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NORTH
TOWN OF NORTH ANDOVER
0
PERMIT FOR PLUMBING
SSACHUS
This certifies that ... T, �01 `/... ...........
.......... ..........
has permission to perform
plumbing in the buildings of.�4-A-4,05v~o ...........
at .... ....... North And -over, Mass.
Fee L i c. N 0. .......
PLUMBING INSPECTOR
Check # S,7,jv
FIXTURES
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: NORTH ANDOVER , MA. Date: /-leo Permit#
Building Location: % S 1JX1 Al tt 5 T Owners Name: ,0fd,66f / 1jA-00 W d
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑
- -
New: ❑ Alteration: ❑ Renovation: ❑ Replacement: 0 Plans Submitted: Yes ❑ No ❑
FIXTURES
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes El No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
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
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
❑
Signature of Owner or Owner's Aaent Owner [:] Agent
I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my
nnowieage ana mat an piumnmg wont ana installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Titre p Plumber Signature of Licensed Plumber
Cityrrown ❑ Master�J��
' APPROVED OFFICE USE ONL
Journeyman License Number: d
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Check One Only Certificate #
Installing Company Name: HALLORAN PLUMBING
❑ Corporation
Address: 826 DALE ST.
City/Town: N.ANDOVER
State: MA
❑ Partnership
Business Tel: 978-685-9504
Fax;
❑ Firm/Company
Name of Licensed Plumber: THOMAS HALLORAN
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes El No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
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
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
❑
Signature of Owner or Owner's Aaent Owner [:] Agent
I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my
nnowieage ana mat an piumnmg wont ana installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Titre p Plumber Signature of Licensed Plumber
Cityrrown ❑ Master�J��
' APPROVED OFFICE USE ONL
Journeyman License Number: d
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TOWN OF NORTH ANDOVER
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PERMIT FOR GAS INSTALLATION
This certifies that ...fo!??...44C ,r4o ........ .. .
has permission for gas //in�ns ins
tallation
in the buildings of ..,lIQ ! "-�U...................
at... ........
Fee.. 4a ' !�' Lic. No..
Check # 6 g -r
North Andover, Mass.
GAS INSPECTOR
FIXTURES
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town: NORTH ANDOVER , MA. Date: 1-1,6 ,-1.2— Permit#
Building Location: 90 .SUIV146C' S T Owners Name -80,6,-/? 7— 4/P/�t�tt/D
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential El
New: ❑ Alteration: ❑ Renovation: ❑ Replacement: S Plans Submitted: Yes ❑ No 0
FIXTURES
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Check One Only Certificate #
Installing Company Name: HALLORAN PLUMBING
❑ Corporation
Address:826 DALE ST.
City/Town:N.ANDOVER
State: MA
❑ Partnership
Business Tel: 978 6859504
Fax:
❑ Firm/Company
Name of Licensed Plumber/Gas Fitter:TOM HALLORAN
INSURANCE COVERAGE:
1 have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 0 No ❑
If you have checked Yes please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy 0 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
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and
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
compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
Type of License:
By Q Plumber
Title ❑ Gas Fitter Signature of Licensed Plumber/Gas Fitter
❑ Master
Cityrrown ❑Journeyman License Number:
APPROVED OFFICE USE ONLY ❑ LP Installer
Date.... /.... .......
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that.
has permission for gas installation . ..........
in the buildings of .. f t..%l�� .��. 0 .................... .
at t !u ��l �f�P-S ........ North Andover, Mass.
TFee. r;K �o Lic. No.. V. /........................ .
Check #
GAS INSPECTOR
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ERIC C. FOSTER
PLUMBING & HEATING LLC
145 STEOMAN STREET
CHELMSFORO, MA 01824
Telephone 976/256-5976
369-6077
Fax 97EV452-471 1
COMMONWEALTH OF MA.SSACHUS-E'f:FS7--" COINTFOL f,' D359008
IN PLUMBERS AND GASFITTERS
LICENSED AS A MASTER PLUMBE
!!�sUF' S, Fl IN , 1JC;Ff4SF TO
ERIC C FOSTER
84 DEPOT RD
WESTFORD MA 01886-1359 C
9311 05/01/04 536321
COMMONWEALTH OF MASSACHUSETTS
IN PLUMBERS AND GASFITTERS
LICENSED AS A JOURNEYMAN PLUMB R
!SSl CSTFIFLirl"71-isf-
ERIC C FOSTER
84 OF -POT RD
WESTFORD MA 01886-135T
11471 05/01/04 536320
IMPORTANY
. i. 1""'t 0I our Board at the:
It mi�' ftt�ilj')YOO: 'wilty y
Division of 1-ice*i1imurc. 239 Gaur,0wV1Y St..
