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Miscellaneous - 81 CHADWICK STREET 4/30/2018
Date ...... r.—...`7.......�.®.�. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................................../1aitJ crL has permission to perform ......��� 4 �" A r' a ................................................................... wiring in the building of . .0.. P ....�' ............................................................... [ Ck.A.4..0 l C V S..( . ............ . North dover, Mass. ELECTRICAL INSPECTOR Check # 535? THECOMMONWEALTHOF UJAP. ; 11 /a�►r i J7070 -177A APPLICATIONFOR PERMIT TO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Town of North Andover The undersigned applies for a permit to perform he electrical work c Location (Street & Number) Q tr Owner or Tenant R O A —P DA t" An D P i-7-4 Owner's Address Office VAP, only $&W Permit No. R70MR120 . Occupancy & Fees Checked RM ELECTRICAL WORK ELECTRICAL CODE, 527 CMR 12:00 Date 7_4f0Y ed below. To the Inspector of Wires: Is this permit in conjunction with a building permit: " a x ftes M No (Check Appropriate Box) Purpose of Building 006Z4111i Utility Authorization No. Existing Service Amps�Volts Overhead Underground New Service Amps Volts Overhead Underground No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work —k!/lid— 41/1 A/ 7Lfi/J�9/lAd090,0/iia No. of Lighting Outlets -- J No. of Hot Tubs No. of Transformers Total o7,5 KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets 070 No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW / No. of Self Contained Detection/Sounding Devices Local Municipal r -'—J Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis . No. Hydro Massage Tubs No. of Motors Total HP OTHER( P Ot"ir 11 f J r`9 12E14771g C-&1 (! � ✓ /I —1� -` /00 hmnaroeC�a� Pt�s�antbthetaquitarla1lstsettsG�taallaws Ihawa=u tL>ab*kmrm eR lLym kxirgCm CoNw,Woritsmi:6latrialap abt YES IhawsihriWdv*lpro4of=rte1Ddr0ffioe YES Yycuhavectlec1odYB,*we NSL ANICEL-E] BOND a MHM �Jftwe*cfy) 1-070,jg L fM-,46 VTyYft �I/o 7 d EMm&dVak&olBactdcalWdk$ WodcroStat h�sxclimD*RoWested Rao Final idlit /AGL FIRMNAME paw. PO&EIZ T MiwlLC/L &6F e- 7/2 t IicerwNo. I/LY6 1 Lion >see /�" 6/d --t— m I, -JCA- Signatiae / `v( / -� LiaalseNo BtuulessTelNo. ,fjt�3" l3 `/-- /hS� ()t aX a ��{ 0�4 o a? AkTe1Na 60 "eqr- aV33 OWNER'SINSURANCEWANIIt;IamawatedaftLio wdoesnothaNethei mmoecomrWeritswbsrardegwmbtastaWWbyMassxhuwnsGerlaallaws and thatmysigtlahaeon dusptmritappliration waives this tegmartert. (Please check one) Owner Agent Telephone No. PERMIT FEE signature of owner or Agent 9 ► 8 4 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ............... .... .. / .. ... . has permission to perform . / �?�[P!?�°-� A1,7 4 .441y— . plumbing in the buildings off .......... e rl .e at .. �3� .. �%?4 �`-�1�.! .. .... , North Andov er, Mass. Fee .. ` �!L ic. No.. �'S'�3 !7: c`i�•! � t>. ' �"c....... . PLUMBING INSPECTOR Check # 4k3c,�, 1d►-41r1I:jxA MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:_ /y� • �/��� , MA. Date: Permit# Building Location: �% C?ltJric. c Owners Name: DEDICATED Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: T/ Plans Submitted: Yes ❑ No ❑ 1d►-41r1I:jxA INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes U�/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 Owner ❑ Agent ❑ Signature of Owner or Owner's Ager I hereby certify that all of the details itted (or entered) regarding this application are true and accurate to the best of my r%nowieage ana tnat an piumDmg worK ana instaiiations perrormed under the permit issued for this application will be in compliance with all renmen& Prvviswn or me massacnuseus state numoing coae ana cnapter 14Z of the ueneral Laws. By Type of License: x Titleumber-Si-gnature of L' nsed Plumber City/Town Master License Number: APPROVED OFFICE USE ONLY ❑Joumeyman DEDICATED z SYSTEMS Lnn Y O w > Z of aLn Z Y H ¢ = Q Ln LU H Z = 0 0 Q W w Z 3 H s to a W z i- W z N tA Z 0 2 g kn 0 a F- u �—� Q v' oae o'�e sac z O Q w Q LL F„ Vf 0a. W 0 W of Ln J Z a , O' CY zz LU LU cis O � W he Q Q y a 0 O H > > O 0 0 Q Rle z Q U5 Q Q = 0 H W Q Q Q co m o o v_ s x 5 5 oe (A 0 �- S 3 3 3 0 ¢ 0 0 0 3 SUB BSMT. BASEMENT 1ST FLOOR 2"D FLOOR 3RD FLOOR 4T" FLOOR 5T" FLOOR CH FLOOR 7T" FLOOR 8T" FLOOR Check One Only Certificate # C,�� d ,�,, � Installing Company Name:/ � lrl 6 / 4 �D •1i i U/� Orporation �I Addressof!14"aI"Ag. �/D City/Town: State: El Partnership Business Tel: "lvis p,m" Fax: WA'?5-- M ❑ Firm/Company Name of Licensed Plumber: 9A*0jC Aasc I INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes U�/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 Owner ❑ Agent ❑ Signature of Owner or Owner's Ager I hereby certify that all of the details itted (or entered) regarding this application are true and accurate to the best of my r%nowieage ana tnat an piumDmg worK ana instaiiations perrormed under the permit issued for this application will be in compliance with all renmen& Prvviswn or me massacnuseus state numoing coae ana cnapter 14Z of the ueneral Laws. By Type of License: x Titleumber-Si-gnature of L' nsed Plumber City/Town Master License Number: APPROVED OFFICE USE ONLY ❑Joumeyman .1 The Conntonvealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 tVashington Sheet Boston, MA 02111 unpip.mass gouldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name Address: off Phone M Are you an employer? Check the appropriate box: 1. 