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HomeMy WebLinkAboutMiscellaneous - 8 MARBLEHEAD STREET 4/30/2018N O O° O � O D O r o m O = m C) O O m m O m ``'919 -� Location x 14-bve" No. 0 2_ } ^ 1 Date 4 fl, 4 ® . I TOWN OF NORTH ANDOVER 0 �a b' lib Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Feet' $ 3y'� TOTAL D $ Check27419 #/ a Building Inspector f. CD h 0 0 c cQ Z m Z D r F r c Z m N a Z N m X O 00 m v _< -a w cn —I O 0 0 2 . CDcn E <cn �o O 0 =��� 0 0 ) M o 3U) TI CD =r -vo'— mo m N o 3 CQ cn ��D o L CDW�o� o v -z (n CL Q- �» m-0 C/)Zr Z3n: � N r, cn cn c Uj o o 0o O a' x ocD3 =o *kV?o xn CD o c(n o �� CL co " 0 3 o Nom. 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MI I I Q CD A O z° V a CD o� I Q ° z° o� o� lElty N N W �t M Location No. DA Date Check #�IlG 27418 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee "5 $ ` TOTAL $ Building Inspector E U) .O (D 0 r. 0 0 2: U) C o U) �° 2 � o 0 N n�� m - 0 0MEX Zr Q (D -n (D0 -m ON � = �. CD (D 3 0 = -0 (D Q D p O -0 -�, < N U)p (OD (Q 0 '" _L O 0 CD n ,� (D X 0 �-0 � 0 v 0 :3A Q. O 0 CQ C =3 =r C N (n cp 3 r. (CD O Q 3 O (D h(c 0 U) =3 �. N (D < r. '-► CD 3 cn (a. o c _ _ o Cn0 cD =3 (D 3 Sr. o (D Cn CD �cn CD o o : (D CD o� 3 Z0 U) 0 o ::r o M � (D CL ~' m < m 0. q .d ,a° a p� m > y ; iV A Z X �� � o mi fR ION N 00 00 O •P KE Ln ua 0 0 c N •t Uq O n' •t O O.. 0 .t w W ((DD 0 •� CD Z3 rb c � a � CD cD cn o o < cD O � •+ CD p� o p, a cn t' CCD t3 CD W �• t3 r CD p `C r" cn �� oo��• D :orLn , �. 6 CD o o ID o o 0 CD P- -, o 0 u � .aq O � (D -0 P) 0 cnD °cD° ID �.o =r•Q R oaa SM r - m (D m CD o C c CD 15- Q.- 0 m CD O.. O OQ It lo'n CD T i CL CD Ln En M �ca). co ^ �\ . \�7, � CD CD :a U'.> \ (Dt a) CD =r =r ca o22 o £ C a 2�� 2 J®Q2/ / (a CD o e _ e E £ 92 k oz E3 CL .o 2 f �� �» (25 0 & 1 mak\ Pr ƒ _ �E7 2 � /%§ U— n § c \ �. 7 w � E \ � 2 =r 01,n CD c / / 3 2 � k £ § / � \ 3 k « ƒ § _ 0 0 £ � \�7, � � ' Pictometry Online Page 1 of 1 Print Date: 04/03/2014 Image Date:04/01/2012 Level: Neighborhood http://Pol.pictometry.comlen-us/applprint.php?title=&date_fmt=m/d/Y&year=2012&month... 4/3/2014 i Date ...... !.? ..2'. O..'..[. . TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..........t.� . t mow..�L.t.'............-1z has permission to perform .........r� 7` P . . ............y ........................................................................ wiring in the building of ..... �c.. �� .�F� ... cJ.. .. G'cMS................................................ at .. .......& 'C8.4.JE.... ?Y! n. ......sL" ............... North Andover, Mass. +ee... [ "' Lic. No. .1Q..lf............................. �2..� t......... ............ ......... ELECTRICAL INSPEfOR ;,heck # 2 I R Commonwealth of Massachusetts Official/ Use Only 'b Permit No. G C Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/07j (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ,.� All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9--20--13 City or Town of: NORTH ANDOVER To the Inspector of Wires: V,_� By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street &Number)al'1�K49LFL-JeJ.4-T Owner or Tenant '3,,4,k Telephone No. 6b3 2-3y, ZfI4 3� Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) \ Purpose of Building �'v� �tt�"cia % Utility Authorization No. - Existing Service '?ejy Amps / "ICU / Ztfr? Volts OverheadE3--- Undgrd ❑ No. of Meters 2-- New iNew Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the.following table may be waived by the Inspector of Wires. Lo No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Z Above In- Swimming Pool rnd. [:jrnd. El o. o Emergency Lighting No. Units No. of Receptacle Outlets 2 l No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. l� of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: I'v f�J./ •I' 3f low A c tori fif Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 5� -?,0 `% Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such C!0!5we is in force, and has exhibited proof of same to the permit issuing office. UR CHECK ONE: INSANCE [BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: 1,91fl1/< Licensee: 10114A 2 Signature 1C -X,'&,4__ LTC. NO.: (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.•�,7�%�02 7� Address: P, �q5 �- N% - /!/// 493.0 7Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent FPPRMITFEE.-$ 12_S'__,6,0 Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the \ permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass M Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 151 Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL R H INSPECTION: Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: — /G — / ROUGH INSPECTION: Pass EN Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSP Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: ; ._ Date: DEB WEINHOLD ... TOWN OF MERRI�IAC, MA. .......dweinhold@townofinerrimac.com �r The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations IV 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance .Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): i Address:,�� S�� 4 i City/State/Zip: Phone #: , 7 �b 22 Are y9u an employer? Check the appropriate box: 1. ETI am a employer with 1 4. ❑ I am a general contractor and I employees (full and/or part-time).* have ]fired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. # ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. [:1 We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑New c siruction 7. emodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they ate 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. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. (/�( Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certtfy under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone #: Official use only. Do not write in 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 #' 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 -contractors) 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 permit/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 bum 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 02111 Tel, # 617-727-4900 ext 406 or 1-877rMASSAFB Revised 5-26-05 Fax # 617727-7749 wWW_Mass.govfdia This certifies that has permission to perform . :' � ,,, , , , , , ,,, , , plumbing in the buildings of. . :a.(, o,,. . . �.) o .-� R 1- e rc T at . ..4Ms•..{...... . ... . . .... . North Andover, Mass. Fe- .\Q1. Lic. No. rs36........ . ........... . -PLUMBING INSPECTOR Check # lS-E V /o13—,,) ' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK -I CITY �2 �e4 MA DATE _ PERMIT # �II� JOBSITE ADDRESS f' -.----:]OWNERS NAME _ vp . _ _ _ P OWNER ADDRESS ,R1 ` - TEL /�- ZyfG FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL ®` PRINT CLEARLY NEW: RENOVATION: EM REPLACEMENT: E] PLANS SUBMITTED: YES E] N0[] r= FIXTURES 1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 1 11 12 13 14 BATHTUB - CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM ' DEDICATED WATER RECYCLE SYSTEM DRINKING FOUNTAIN FOOD DISPOSER FLOOR / AREA DRAIN ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET WATER HEA I have a current Iiabilb insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 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 UiM this requirement. CHECK ONE ONLY: OWNER 0 AGENT Q SIGNATURE OF OWNER OR AGENT 1 hereby certify that all of the details and Information I have submitted or entered regarding this application are true and e4tiote to the best of my knowledge and that all plumbing work and installations performed under the permit Issued for this application will be in oomplla ail Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 5 PLUMBER'S NAME Steven Carr LICENSE # 15366 SIGNATURE MP 0 JP Q Nk CORPORATION [:) # PARTNERSHIP O# LLC 0#SOLEPROP COMPANY NAME SPC Plumt & Heating ADDRESS 12 Concord St. CITY I Methuen ,-----__]STATE ® ZIP 1 01844 TEL 978-8153936 FAX[_978-208-1081 CELL 978-8153936 EMAIL ph zon.not A XX -7 W Date ..."I. -I ... I—A .... I .............. