HomeMy WebLinkAboutMiscellaneous - 680 FOREST STREET 4/30/2018 680 FOREST STREET
210/105�110000.0
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7�� ��4Y 0 719 _
j • 1 Date..... ........ .4).
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N NORTH
: TOWN OF NORTH ANDOVER
Ln3? e•.r ,.,e OG
" ; PW
isidift % PERMIT FOR WIRING
,SSACMUS�
e
This certifies that ....... , .. tl.!.....*.....................
has permission to perform ...,.....r.............................
t wiring in the building of �-
1 t— ...................... .North Andover,Mass.
at...........:..`.....'.......... A ..................
Fee.._!.,)... Lic.No. :......... ..a...............................................................
ELECTRICAL INSPECTOR
� �7^+ �L TH R` AVER 06/25/95 11:06 .00 PAIP
WHITE: Applicant CANARY:T.R, 9604 PINK:Treasurer GOLD: File
Office Use Only
-
01 4t `Amjnjlnm# af MaggaOU&S Permit No.
i9epa'1ment of Pubilr tifttq Occupancy& Fee Checked U
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank) (/v
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to beP erformed
in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
4*,Ir or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant GVy AAS0
Owner's Address I
Is this permit in conjunctionwitha building permit: Yes No (Check Appropriate Box)
(
Puroose of Building � � �f11'� - Utility Authorization No.
Existing Service Amps _� Volts Overhead 17� Undgrnd ❑nn No. of Meters
New Service Amps _J Voits Overhead 7L-- Undgrnd u No. of Meters
Number of Feeders and Ampacity '
Location and Nature of Proposed Electrical Work wl,ige s ..a,_w S 1` F 1�
�l ttEt t4t�&91 a7c71 f�J
Total
No. of Lighting Outlets I No. of Hot Tubs No. of Transformers KVA
Above In-
No. of Lighting Fixtures )-/ I Swimming Pcci grnd. _ grnd. 71 Generators KVA
i No. of Emergency Lighting
No. of Receptacle Outlets I No. of Oil Burners Battery Units
No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones
Total No. of Detection and
No. of Ranges I No. of Air Cond. tons Initiating Devices
No.of Heat Total Total
No. of Disposals Pumos Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers I SpaceiArea ?-!eating KW Detection/Sounding Devices
Municipal
i(Other
Heating KW
No. of Dryers I g Dev ces Local ! i Connection ,
No. of No. of Low Voltage
No. of Water Heaters KW Signs Ballasts Wirinc
No. Hydro Massage Tubs I No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements cf '.Massachusetts general Laws
I have a current Liability Insurance Policy including Ccmoietea Operations Coverage or its substantial equivalent. YES = NO = I
have submitteo vaiid proof of same to the Office. YES = NO = If you have c cked YES. please indicate the t e of coverage by
checking the appropriate box. C77KO/^r�rQ A
INSURANCE = BOND = OTHER = (Please Scecify) (E pirationatel
D
Estimated Value of Electr al Work S 1 c
FinalInspection Date Recuestea: Rough �! r nal
Work to Start
Signed under the Penities of perjury: -
LIC. NO.
FIRM NAME -
Licensee Signature LIC. NO. /
i`,� c Bus. Tei. No. 7-7 ` —D
Address ` � J ' Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 Agent
(Please check one) 417J��
Teleohone No. PERMIT FEE S
(Signature of Owner or Agent) x-5565
Date..... .(:
23132
tko
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
8
AT..
,SS�CMuSES
J
This certifies that -1/1 . 1; A //,-I
.........................................................................................
has permission to perform ............ 4'n,
.......................................... ...............
wiring in the building of....... v.......r..... ....................................
T..................... .North Andover,Mass.
at............. ....... I...............
Fee.'7 7 . ...............................................................