0271 am a employer with 4• ❑ I am a general contractor and 1 .___lam` employees (full and/or part-time).* have hired 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. employees and have workers' [No workers' comp. insurance comp. insurance # required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. (No workers' comp. insurance reouired.l Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. [] Building addition 10.❑lectricaI repairs or additions I I G? Plumbing repairs or additions 12.❑ Roof repairs I3.❑ Other *Any applicant that checks box #1 must also till 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. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I ant an employer t/rat is provitlirrg workers' compensation insurance for my ennployees Below is the policy and job site information. Insurance Company Name: MM /�l/`'l/�G — Policy # or Self -ins. Lie. #: O �31p 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. 1 do hereby certify,Per the pains and p n /ties of perimy that the information provided above is trite and correct. 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 #• At�qW CERTIFICATE OF LIABILITY INSURANCE OP ID NEMA DATE(MMIDDIYYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 11 09 ll THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: e certificate holder is an ADDITIONAL INSURED,policy(les) must be endorsed. D, su eat to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Macdonald & Pangione Insurance NAME PHONE (AIC, No, Ext): 1 C, No): P.O. Bos 428 104 Main Street EADDRESS: North Andover MA 01845 Phone: 978-688-6921 Fax:978-688-5350 PRODUCER CUSTOMERIDB: ANDOV-7 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: Utica Mutual Insurance Co Andover Plumbing & Heating CO PO Box 262 INSURERS: TraVelera Casualty & Surety PL 31194 _.. INSURER C Andover MA INSURER D: INSURER E : 10/26/12 INSURER F : MED EXP (Any one person) $5,000 a.V VrawaaCW I.GR t RrIL..A 1 C t11UMMtK: RFVI_CICIN NIIIMRFR THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE INSR POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 rA X COMMERCIAL GENERAL LIABILITY L CLAIMS -MADE I ] OCCUR 14481325 10/26/11 10/26/12 PREMISE�S(E� e�n�e $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 _ GENERAL AGGREGATE s2,000,000 14 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 X POLICY JET LOC $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accideru) $1,000,000 BODILY INJURY (Per person) S f ALL OWNED AUTOS I BODILY INJURY (Per aeciderd) S A {� I------ttt SCHEDULED AUTOS HIRED AUTOS IBA -7A965705 10/26/11 10/26/12 PROPERTY DAMAGE (Per accident) $ H NON -OWNED AUTOS $ S A X UMBRELLA LIAR X OCCUR CULP 446141 10/26/11 10/26/12 EACH OCCURRENCE $1,000,000 EXCESS UAB CLAMS -MADE AGGREGATE S 1 , 000 , 000 DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXEC OFFICERIMEMBER EXCLUDED?I Lj A 10/26/11 10/26/12X IOTH TORY LIMITS ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE S 500 , OOO (Mandatory in NH) Bs, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500 OOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder as listed below CERTIFICATE HOLDER CANCELLATION Town of North Andover Plumbing & Gas Inspector Building Dept 1600 Osgood St Bldg 20 #2-36 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. North Andover MA 01845 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD 4/, . r •4!� wLTn r. •.r s - A1�D'GAtSFITTE i • REGISTERED AS A :PLUMBING CORP.. =GEORGE R LAROSE ANDOVER PLUNBING & HEATING C 20 AEGEAN DR -. _:UNIT 10 METHUEN MA 01844-1580 . 2122 .0510'1/!2 784203 , _ Date. 140©I 1........ ~o TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that.. ....... ... . has permission for gas instillation . �.4* 4 in the buildings. of . ..!� . L o,�J/n.Ql''.................. . at ...9/.. .... ...!