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that...a.-k.r.,,�.. . ....... ........................................... has permission for gas installation ..-.% ......RA. ...... ,11-1 ......................... in the buildings of. tea............ r . ...................................... at .. . cl ..:1 ............................ NorthAndover, Mass. Fee.A ... ....... Lic. No.14... 54Y ........... ............. --!G ASINSPECTO Check # 8877 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY iU'��/ i- MA DATES 3 PERMIT # no I� JOBSITE ADDRESSA-itis"a`,, OWNER ADDRESS ik'U'I� ��I G-23 ` ZY .. FAX TYPEzR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL RRLN � CEARLY NEW: RENOVATION: 93 REPLACEMENT: [j PLANS SUBMITTED: YES ED NO LJ APPLIANCES Z FLOORS— I BSM I 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 1 10 1 11 1 12 13 14 BOOSTER n. 410A 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES P2, NO L I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY t BOND rj 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 E j AGENT ED SIGNATURE OF OWNER OR 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and;duto the best of my Knowteage and that all plumbing work and installations performed under the permit issued for this application will be in compliance ' ail Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME i Steven Calc LICENSE , SIGNATURE #5386 MP D, MGF 0 JP E JGF [j NPI Ej CORPORATION D# - PARTNERSHIP Lj#[ = LLC L# sole rop, } ADDRESS COMPANY NAME: SPC Plumbing 12 Concord „ ff St CITY ` Methuen STATE MA ZIP E 01844 TEL 978.815-3936 FAX LH8-208-1081CELL978-815-3936 EMAIL spcph@veriaon.net.��-� ^ ., - t ., A .. f� � i . � ...! '� . i .. � � f.. e 1• r _ � , � i .., � The Cotntnonlvealth of Massachusetts Deparlinent of Industrial Accidents Office of Investigations 600 6Mashington Street Boston, AM 02111 lviviv.mas&gov/dia Workers' Compensatiou Insurance Affidavit: Builders/Contractors/Electricians/PIuu abers 'kADDlicant Information Please Print Lep_ibly Name (Business/Organization/Individual): SeG 1h Uh► 3 N t, # A 71 L Address: IZ- tsy4 coesoo Sr City/State/Zip: 1b tr"tcnf. b A in t'04 Phone #: Are you an employer? Check the -appropriate box: 1. [� I am demployer with 3 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp, c. 152, § 1(4), and we have no insurance required.) t employees. [No workers' comp. insurance required.) Type of project (required): 6. ❑ New construction 7. [ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0'Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other *Any applicant that checks box #1 must also Gil out the section below showing their workers' compensation policy information: t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContraelors 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. Insurance Company Name: N0 401 L + Policy # or Self -ins. Lic. #: �� )�� I �3� � Expiration Date: 12-1101 2_dI J Job Site Address: ! 11RCity/State/Zip: 4. xrn Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day gamst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ify tr':dtr the pains and penalties of peijur), that the infor•nration provided above is true and correct z Oficial rtse only. Do not 41M in this area, to be completed by cloy or tolvrr official. City or Town: Permit/Liceuse # Issuing Authority (circle one): 1. Board of health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5..Plutrtbing Inspector 6. Other Contact Person: Phone M Location q / i 1' �` "-C,CL— "'' el No. Date i . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ �� r Building/Frame Permit Fee $ 10 �! Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 1fv� Check # 1 26726 If} ilding Inspector .q Ly J BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ,_hu- n . 11-iu t kA /JV 4G . 11 w I, Identification Please Type or Print Clearly) OWNER: Name: 'Tet ria,S rr 7" Phone: Gd � d 35/— .2 Address: ARCHITECT/ENGINEER Ur Ad ic-k ff 556 G Phone: 603 99 Address: a:ns ( /'+)t..... N e H_ Q 7n 7 9 Reg. No. $0�_ FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 9a 1560 FEE: $ 70• a? Check No.: ,i 2 Z� Receipt No.: mac, NOTE: Persons contracting with unre istered contractors do not have access to the guarantyfund A 4 / W DO X EXISTING BUILDING CODE EVALUATION EKeys4cars 11 Marblehead Street North Andover MA AWWO 3 y : ==7 A FR C H I T E C T U R E �151 Main Street, Salem New Hampshire 03079 TEL. (603) 894-5117 10 JULY 2013 u IN Eel J 0 0 vov A 10 July 2013 R C H I T E C T U R E Town of North Andover 1600 Osgood Street, Suite 2035 North Andover MA 01845 ATTN: Gerald Brown, Inspector of Buildings RE: EKeys4cars Proposed Existing Building Modifications 8 Marblehead Street Existing Building Code Evaluation Dear Inspector Brown: Per your request, I am pleased to provide the following existing building code evaluation as required by the Massachusetts State Building Code, as appropriately applied. The existing building is proposed to have 'minor' alterations to accommodate the work establishment of the prospective owner. The alterations will be limited to the area.to be occupied by the proposed work establishment of the prospective owner. The entrance to the building area within the work scope limits will be made 'accessible'. The existing toilet facilities will be modified to be made 'accessible.' A proposed overhead door will require structural evaluation of the existing header. The existing ventilation system will require modifications to allow for fresh air, and positive air pressure in the occupied front finished space. The unfinished area will require a new heating system, exhaust air system, and heat transfer system for 151 Main Street Salem NH 03079-3109 Tel: (603) 894-5117 X IRE X 10 July 2013 8 Marblehead Street/ Code Evaluation Page 2 fresh air. The existing fire alarm and detection system will require modifications to coordinate with the space configuration. Carbon monoxide detectors should be installed in all occupied areas. The existing building alterations do not meet the threshold that would require the installation of an automatic fire suppression sprinkler system. All new building components and finishes will be installed in accordance with the current building code requirements. The following are the applicable codes as referenced by 780 CMR 8th Edition: IBC -International Building Code IEBC-International Existing Building Code (deemed the Existing Building Code of Massachusetts) 780 CMR -MA Amendments to the IBC & IEBC 521 CMR -MA accessibility regulations 527 CMR -MA fire preventions and electrical regulations IFC -International Fire Code IECC-International Energy Conservation Code IMC -International Mechanical Code 248 CMR -MA plumbing regulations The following are the objective references to the pertinent code sections relevant to this building's alterations: Reference: Mass Chapter 34 Amendments Per 3401.1 IBC Chapter 34 is deleted in its entirety. ( IEBC is the `code'.) Per 101.5.0 No compliance alternatives are proposed. Per 101.5.0.1 Submittals. 