that all of the detalls and Inforinallon i have submitted(or entered)In above dppUcaUay We twoandls to the e , s,kno+nedpo and that all plumbing wack and Installations performed under the permit lssued for lhls appllcaUo I be N r mpllance with aU�r .! rUMnt prvvtafons of the MassachWGUS State Gas Code and Ghapiur 142 of the General La s. .. T e of Ucense: f'tumber Gasfiller 9 r Ceased b of lite( Jcf'y Joutee an \ Ucensa Number- e 4r a s-1 Fold,Then Detach Along All I"2iforalions COMMONWEALTH aF MASSACHUSETTS BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE co PL LICENSED AS A JOURNEYMAN PLUMBER PERMITS FOR PLUMBING AND GAS FITTING ISSUES THIS LICENSE TO INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE I TYPE THOMAS R GAGNON OFFICE OF THE STATE BOARD. —J PO BOX 8860 Co SALEM MA 01971-8860 a 572487 18597 05/01/00 572487 o N • • D Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS co BOARD IN PLUMBERS AND GASFITTERS IMIOc?TANTNOTICE PL LICENSED AS A MASTER PLUMBER PERMITS FOR PLUMBING AIND GAS FITTING ISSUES THIS LICENSE TO INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE . OFFICE OF THE STATE BOARD. TYPE THOMAS R GAGNON i —M N PO BOX 8860 n 0 W SALEM MA 01971-8860 9 a 572485 10136 05/01/00 572485 ■ N • , li nSC f D•! .�� ��F P r Fold,Then Detach Along All Perforation=_ - Fold,Then Detach Along All Perforations J COMMONWEALTH OF MASSACHUSETTS co co BOARD IN PLUMBERS AND GASFITTERS IMPORTANT NOTICE PL REGISTERED AS A PLUMBING CORP: PERMITS FOR PLUMBING AND GAS FITTING ISSUES THIS LICENSE TO INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE TYPE THOMAS R GAGNON OFFICE OF THE STATE BOARD. , I � —C U , PO BOX 8860 SALEM MA 01971-8860 a 572486 1524 05/01/00 572486 r Fold,Then Detach Along All Perforalions � I i, DEPARTMENT OF PUBLIC SAFETY Restricted To: 00 SPRINKLER CONTRACTOR LICENSE Number Ex0res: Birthdate: SC'; �002265 OSJ. 1/1999 08/31/1957 Restricted Toy 00 THOMAS V,'lON f } PO BOX 8860 `'' SALEM, MA 01970 2866 Date. ...... F NpRT1y , TOWN OF NORTH ANDOVER g Frp.tt�ao ,e�ti pp PERMIT FOR CCAS INSTALLATIO4 s 9 �,SSACMUSEtt d O This certifies that . . . . . . . . `' . . . . . . . . . . . . . . . . .:N. . has permission for gas installationP�. . . .� �.4. ... . . . . . . . in the buildings of . .� _r.!. ! ' . . . ( l�:,? . . . . . . . . . . . . at . . . . t�. . �,!a.i`J�"'.�. . '��.. . . . .. North Andover, Mass. Fee. ./--i.�-. . Lic. No..b�Q.C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTINC (Print or Type) < NORTH ANDOVER Mass. Date building Location ,/ Permit # ZIT/ C 7 Owners Name (11 Ge-'3 j'90'C> • = New T. , Renovation t] Replacement p Plans Submitted D FIXTUR=c N 0 W N N Q 0 CC .p � .N p� h F d! j Q V t S cc S�I o / Cr m to tom- w w o o Q 0 W a W a t- ; y W W O W Z Q x a 0 CC W 4 Lt: H a h x 0 }. x I- Z H W US N 0 ? 9Ll.. Z 4 W G a •• W O 2 cc 0 N Z d ,u > C W O 2 Q Q Q < O O WO a z o cti z u. a o .s v y o M t- o f G1 SUR—BS*,AT. e s BASEMEKT ' -ISTFLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTK FLOOR STH FLOOR (Print or Type) Check one: Certificate Installing Company Name///�/aM f� Da�/ 1'��d t��o , Q Corp. Address 90 &T—W tjZ)_ _ - %� jG9 ,( = Partner. Firm/Co. Business Telephone: rT5"T Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Ex Other type of indemnity Q Bond 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. Signature of owner/agent of property Owner U Agent E I hereby certify that all of the details and information 1 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 to. this application will-be in compliance with all pertinent provisions of the Massachusetts State Cas Code and Chapter 14I of the General Laws, By TYPE LICENSE: Plumber Title Gasfitter Signature of Licensed City/Town: Master Plumber or Gasfitter Journeyman APPROVED (OFFICE USE ONLY) —.LiC��® N bur ?t 2561 Date.. ?. b / a. A NORTH. -TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATIOt 9SSACHUSES This certifies that f!t f-�. �- o` has permission for gas.installation W.<<: -f in the buildings of . !rf .t f . . . . . . . . . at . . . .`�. :! . .i .-71- �. . . ; . . . . . . . : . North Andover, Mass. Fee. .7.` . .�. Lic. No.. ..... . . AS INSPECTOR ` x WHITE:Applicant CANARY:Building Dept. PINK:Treasurer. GOLD:File