�... s , N/North Andover, Mass. Fee..? -U. , 'L? Lic. No.. GAS INSPECTOR Check # 10JK a a— - I FIXTURES MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING co City/Town: MA. Date: Q / Permit# Building Location:dAQ&LWS,7-, Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential IiK New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No ❑ FIXTURES INSURANCE COVERAGE: �/ I 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 1 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 ❑ Sionature of Owner or Owner's Aoent 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 �gd Chapter 142 of the General Laws. Ty of Licenser y By mPlumber Title El Gas Fitter Signature of L censed Plumber/Gas Fitter Master City/Town []journeyman License Number: OPPRnVFr1 lnFFl(:F I IRF nN1 Vl ❑ LP Installer r co vi W W Y WW 0 UJ O U) _ r2 to W Z H Q Z J } W z fn O W M O W H W N> W to W W m O ~ Q a. F C Q W W X W ~ Q Z W O W W Z W to = W O N W Z W = d• Q' � Z V W Z W >- lY W J F- J Q F- Q O m Z -� O W O Z LL O~ W H W o o 0 0_= g 'O W 3 0 U LL �° 16->>> SUB BSMT. BASEMENT isT FLOOR 2 NoFLOOR 3 FLOOR 4 H1 FLOOR 51HFLOOR 6 FLOOR 7 1H FLOOR 8 FLOOR Installing ��%� I , ✓ ��C Check One Only Certificate # Company Name:/ti,�rQ �i�, !! Address&4w,,m/t g• /Q City/Town:-/—&�-A/ State: Corporation Business Tel: �p mJr �p jws Fax: 69vtoln-6-- Jr � Partnership ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: �/ I 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 1 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 ❑ Sionature of Owner or Owner's Aoent 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 �gd Chapter 142 of the General Laws. Ty of Licenser y By mPlumber Title El Gas Fitter Signature of L censed Plumber/Gas Fitter Master City/Town []journeyman License Number: OPPRnVFr1 lnFFl(:F I IRF nN1 Vl ❑ LP Installer r The Commonwealth of Massachusetts Department of Inditstrial Accidents `' ► Office of Investigations �j 600 Washington Street Boston, MA 02111 r unpw-mass gouldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly r Name (BusinesslOrganization/Individual):� Q(W #'Z�ff/f qAAI ,15 Address: �tryi�tate/Llp: //f�Tf1�1�llrf' Q/�' Phone #: Are you an employer? Check theappropriate box: 1. V1 am a employer with �_ 4• ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired 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. employees and have workers' [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.) t c. 152, § 1(4), and we have no employees. [No workers' comp. insurance reouired.] —JY,5X3 Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑lectrical repairs or additions 11.� Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #[ must also fill 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. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. lrthe sub -contractors have employees, they must provide their workers' comp. policy number. 1 ant an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information._ Insurance Company Name: t,171C j /%gP"74 WL �_1VL1; 7 / � � I Policy # or Self -ins. Lie. #: ���3�� Expiration Date: Job Site Address: �GlJi* �% City/State/Zip:/YO•, /� ", a fig - 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. 1 do hereby certify ut er the pains and penalties of perjury that the information provided above is trite and correct. Si nature:��� Date- 1/1,41/ Official use only. Do not write in this area, to be completed by city or town offtciaL City or Town: Permit/License # Issuing Authority (circle one): 1. Board of .Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone #: i'f�CUERS A1lD=GASFERS REGISTERED AS A :PLUMBING CARP. GEORGE R LAROSE ANDOVER PLUMBING & HE.ATING C <_ 20 AEGEAN DR :.:UNIT 10 " =� METHUEN MA 018.44-1580.. 2122 05101./-12 784203 , MAGNETIC 1999 00 •- Ld � ca LO C O rn o k V L�] N U o2f o� a CIS, 5 a COv, g r W>o Vw� c°�io A Z7Q�.. r4 �j It O co Ooow w0-o co o DUQ Go o �_�L © Q c Z:10 >-3F- ),- zg i ZWZCD'vWa rn Vv V-4 %_e z wZ�ww Ugh x - o N �o 51�,m�� =a� � w n Z UW zw=zo= �OZOLdZ Z drn �� Q l!1 z4wZdW cn� n x m MAGNETIC 1999 14 Location No. 5 a S Date 3- 1�L`c q Check # 1 7 ,i 1 S TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ r;2 OJ Other Permit Fee TOTAL -� Building Inspector 00 M �v Z O z M 90 r M rM VI TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: a -�� SIGNATURE: Bui7n Co 6ssionerfl for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /OI(fDSv�F3r Zoning District Proposed Use )Areas Frontage ft 1.6 BUILDING SETBACKS ft —Lot Front Yard Side Yard Rear Yard Required Provide Required Provided R aired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ower of Record f t r Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: ►Name Print Address for Service: Si nature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ C_,�!e Licensed Construction Supervisor: License Number ,3 r3��c�1 l-E,� l � ���c�o�er/`�N Address _jar : � � f 7/`/��QS Expiration Date Signature Telephone s 3.2 Registered Home Improvement Contractor Not Applicable ❑ 1� Company Name Registration Number JD t r Address Expiration Dke Signature Telephone 00 M �v Z O z M 90 r M rM VI SECTION 4 - WORKERS COMPENSATION (NLG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ...... No ....... 