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HomeMy WebLinkAboutMiscellaneous - 684 MASSACHUSETTS AVENUE 4/30/2018 (2) n N° 1 719 Date... .......... NORTH °`,"'° '•�"° TOWN OF NORTH ANDOVER a PERMIT FOR WIRING c", This certifies that .. �,. ��....................... .....................!.............................. CCY has permission to perform .. A, - .... .. ............... .................. wiring in the building of r/J t'-:: ................................................ fN at .q....... ......................... .North Andover,Mass. R v , Fee�/1......'..... L>ic.Nos�4'. './... ........... !:-........s:.:.G-0�..,�........... ELECTRICAL INSPECTOR V C �` 5 � v WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THEC0MW10AW F.ALTHOFMASS,4affJ'S= Office Use only DEPARTALEATOFPUBLIMIUT Permit No. I// f MAP 062 OFFIREPREI/E1VI70NREGULA770NNS27CMR12.00 OV Occupancy&Fees Checked PARCEL V �c _ 1-- PERA41T TO PERFORM ELEC7RICAE WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS I7. cmcAL CODE,527 CMR 12:00 ^ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date L/;w r Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) K 0 y 1 AfC Owner or Tenant Owner's Address r Is this permit in conjunction with a building permit: Yes® No (Check Appropriate Box) Purpose of Building A= Utility Authorization No. Existing Service 10V Overhead ® Underground ® No.of Meters New Service Amps/ Volts Overhead [= Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work _N?of of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No of Lighting Fixtures / Swimming Pool Above Below Generators KVA I ( and ED ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and ` Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW LocalMunicipal r7 Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER htstaaroeCoaage FutsuatttothetttmantofNlassadtuset�GataalLaws Ihaw aamatLnbihiyhumrePohymadTCm#&ie Ca&rdWoriis egivala# YES ® NO Ihaw subrna2dvalid pmfofsameto&Offm YES NU ® lfjwha%edrdwdYES,please hdcalethetAxofW&agebyct=kirgthe � w �s�t ��y '9� 14 Est�edvahr Wctk$ � ,CA-0 htspaa�nl� a1 0 Final So-ed WdAe NAME 42ZOL /G LicaseNa _5"�Z�1ae Limtsee Bt tshss TCL Na A�,IE 4W _ �� � d �� AlTd.Na OWNER,SINSURAI�WAIVER,IanawatethattheL=wdomnatterthe in ran mYaa errZst.>IautalegrAatasm4mWbyMmsadumC=al Laws and>ttmy9gs:MWMc tthispeaMTpfiCMWwainthisM4Z*U Lott (Please check one) Owner ® Agent ® Telephone No. PERMIT FEE$ Locations No. f Date /� 7 NORTTOWN OF NORTH ANDOVER 3�O°,,`•O ••,SOC F - op Certificate of Occupancy $ Building/Frame Permit Fee $ '� s'"'°''<� Foundation Permit Fee $ sAC HU Other Permit Fee $ ,- Sewer Connection Fee $ 1 Water Connection Fee $ TOTAL f, $ a S 41 Building Inspector 'I 3 U 6 �/20/9914:47 25.00 PAID - Div. Public Works Location Date 1 f ppRTly, TOWN OF NORTH ANDOVER .o `A Certificate of Occupancy $ Building/Frame Permit Fee $ r �ss�►CNusE� Foundation Permit Fee $ iaa, Other Permit Fee $ Sewer Connection Fee $ 10::�O f ¢ Water Connection Fee $ 10&2. b TOTAL a I S 9 "— 41)XF 3 Bui.Iding'Inspeecc/tor 5 �4/CO/99 14:47 loo.oo PAID = Div. Pubfiic*orks Location 33 S j elf ' 7 iNo. Dated aoRTM TOWN OF NORTH ANDOVER o Of•t.ao ,.1ti ? � • oma a Certificate of Occupancy $ A. * I Building/Frame Permit Fee $ �'�s'•^°''tom Foundation Permit Fee $ SACH SE P-e IACIP Other Permit Fee ,tIf $ r Sewer Connection Fee $ Water Connection Fee $ TOTAL 1 3 U 2 4 Building Inspector Div. Public Works PERMIT NO. APPLICATION FOR PTERMIT TO BUILD****** *NORTH ANDOVER, MA M1IAP NO. "-a LOT.NO. Z. 2. RECORD OF OWNERSHIP DATE BOOK PAGE ZONE ? SUB DIV. LOT NO. /R,-/1(U& LOCATION 6L1l�..S �`1 f<� PURPOSE OF BUILDING OWNER'S NAME `�GZSiz�C NO.OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME _ SIZE OF FLOOR TIMBERS A-)C> ] T 2ND 3RD BUILDER'S NAME ��� �psL1 S7r- 1C�f'fJi� SPAN a le DISTANCE TO NEAREST BUILDING 1-0- DIMENSIONS OF SILLS 4- DISTANCE FROM STREET 30 t DIMENSIONS OF POSTS DISTANCE FROM LOT LINES-SIDES a O REAR DIMENSIONS OF GIRDERS AREA OF LOT % '7' FRONTAGE 2S HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW Aj O SIZE OF FOOTING /0 k 2-o 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 INSTUCTIONS 3. PROPERTY INFORMATIONZ�c 1�a(- LAND COST EST.BLDG.COST OC7 PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PER SQ. FT. EST.BLDG.COST PER ROOM ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. APPROVED BY: PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR DATE FILED OWNERS TEL# CONTR.TEL# (,pc, ( . CONTR.LIC�# 3D 6 U SIGNATURE OF OWNER OR AUTHORIZED AGE FEE $ per H.I.C.