............ Lic.No.-
ELECTRICAL INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
office Use Only 3 3r�lJ
- u4t Crommunwato of Magoar4af1#s Permit No. +
i9epartmie It of Public —%fttg Occupancy& Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR Y:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
(X)Q 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 & Nuer) C��� �C7V� S:_; '
Owner or Tenant
Owner's Address �— �,—r
Is this permit in conjunction with a building permit: Yes No O: (Check Appropriate �Bo/x)
Purpose of Building `�kf vUC:f t�H yyl - —\--)(_.J 't-tUtility Authorization No. �-7�p/?s
Existing Service . Z C70 Amps —0-0i 9y0 Volts Overhead ( y Undgrnd ❑ No. of Meters
—
New Service r00 Amps Ldniv Volts Overhead Undgrnd ❑ No. of Meters l
Number of Feeders and Ampacity �n
Location and Nature of Proposed Electrical Work i�fe���C�
No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total
KVA
No. of Lighting Fixtures I Swimming Pool Above In- r
grnd. L_ grnd. Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets No. of Oil Burners Battery Units
No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones
No. of Ranges No. of Air Cond. Total No. of Detection and
tons Initiating Devices
No. of Disposals I No.of Heat Total Total
Pumps Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices
No. of Dryers Heating Devices KW Local �- Connection Other
C Connection j
Other
of No. of Low Voltage
No. of Water Heaters KW Signs Ballasts Wiring
No. Hydro Massage Tubs I No. of Motors Total HP
OTHER:
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 = NO = If you hav hecked YES, please indicate the type of cove age by
checking the appropriate box.
INSURANCE = BOND = OTHER = (Please Specify)
(Expir tion Datei
Estimated Value of E!ectrical Work S /
Work to Start Inspection Date Requested: Rough Final i!I 411
Signed under the PenaltieAs,of perjury: I
FIRM NAME -9r� C V99-� � vo, \,4J LIC. NO. V 0 9 3
Licensee ^� Signature LIC. NO.
�
/� �� E�� S 1 � V�� S �l Bus. Tel. No. 2?(/'— �//77
Address ` Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 Agent}
(Please check onel � i J
Telephone No. PERMIT FEE S CJ
��� 6�- (Signature of Owner or Agentl x•6565
Location � � iy�
No. Date
4O0 TOWN OF NORTH ANDOVER
f
Certificate of Occupancy $
Building/Frame/Frame Permit Fee $
9
Foundation Permit ee $
s�cMust
Other Permit Fee $ ZC
Sewer Connection Fee $
t Water Connection Fee $
f. TOTAL $
`. ��. Building Inspector
9511.0 7 25.00 PAID
.. � .
Div. Public Works
PE&.ItiT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP (DATE 1BOOK 'PAGE
ZONE I SUB DIV. LOT NO. I -
LOCATION .�-
// /�� � / f� PURPOSE OF BUILDING �^
OWNER'S NAME V V J NO. OF STORIES L IZE
OWNER'S ADDRESS /� ('��• BASEMENT OR SLAB
CJ
ARCHITECT'S NAME -113
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME /f um \ SPAN
DISTANCE TO NEAREST BUILDING 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 ]r /� �/G C IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF COD(—E T 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
INS UCTIO p,/� 3 PROPERTY INFORMATION
� �( LAND COST
SEE BOTH SIDES
/Cny EST. BLDG. COST
PAGE 1 FILL OUT SECTIONS 1 - 3 �J./uC� EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 VVV 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 PPROVED BY BUILDING INSPECTOR
POD
DATE FILED S
BUILDING INSP[CTOR
S AT E 6;,IrWNER OR AUTHORIZED AGENT
F E E � L OWNER TEL.q 16 OV
PERMIT GRANTED CONTR.TEL.q
1Z'2 19
CONTR.L C.I
H.I.C.q N '
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY 11 1 S.'ORIES 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 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW D
PIERS PLASTER _
_ DRY WALL
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'TAREA _
/, /, �/, FIN. ATTIC AREA _
NO B M 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 _ COMMCN
VERT. SIDING ASPH.TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR I_
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR _
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE I HIP BATH (3 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. 8 COLS. STEAM t
STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
GAS
7 NO. OF ROOMS OIL
B'M'T 2nd _ ELECTRIC
1st 13rd NO HEATING
i
Town of ? � NORT Andover
.� L
280
art dover, Mass23 19 qr
T O �- CAKE
Coc HIC HEWICY
A
a\V ERATED
E BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
�+ � BUILDING INSPECTOR
THISCERTIFIES THAT. n.... ........L,AS.n............................................................................................................ Foundation
has permission to e".. cmf?..................... buildings on .4.80....r nom--__� __ ..........�............................. trough
to be occupied as��t.��A. .4 .....5. . .,.....rA:gL... �.....�- 1�.............................................. Chimney
provided that the person accepting this permit hall 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. Rouge,
,
D
PERMIT EXP 6 MONTHS Final
ELECTRICAL INSPECTOR
UNLESS CON T Rough
Service
BUILDING SPECTOR
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 DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
PLANNING FINAL CONSERVATION FINAL street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT
TOWN of NORTH ANDOVER
AFFIDAVIT
I3e hpnmait Gmbmctcr Law
ailai3it m Int t%UCatirn
M� c. 142 A rginies that dire "Voa w= dzm, altmaticn, rm3m am, repair, modeorizat cn, oamErsim,
imprvveiat, rem ml, dmx)htLcn, or amb=4m of an adhtzm to any p cL- easti g aan: "owned build-
ing cmtair&g at least me bit not wre tial far dwelling unnts...Or to sftrb* s 4idi are adjacent to
a xii residare or hril"'be done by reo-Rtered conizacbo , with cwtain acep6cm, alug with otbw
re nlffilts.