0 SECTION 5 Description of Pioposed Work check all applicable) New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Dees�criQptiiogn of Proposed Work: _ o )U 01 r--Vp x Z ��—FX.�R aaf/ OT d�� � 4 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building / (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) —� 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TINMERS 1 2 3 SPAN D11V ENSIONS OF SILLS DIlvIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Add- FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that allnecessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. �....■■....■■........r■a..a.a.,..■..■.aa.a■aaaaaaaaraaaaaaaa■.■■..,.,....l.• APPLICANT �.CL �Y„�j /'t�'.1 ey)M411ONE ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION NUMBER STREET STREET NUMBER ' ' Cz �( OFFICIAL USE ONLY RECON04ENDATIONS OF TOWN AGENTS /■....,l.,.a...l....,..l..i�...liiii..ilii,.i�...... ...... ...............l....■ DATE APPROVED CONSERVATION ADNIINISTRATOR DATE REJECTED CONIMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS R DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMIVIENTS PUBLIC WORDS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE DELANEY CONSTRUCTION 39 SALEM STREET LAWRENCE, MA. 01843 978-685-3752 LIC # 061988 TO: BOB & PAT COPPETA 81 CHADWIICKST NORTH ANDOVER MA HIC # 104625 PROPOSAL phone 978-683-5494 Job Name / location SAME Job Number 1171 date 11-16-2003 Job phone We hereby submit specifications and estimates for: FRAME GARAGE AND ADDITION AS PER PLAN i DIG HOLE FOR GARAGE AND ADDITION INSTALL 8" FOUNDATION BELOW FROST APP 4' TAR FOUNDATION WHERE NEEDED AND BACK FILL POUR 4" CEMENT FLOOR IN GARAGE UNDER ADDITION SHALL HAVE CLEAN FILL OVER .6 MILVAPOR BARRIER INSTALL ADDEQUATE ACCESS & VENTILATION TO CRAWLSPACE ALL LUMBER SIZES SHALL BE AS ON PLAN AND WALLS AND ROOF SHALL HAVE PLYWOOD INSTALL ATTIC TRUSSE OVER GARAGE 2' OC WITH 5/8 CDX PLYWOOD INSTALL 2 ANDERSON WINDOWS IN GARAGE TW21042 1 IN ADDITION TW2842 2 ON 2ND FLOOR ANDERSON TW2842-21 TW21042 KITCHEN TW 2832 INSTALL 3 -2/8X6/8 N-63 GBG DOORS 1 2/8X6/8 B-LABLE BETWEEN HOUSE AND GARAGE INSTALL 1 VELUX SKYLIGHT IN VS3061N KITCHEN INSTALL 2GARAGE DOOR TRANSOMS OVER GARAGE DOORS INSTALL 2 INSULATED GARAGE DOORS WITH GARAGE DOOR OPENERS $2500.00 ALLOWANCE FOR DOORS AND TRANSOMS DEMO EXSISTING KITCHEN INSTALL 2 BEAMS AS PER PLAN IN KITCHEN AND MUD ROOM INSTALL 3 TAB SHINGLES TO MATCH EXSISTING AS CLOSE AS POSSIBLE WIH ICE AND WATER SHIELD INSTALL CEDER CLAPBOARD TO MATCH EXSISTING AS CLOSE AS POSSIBLE WITH TYVEK HOUSE WRAP ALL TRIM SHALL MATCH EXSISTING HOUSE AS CLOSE AS POSSIBLEAS ON PLAN PRICE DOES NOT INCLUDE ANY PAINTING OF EXTERIOR OF HOUSE INSTALL 1 NEW BULKHEAD AS PER PLAN MATERIAL AND LABOR $96,700.00 We Propose hereby to furnish material and labor - complete in accordance with the above specifications, for the sum of: Dollars $ 96700 Payment to be made as follows: BE DETERMINDED BEFORE JOB IS All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involviing extra costs will be executed only.upoh written orders, and will become an extra charge over and above the estimate. All agreements continget upon strikes, accidents or delays beyond our control. Property owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Acceptance of Proposal-Theabovepricesspecifications Signature and conditions are satisfactory and are hereby accepted. You are authorized to do the work as speed. Payment will be made as outlined above. Date of Acceptance: 1'2 1 ') ] ' " -Z Signature Authorized Signature _..... _......_ _.. . Note: This proposal may be withdrawn by us if not accepted within 30 days i DELMEY CONSTRUCTION 39 SALEM STREET LAWRENCE, MA. 01843 978-685-3752 LIC # 061988 HIC # 104625 We hereby submit specifications and estimates for: PROPOSAL phone dr!ie Job Name / location Job Number Job phone INSTALLATION ; WALLS R-11 FIBERGLASS BATTS FLOOR R-19 FIBERGLASS BATTS (OVER UNHEATED SPACE ONLY CEILING R-30 FIBERGLASS BATTS GARAGE SHALL NOT BE INSULATED EXCEPT FOR WALL BETWEEN HOUSE AND GARAGE PLUMBING SHALL INCLUDE HOOKUP OF 1 KITCHEN SINK AND DISHWASHER 1 WASHER AND DRYER PRICE INCLUDES 1 DB BOWL SINK AND FAUCET ALLOWANCE $350.00 ELECTRICAL INSTALL PLUGS AND LIGHTS BY MASS CODE ALL -LIGHT FIXTURES AND DIMMERS SHALL BE PICKED UP BY OWNER SHEETROCK KITCHEN ADDITION AND GARAGE WITH 1/2 " SHEETROCK EXCEPT WALL BETWEEN HOUSE AND GARAGE SHALL BE 5/8 FIRERATED SHEETROCK TRIM OUT ALL WINDOWS AND DOORS IN ADDITION INSTALL KITCHEN CABINETS AND COUNTERS