Sth Floor, 3nston, 02
ot wif chall(In6. nobly Vow hmu'd
utwc m
'w alldis'- :t.- l'ItIl'if I I 111!X.
;iuoewai Appic.ition. Aw- yc; it f. -I ti, you, R:onsc TIL11110-01.
I hilicefl,e it skjj-tiEpt is tit(, nl tht, Genu Lfvvs
s IA not bo loalind
li is j. pnrsondi p1ivP'-g';. tin'l 1�ills
�ii..ji.ofi to aTiv othe, persol'. Kuup this licem;c on ""out
),, UUSh v. :,s r-qulit--1 l -V lavi.
GONTROL-„ D 3 5 -' 0 0 7
l%"P0RTA*N`
i,,j lost ol, r f,,t)v ytim 1,iiard at ihc!:
Divillior of ProfesqionLi Liccirinturc, 23%, C::w-'Pwcy St..
59-, Floor Banton. RSA 112114
I
P," irltirut- �hv�-m is ;hanoed j(itity will'board
wuxi oarric of nsur; ;M)pi-'l mililiwj it fi�f�X;
1+ t -rvid AI)ptic-Atin. Xw,:v!; ic-ft i to -V,)I;i li-lilsC nuiilb0f.
n_ ci, butlif-d to th(- olovision. f){ Ifif , if.fler-11 1 vlw:;
pici-on"'11
i -r assigncd to airy villm i'mon. K;isij- iftit, lit;! nsf. (-n your
lx)stod as toau,red thy law.
Safety Insurance
�0
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
NORTH ANDOVER, MA
RE: Insured:
Property Address
Policy Number:
Claim Number:
Date of Loss:
Company:
Board of Health or
Board of Selectman
City Hall
01845 NORTH ANDOVER, MA 01845
ROBERT ARMANO and HELEN ARMANO
70 SUMMER STREET, NORTH ANDOVER, MA
HMA 0322672
BOS00027874
12/1/2011
Safety Indemnity Insurance Company
Claim has been made involving loss, damage or destruction of the above -captioned property,
which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be
applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please
direct it to the attention of the writer and include a reference to the captioned insured, location,
policy number, date of loss and claim number.
BRIAN MURPHY Claim Examiner 12/7/2011
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 3422
Fax: (617) 531-8865
Email: BRIANMURPHY@SAFETYINSURANCE.COM
Location ( C Y�I1!t1 E9,
No. _ Date Ct
Nom,, TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
41
Foundation Permit Fee $
SACMUSE
A.
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
`✓"� 6a.•. Cwt j 06/22/95 11:53 982. oo PAID
Div. Public Works
8934
a
Location
No.-.,.� Date '�-��''7-5
NO"T" TOWN OF NORTH ANDOVER
Certificate of Occupancy $
W * s
Building/Frame Permit Fee $
,y� < -_
^ss�eMuset Foundation Permit Fee $
!` Other Permit Fee $
4 � F
Sewer Connection Fee $
$ , lUO. 45t Water Connection Fee $ 51)
d TOTAL $
Byild g Inspector
7M Div. u c Works
Location 90 m M P.P J
�lo. ZSR Date
ro
N
1
T.�
71
J
X031
f
8303
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$ 5U
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL_
Q---
�'
$I
Building Inspector
Div. Public Works
PE&J1IT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
s
4
PAGE 1
MAP isIO.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZONE 2
I SUB DIV. LOT NO.
l� a lk 1r
/ J
.J
5 7
PURPOSE OF BUILDING
J
}LOCATION
L NER'S NAME
�o�c o®a e7 --e -o- T��
OWNER'S ADDRESS r) J K 1, � jaj r4 "�
NO. OF STORIES IZE
BASEMENT OR SLAB �5--e"4
ARCHITECT'S NAME C a ✓l
z l
SIZE OF FLOOR TIMBERS IST /0 2ND Q 3RD`.