# PERMIT GRA,]TED 19 10 Revised 11/97 JM • Town of North Andover NORT#1 OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES x 27 Charles Street :^O North Andover, Massachusetts 01845 f ° WILLIAM J. SCOTT SSACHUS� Director (978)688-9531 Fax(978)688-9542 In accordance with the provisions 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 c 11, S 150 A. The debris will be disposed of in: �r477 (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ( ; ._.._.. _ .. ✓!ie "V/0077//7d0J7.LlIP�Q%Gt� o�✓�laaoacfuJeCt1' G - i e -w X.. Xx", 03/19/1999 'DUNACOR E :.: ...1: .1: :.:.:111ty . ........... PRODUCER (603)893-9450 FAX (603)893-9480 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lakeside Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Stiles Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem, NH 03079 COMPANIES AFFORDING COVERAGE .................................................................................................................................................... COMPANY Peerless Insurance Co. Attn: Judy George Ext 130A .....................................................................................................................................................:................................................................................................................................................... INSURED COMPANY Voter Company Construction 170 Brady Avenue .................................................................................................................................................... Salem, NH 03079 COMPANY C ................................................................................................................................................... COMPANY D .................... ......................... ... ..... . ............................... ..... ... .. X. ..... ....... XXI.. .... ...... x ........ .. xx: ....... .. ... .... . . ... 'XXXX . ........... .... .. . . ..........................x .......... . .. .X". . ........ ... ................ .............................. ........ .. ... .............. ............................................. ... ......... . i..i.. ......... .............................................. ... ......... .. .. ............ .............................................:... ......... . . .......... ............... ... ........................ ......... .. ............ .............................................i .......I ............. NAM THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS S14OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ....................................................................................................................................................................................................................................................................................................... COPOLICY EFFECTIVE POLICY EXPIRATION:: TYPE OF INSURANCE POLICY NUMBER LIMITS LTR DATE(MM/DD/YY) DATE(MMIDONY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 .................................................................................... COMMERCIAL GENERAL LIABILITY .. PRODUCTS.complop AGG $ 2,000,000 . ........ ...................................................................................... PERSONAL ADV INJURY CLAIMS MADE x : $ OCCUR 1,000,000 A ........ ....................................... CP9234515 06/01/1998 06/01/1999 .......................... . OWNERS&CONTRACTORS PROT:: EACH OCCURRENCE : $ 1,000,000 .............................................................................. FIRE DAMAGE(Anyone fire) $ 50,000 ............................................................ ................................................................................ MED EXP(Any one person) :$ 59000 AUTOMOBILE LIABILITY X ANY AUTO COMBINED SINGLE LIMIT w .................................................................................... ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per P—) 9203398 A N, 12/23/1997 : 12/23/1998 :..................................................................................... HIRED AUTOS BODILY INJURY :NON-OWNED AUTOS ....................................................................................... ................................................... PROPERTY DAMAGE :$ GARAGE LIABILITY AUTOONLY-EA ACCIDENT $ ... .................. .................. ............................ .......... ANY AUTO OTHER THAN AUTO ONLY: .......................... .......................... ....... ...... .............................. ........................................................... EACH ACODENT:$ ..................................................... .................................................................................... AGGREGATE:$ EXCESS LIABILITY i EACH OCCURRENCE $ .............................................: -.............. ........................ UMBRELLA FORM AGGREGATE ....................................................................................... OTHER THAN-UMBRELLA FORM $ X WC STATU- ........... WORKERS COMPENSATION ANDTORY LIMITS ER :; EMPLOYERS'LIABILITY A ........ WC9168686 04/28/1998 : 04/28/1999 • EL EACH ACCIDENT.............**.................. ............ ...... 100000 .................... THE PROPRIETOR/ i INCL EL DISEASE-POLICY LIMIT $ 500000 PARTNERS/EXECUTIVE ....... ................... .:. .....................,........................................ OFFICERS ARE: X EXCL:: EL DISEASE-EA EMPLOYEE;: $ 100000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLgSISPECIAL ITEMS 'overing work to be performed by the insured ............... . . . ......... . ......... 0 ............... ........ .. .. . ... ......... XX "o X....... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED En BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING.COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, North Andover Building Department BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 27 Charles Street OF ANY KIND Ur ,M:!�COMPANY,IL-eAqSgEE%REPRESENTAT1VES. N Andover, MA 01845 AUTHORIZED REPRA4&NTYIVE ... ..... ..... . ........... ---w ............................ ....... .. .......................... ....... .................. ......................... ......... ... ... . ......... . . ... .... ......................... .......... . ............. . A ................................... ....... ....... ......................... ..................... .............. ` a CARLS®N Better REAL ESTATE I I OW M eso SCHRUENDER DIVISION 73 Chickering Road (Rt. 125/133), North Andover, MA 01845(978) 685-5000 Fax: (978)685-5900 March 31, 1999 Building Inspection Town of North Andover North Andover, MA 01845 TO WHOM IT MIGHT CONCERN: Please be advised that I looked at the application for 684 Mass Avenue and in my opinion the home is not in the Historical District. It therefore does not need approval from the Olde Center Historical Commission. Any questions please call me at 978 685 5000. Sincerely, G� eorge H. dcrue(jnder, Jr. Chairman North Andover Historical Commission • 9 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: f�D rJ/�®-y Est. Cost / Address of Work A/A Ale Owner Name: "—Z)6"� �/�C� Date of Permit Application: b 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: X tol 99x Dat IL Owner Name NORTfq `F D A, ' own ® dove, No. IJ9 dover, Mass., �- e.1111P /go o �oc��Q,�,rt �y ADRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT...... ..... ,,,,,,,,,,,,,,, A �® C BUILDING INSPECTOR a ........... Foundation has permission toe ..... ®V b i M/�/�� undation ......... i moldings on . ... ......... f ' Rough to be occupied as.... ... ........ � �..® ..... ..�`1...® .... �r ... .... .. ' Chimney provided that the person accepting this permit shall i P p p g p a n every respect conform to the terms of the application on file 1Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction o Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough C PERMIT EXPIRES IN 6 MONTHS HS Final ®� UNLESS CONSTRUC ELECTRICAL INSPECTOR Rough ...... .. . .... .... . ......... .......... ............................................ 