KITCHEN CABINET ALLOWANCE $8000.00 INSTALL FLOORING IN KITCHEN $18 SQ YD LINO $4.50 PER SQ FT MATERIAL AND LABOR TEAR OFF ROOF AND FRAME IN NEW ROOFAS PER PLAN ALL MATERIAL SHALL BE BY PLAN PRICE DOES NOT INCLUDE FINISHING OF UP STAIRS UNDER NEW ROOF PRICE bOES NOT INCLUDE ANY PERMITS PRICE DOES NOT INCLUDE ANY INTERIOR OR EXTERIOR PAINTING ALL CONSTRUCTION MATERIAL SHALL BE REMOVED FROM PROPERTY WHEN JOB IS COMPLETE PRICE INCLUDES ALL DUMPSTER We PrOpOSe hereby to furnish material and labor = complete in accordance with the above specifications, for the sum'of: Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications irwolviing extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate: AN agreements oontinget upon strikes, accidents or delays beyond our control. Property owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Acceptance of Proposal -The above prices speamations Signature and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature Authorized Signature: Doliars b Note: This proposal may be withdrawn by us if riot accepted within days Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 104625 Expiration: 711412004 Type: DBA DELANEY CONSTRUCTION Michael Delaney 3 BEECH HILL DR. G� e LONDONDERRY, NH 03053 Administrator ✓ize Pominzoye,�� a�✓����,a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR I Number: CS 061988 Birthdate: 09/01/1964 Expires: 09/01/2005 Tr. no: 2169 Restricted: 00 MICHAEL W DELANEY 3 BEECH HILL DR, LONDONDERRY, NH 03053 Administrator ►Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 workers' Compensation Insurance Alfdavit Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one wworking in any capacity 1 am an employer providing vAxkers' compensation for my employees working on this job. ,address I-swe to secure coverage as required under section 2M or MGL 152 camleed to the' and/or one yeme hnprisonn ent.as Weltas halt �36eSam� a�?DP Posxion ci �ximinal Pena>ties of a�finee Apr � s1.5+ understand that a copy of this statement may be forwarded to the Office of Irry tigatior►s 0 the DM image mon. ab hereby c wW wxfer the pram and penalties of penury thet the afforme iarrprovk*d above is true aw carred: Signature tate Print name _Phone # Official use only do not write in this area to be completed by city or town offic iW City of Town QtJllding Deft. pcheck rf immedbate msportse is required - Sel�rnaWs a Lke-1wng Boa Contact person: Phone # I] Health Departs E] Other '® �FIVSURANCE DATEMM,DD\Yr, .... ... ....C11ERTIFICATE ..... _ 01-06-04 . PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DEANGELIS INS AGCY INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 283 MERRIMACK ST* ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. METHUEN MA 01844 COMPANIES AFFORDING COVERAGE COMPANY 26BPP A THE TRAVELERS INDEMNITY COMPANY INSURED COMPANY DELANEY, MICHAEL DBA B DELANEY CONSTRUCTION 3 BEECH HILL DRIVE COMPANY LONDONDERRY NH 03053 C COMPANY D COVERi4QES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM\DD\YY) POLICY EXPIRATION DATE (MM\DD\YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG. $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR. PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE $ LIMIT BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per Person) $ BODILY INJURY (Per Accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (UB-943X592-7-03) 10-06-03 10-06-04 STATUTORY LIMITS EACH ACCIDENT $ 100, 000 THE PROPP.IETOR, PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 DISEASE-EACH EMPLOYEE Is 100,000 OFFICERS ARE: X EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CfRTIFiCATE HOLDER 0AIrECEklA� ICJ) ....... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BOB COPPETA 81 CHADW I CK ST NO ANDOVER MA 01845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE IAGOI2SS{353} OR3CORPON9993.; Tiavelers 01252 -AM • 1000 LEGION PLACE ORLANDO FL 32801 BOB COPPETA 81 CHADWICK ST. NO ANDOVER MA 01845 ACORD CERTIFICATE OF INSURANCE (On Reverse) North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: CLL -4 S) (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Job Truss Truss Type arty Ply 9 snow 120 Mph win 14838403 WSI_STK A2410 ATTIC 100 1 1 Job Reference (o tional) Wood Structures, Biddeford, ME 0 005 5.1 s Mar 25 2003 MiTek Industries, Inc. Fri May 30 11:15:20 2003 Page 1 ,1-0-9 3-3.0 , 5-10-4 9-10.13 12-0-0 , 14-1-3 , 18-1-12 20-9-0 24-0-0 j 1-0-0 3-3.0 2-7-4 4-0-9 2-1-3 2-1-3 4.0.9 2-7-4 3-3-0 1-0-0 6x8 = Scale= 1:67.2 NOTE: DUE TO THE OVERALL LENGTH TO DEPTH RATIO OF THIS 7 TRUSS, THE FLOOR MAY EXHIBIT OBJECTIONABLE VIBRATION 2.5x6 = AND/OR DEFLECTION. BUILDING DESIGNER TO CONSIDER 10.00 12 2.54 = PROVIDING MEANS TO DAMPEN POSSIBLE FLOOR VIBRATION. 