Type of Work: -�02<� <C Cit Est. Cost
Address of Work )P<f / � l
Owner Name: 627_-V't
Date of Permit Application: �( f
I hereby certify that:
Registration is not required for the following reason(s): For office Use Only
Work excluded by law Rmdt No.
Job under $11000 Date
�Building not owner-occupied
er pulling own permit
Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTIRACTORS_-
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRA-
TION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
Signed uxkr pe:al.ties of perjL y:
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR:
Notwithstanding the above notice, I hereby ply for a permit as the
owner of the ove property •
A;'
1
Date ftner ame
.S
It + ' r •
---__ The Commonwealth of Massachusetts
Department of Industrial Accidents
I — SMIMof/ 9898os
600 Washington Street
`J� Boston,Mass. 02111
Workers'Compensation Insurance Affidavit
Tr
1 MMMMM
e v
19cation: O() �lzeY� �� -
e Ov c G� s # — Cj
I am a homeowner performing all work myself.
E M I am a sole proprietor and have no one working in any capacity .
gagggim M1111
I am an employer providing workers' compensation for my employees working on this job.
comoanv name. -.
address.
c�tv� phone#,,_
insnrance:co. Roney#
O I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices:
company n%ame.
address.
. . phone#
insurance_co. policy#
cotnpany;name
.
address.
city: 1.1. phone#.
Insurance co. policy.# .
c ona ee', ec � 11111111111 BE=
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
!do hereby certify under the pains and 7penIdes of Ty that the information provided above is true and correct /
11
Signature Date J
_, Print e L-L� - C Q - Phone# � r�Y
official use only do not write in this area to be completed by city or town official _
city or town: permit/Gcense# riBuilding Department
pLicensing Board
check if immediate response is required Selectmen's Office
- C]Health Department. I contact person: ` .phone#; nOther
(revised 3/95 PIA)
a
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", 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 section 25 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, 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.
.� s �.., y 1 i. siL. r
A r
fry •>r " r y .s y y
w.,.: _-:vcP.a ,a_ s.. sb„- '_`
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names, address and phone numbers as all affidavits 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.
~ 5 � s 10 11"
a.-xr a �, w- vm .�.. � .,,'t�U,s7".S'.' ,.I+� Yzs-..,- .�, .,f `+v. �../.��,�.:e% s.y` r/,R_ •"x.'