151 Main Street Tel: (603) 894-5117 Salem NH 03079-3109 10 July 2013 8 Marblehead StreeVCode Evaluation Page 2 No non -or partial compliance or alternative compliance components are being proposed. Per 101.5.4.0 Investigate or evaluate the existing building Limited to: ...'Portion thereof, of proposed work on the work area under consideration, as impacted by the proposed work. The entire building, structure, and foundation are not affected by the proposed work. Limits of alteration area shown in diagram below: --------------------------- IS T O R A G E S H E D o G A R A G 'E — — — / , L 151 Main Street Salem NH 03079-3109 E V I CL PASSAGE LII it FLFC ELECTRONIC hull 570RAGE III TOILET I ST AX. 3 AREA MAX. ( MAX. 3 CARS ) �I II ORE o 0 0 n COlRTESCVST0I..ERYAREA �OM II(� oPPICE � Tet: (603) 894-5117 V I CL PASSAGE �I Seklw:E COlRTESCVST0I..ERYAREA WAITINGAREA D LSA DISPATCHno O D D 1 8 SCALE IN FEET- CONC. SLAB vF � PLAnr r�w�ao I n 1N 0 P K A R E A L I M I T S Tet: (603) 894-5117 9 10 July 2013 8 Marblehead Street/Code Evaluation Page 4 Reference: IEBC, (The Existing Building Code of Massachusetts) Ref. 104 Building Evaluation Per 104.2.1.1 To determine the existence of any potential non- conformance with the provisions of this code. The area of the existing building upon which the modifications will be made is described as follow: Concrete floor slab on grade. No potential non -conformities with this code are evident. Reinforced concrete columns, reinforced concrete beams, and concrete plank roof structure . No potential non -conformities with this code are evident. Masonry and storefront curtain wall system. No potential non -conformities with this code are evident. p Rigid insulation and membrane roof covering. No potential non -conformities with this code are evident. Automatic fire suppression sprinkler system. MGL c. 148, d.26G w/ amendments, ( Chapter 508 of the Acts of 2008,) takes precedence. Modifications do not meet threshold of 'Major' alteration per Massachusetts Fire Safety Commission Memo dated 151 Main Street Tel: (603) 894-5117 Salem NH 03079-3109 X J 10 July 2013 8 Marblehead Street/Code Evaluation Page 5 10.14.09. Above ceiling HVAC unit. Potential non -conformities with this code are addressed as relevant to IECC. Fluorescent lighting fixtures. Potential non -conformities with this code are 0 addressed as relevant to IECC. Fire detection system. Potential non -conformities with this code are addressed. System to be enhanced as required by relocation and adding components. Illuminated exit signage and emergency lighting. Potential non -conformities are addressed as relevant. Systems to be enhanced as required by relocating and adding components. Results of investigation and evaluation propose no compliance alternatives. 10 No major building structural alterations are proposed. No hazardous building materials exist or are proposed. ( ACM review per EPA requirements to be conducted independently by current owner prior to sale.) No hazardous conditions are evident or are proposed. CO detectors are to be installed. 151 Main Street Salem NH 03079-3109 X Tel: (603) 894-5117 9 10 July 2013 8 Marblehead Street/Code Evaluation Page 6 Lighting and ventilation to be addressed per IECC. Economizer to be installed on any new HVAC unit. Reduction controls to be added to lighting area. Positive air pressure to be established in the occupied areas. Ventilation and heat exchange to be provided for the service area. O Ref. 301 Compliance Methods Per 301.1 Exception: Alterations comply with the laws in existence at the time the building or the affected portion of the building was built, shall be considered in compliance with the provisions of this code.... Unless the building has sustained significant structural damage .... or is undergoing more than limited structural alteration as defined in 907.4.3. The existing building was permitted and constructed under previous edition of MSBC and deemed compliant per occupancy. The building has not sustained any significant structural damage. The proposed work does not meet the threshold of a 'substantial structural alteration' Ref. 403 Alterations Per 404.3 Structural Element Gravity Load Proposed alteration for existing window header to accommodate proposed overhead door width. Existing Structure to be shown to, or enhanced to, carry the loads per IBC. ( Structural Investigation and Structural Engineering Consultation required.) A special request will be made in accordance with IBC 107.3.4.2 151 Main Street Salem NH 03079-3109 9 u Tel: (603) 894-5117 r.� U A X 10 July 2013 8 Marblehead Street/Code Evaluation Page 7 Deferred submittals, and 107.4 Amended construction documents, to allow time for the above referenced Structural Evaluation. Ref. Chap. 5 Classification of the Work Per 501.2 The work area is identified on the plan. Per 504.1 Alteration Level 2 Chapter 7 & 8 compliance required. Ref . 701 Compliance Per 701.2 The proposed alterations will not make the existing building less safe. Exception: Alterations to confirm to IBC. Per 702 All new building elements and material will comply with IBC. Per 703 Level of existing Fire Protection will be maintained or enhanced. Per 704 Level of egress to be maintained. Per 705 Portion of building undergoing alterations will be made accessible. Per 706 Structural. The proposed alterations do not include replacement of equipment supported by the building or replacement of roofing. Per 707 Energy Conservation. The minimum requirements of ]ECC for this level alteration are to be complied with. ( I.e., Economizer/fresh air requirements and electrical lighting reduction controls.) 151 Main Street Tel: (603) 894-5117 Salem NH 03079-3109 1 10 July 2013 8 Marblehead Street/Code Evaluation Page 8 Ref . 801 Alterations Level 2 Per 801.3 Compliance. All new building components to comply with the requirements of IBC. Redundancy to IBC with allowance for less stringent provisions. C) Full compliance with IBC proposed for new work. Ref. 802 No Special Occupancy proposed. Ref. 803 No Vertical Openings. ( I.e. protected stairs in work area.) Per 803.4 Finishes All new finishes will comply w/ IBC. Ref. 804 Fire Alarm (per NFPA 72) Per 804.4.1 Occupancy requirements Exceptions: " Occupancies with an existing, previously approved fire alarm system." p The existing fire alarm/detection system will be enhanced as required to accommodate coordination with proposed alterations. Ref. 805 Means of Egress Per 805.3.1.1 Single exit allowed. 151 Main Street Salem NH 03079-3109 Eel u (Mass Amendments supersede and require 2 exits.) Two (2) exits provided for. Tel: (603) 894-5117 r A 10 July 2013 8 Marblehead Street/Code Evaluation Page 9 Ref. 806 Accessibility Accessible route provided for. Ref. 705 Compliance. Ref. 807 Structural Per 807.2 0 New structural element if required to comply w/ IBC. ( Relevant to proposed overhead door header review.) Per 807.4 No new gravity loads proposed. Ref. 808 Electrical All new electrical work to comply w/ NFPA 70. Ref. 809 Mechanical Per 809.2 Altered existing systems. Fresh air and ventilation air to be installed per the requirements of ASHRAE 62. Positive air pressure required in occupied areas. (Existing or enhanced air handler to be balanced accordingly.) Per 809.3 Local exhaust air required for open service area. (Suspended gas fired heaters and heat exchanger on fresh air intake proposed for open area.) Ref. 810 Plumbing 151 Main Street Salem NH 03079-3109 X Tel: (603) 894-5117 9 10 July 2013 8 Marblehead Street/Code Evaluation Page 8 Per 810.1 Occupancy load not increased by more than 20%. Mass Plumbing Code allows for Uni-sex Accessible Toilet Room. Ref. 811 Energy Conservation Per 711.1 IECC compliance only applicable as the code relates to the `new construction' only. O Alterations to conform to IECC. Reference: IBC Chapter 3 Use & Occupancy Classification Section 311 Storage Group S-1 Motor vehicle repair garage. Chapter 5 Allowable Building Heights and Areas Table 503 4 stories 26,000 s.f., 55' high Proposed alteration area limits: 4,484 s.f. single story Existing building area: 9,028 s.f. single story w/ mezzanine Chapter 6 Type of Construction Table 601 Non-combustible Type II B Respectfully submitted by: Tim Warnick, Architect Warnick Associates, Inc. ARCHITECTURE 151 Main Street Salem NH 03079-3109 X Tel: (603) 894-5117 'kation No. ell Date l NpRTq TOWN OF NORTH ANDOVER o @Xrtificate of Occupancy $ Building/Frame Permit Fee $ rn "'°' sACMus Foundation Permit Fee $ er Permit Fee $ Nit $ Sewer Connection Fee $ Water Connection Fee $ �— TOTAL Building Inspector .7c �`�a Div. Public Works P]�FWUT 240. 