6 8 3x6 II 3x6 II 6x8 �i 6x8 2x6 �� 5 9 2x6 / 4 10 n 3 11 12-0-0 z 1z 1 d 410 = 16 15 14 4x10 = 6x6 = 46 = 6x6 = i 5-10-4 18-1-12 24-0-0 r 5-10-4 12-3.8 5-10-4 Plate Offsets KY): [2:0-10-2,0-1-101, [5:0-4-4,0-1-81, gel, [8:0-0-14,0-0-81, -11,0-0-41, [10:0-4-0,0-0-101, [11:0-2-12,0-0-121, [12:0-10-2 ,0-1-10], [14:0-3-0,0-4-41,[16:0-3-0,0-4-4] LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 42.0 Plates Increase 1.15 TC 0.70 Vert(LL) -0.60 14-16 >473 240 M1120 169/123 TCDL 7.0 Lumber Increase 1.15 BC 0.90 Vert(TL) -0.79 14-16 >359 180 BCLL 0.0 Rep Stress Incr YES WB 0.66 Horz(TL) 0.04 12 n/a n/a BCDL 10.0 Code BOCA/ANSI95 (Matrix) Weight: 1451b LUMBER BRACING TOP CHORD 2 X 8 SPF 195OF 1.7E TOP CHORD Sheathed or 5-4-14 oc purlins. BOT, CHORD 2 X 6 SPF 166OF 1.5E BOT CHORD Rigid ceiling directly applied or 9-11-3 oc bracing. WEBS 2 X 4 SPF -S Stud WEBS 1 Row at midpt 6-8 THIS TRUSS IS DESIGNED FOR RESIDENTIAL USE ONLYI 30 - LOAD IS ADEQUATE FOR ATTIC LIGHT STORAGE AREA AND/OR SLEEPING ROOMS ONLY! (30 PSF IS NOT ADEQUATE FOR A WATERBED LOAD, CORRIDORS, OR BASIC FLOOR AREA) REACTIONS (Ib/size) 2 =1942/0-3-8, 12 =1942/0-3-8 Max Horz 2=6150oad case 5) Max Uplift2=-678(load case 6), 12=-678(load case 7) FORCES (Ib) - First Load Case Only TOP CHORD 1-2=55, 2-3=-2682, 3-4=-2433, 4-5=-2276, 5-6=-1688, 6-7=531, 7-8=531, 8-9=-1688, 9-10=-2276, 10-11 =-2433, 11-12=-2682, 12-13=55 BOT CHORD 2-16=1857, 15-16=1510, 14-15=1510, 12-14=1857 WEBS 6-8=-2202, 5-16=1069, 9-14=1059,3-16=-493, 11-14=-493 NOTES 1) Wind: ASCE 7-98; 120mph; h =35ft; TCDL=4.2psf; BCDL=3.Opsf, Category Il; Exp C; enclosed;MWFRS gable end zone; cantilever left and right exposed ;Lumber DOL= 1.33 plate grip DOL= 1.33. 2) Design load is based on 42.0 psf specified roof snow load. 3) Unbalanced snow loads have been considered for this design. 4) " This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas with a clearance greater than 3-6-0 between the bottom chord and any other members. 5) Ceiling dead load (5.0 psf) on member(s). 5-6, 8-9, 6-8 6) Bottom chord live load (30.0 psf) and additional bottom chord dead load (0.0 psf) applied only to room. 14-16 7) Provide mechanical connection (by others) of truss to bearing plate capable of withstanding 678 Ib uplift at joint 2 and 678 Ib uplift at joint 12. LOAD CASE(S) Standard DESIGN LOADING: TCLUTOTAL (PSF) VSH OF M4S SqC 42/59 @ 24" oc. S1� 53/74 @ 19.2" oc. 63/79 @ 16" oc. �`r STEPHEN W. BL N NO, 31927 A9oF Q RfGISTER�� FSS/ONAL ENG\ June 13, 2003 A Waminy - Verify deslyn parameters and READ NOTES ON THS AND INCLUDED MITEK REFERENCE PAGE MII-7473 BEFORE USE ID Design valid for use only with MiTek connectors. This design Is based only upon parameters shown, and is for an individual building component to be Installed and loaded vertically. Applicability of design paramenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown is for lateral support of individual web members only. Additional temporary bracing to insure stability during construction Is the responsibillity of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance 101 regarding fabrkation, quality control, storage, delivery, erection and bracing, consul QST -88 Quality Standard, DSB-89 Bracing Specification, and HIB -91 ``�i' Handling Installing end Bracing Recommendation available from Truss Plate Institute, 583 D'Onofio Drive, Madison, WI 53719 ■.■ iTe NEW ENGLAND ENGINEERING SERVICES INC February 5, 2004 Mike McGuire North Andover Building Inspector 27 Charles Street North Andover, MA 01845 Re: 81 Chadwick Street, North Andover Dear Mike: Enclosed is a copy of the assessor's map showing 81 Chadwick Street and the properties abutting 81 Chadwick. Measurements of individual setbacks as determined by this office in the field are shown on the plan. The average setback for the homes on the same side of Chadwick street is 18.57 feet. The average setback for the homes on Prospect Street on the same side of the street as 81 Chadwick Street is 14.34 feet. The average for all of the houses shown on the plan on both streets is 15.59 feet. If you have any questions please do not hesitate to contact this office. Sincerely, c 0. Benjamin C. Osgoo , Jr., EIT President 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 �i ',yr`?�.2'{ e� Asy�A'��' cn T4'Q.''-'sa.'f�Att'�'R E!'aF.i'• Qrr. a_i, Ll.. - _ `•,��:�. .. i.+� - _ c u .. w i _ O m NW OJ ao g N N « $ m $ "a M qNj -P e r mR N M "- N Io v — rn a N u W Q� $ Z 2 N / � V / Q LL F N N n v M 7i rn m �� `a L(% N A N T N a r N t co NT N N e � RN $ J N } 1- kn �. J O 00 N M . -7 1 o o W 1 co r � w J 8O O m in 9, G Cd L CL r a N 0 e N r C 0 10 O O N .