City or Towns
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. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
-R � r
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Ef"ice of Investigations
600 Washington Street
Boston,Ma. 02111
fax#: (617)727-7749
phone #: (617) 7274900 ext. 406,409 or 375
PE)��tIT N�. - APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1
MAP 4.40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE
f , OZONE I SUB DIV. LOT NO. I
LOCATION �/I y PURPOSE OF BUILDING C G
ll�J f/-� /
OWNER'S NAME tvh �/`� NO. OF STORIES (l SIZE
OWNER'S ADDRESS BASEMENT OR SLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST Q 2ND 3RD
BUILDER'S NAME y SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
/DISTANCE FROM STREET POSTS �X
/ DISTANCE FROM LOT LINES—SIDES � REAR cp'� " GIRDERS
AREA OF LOT ��. FRONTAGE J HEIGHT OF FOUNDATION v THICKNESS
IS BUILDING NEW fS SIZE OF FOOTING X
IS BUILDING ADDITION �j+„ /)�,� �i �.)/ 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 /r/G
✓BOARD OF APPEALS ACTION. IF ANY /-/0 y� IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE (�
INSTRUCTIONS 3 PROPERTY INFORMATION
LND COST
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 METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
r I
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
JDATE FILED S o2cS /d�L_
BOARD OF HEALTH
S! AT RE OF NER OR AUTHORIZED AGENT
FEE O 0
PLANNING BOARD
PERMWGRAT i
t s f Z---
"^" BOARD OF SELECTMEN
C�_ �
MAY 18M
BUILDING IN RECTOR
r jaw,
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY 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 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 11
AREA FULL FIN. B'M'TAREA _
V, v, '/, FIN. ATTIC AREA _
N_O B-M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WAILS 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDW D _
ASBESTOS SIDING _ COMMCN
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 ro
STONE ON FRAME _
SUPERIOR I-i POOR _ s
ADEQUATE NONE a
5 OOF 10 PLUMBING / �U' IsT
0
GABLE HIP BATH Q FIX.) = 36
GAMBREL MANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET /pQ
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _ !v
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
1
TILE FLOOR 5g1� z�
TILE DADO
6 FRAMING I 11 HEATING I I
IV s
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN,
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
GAS
7 NO. OF ROOMS OIL
B•M'T 2nd _ ELECTRIC /0 (CA
1st 13rd I NO HEATING (p J l..t.�
r
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: Phone
K
LOCATION: Assessor's Map Number P Parcel
Subdivision Lot(s)
Street ����.s St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
x Date Approved
\Conservation AdmirYistrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Z)Z�A) Date Approved �'TI�/9P
alth Agent Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
t
i
• I
Town of North Andover ..
BUILDING DEPARTMENT
Homeowner License Exemption
(Please print)
DATE
JOB LOCATION Axes-
Number Street Address Section of town
"HOMEOWNER" 63UK C so ���-Os�� (644 IZ Z-az X26
Name. Home Phone Work Phone
PRESENT MAILING ADDRESS 6 FU j=pf�P f
A4 "/Y clvegf
City Town State Zip code
The cur "
rent exemption p for homeowners was extended to include owner
occupied dwellings of six units or less and to allow such homeowners s 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 HOMEOWNER:
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 dwell-
ing , attached or detached structures accessory to such use 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 , on a form acceptable to the Buldin Official
p g ,
that he/she shall be responsible for all such work performed under the
j
'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
. .North Andover Building Department minimum inspection procedures and
requirements and that he/she will comply with said procedures and
requirements .
HOMEOWNER' S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
'Note: Three family dwellings 35, 000 cubic feet , or larger, will be
required to comply with State Building Code Section 127 .0 , Construction
Control .
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WIHSERVX1�UNC ,_ HNAL SE EHI IA _FINAL PLANNING FINAL
. NORT 9
4 .1 Town of 0 ndover
185
DRIVEWAY ENTRY PERMIT
K er, Mas
C HE IC
A \v
OQ Q�
SS
BOARD OF HEALTH
P E. RMIT T 0 .
... 10�S.
THIS CERTIFIES THAT ... ...�... ...............................................
• BUILDING INSPECTOR
has permission to erel�W.. .. buildings on ... ..~. araor .ro.r Rough
3CA6-WeAf
to be occupied as..... .......
Final
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in
PLUMBING INSPECTOR
this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough
Buildings in the Town of North Andover.
Final
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES I O N T H S ELECTRICAL INSPECTOR
Rough
UNLESS CONS UC T T Service
Final
BUILDING INSPECTOR GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Final
Display in a Conspicuous Place on the Premises
FIRE DEPT.
Do Not Remove Burner
No Lathing to Be Done Until Inspected and Approved by Smoke Det.
Building Inspector