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. SEE REVERSE SIDE Smoke Det. 3198 Date.t .`.:`�.... �..... r NORT" ti TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION. f O • • N SACHUSEt This certifies that . .,.,. . . . . . . . . . . . . . . . . . rn has permission for gas installation . ?) . . . . . . . . . . .. in the buildings of . . . f. . . . ..! . . . . . . . . . . . . . . . . . . . . . . . . w at . . . ..�. .`. . .l %�i r !'`. -`. . . ., North Andover, Mass. Fee., ..:^ :. . Lic. No. GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer MAP S"� �j PARCELS U �--. FORWARD ��• _j 1 _.____� MASSACHUSETTS UNIFORM APPLICATON FOR P G ��Type or print) Date �w e. 19 - NORTH ANDOVER, MASSACHUSETTS ? c, Building Locations Permit# J /� Amount$ 2 J� Owner's Namee� 1�iL� New Renovation ❑ Replacement ❑ Plans Submitted ❑ _ � w v; w Cn a n y _ z z C� � z w c w -c C C z Gn z C c w � ^? � � w � � w w � w ` ❑ � w w L w w z 't SUB-BASEM ENT 18 A S E M E N T 1 S T. F L O O R 2N D . FLOG R 3RD . FLOOR 4 T H . F L O G R Tr H . F L O O R 6T 11 . FLOOR 7TH . FLOGR 3 T H . F L O O R Name. tyP �t �G'1/�^f C G� /�1 Check one. Certificate Installing Company Corp Address jS— lis Liz`___ ❑ Partner. H Business Telephone lag ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current Iiability.Insurance policy or it's substantial equivalent. Yes No❑ If you have checked ves,please indicate the type coverage by checking the appropriate box. 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: SILnature of Owner or Owner's Agent Owner ❑ Agent ❑ 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 Perm' Is ued For this application will be in compliance with all pertinent provisions of the Massachusetts Stat as C e and Cha r 2 of the General Laws. By: ignature of Licensed Plumber Or Gas Fitter Title Iumber . Pl p City/Town ❑ Gas Fitter LicengeNurnoer ©—Master APPROVED(OFFICE USE ONLY) Journeyman .i Locationy-c- ' _No. Date r l 04AORTM TOWN OF NORTH ANDOVER `p Certificate of Occupancy $ Building/Frame Permit Fee $ a cMusE� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ ' Water Connection Fee $ TOTAL $ ,i Z (} Building Inspector t .3 U /17/99 13:59 279.44 PAID Div. Public Works 1'I?RMIT NO. l0 APPLICATION FOR PERMIT TO 3UIL1)********NORTII ANDOVER, MA • AI\1'NO.'—A � LOT.NI). a 2. RlCURU F l>\1'NEKJ1111' DATE BOOK PAGE • 'r.Oh!' 3 SUB I)IV. 1.0'1'NO. 1,(i(:.��"1()N �� MUSS ��� 1'l1RPOSF(N Bllll DING �4pq1,L1 jeOO( f /J /J ('w4R'S NAME ���� ��%(X� NO.Of:S I-OHIES � S1ZF 24,24 ' ()WNER'S ADDRESS -4A49 S.S A114 BASFMENf OR SLAB ,4Rt'1III EC1''S NAME lD v^ n SIZE OF FIOOR I IM13URS INI ax/0 2 ND -- 3 RD BI)11.DER'SNAME 1/C)T�� CO �ONS�,�UC/r/(`�/� SPAN /a i DISTANC F TONEAREST BUILDING ?b f DINIENSRNJS OF SILLS q7x 6 DIS 1'ANCE FROM S fREF'I' 37.0 3O DIMENSIONS(N:POSTS o?X (D DIS I'ANCE FROM LOT LINES-SIDES 72'a�REAR /00 DIMENSIONS OF GIRDERS AREA OF LOT /�C f FR(NJI AGE 22 CJ Q I IEIGI IT OF FOUNDATION g61" THICKNESS &.I f SBUILDINGNEW! NO -SILFOFF(X7fING � : (7�( X Is BUILDING ADDIII(Nl SCS MATERIAI.OFCIIIf1NEY IS BUILDING ALTERATIONN0 IS BUILDING ON SOLID(NCFII.LED LAND WI1.1.'BUILDING CONFORM TO RE(2111REME141 S OF CODE 6 s IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING C(NNNEC1'ED TO TOWN SEWER IS BUILDING CONNECTED TO NA'T'URAL GAS LINE E S INS-IU('7'IONS 3. PROPER'Tl'INFO RI\IACION LAND COST Jec /3 ` ES 1 BLD(!.COS f OQD PAGE I FILL OIff SECTIONS 1-3 /� ✓/_ EST..BLDG. COST PER So. FT. 7©.00 SQ rT ESI. BLIX.i.COS I PER R(X)M EI ECTRIC METERS MUST*BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. AI_FACIIEDGARAGESNIUSTC(NJFORM'fOSTATEFIRE REGIHATI NJS 4. APPROVED BY: C PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECf(N( B1111.0 G 'C'FOR DATE FILED ,,3 f f9�! ( OWNERS TEIA .978— (P 8S ...-r- __.