- ~ 0 147 � ~ 27115, f 5T 1 E7� �10 tOT y��l MadH� 1Naj 143 33� M �1 IcK � A 0,n1 ,s l6`o y a 9 % 8- 9 60-o23S7 \ - & J9-a.J—8 rya ? IV NEW ENGLAND ENGINEERING SERVICES INC March 8, 2004 Mike McGuire North Andover Building Inspector 27 Charles Street North Andover, MA 01845 Re: 81 Chadwick Street, North Andover Dear Mike: Enclosed is a plan showing 81 Chadwick Street and the properties abutting 81 Chadwick. Measurements of individual setbacks as determined by this office in the field are shown on the plan. The measurements have been taken by transit survey in the field and the plan is stamped by a surveyor. The average setback for the homes on the same side of Chadwick street is 19.43 feet. The average setback for the homes on Prospect Street on the same side of the street as 81 Chadwick Street is 11.4 feet. The average for all of the houses shown on the plan on both streets is 14.23 feet. All of the averages calculated above do not include the existing offsets at 81 Chadwick Street. If you have any questions please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood, Jr., EIT President Oecelve D MAR 8 2004 BUILDING DEP4 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 a OUND n 7 g, r E r 20.2' 14.V 3.3' PROPERTY LINES WERE COMP;LED FR?M THE ASSESSMFNT MAPS, RECORDED SURVEY PLANS, AND 7EEDS, FOUND RECORDED AT THE R_GISTRY OF OEECS. THE LOCATION OF THE BU!LDIraOS ARE =FOM A LIVITED SURV'E`. PERFORMED ON 2/24/2002 & 2/27/2004. A-+1 DRAWN CHECKED 644 BY: `5D e,,.. Irl? & 1�.C.O Jr 1D I BUILDING LOCATION PLAN CHADWICK & PROSP 'CT STREETS NCRTH ANDOVER, MASSACHJSETTS SCALE: 1 " = 60" MARCH 3. 200A NEW ENGLAND ENGINEERING SERVICES, NC. 60 BEECHWOOD DRIVE NORTH ANDOVER, MASSACHUSETTS (�? /8) 685--1768 ' � H o U V) OZ Z o Z p O FM 21-1) N LLM 4-1 O kn 0 O �Z N C LL C ' .L+ d i m a, N Ul �N �• ° ° 3 > 0aj o o o u a 1�� m to 3 ami vi CL Im °>.0 :° E Qaj 0 CL 4- 0 0 W c (on U ° o H H `ti E cW 32 N a . aLL .0 in M w%-.0 O ob z BE h ° gL.� O O (11 z > m V3 W cz oUW Am wa�' w o�4' C w w co cn GO ` V O * "20,� E ca m z =cm 1; A �.co- y = C O co 00.2 ce •k E co c o to o a�� m AA♦ �C OQ � A _ y Z O Yi O C=MV Q � . y dC 'O H m = to V m CL 0 N M r0. N m y0„ m ' V!AS) W O A ro ro CLLJ to CL= 43i's r Go ci � . o c' O y a moo z CLM rc m .0 WN O !- z S awm :POO A V J M 0 � c � C*CD Q y m m L- I.= CL �. �3 CD L Cc O CLCqu �a CO) C Z O V CO) C C d h D ul N W o� W uj co Am g ts C O .16 V MCI -C A O m C :t G 10,3 EQ r.. CQ0 to �• �O m GO ` V O * "20,� E ca m z =cm 1; A �.co- y = C O co 00.2 ce •k E co c o to o a�� m AA♦ �C OQ � A _ y Z O Yi O C=MV Q � . y dC 'O H m = to V m CL 0 N M r0. N m y0„ m ' V!AS) W O A ro ro CLLJ to CL= 43i's r Go ci � . o c' O y a moo z CLM rc m .0 WN O !- z S awm :POO A V J M 0 � c � C*CD Q y m m L- I.= CL �. �3 CD L Cc O CLCqu �a CO) C Z O V CO) C C d h D ul N W o� W uj co ��Location(;1 Sl. �l In! i G � No. Date S—/6-0 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ r�5 O� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ OCA Check #Cc,c,h " Building Inspector TOWN QP NORTH AINTD®VE TENT BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING M � BUILDING PERMIT NUMBER: � �^ DATE ISSUED: SIGNATURE: Building Commissioner/I or of Buildings Date SECTION 1- SITE INFORMATION 1.1 PropertyAd/dress: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: j(/ - Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R aired Provided C? % -5— 3 U 1.7 Water Supply M.G.L.C.40. § 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone _ Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record t' S ame (Print) Address for Service Sign telephone 2.2 O ner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: i Address +, Signature 3.2 Registered Home Improvement Contractor Company Name Address Telephone Not Applicable ❑ License Number Expiration Date Not Applicable ❑ Registration Number Expiration Date +% SECTION 4 - WORKERS COMPENSATION (NLG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction K I Existing Building 0 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. I Demolition ❑ I Other ❑ Specify Brief Description of Proposed Work: f ..s( I SECTION F - F.RTIMATFTI ! f1NCTi?TTt runty nnrmr �""— _ _� ----- ----- Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE OA'Y 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbinR Building Permit fee (_) X tbl ---'� a 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 V U nmrr%AT n _ !\t: 11TT,.