BUILDER'S NAME 1-1-6 R L4l 1 l
I.,1
SPAN 13 ' --
DISTANCE TO NEAREST BUILDING �y�(�,
(i
/
DIMENSIONS -OF SILLS L/ x ---
" POSTS (
DISTANCE FROM STREET ''
DISTANCE FROM LOT LINES - SIDES ��
REAR
GIRDERS
.l
AREA OF LOT q� �3(
_1 i 7
FRONTAGE I/�n�!V11 °
f (,9_6 Q /
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW ..{ S
SIZE OF FOOTING A) u X
IS BUILDING ADDITION °( o
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SbLID OR (FILLED LAND
✓ C�a /' QI
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE /�
L
IS BUILDING CONNECTED TO TOWN WATER ' .e S'
BOARD OF APPEALS ACTION. IF ANY
i(/
ISOUILDING CONNECTED TO TOWN SEWER
, ^
IS BUILDING CONNECTED TO NATURAL GAS LINE e S'
INSTRUCTIONS
PERMIT FOR FOUNDATION ONlY
SEE BOTH SIDES REGULATED BY PIRA. •114.8-S. B.C.
PAGE I FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12 DATE FEE PAID
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED Q ,S
n A �
SIGNATURE OF OWNER OR AUTHORIZED AGENT, J
F E E � _
bgn -_-•
PERMIT GRANTED G
ud Id 19�
1
Len _ g 1995
PERMIT FOR FRAME/BUILDING
3 PROPERTY INFORMATION
LAND.COST (X)�
EST. BLDG. COST ,/-9 CJ�)
I(okl �fw�
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INSPECTOR
OWNER TEL. # 6/ (- r /2 9
CONTR. TEL. # n ll> -g
ONTR. LIC. N r
H.I.C. N
03, Lam•
it
SINGLE FAM
MULTI. FAM
APARTMENTS
OCCUPANCY
STORIES
�_ OFFICES _
CONSTRUCTION
2 FOUNDATION I 8 INTERIOR FINISH
CONCRETE _ B I 2 , I3
CONCRETE Bl K. PINE
ISIDRY
WALL
_
.�TIL:�I_
UNFIN.
�I'�1I
3 BASEMENT
AREA FULL
`FIN --B M'T' AREA
'4 '/� '/,
FIN. ATTIC AREA l.:
^
:SG
NO BMT
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS
I 9 FLOORS
CLAPBOARDS
B
1
2
3
DROP SIDING
CONCRETE
�_
WOOD SHINGLES
EARTH
ASPHALT SIDING
HARDW D
_
ASBESTOS SIDING_
COMfACN
VERT. SIDING
ASPH. TILE
_
STUCCO ON MASONRY'
STUCCO ON FRAME,:
BRICK ON MASO NRY
ATTIC STRS. 8 FLOOR _
BRICK ON FRAME.'
CONC. OR CINDER BLK.
STONE ON MASONRYI
WIRING
STONE ON FRAME
_
SUPERIOR POOR _
I
ADEQUATE ) NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH (3 FIX.)
_
GAMERELl
I
MANSARD
TOILET RM. (2 FIX.)
Al
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 ,;
`11 HEATING
WOOD JOIST ` `'
PIPELESS FURNACE
_
FORCED HOT AIR FURN.