00 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. MAP X40. LOT NO. 2 RECORD OF OWNERSHIP DATE (BOOK iPAGE ZONE I SUB DIV. LOT NO. LOCATION L /74 PURPOSE OF BUILDINGV;rl � /'%1 W0 A, /op Y./� K V OWNER'S NAME A-��1c�--J'V�+,�-'�• NO. OF STORIES of e+{S,.ICZ.:Ev�� OWNER'S ADDRESS 4i7V u I /l/,I/ BASEMENT OR SLAB '` A (y v ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME - J, ,.'riaE DISTANCE TO NEAREST BUILDING ///n�_ /� Q SPAN DIMENSIONS OF SILLS DISTANCE FROM STREET '• POSTS DISTANCE FROM LOT LINES - SIDES REAR C) GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW �v /I d SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION J IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE `S. IS BUILDING CONNECTED TO TOWN WATER GS BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER �J IS BUILDING CONNECTED TO NATURAL GAS LINE gs INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 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 FEE ��Q& tj L/ PERMIT GRANTED •�• L OWNER TEL. 19 '! CONTR. TEL. CONTR I fC 1*3 It ►L e � da 3 PROPERTY INFORMATION LAND COST EST. BLDG. COSTSy o EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. �. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN 1 BUI d INSPECTOR 5 1 OCCUPANCY GABLEHIP GAMBREL MANSARD SINGLE FAMILY - STORIES _ MULTI. FAMILY OFFICES WATER CLOSET APARTMENTS W Lkra LAVATORY CONSTRUCTION WOOD SHINGES 2 FOUNDATION KITCHEN SINK HOT W'T'R OR VAPOR 8 INTERIOR FINISH WOOD RAFTERS CONCRETE AIR CONDITIONING 3 1 2 13 CONCRETE BL K. PINE 7 NO. OF ROOMS GAS BRICK OR STONE EEIHARDWD B'M'T 2nd _ 1st 13rd I NO HEATING PIERS _ PLASTER ORY WALL _ _ UNPIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA 1/1 1/: 1/1 FIN. ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE _ WOOD SHINGLES EARTH ASPHALT SIDING HARD"rD I� STUCCO ON FRAME _ BRICK ON MASONRY ATTI BRICK ON FRAME CONC. OR CINDER BILK. WIRING 5 ROOF II 10 PLUMBING GABLEHIP GAMBREL MANSARD BATH (3 FIX.) TOILET RM. 12 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES TIMBER BMS. & COLS. LAVATORY STEAM WOOD SHINGES STEEL BMS. & COLS. KITCHEN SINK HOT W'T'R OR VAPOR SLATE WOOD RAFTERS NO PLUMBING AIR CONDITIONING BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 'r- - �I TILE DADO , 6 FRAMING WOOD JOIST 11 HEATING PI PE LESS 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 7 NO. OF ROOMS GAS OIL ELECTRIC B'M'T 2nd _ 1st 13rd I NO HEATING C2 CO) C d 'C O CD C� Z y CCD O 'v CLcm r �' OC CL = y a� -v O COQ CD CCD O C. _ Q CD CD O CD w w S C O co)" CD CZ CD O co) CO CD I S- CD v y O 'CZ cD o CD 0 C CD O r 1� C/) n O z p _ O d y C cr N y CD C2 m C7 C= H CD a C �• z =r-pw co .+ = .* m C T .. a �+ a 0 T CD CD H o �•-1 N =r CD 2 CA IC p O C N• cn W =r CL �a Uc o s .IL co C H 7C-ro H c CD a > C co, o .c = : CL — CL .H G C ,,,► CD N ((^^ ? O_ V/ N CD N O_ C O � m O CD + .rt �►CD N s. 'h CD CL lb a ._ C2 . z O md =a ti X, " z tz x Cil Z O °= 0 aGa "Cy r tz W w' a- K 0° .d C/) 00 Q x tz x y 0 9 0 c CD l OFFICES OR. APPEALS BUILDING CONSERVATION H EAL"I"H PLANNING 0 Town of NORTH ANDOVER DIVISION OW PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIIZEC*1*011 120 Main Street North Andover. tWissac'huscIts O I H4 i ((i17)fN5-4775 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number t 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 111, S 150A. Tice debris will be disposed of in: !: I (Location of Facility) c ;14 Siature mt Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. n L w� 4A etcCk /Z Z'Xzi =w\JT IPV n 0 V W !N D 11�✓ )`:, ✓Lf W t i✓n tWj f"Wiv q u+J Ht n W W W xxx in 4n coo a a a N N h N CI C �.0 N f (�< — alz� 3 QW m w 14 r � _ � �, w;� , �$ r• , � jam.. o„ �,F. i .z-• _. - - gym. �.mann._u3- - •.��^,*+.•*»- _ z o y :v -i v 5►t7i rn 41'. CSN ri+ 0 • r �y <%. o� I Inc m t O F'! W 4"to _ h tam i o f CA t, n0 m Ho 0O M J Q .0 _ .. O o _ ft; !- W aD mi Location No. Date kofyof'4 TOWN OF NORTH ANDOVER ,a�.0 9 Certificate of Occupancy $ J Bui , ing/Frame Permit Fee $ dation Permit Fee $ - f ✓� ;';:G`� ther Permit Fee $ �,- Sewer Connection Fee $ 1l�lat���nnection Fee $ �P�OTAL $ T / r/. Building Inspector Div. Public Works PERMIT NO ff S.r s APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. MAP 4J0. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. �I LOCATION Q A% e oO PURPOSE OF BUILDING `Y�AMuS�S_�ISS�iyL I/Ii/�A%7�IJ%G OWNER'S NAME f V� �� NO. OF STORIES �1 SIZE C–v_2 l' OWNER'S ADDRE /�j f'0ive .�/ _ {— l�� BASEMENT OR SLAB ARCHITECT'S NAME syly—fl7�„ e- SIZE OF FLOOR TIMBERS 1ST Ax r L 2ND 3RD BUILDER'S NAME 19 i-)' /,Z Aw l� V SPAN y 2.L5—Fee .L5—CGG / DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR 6--e G• AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING % IS BUILDING ADDITION ve J C f MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 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 SIGNATURE OF OWNER OR AUTHORIZED AGENT EMMA I PERMIT GRANTED 19 '17 OWNER TEL. M �i._ 19?—'_dUl, 0-7 CO'gTR. TEL. CW -JR. •1_!C.:r c55'LZ r 3 PROPERTY INFORMATION LAND COST ad EST. BLDG. COST 22.6-0-j-_) EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILD Na INSPECTOR 1 OCCUPANCY APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 'CONCRETE 3 1 2 13 CONCRETE 8L'K. PINE _ _ BRICK OR STONE HARDW D — _ — — PIERS PLASTER DRY WALL . UNFIN. 3 BASEMENT AREA FULL FIN. 8'M'TAREA _ '/. 1/1 '/ FIN. ATTIC AREA _ NO 8 M T FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING— HARDIV'D ASBESTOS SIDING COMMON VERT. SIDING ASPH. _71LEIA STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY - ATTIC STRS. & FIOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING ST NE ON FR ME. r Un SUPERIOR I --I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GARIF I I HIP i 11 BATH 13 FIX.I I LAVA �ITILE FLOOR TILE DADO 6 FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FUI TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. y HOT W'T'R OR VAPO WOOD RAFTERS ^ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL z,�I 2nd I _ ELECTRIC 1st 3rd I NO HEATING BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.,S�R .` C,z T -i i 77-1 TI i -M a m C= ri rn, L F 7 t4 i 77-1 TI G) a m C= F 7 IT j r7l i 77-1 TI G) a m C= �c.h1sJ SUBJECT____•^G^,,___-----____"___'_'-'__"_-'_ ------------------------------------------- COMPUTED BY --- ,�C1-----_---CHECKED By ----------- SHEET NO ----------- OF JOB NO. __------ -. DATE ------------------------- 6 -- -------- Project !� '� `'LA� Acc. No. Subject Sheet No. of Date 19 Comp. �� Check Cont. No. Rai s7rz-oh,,-- Soo,.) Low -z o�� Z fj - C5 G CIS per: A Lo �Q an Redo Den = D =2o fir kb= R� --,30 - I S JD ao a W Li 0' 1.1 2.3a —( AL = (w.)(y �6,) =. 2 Naz -2(2-3-8)L 11.S75ZL Moa S4 2.35 = 3.88 WL C5L,:35 ps4 -e— Cl ' S .1 __s y }-�- 20 p--,( d �- I� —TsnS i35 p►F' =,S piF S„a. I7 -t -s !,A 4 sz p' zxa.s pfd' 6 -U, , - Z -s PW dnA 391 p w, iho,,, to rQ, V = O @: 7.2-77' 4�,,, Rk c,,d Xv = H(gz 4-� / 4 Project 8'r'��' Acc. No. Subject Sheet No. of Date -1 9 Comp. � Check Cont. No. 0, L cS =- G 1-1 w,7 l loll O'm 01-15) Z mcm"L 4, Zx Io I(�S -Pb 9-70 p�: 'Z, -34 C1.1S') �v - S2 �ko/z� -X83 lLs 3 C�83) 73 `b psi 2 13S`b 1.15 2 10 (2 1G" 0 C, JLJ9uevt 3"vv-r CClAn ( 00\ - 6 S �qr� SZ PW rYv► - sa 04-)'A- z- V= srz cis)/z = Lto940 f►,. CD 1. Pte .. LtoR- 2 = St92 Ibs Q/' 3•�,,� 120 �'}�� (jiv (� C1 n Co• d, rMr e !✓b _ 2tioo (J5, c ('( —7 flog OCO Jqv Ps -t r� S`. x Oara v w v Cf) c O 0 bo 2 v U OO U m U cn w cs: O U. ¢ � c z W 90w C/) o n°n r LU An V z C CD " 6D C O C O ` C h O C Vcj O V 0.� C . •O. O W m C �= O O � �EQ m m CE like Sa N � c •C� Ci C2 ®cm ti C E c:r E LA m mCDCL N fly vm 3 cm m N C2 ca m CO) C y R C 0 E N a m to -v.: m N_ m W8 C: L = O Cf 2oa C _ma c g = m 44 .cma ' - o �c�•�Z o .; �c�o c H m N ) t W CO �� Com. � ' .y O.L O C Z oc 'E �V o W Ca V m p C COD L CL. O .CD m O H s r0-. C. �.. m `J co J Q 0 Z ELL_ co O F 0 c LIJ Z Q, O o CO) C C± z z w "O > CO)C .0 Q LA �E w m m Cw Z w > L 0 a7 O = R� Q co > 0 C Cd i O Q a a � �Cc :i Q z •CO2C ai LL_ ' C z cl V CL y LL_ C Cc Q COD CD 5 Z z � � Z LL LL V. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING v `y (Print or Type) qq NORTH ANDOVER Mass. Akaft L Date , d kuilding Location r _ F11:VFCt 14GPermit # 3 Owners Name "'y - ' �, ���''�►� • New Renovation D Replacement�] Plan bmitted FIXTUPcc (Print or Type) Installing Company Name Address PO F(Z�s'k' J6 n P4,Z POJZ, N tS-S 1A1A- 19- C 64P« ," Check one: Certificate Q Corp. Partner. Firm/Co- Business Telephone: L%a --07� 7 Name of Licensed Plumber or Gas Fitter�-: L (AP L E! �^ Insurance'Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity Q Bond �( Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this ap Ica - n doe n have any one of the above three insurance coverages. -Signature oro ner/agent o propert Owner Agent I hereby certify that all of the details and infotmation 1 h submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations petformcd under Permit issued for this application will -be an compliance with all p=tInent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE•TA k PA.,& ct-f Plumber Gasfitter ignature of Licensed Master Plumber or Gasfitter Journeyman :7 License IJumber N x t- i 1 41 - m O d Q to w S w w o t -N p• W > tW w w as rn wt a Z d t,1 s x. a X a Q w O t" to t4u z a w e x.• r w ,. H a> m z LL o z a rn z a L1 x > o C 0 W Y W z a� 4 .cc to 4 C j O v O x> W ca O a 411 t- t— o SUB—as'"aT. RASEMEHT IST FLOOR 2HO FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TK FLOOR STH FLOOR (Print or Type) Installing Company Name Address PO F(Z�s'k' J6 n P4,Z POJZ, N tS-S 1A1A- 19- C 64P« ," Check one: Certificate Q Corp. Partner. Firm/Co- Business Telephone: L%a --07� 7 Name of Licensed Plumber or Gas Fitter�-: L (AP L E! �^ Insurance'Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity Q Bond �( Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this ap Ica - n doe n have any one of the above three insurance coverages. -Signature oro ner/agent o propert Owner Agent I hereby certify that all of the details and infotmation 1 h submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations petformcd under Permit issued for this application will -be an compliance with all p=tInent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE•TA k PA.,& ct-f Plumber Gasfitter ignature of Licensed Master Plumber or Gasfitter Journeyman :7 License IJumber DATE: EXISTING MAIN ©YE NO EXISTING SERVICE YES F] NO I rV IV Ir -%L/ r%%.! 11-I VfII L/'•1I I$,JIV FORM SIZE ` S� PRESSURE / CODE SIZE -5 CODE PRESSURE PRESSURE CODE PRESSURE CODE REGULATOR CODE E MAIN $ SERVICE $ FIT $ TOTAL $ L ACCEPTED YES NO ROR REQUIRED � YES NO LVM FORM REQUIRED YES Q NO U ENGINEERING COMMENTS ENGINEER DATE - DATE COMPANY REJECTION ❑ CUSTOMER NOTIFIED COMPANY APPROVES ❑ CUSTOMER REJECTS S i) COMPANY APPROVES ❑ J CUSTOMER ACCEPTS ROR DPU NO. AUTHORIZATION NO. MAIN SERVICE BUDGET jr-1YES LINO ACTUAL COST MAIN SERVICE METER FIT OVERHEADS TOTAL ROR CHARGE % OTHER CHARGES $ CUSTOMER CONTRIBUTION SSECT APPROVALS DATE FINANCE CONTROLLER RETIREMENT F]YES [-]NO FOOTAGE SIZE SUPPLEMENT RYES DNO REASON YEAR INSTALL BASELOAD (CCF/MO. NEW + EX) CCF USE PER DEGREE DAY METER SIZE CODE NEW REVENUE CLASS NEW RATE CODE METER FACTOR CODE DWELLING UNITS GRID NO. C+I MONTHLY READ [-]YES D NO DATE SET n � :.tet .&` « n ® .j .,n .�,,, �� •� r`,°`,a.F �3;� �tY^•6, '�.,,� i� �` v� ��� ..�,.:.. :>i,'i;. ��...e� �x'�o .F DIS NO f AUTHORIZATION NO:; SERVICE INSTALLED DATE , NEW MAIN REQUIRED YES �O SIZE LENGTH NEW SERVICE REQ. YES D VO SIZE LENGTH Ih °' a $ NEW METER REQ. © YES ENO SIZE � � M METER LOCCATIONATIONDE U •�v ., a$ ° TOTAL CAPITAL COST: h l' $oa $ ,e• :. Y 09 17 PRESSURE CODE PRESSURE CODE REGULATOR CODE E MAIN $ SERVICE $ FIT $ TOTAL $ L ACCEPTED YES NO ROR REQUIRED � YES NO LVM FORM REQUIRED YES Q NO U ENGINEERING COMMENTS ENGINEER DATE - DATE COMPANY REJECTION ❑ CUSTOMER NOTIFIED COMPANY APPROVES ❑ CUSTOMER REJECTS S i) COMPANY APPROVES ❑ J CUSTOMER ACCEPTS ROR DPU NO. AUTHORIZATION NO. MAIN SERVICE BUDGET jr-1YES LINO ACTUAL COST MAIN SERVICE METER FIT OVERHEADS TOTAL ROR CHARGE % OTHER CHARGES $ CUSTOMER CONTRIBUTION SSECT APPROVALS DATE FINANCE CONTROLLER RETIREMENT F]YES [-]NO FOOTAGE SIZE SUPPLEMENT RYES DNO REASON YEAR INSTALL BASELOAD (CCF/MO. NEW + EX) CCF USE PER DEGREE DAY METER SIZE CODE NEW REVENUE CLASS NEW RATE CODE METER FACTOR CODE DWELLING UNITS GRID NO. C+I MONTHLY READ [-]YES D NO DATE SET n � :.tet .&` « n ® .j .,n .�,,, �� •� r`,°`,a.F �3;� �tY^•6, '�.,,� i� �` v� ��� ..�,.:.. :>i,'i;. ��...e� �x'�o .F DIS NO f AUTHORIZATION NO:; SERVICE INSTALLED DATE , 'SERVICE FOOTAGE `y SERVICE SIZE METER FIT INSTALLED AMOUNT REBATED ��,+ DIVISION TIME IN °' a $ YES No #'.�.'. . :, ,sem..,.+.�e,...sw. •�v ., a$ iP�LI $ ,e• :. Z NAME HOME TEL. NO. STREET NO. STREET NAME - TOWN O ARCHITECTURAL FIREPLACES - 2 STREET NO. STREET NAME BUSINESS ZIP CODE LANDLORD NAME 0 8 MARBLEHEAD ST 975--4409 LL TOWN ZIP CODE LOT NO. FLOOR/APT LANDLORD ADDRESS TELEPHONE NO. z NA 01845 00-0000 W CUSTOMER AT THIS LOCATION YES NO I CUSTOMER ACCT. NO. 4041,x,500216-9132 EX. EQPT. CODE EX. REV. CLASS REQ. EQPT. CODE PROSPECT TYPE RESPONSE �qDE COMPANY DIVISION TIME IN DATE NOMAD NUMBER ' iP�LI 01 04 09 17 07/30/93 lary9$0 a Z NAME HOME TEL. NO. STREET NO. STREET NAME - TOWN O ARCHITECTURAL FIREPLACES - 2 STREET NO. STREET NAME BUSINESS ZIP CODE LANDLORD NAME 0 8 MARBLEHEAD ST 975--4409 LL TOWN ZIP CODE LOT NO. FLOOR/APT LANDLORD ADDRESS TELEPHONE NO. z NA 01845 00-0000 W CUSTOMER AT THIS LOCATION YES NO I CUSTOMER ACCT. NO. 4041,x,500216-9132 EX. EQPT. CODE EX. REV. CLASS REQ. EQPT. CODE MEDIA COJ�E RESPONSE �qDE BEST TIME TO CALL ANYTM ISALESPERSON�EMP. NO. MASTER NOMAD NO. SALES CLERK SEVIGAIY 0989 ItFC . !�R'Ft.'�`T. ,s -T. -•a, •'T�.�.eeT^+. .. '. � .:.v'r,^��'.r•+-.•,�rr�—R;..'T�v�':��-rt+:.n^�.�.g'YC�:.e,�'R.'�'e�:T.+-^�<xt�'^�a�'^^.P-.���4.. a-e•...'—.tne�-e—....-na-. . Date ... "1-301 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • Cq3 9 so This certifies that .... I-kz has permission for gas installation in the buildings of J atY, ev Fee.. .. .Lic. No.32� .. WHITE: Applicant CANARY: Building Dept. Ando .......................... GAS INSPECTOR PINK: Treasurer GOLD: File - I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER Mass. Date YX 1. kuilding Location lnli. (?/3,41- / G Y 4 -5/9G2� 7' Permit # Owners Name _ • New -7 Renovation D Replacement Tr Plans Submitted D FIXTllP!=S (Print or Type) Check one: Certificate Installing Company Name /Tzi .ez-7—A-e2 &Q Q Corp. Address 3 Sj,�A/,,,[ j o)/vG = Partner. Firm/Co. Business Telephone: y� Q G` Name of Licensed Plumber or Gas Fitter QT Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F BondEj 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 17 Agent El 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 al! plumbing work and installations performed under Permit isseed for this application will -be in compliance with all pertinent provisions of tho Massachusetts State Gas Code and Chapter 142 of tho Genera! Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gasfitter Signature of Licensed Master Plumber r Gasfitter Journeyman �� License Number . mom FORM (Print or Type) Check one: Certificate Installing Company Name /Tzi .ez-7—A-e2 &Q Q Corp. Address 3 Sj,�A/,,,[ j o)/vG = Partner. Firm/Co. Business Telephone: y� Q G` Name of Licensed Plumber or Gas Fitter QT Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F BondEj 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 17 Agent El 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 al! plumbing work and installations performed under Permit isseed for this application will -be in compliance with all pertinent provisions of tho Massachusetts State Gas Code and Chapter 142 of tho Genera! Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gasfitter Signature of Licensed Master Plumber r Gasfitter Journeyman �� License Number . Date ...! TOWN OF NORTH ANDOVER or PERMIT FOR GO AISTALLATION �e 9SSAC tw r MU5ES ��.r.`. -A6) This certifies that ....... ? . has permission for gas installation ....:'f <`.', -f !"-�� ...—r. L;.:: r L in the buildings of t f r/ % , j - , , /', , , •,� �r at ...` ..,1.1r,.t.f°r�..�. N .. , orth Andover, Mass. Fee.J. ' -''.. Lic. No. ✓r _ 6 .................... 