` ? r `7'1 ,a, 6 j i ;' r•�S U II l� L5 I tI i 1 C(NdfR.lTa.11 C(kJIR.I.I(m 04301.0 01.0 SIGNAIIIRI:11FOWNI:RORAtI"II10RIAi1)A(iI.HI' MAY PI RLIII GRAN'IEI) L.. �� vl *�'' ori✓ a_i i 19 _ 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 or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT_,�� &S-/-P6C PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION0 ,/ LOT (S) STREET ASS N ST. NUMBER 04 'OFFICIAL USE ONLY""' R ENIDATIONS OF TOWN AGENTS: _ X CONSERVATION ADMINIJTRATOIR DATE APPROVED DATE-REJECTED COMMENTS TOWN PLANNER DATE/APPROVED rJ� DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS 4� PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE ` = The Commonwealth,of Massachusetts ( Department of Industrial Accidents — Mics 0//0seW9171f8ns 600 Washington Street Boston, Mass. 0 111 Workers' Compensation Insurance Affidavit name: location: city phone# I am a homeowner performing all work myself. C] I am a sole proprietor and have no one working in any capacity I am an employer roviding rkers' compensation for my employees working on this job. . . b n�5 aCt7t1 tiJ address. /l 030 7( phone#: (DC 3 98 5 insttranceco: �' G2�ESS (NS CD/1�Jp�t// policy# WC M I am a sole proprietor,general contractor,-Yor homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: company name address. •.. phone#: insurance:cn_ poll # company,name• address• cim phone#: msarancs co pop icy# 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 51400.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the ffice of investigations of the DIA for coverage verification. I do hereb e fy and r 1 pai nd "e y that the information provided above is true and come Signa .>r Date Print name Phone# L3 —8M21?- 0 )j Echeck ly do not write in this area to be completed by city or town official permit license p r-IBuilding Department C]Licensing Board mediate response is required C]Selectmen's Office C]Health Department n• phone q: f�Other (rcvued 3195 PIA) �, - � � .. � � J�ie-"(�o��UrnanureaCt�• d���•G�40a-cf7�u1P/,�.1 i i CARLSION jhBetter REAL ESTATE IHomeso SCHRUENDER DIVISION 73 Chickering Road (Rt. 125/133), North Andover, MA 01845 (978) 685-5000 Fax: (978)685-5900 March 31, 1999 Building Inspection Town of North Andover. North Andover, MA 01845 TO WHOM IT MIGHT CONCERN: Please be advised that I looked at the application for 684 Mass Avenue and in my opinion the home is not in the Historical District. It therefore does not need approval from the Olde Center Historical Commission. Any questions please call me at 978 685 5000. Sincerely, eorge#Wcr-uejnder, Jr. Chairman North Andover Historical Commission r10RTy Town of Andover ° - rn Nol rp * _ s dover, Mass., 19 cIr 0 LAKE A '9 _COCN ICMEWICK i�'�•` �AATED�pa`s S fG BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System T �( BUILDING INSPECTOR THIS CERTIFIES THAT...... ./.tom. ./ ........ .. .. .....DC 1�............................ � � Foundation has permission to erect..........y.......................... buildings on ........... 0..5.4. ....... ......o? �a y � ........ .. . v'; N Rough to be occupied as....'A.v.%1.4........T' 00 l.... .._. 104N�1 i.� 5'.1%0 t+ 0 V% 't 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 � rZ � / PERMIT EXPIRES IN 6 MON S Final 0 UNLESS CONSTRU3, tkRT5 ` 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 Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. PLAN OF BUILDING LOCATION IP(f) . IR(f TAX MAP 59 LOT 24 717 684 MASSACHUSETTS AVENUE NORTH ANDOVER, MA IP(f) \ NAPM 59-24 PREPARED FOR: VOTER COMPANY CONSTRUCTION 27,340 SQ.FT.f BRADY AVENUE SALEM, NH 03079 75.9' �aaa ,o� NOTES \ 21 O (1) THE PURPOSE OF THIS PLAN IS TO DEPICT THE EXISTING BUILDING LOCATION RELATIVE TO THE PROPERTY BOUNDARY LINES AS REQUIRED BY THE TOWN OF XISTIN IP(f) ESO ABLISH RTH DPROPERTY OVER DLIINESNG DFORRANYNT.PURPOSE THIS LAN SHALL NOT BE USED TO WELLING GARgGE (2) BUILDINILT G FEATURES LOCATED IN THIS SURVEY ARE LIMITED TO THE EXISTING (3) THE LOCATION OF THE BUILDING SHOWN ON THIS PLAN WAS DETERMINED BY FIELD INSPECTION ON MAY 04, 1999. (4) ZONING DISTRICT: R3 30,+ (5) REFER TO PLAN OF REFERENCE FOR PROPERTY BOUNDARY INFORMATION. MASS gCNUs 1 E7TS gVfNVE IR(f) M co O SCALE: 1 "= 40' DATE: MAY 04, 1999 � A�% LTH OF Paul Aago ur. . . v PLAN OF REFERENCE: ��. w ���a� SFC ENGINEERING PARTNERSHIP INC. N P �� SUBDIVISION OF LAND OF BICKNELL ESTATES NORTH ANDOVER, MASS., V — 25 SUNDIAL AVENUE SUITE 205W arc,ry, o MAY 1950, SCALE 1"=40' BY CHARLES E. CYR C.E., REV. 9/22/50. MANCHESTER,NH RECORDED WITH ESSEX NO. DIST. REG. OF DEEDS AS PLAN # 2296. a A „ ,,, f TEL 603-647-8700 FAX 603-647-8711 N 2396-MS 1