TIMBER B S. 8 COT'S:_
STEAM
_
STEEL BM &'COLS:•
HOT WT'R OR VAPOR
_
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
_
UNIT HEATERS
GAS
7 NO. OF ROOMS
OIL
B M'T 2nd
ELECTRIC
_
lsr to 13 d
NO HEATING
BUILDING RECORD "
12
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTATICE FROM
LOT LINES AND EXACT--, DIMEN.StONS OF BUILDINGS. WITH ORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAW
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FORK U - IAT RELAX 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*****************
Ir,
APPLICANT: �'DX wnJacV P -P1 I JT (fir ✓J Phone 1/aS5'
LOCATION: Assessor's Map Number Parcel
Subdivision O )<jA nod Lot(s) _
Street U l" vy► -P r S' St. Nu-,ber 7_
************************Official Use Only******************x****
RECO�- 2- DA O TO AGENTS:
oved aeperQ
Conser-1ation ad=inistratcr Date Rejected
tit -g -
Town Planner
Conr„er. :s
F c c d T-n-pec==-::ealth
-'J�
Ce::
t
Date Approved
Date Re;ectz^
Date approved
Date Re-+ ec zed
Date Approved 16
Date Rej ec zed
Pub :Jcrks - sewer/water connections
driveway pe=it
Fire Denar--inert
5 0-
Receive- by Building Inspector Date
4 ,
ocn,0+995
s
S //E.PEBY G•e M, -Y TO 7We T/TLE /,dS6/ealt- ANG RL. or Rl—/Y N
Tt% TINE B.4/V.t' T.s�gT TNEO/r'ELG/.u6 /J GUC'ATEO O.c/
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Location 'Z>UmtY ft a S�
No. z " (Z Date
_f o0 h,. - TOWN OF NORTH ANDOVER
rry0
Certificate of Occupancy $
Building/Frame Permit Fee $
�N�S Foundation Permit Fee $
CU
Other Permit Fe0 $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ 2S
..
8605
0
Building Inspector c
Div. Public Works
I OHTN
KAREN H.P. NELSON o?� N ��°°D
i Town of 120 Main Street, 01845
Director' NORTH ANDOVER (508) 682-6483
s
BUILDING
CONSERVATION ss,°" 5� DIVISION OF
Y ANN NG PLANNING & COMMUNITY DEVELOPMENT
CHIMNEY APPLICATION AND PERMIT
DATE Ll /� �I _ / , PERMIT # e -
LOCATION
1.
OWNER'S NAME
BUILDER'S NAME
MASON'S NAME
MASON'S ADDR
MASON'S TELEPHONE
MATERIAL OF CHIMNEY, 6�l
INTERIOR CHIMNEY EXTERIOR CHIMNEY
NUMBER AND SIZE OF FLUES�,CyC
THICKNESS OF HEARTH A)
Will chimney or fireplace conform to requirements of the code and
have rules a d egulat'ons been received:
DATE
SIGNATURE OF MASON CONTR. LIC.
EST. CONSTRUCTION COST/CONTRACT PRICE ` oo d
coo
14
�¢ PERMIT GRANTED �/ �' FEE ZS
ROBERT VICETTA, BUILDING INSPECTOR
INSPECTED
REMARKS
SOLID BRICK REQUIRED
THIS PERMIT MUST BE DISPLAYED ON THE PREMISES
0
The Commonwealth of Vassachuse=
Department of Industria! Accidents
/fes StIffr stwoo s
600 Washington Street
Boston, plass 02111
~- Workers' Compensation Insurance Af idavit
I homeowner performing nil work myself.
ry, am a sole propre:or and have no one wcr.K.--z s any ct:ac:ty
C I am an employer providing workers' compensarion for my empiovees working on this job.
addresm
_..
insurance co notice
I am a sole proprietor, general contractor. or homeowner i c r,:ie one) and have hired the contractors listed below who have
the following workers' compensation ponces:
company name
address:
cri.
ohonrUr
insurance co aolicyif
Co ntnany name. .. .. ..
address-
city. pFtone ft
. ....... .
insurance co volley#
'fit rare i33f�onaf grace t:eeessary
Failure to secure coverage as required under Section '—SA of MGL 1:: can iead o ttre imposition of criminal penalties of a fine up to s1-400.00 and/or
one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of 5100.00 a day against me. i understand that a
copy of this statement may be forwarded to the Offfee of Investigations of the DEA for coverage verification.
I do hereby certify under the, pains and
Print name
th= the infortr+at on provided above is true and Corr
Daze ss /
official use only do not write in this area to be completed by city or town otS2eial
city or town: permiaticense —,Building Department
C:. Licensing Board
Gt check if immediate response is required [Selectmen's Ogee
CHealth Department
contact person- pbooe m0ther
( 0 2195 P1A)
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