11/19/93 08:49 "GAS INSP CTGAID s WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File t MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING> (Print or Type) ' NORTH ANDOVER Mass. Date s kuilding Location Permit # Owners Name�1j",4/ New '—t Renovation ReplacementAIRES Plans Submitted7. FIXT - / - T Check one: Certificate r--] Corp. Partner._ Firm/Co. Business Telephone: 63 6 Z ! !ol�) Name of Licensed Plumber or Gas Fitter ,�� Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the un rsigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. gnature of owner/agent of property Owner F] Agent 1 hereby certiry that all or the devils and ieformation 1 have submitted (or entered) in above application are true and accurate to the best of mY knowtedge and that at! plumbing work and installations performed under -Permit isseed (oz this appHntion will -be -in oom liance with a1! pet"ent provisions of the Massachusetts State Gas Code and Chapter 14: of the Genera! LAWS. . By TYPE LICENSE: Plumber g:j�/ Title Gasfitter Se,91naeure of--Licen City/Town: Master _.. Plumber or Gasfi_tter APPROVED (OFFICE use ONLY) r___ Journeyman Lic ns a Number IMEMEMMENEMMERIMMIMMINMEMEMEME / - T Check one: Certificate r--] Corp. Partner._ Firm/Co. Business Telephone: 63 6 Z ! !ol�) Name of Licensed Plumber or Gas Fitter ,�� Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the un rsigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. gnature of owner/agent of property Owner F] Agent 1 hereby certiry that all or the devils and ieformation 1 have submitted (or entered) in above application are true and accurate to the best of mY knowtedge and that at! plumbing work and installations performed under -Permit isseed (oz this appHntion will -be -in oom liance with a1! pet"ent provisions of the Massachusetts State Gas Code and Chapter 14: of the Genera! LAWS. . By TYPE LICENSE: Plumber g:j�/ Title Gasfitter Se,91naeure of--Licen City/Town: Master _.. Plumber or Gasfi_tter APPROVED (OFFICE use ONLY) r___ Journeyman Lic ns a Number -TO 1964 Date ...!/.............. J ,,ORT#i TOWN OF NORTH ANDOVER 6tip ON ' PERMIT FOR GAS INSTALLATION A L ^a f A This certifies that ... r-�- has permission for ga sta tion _ in the the buildin of %tr . .. ., . +o .... . at .. .. . ..... , North Andover, Mass. Fee.. Lic. No. /%o.71. ....... ............. 'p�/50.00 PAID. GAS INSPECTOR WHITE: App icao i8�1 (ding Dept. PINK: Treasurer GOLD: File s gORTN Ot,tr�e �e1�0 ti 'A Ss�CHUSf` NORTH ANDOVER BUILDING DEPARTMENT 27 CHARLES STREET Tel: 978-688-9545 Fax: 978-688-9542 DATE: ►YovF m B,oc 2 s r j, -A -1)7 --Tc igj6SsN vo L/ -T- c . ADDRESS o /��tia�r�f�o ST2�T %�QT,U �NOay�•�- /l%4/P�/Sr ZONINGDISTRICT:--Tv-.zos-ff S TYPE OF BUSINESS:__ BUILDING LAYOUT PROVIDED: (YES J NO AVAILABLE PARKING SPACES: ZONING BY LAW USAGE: YES NO BUILDING INSPECTOR SIGNATURE NORTH ANDOVER BUILDING DEPARTMENT 27 CHARLES STREET Tel: 978-688-9545 Fax: 978-688-9542 DATE: sr a �F m B� 2/,T yv / NAMEA 1 �A-N ?=c -(&1eS P Lo.&s ADDRESS oG /Yl ANO L -f- /-ACV-4 o r Ivo QTk A,vp J,IeA- ln,4 O/S-/T ZONING DISTRICT: S TYPE OF BUSINESS: BUILDING LAYOUT PROVIDED: (YES NO AVAILABLE PARKING SPACES: �o i - ZONING BY LAW USAGE: YES NO BUILDING INSPECTOR SIGNATURE, c, rof ✓4/©10ads This certifies that C has permission to perforr, Date... TOWN OF NORTH ANDOVER PERMIT FOR WIRING a.......... .............................. qai64N� . ... ......... I ......................... wiring in the building of . .......... Fee ��!............... Lic. No//5 Check# 5441 ......... . North Andover, Mass. ............................................................. CAL NSP ECTUR I 1 r Commonwealth of Massachusetts Official Use Onlly Department of Fire Servic S Permit No. — Occupancy and Fee Checked BOARD OF FIRE PREVENTION RE . LATIONS [Rev. 11/991 leaveblank APPLICATION FOR PERMIT PERFORM ELECTRICAL WORK i. All work to be performed in accordance with a Massachusetts Electrical Code (MEC) 52 CMR 12.00 (PLEASE PRINT IN INK OR P AL FO rA rION) Date: City or Town of: To the Inspect r of W res: By this application the undersignP tv e of i� o` er tentio to pe rm the electrical work described below. Location (Street & NWber) A // �� A _ Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit? .. Yes . 0 No [9"' (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the following table may be waived by the Insvector of Wires: No. of Recessed Fixtures No. of Ceil: (Paddle) Fans of Total TransSusp. Trsformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- 1:15. rnd. rnd. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Kit Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. o No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector oJ'Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) '.i ,, (Expiration Date) Estimated Value of Electrics Wo : (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the ains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: cesLIC. NO.: 1 Licensee: John S. Bassett Signature LIC. NO.: 15330 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 603'594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Li see does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: S , FA O F o t ,'rSACNUS� This certifies that ..... . has permission to perform plu bin in the buildings of at Fee... Lic. No.. 2 Check # 6317 Date. MOWN OF NORTH ANDOVER PERMIT FOR PLUMBING _J ........ North Andover, Mass. . .............................. PLUMBING INSPECTOR -MASSACHUSETTS UNIFORM APPLICATION FOR RMtT TO DO PLUMBING (print e(TYPO -42, A Y d o vE." . Mass. Date I Penmr*vt (IJP/7 11 Butldino Navy ❑ Flermation El� _Owner's carne � •f-�►•N i'fC �2 rs�l � �S � 'I _Type d Occupancy Co-r4� ❑ Plans Submkted: Yes ❑ No Er " - Indalluw comimy Name_ my Q.el i a bi e►� 1 ►�, ara��c Check one:. Certificate Address 1 4 L&�C� L6 t� •C l.L �—p - . o P� - Stl*w= Telephone q% V - Gf 3 `7- % L10 - ❑ hmi/Co. None OF t.icemed plumber PC14 L r--6 INSURANCE COVERAGE ! tltve a cttrreryt lEiab�ity_k=utance Roney-orlt .substardnJ k Yes p' Genf wtzich rnts-ti►e r�equarents o[ IuTGI Ch. 1-4Z If Y u have checked Y-0. Please indicate the type coverage by cheddng the appropriate boot. A IWAttyr irisurxnce policy, , g,' Other type of khdemnity ❑ - Bond ❑ OWNER'S INSURANCE WAIVER: t am aware bud the licensee does not have the Insurance coverage acquired by J Ctw#er 142 of the Mass. General Laws. and that my signature on aft Permit application waives this requirement � Check one: swid—me of or Owner's t Owner ❑ Agent ❑ 1 herby osw4 that rtdy uW:tt of the details and information 1 lure wbmTltod (m wdw*dt. in at,om,�appkabm,are true cad aooraate to the best of my P � eP+ s of the mss y work Ana .irutaEations rder the AacmiE ir�ed for this ap�tion w�f be in oornpfiano, wHh ed[ sadxmft State Coda 142 of the General BY - Trde s o c4fi"own- Type of license: Idasier B/ yr t r1 a as z 0 za 4C < z N < C • s i- z 0 o z z a C d 7 V= 6 Q a p}<♦ p x C 0. C < O X C far 0 9 < C •i < rr a O Sj Z 1= a ac J O a o n j; S} A d a< e a o SIlB—gSilT. - - BASEMENT IST FLOOR 2ND FLOOR ARD FLOOR 4TH FLOOR , STH FLOOR eTH FLOOR 7TH FLOOR STH FLOOR Indalluw comimy Name_ my Q.el i a bi e►� 1 ►�, ara��c Check one:. Certificate Address 1 4 L&�C� L6 t� •C l.L �—p - . o P� - Stl*w= Telephone q% V - Gf 3 `7- % L10 - ❑ hmi/Co. None OF t.icemed plumber PC14 L r--6 INSURANCE COVERAGE ! tltve a cttrreryt lEiab�ity_k=utance Roney-orlt .substardnJ k Yes p' Genf wtzich rnts-ti►e r�equarents o[ IuTGI Ch. 1-4Z If Y u have checked Y-0. Please indicate the type coverage by cheddng the appropriate boot. A IWAttyr irisurxnce policy, , g,' Other type of khdemnity ❑ - Bond ❑ OWNER'S INSURANCE WAIVER: t am aware bud the licensee does not have the Insurance coverage acquired by J Ctw#er 142 of the Mass. General Laws. and that my signature on aft Permit application waives this requirement � Check one: swid—me of or Owner's t Owner ❑ Agent ❑ 1 herby osw4 that rtdy uW:tt of the details and information 1 lure wbmTltod (m wdw*dt. in at,om,�appkabm,are true cad aooraate to the best of my P � eP+ s of the mss y work Ana .irutaEations rder the AacmiE ir�ed for this ap�tion w�f be in oornpfiano, wHh ed[ sadxmft State Coda 142 of the General BY - Trde s o c4fi"own- Type of license: Idasier B/ yr COMMONWEALTH OF MASSACHUSETTS IN PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMBE ISSUES THIS LICENSE TO PAUL F FAUREL m 170 SALEM RD DRACUT MA 01826-282 10641 05/01/06 931981 ow A COMMONWEALTH OF MASSACHUSETTS . -.AM 1.4 IN PLUMBERS AND GASFITTERS REGISTERED As A PLUMBING CO P ISSUES O PAUL FAUYEL MY REIABLE PLUMBER, INC 170 SALEM RD DRACUT MA 01826-2822 2471 05/01/06 931982 �. COMM Date ......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING � This certifies that ................�...................................................................... has permission to perform ........... ....... .............................................. wiring in the building of -t7 at ...... i ..... ............ ....... North Andover, Mass. Fee. ,.'... '..'o ...... Lic. ...... ..... e ................................ ELEcm'I'CAL INSPECTOR Check 0 �19 '9 VC 5568 TBE CO[YI WON EALTHOFMASSACHUSL+775' Office Use only - DEPARTAIDVTOFPUBIlC Permit No. s BOARDOFFIREPREVENITON 0NS527CMRI2.� Occupancy & Fees Checked APPLICARONFOR PERMIT TO P ORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WrI71 'HE MAS ACHUSSTS ELECTRICAL CODE, SZ7 CMR 12:OO D (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date !/ Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical world d6cribed below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes m No ® (Check Appropriate Box) Purpose of Building Cpyyw Utility Authorization No. Existing Service Amps�Volts 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 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above round 1:1round Below Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets � No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and r No. of Disposals No. of Heat Total Total Pum s Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW 0 Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER InsL==Cowraga RUS=tttothetagtmerr ZOfNb%adES�ZCffn lIaws IlaamagIiabkh mnceFbbLyin kidffgComplete CoNeageoritsmbtsWtW xvalart YES NO IhavesuhTlikdvalidptoofofsametoftOffim YES ff}ouhaNedhededYES, pleasei1Xk&thetypeofeowragzby drdciig theappicjxiie box ED El NSURANCEFTT BOND MIER (PleaseSpacf'y) EstirnamdValueofEbchical Wctk $ WorkloStart ftEpeclimDaleRquesled Rough Final Signed undxTr PennYm of petjuty. % HRMNAME LxximNo. lica>see 7— /'' Z- Signature LicawNo BusinessTel.Nb ,a tldrt�ccc_b / �� �s s � x � �� w /L �i�/G � � Alt Tel Nb. ?7<Ll OWNER'SINSURANCEWAIVER,IamawatethatthoLK= edmnothawtheinstrmxcovuageoritsllb�mpvalulasmgumedbyMassadmset Gffrallaws and thatmysignatuueonlhispermitapplicationwaiwsthis re m ixilt ry (Please check one) Owner ED Agent`Y F416 ✓ Telephone No. PERMIT FEE Signature o caner or gen i k ti C4 � S2 i k ti C4 � Date... ....... TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION This certifies that........ has permission for gas installation .... Asl-allze ............ in the buildings of ............................ le ................ . NZth dolver Mims. Fee.W��? Lic. No ........... ....".'7.. . ....... .. GAS INSPECTOR Check # A? 3 • PRASSACHUSETTS UNIFORM AIPPLICAT1011 FOR A PERMIT TO iPERFORPA GAS FITT"'G WORK t^ - CITY r s. MA DAT I � ERMIT # y` JOBSITE ADDRESS gj _ ]OWNER'S NAME{ W OWNER ADDRESS TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL _C RESIDENTIAL. CLEARLY NEW: '.._j RENOVATION:'. REPLACEMENT; PLANS SUBMITTED: YES NO [� APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER ! COOK STOVE ;. ... i ._. _ _.-= __: : � � l _ :.. - int _ � --- • , _'_ _._ ._ DIRECT VENT HEATER _. - DRYER FIREPLACE_- FRYOLATOR : _ _ FURNACE GENERATOR z GRILLE INFRARED HEATER 4, LABORATORY COCKS l _ _ .. '.: -. _ ... _ _ ...-- - _ MAKEUP AIR UNIT ; OVEN .. -- - - --- - - --- POOL HEATER ROOM / SPACE HEATER - --- — ROOFTOP UNIT TEST - ..._ ,.. _ - ! y UNIT HEATER. f 1 - ti UNVEMTED ROOM HEATER �.: WATER HEATER. OTHER r —1-777 I INSURANCE COVERAGE I have a current liabif- insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES [�- _INO . . I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE 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 _j AGENT. ¢a SIGNATURE OF OWNER OR AGENT 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 voarefflnent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. P BER-GASFITTERNAPJE UI1 :. .: .; LICENSE #t'/5051 - SI NATURE MP J MGF G !; JP [".J, JGF LPGI µ CORPORATION COMPANY NAME ��V1 S1(LUf? b jADDRESS CITY �I�/I STATED ZIPDt T ;TEL.v�? 1 FAX �ICELL z z O u P41 i -RD r� 1 bLLI LU °- f 9 a U: LU a. 9' ua ® en o � W � a- v . 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City" or Town officials Pize bczzl ttlaf'ttle affidavit as colillplte aud,print�nilegbiyeDegaYtlilersthas pr€d aceut tlze:bottonr- �fiittie:aF�l��'zt�izryou��fffftl©zit"FYY�tlteeveaYfflLe��fliee:t�€F1zsi�g�b�rs:ItAsnfb�cont�E'yoIIr��g;�l���,�; pp Iii;anC:, FFetYse:&e sYu fa filGwatYie penri'IIiceYzse zuYndieucTt nvR ile useY'aare#erence ziYatYtlierr..a�ciFCna �tfr�xusEsuizaluiY�grte:peY�l�f�ense:�PP�atousszYsan}, gr.�naweeny,.zzecct:ozD�l�rsYdinli���#i:-i'F,mdi�tiiz�:ezYrz;ent'W' ;i pa+Ti�! infoizDnYtiori GYl'<necessarg€�tuui x"�oll��ifl�e:�'It• i�ss�'tlieapp�sanfi sfio.Ycltltn�'e;,`��i�fb�aifnx��zvn f!► Yt u'� eQbl}=-c tlieaLF iTa��'f iTfatl zYrCieclr iini -s€� _(city, or 'm zlYark rTG �fl`ialtasproofffa€.�tt.a�iazrtrxerfoMrr.fiititeepezlzlzi.ort�i;ezlses Fs�.z#ens,afl�caY#?YctFtznustiEie,fnezt;ceciFa'ol;Y"ufa�e�nethe, ear }er vle os obtaffingaFceise-opofeTafe&foonybmfessor mn o &a:e: a;t:�YiSIDSe ©x tti rnti frn•Xincr�, tr.� �.os . ti.. . rw ---- `- .r ... I e(l ret tie igati®nsx uiilll e t all}, ��l gr,acti!morag yp",cdoAragmd ��►j>yt►tzs� seta ncD �esatagise its- a ca# _ e''s;addie fe - > ]��Inslr�e-anc� f�iF IA�YYB9: IIP at t ent 4 .� cI'n�rsYaT4d"Acemb Ofte Tel. 0 617-727-49 ed4W or 1477,�S y 0 �+ cl V7 U~1 n A tD cho O Q' rt rt ►g. Q �+ rt Q fD y t3 (u �+ yj' VAi 1►� y I `G � q . (D CD CD CD "ID Q o �.Z. Z6 o O o �.o it QQ m 0 0 FOy y CD X90 00 .1.' n 5 A o o �: �• �' rt U, Cb �'. (D 'cs �* t --o SLm l Y N(y.•y ' Cod • M o o� -M A o� �pO .z Old w °q ¢ � _�. (D A n �• (D �• O 0 u O C A h o• ;Z6p- '° I-teb - p (D CD to wZ' 0 C 00rD lD A g g � '� a ,oF 0 A: chonge to door 1/22/93 REV n � roti w 0 a o G0 0 � L � r* 0 i 0 n o p 0 � � X41 0 q N 4 jrt- r* 0 i N O tp 7 .1 t ocation kAo 4 f Date % 1 3_�3 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/FrameiiP''ermit Fee $ Foundatio WWPjM r6j.%T nNO"'AP�aO�COLLECT ;11> • n Other Permit Fee QR U Sewer Connection Fee $ Water Ction Fee $ TOTAL Building Inspector Div. Public Works APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 MA? dJO. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE — ZONE SUB DIV. LOT NO. I �— LOCATION PURPOSE OF BUILDING C?Sf l OWNER'S NAME ` ✓� NO. OF STORIES SIZ S'y (✓!✓� 76)4W&) OWNER'S ADDRES / q �j�v. u� �� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 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 h/-0 SIZE OF FOOTING X IS BUILDING ADDITION A14) MATERIAL OF CHIMNEY IS BUILDING ALTERATION ye S IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM O REQUIREMENTS OF CODE �7 IJ IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 9�, dkv' IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METERS 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 % Ac y SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE r OWNER TEL. PERMIT GRANTED CONTR. TEL, #- �r / 19 CONTR. LIC. # ,JAN i i 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST f7 � EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN A& x9a BYI 1 a INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 - .. <.. SINGLE FAMILY I_si FI ES THIS SECTION MUST SHOW EXACT•DI,M'ENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES '. ' �* APARTMENTS T F — LOT LINES AND EXACT DIMENSIONS-OF-BUtLDINGS:`WITH•-PORCHES..GA- - RAGES. ETC. SUPERIMPOSED. THIS kEPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH �� CONCRETE � .711. a 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER_- DRY WAIL r`_— [{/J/'/Jj UNFIN. T 3 BASEMENT AREA WkL FIN. B M AREA _ '14 1921 °/ FIN. ATTIC AREA _ NO B FIRE PLACES ;f ' HEAD ROOM MODERN KITCHEN 4 WALLS 19 FLOORS ' DS SIDING _ COMMCN SIDING- ASPH. TILE 1 ON MASONRY ON FRAME- N MASONRY .ATTIC STIRS. :)N FRAME OR CINDER BILK. 51ONE ON MASONRY STONE ON FRAME �I WIRING SUPERIORPOOR _ ADEQUATE NONE 10 PLUMBING 5 ROOF _ GABLE- HIP GAMBREL MANSARD FLAT SHED BATH (3 FIX.),. TOILET RM. (2 FIX.) WATER CLOSET _ _ ASPHALT SHINGLES LAVATORY WOOD. SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL .SHOWER _ ROLL ROOFING MODERN FIXTURES _ �I TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BINS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G ' UNIT HEATERS 7 NO. OF ROOMS GOAS 4, A Cl > 0 Ol 711 M LID M /} IT 27j, 0 LST El CD M > ---i T jD k7,1 L --i m M m n < m rn, 0 �m z m 3 CA C cm CO2 C -i �!� Q3 V O CD n Z H CCD O 'O Cr n dsaCA a� -v CD CD %GC CL Q CD CD O CD C CDCD a O y O tG CD F v CA O � Z CD O CD O C CD 0 C/) C/) n 0 r� C=E - C3 O S O -• VN Cl CT N r =Cm -0 y n CD m c3 ca C Cm CM N s CD .O.fCD N T w = C C m =r CDCD O 03 CAOD m N O C) 3CD �o S O J COD CD CD O e 03 00 O N• C09 W ��• O m M� C. 3 N O CZrt..r' .4 o � ® y 1--� tC :' C7� • I� O m CD ca N C d o CO) �<R c CDN S CD CJ/co S CD 03 W O m � - .... CD �o o Z col CD CD o CD CD .• N CD CD CD W" CLso C, C2: ..o:lb c qw o Co • o Cn 9 C/) Z It CD ~ ?] GOD Mtz C/) rotTj Fr C r P� ?CD (D G G T3 p x o x El H 0 9 0 c CD s SITE.PLAN FOR: MLLI AM bARRETT SCALE: 1= W' DATE : 1=71-53 LOCATE D NO, ANDOVER 3972 0 o.1 / I(7/4'3 ►--� ��� � TN E. �o � �v!� D� fir,' ! S Z' S , PARKINGc SPACES RE.czu«D � 20 J O� No 07 Town of North Andover Office of the Planning Department Community Development and Services Division 9SSACHt1SEt Osgood Landing 1600 Osgood Street Building #20, Suite 2-36 P (978) 688-9535 North Andover, Massachusetts 01845 F (978) 688-9542 James Broadhurst EKeys4Cars 60 Rockingham Road #20 Windham, NH 02087 April 16, 2013 Dear Mr. Broadhurst, According to the North Andover Zoning Bylaw Section 8.3.2.c.i, Waiver of Site Plan Review, the changes you are proposing to the building located at 8 Marblehead St. St. will not require an application for Site Plan Review. The waiver request is granted based on the following information: • The property is currently vacant and the use proposed is automobile related retail, a use which is permitted by Special Permit in the Industrial S Zone, according to the Town of North Andover Zoning Bylaw section 4.135.8. • The footprint of the building will remain the same and there will be no changes to the parking and or to the landscaped areas. • New signage will require a sign permit from the Building Inspector. If there are any questions, please let me know. Regards, z1- ��z�r Judith Tymon, AICP cc: Jerry Brown, Inspector of Buildings BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 zGvkr'.� 13 p- 4T R,iad s- IANNAZZI ELECTRICAL CONTRACTORS & CONSULTANTS 27 CHARLES STREET • NORTH ANDOVER, MA 01845 508-686-7300 • FAX 508-725-4791 Emergency Pager: (508) 396-7399 j%0RTh 0? OOH Town of North Andover • Office of the Planning Department _•� ��'` Community Development and Services Division 9S`SNCHU`rEt Osgood Landing 1600 Osgood Street Building #20, Suite 2-36 P (978) 688-9535 North Andover, Massachusetts 01845 F (978) 688-9542 James Broadhurst EKeys4Cars 60 Rockingham Road #20 Windham, NH 02087 April 16, 2013 Dear Mr. Broadhurst, According to the North Andover Zoning Bylaw Section 8.3.2.c.i, Waiver of Site Plan Review, the changes you are proposing to the building located at 8 Marblehead St. St. will not require an application for Site Plan Review. The waiver request is granted based on the following information: • The property is currently vacant and the use proposed is automobile related retail, a use which is permitted by Special Permit in the Industrial S Zone, according to the Town of North Andover Zoning Bylaw section 4.135.8. • The footprint of the building will remain the same and there will be no changes to the parking and or to the landscaped areas. • New signage will require a sign permit from the Building Inspector. If there are any questions, please let me know. Regards, Judith Tymon, AICP cc: Jerry Brown, Inspector of Buildings BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Location No. Date TOWN OF NORTH ANDOVER 9 e •, Certificate of Occupancy $ Building/Frame Permit Fee $ MMus Foundation Permit Fee $ Other Permit Fee $ s- - TOTAL $ Z&� Check # 19508 61 ing Inspector ,ry." . � �'—"t.�.%:e"�.,.F '9'� `ter.: ..�.-. � _i�lr _kr..+' +s•rcF:v+.F'„�y �'r�.,,yaq."�r'.'y`�,"_ :`iy tiw_.. ., .,,�• No.: C�4 Date - NORTH '616 TOWN OF. NORTH ANDOVER - F p BUILDING DEPARTMENT -Building/Frame Permit Fee 9ssw�►+us ..$ FoundationPermit Fee $ _ { �a Other Permit Fee $_/ Building Inspector COMMONWEALTH OFMASSACHUSETTS TOWN OFNORTHANDOVER 1600 OSGOOD ST APPLICA 7YON FOR CER TIFIOF INSPECTION. Date (} Fee Required (Amount)_—_(D O No Fee Required Accordance with the provisions of the Massachusetts State Building code, Section 108,15, I hereby apply for Certificate Inspection for the below -named premises located at the following address: O Street and Number___ Name of Premises__ft SrinL_ Purpose for which Premises is Used---1.J.,s�__�=��----�% ------------------------------------ Licenses (s) or Permit (s) Required for the Premises by Other Governmental Agencies: License or Permit Ageno Certificate to be issued to// Address_-- --�'—` An L, �4 r�o--C'------------------------------- Telephone��3_ a3Y_ZY ? ,? Owner of Record of Building "<' Address_-- J C �G 2 F�---- ��} �T --�Lv 5—� -- ----------------------------------- Name of Present Holder of Certificate___�4v_v_—�=' __- 1 teal Fes_____-----__-- Name-4-AMcy,ifany---------------------------------------------------------------------- I N---/ ---Z- NATURE dF PERSONS TO WHOM CERTIFICATE TITLE IS ISSUED OR HIS AUTHOIRIZED AGENT DATE INSTRUCTIONS.• 1) Make check payable to: Town of North Andover __________________________ 2) Return this application with your check to: Building Dept. 1600 Osgood ST, North Andover MA 01845 PLEASE NOTE Application form with accompanying FEEmust be submitted for each building or structure or part thereof to be certified. 3) Application and fee must be received before the certificate will be issued. 4) The building officials shall be notified within ten (10) clays of any change in the above information. CERTIFICATE # EXPIRATION DAT& r CERTIFICATE OF INSPECTION WORKSHEET REVISED 3.2006 imc INSPECTION REPORT FORM CLASSIFICATION PASSES INSPECTION yes `nom DATED OWNER �2./I, Is �1 "I I e_ S 0 BUILDING NAME OR NO. } Gi [2� STREET LOCATION I C: ►kS t'i 12) h C,L--� -- TYPE OF OCCUPANCY - Day Care School Common Victualer's EXIT SIGN Auditorium. Restaurant Caf6 Gym Apt. Liquor Place of Assembly yes LIGHTED EXIT SIGNS yes !r no NUMBER OF GRADE FLOOR MEANS OF EGRESS DOORWAYS_ NUMBER OF SEPARATE STAIRWAYS ACCESSIBLE PER STOREYS /j�p�/� EMERGENCY LIGHTING SYSTEM E%r dry cell wet cell operable SPRIUIItLEW ono, ELECTRIC EQUIPMENT VIOLATIONS IVO.7'"'"� yes no FIRE RESISTANT CURTAINS OR DRAPERIES /tel EGRESSES LAWFULLY DESIGNATE obstructed yes HANDICAP ELEVATOR yes no f STAIRS PROPERLY RAILED /V/— yes no --HALLS-AND STAIRWAYS'LIGHTED— —' no UTILITY ROOM - CLOSETS RADIATOR GUARDS ! yes no COMPLIES HANDICAPPED PERSONS LAWS yes no HOW HEATED t;• NO. FIREPLACES yes no BOILER ROOM CONDITION 1ST FLOOR SEATS 1ST FLOOR BAR SEAT /,C/ OTHER LEVELS OCCUPANCY NUMBER (INCLUDING STORIES # AND OCCUPANCY PER FLOOR USE REVERSE SIDE . i i n m 3 3 3 a rpt d c �n o0� 3 ^: irtI •r`J-J ^Cj a 0 Q m � (D cc 3 3 �Z z � O En z O Dc (DZ a r CA d e� � 0 e m D 0o D Dm (D C o rn 0 (� Ln t� oc � � G z n z o � m 0 v 0 o 3 C: o Cr (D �+ o Ln o � n n m 3 3 3 a rpt d c A� -. a rn (D 3 �Z z N O =r Dc (DZ r e Z D 0o D Dm (D C o rn 0 (� Ln A� -.