� Check Number _- ,» ••+,n,a. tea. aaava�lL.nuviq 1v DL, %_U1V1rLZ 1r.0 WMf'4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Vcaner/ `thorized Agent of subject property Hereby authorize My behalf; in all matters relative to work authorized by this building pennit application. Signature of Owner SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION Date to act on 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si iature of Owner/Agent Date r NO. OF STORIES SIZE RDIWNSION NT OR SLAB FLOOR TIlVIBERS 1 T 2ND 3 RD SIZE OF SILLS IONS OF POSTS IONS OF GIRDERS OF FOUNDATION THICKNESS FOOTING X AL OF CHIMNEY ING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE V kJAIV1 - u JU V 1 r1L�LTj-A_10rj ryrt1V1 INSTRUCTIONS- This form is used to verify that all -necessary approval /permits from 1 3�dtxa Boards and Departments having junswction have been obtained. This. does not relieve the applicant and or landowner from compliance with any applicable requirements. �w•■rorwrnor..w..r.r....0....r.wr■wownnowrwrrnro.■•w orsoon on.wOEM seam .o.rr.. APPLICANT �o� — C v d PHONE 3— 7 �¢ ASSESSORS MAP NUMBER ©� LOT NUMBER STREET �( lC STREET NUMBER C/ �rwwrwrrrrrrrrrrrrrrrwrrrrrrr.wrwnworw■■woo•■rowroww.n.rwrrrwrwrrrwrrrw.wr■ OFFICIAL .USE ONLY ...r..rwrr■rwrwwrrram rrrr■■It WE ■r.rrrrn■wawa■rrwrwrrw.rwwrwwas rrwwwwrrrrrrw■ RECOMA4ENDATIONS OF TOWN AGENTS lorerrwrman rwwrrrowns rrrwrr.•wrwwww.wwwww■■wvenoms w•.wwrrwwrr'nwwrrwror.rwww DATE APPROVED K-C, ONSER VATION AD' IINISTRATOR DATE REJECTED DATE APPROVED TOWN PLANNER DATE REJECTED COMIvIEN TS FOOD INSPECTOR -'HEALTH SEPTIC INSPECTOR - HEALTH COivIIvfENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS _ DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DATE D. Robert Nicetta Building Commissioner (978) 688-9545 .•:(978) 688-9542 Fax Please print DA Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 HOMEOWNER UCENSE EXEMPTION JOB LOCATION5�C C4-3 Jr, Number Street "HOMEOWNER 4 ICA Name Home Phone PRESENT MAILING ADDRESS City State Map / lot �-�3 Work Phone Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does . not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.s.Iy DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be 'considered a homeowner. The undersigned "homeowner' assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner' certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE V, APPROVAL OF BUILDING OFFICIAL I wilS loadsOJd AN b�A Q Q wilS loadsOJd Cl) m Cl) 0 m v y d C � O O CA Cl) Cl)10 0CD Z y CD O 'O• C � C CZ =' y O CO') oo� CD o 0 Q� =r a) CD CD o CCD C CD y —• CD CZ O y ccCD I S v y O Z CD O CD O CD CE ? Q o5 m 2 O —•tA y OL col y n at d 0 Z _I Z m n� m CA CD -1 c H 0 -i "I o i? 0 m' m a ccCD -� 0 to o N Jr n O o N' on Q (� w r�° V �' n om •D to o " ff^^ ? /VJ � m C a � : 1v n_ H 0 dye S e -r z H n Q C c 00 — o H< to �. m :�CO) U, =rH 0 m co cmy a �co ( � 0 0 0 Zcoo cn �co0 Z o� om m yCD CD :. cm d md� n� o �o ni o � eo 0 rn s •i cn cn07 z ►n d �n w ;v a- ' ?1 w- c ; JQ x C17 r r '"7 °� 'z r b r 0 m w n x a Cy r" C o x 0 o � � 0 z 7 N -7 H 0 0 c Date ............. TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING t Y SS US This certifies that ............ `..........r. ................ . has permission to perform ............... ....................... plumbing in the buildings of ....... ............................ ..................................... , North Andover, Mass. Fee.Lic. No .......... ........................,...... PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location �/ �i,%f/J!i/il cg/' = Owners Name Type of Occupancy New 0 Renovation Replacement ff FIXTURES n ,s .� g738 Date 21 /,� I/ Permit # Amount "— Plans Submitted Yes E No 11 (Print or type) Chec one: Certificate Installing Company Name A n d n ki a r P 1 h pA=N t g, , C n . T n r Corp. 2122 Address 20 Aegean Dr. Unit -10 El Partner. Methuen, MA 01844 Business Telephone --(q78) h P�- R S R- Firm/Co. Name ofLicensed Plumber George L a RO s e Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate bore Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts StJ 01umb���a d Chapter 142 of the General Laws. VED (OFFICE USE ONLY Type ofPlumbing License 983 icense Numoer Master Journeyman i Date .. ) ...�..... `...'...... O- o ,e ry0 0 TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION 09 i t ,SSAC HUSES h r This certifies that ..f...!:.:....� ..::.....� ..`.. �............. has permission for gas installation .....:....('./ L ............... in the buildings of . S.... ...... `. ' %........................ �. at .......... ` , , North Andover, Mass. Fee... ...:.. Lic. No.......... . Check # ' ......... .GAS INSPECTOR MASSACHUSETTS IFORM APPLICATON FOR PERMIT TO DO GAS°T UNTING �ITYPe or print) '0 NORTH ANDOVE�pR,>MASSACHUSETTS " r° 3uiidine Locations Perrlit # Owner's Name rw d Renovation ❑ Replacement ❑ Amount S Plans Submitted ❑ or rypeJ C4,one: Cerciticate Installing Company Andover Plb4. & Hta. Co.. Inc. Corp. 7199 -.adr�ss 20 Agean Dr., Unit -10 ❑ Partner. .pus ness Telep amt of Licensed Plumber or Gas Fitter Ceorae LagaSe ❑ Firm/Co. : `, S l; R.-kN C E COVERAGE Chec i2`;aveNon a current liability Insurance policy or it's substantial equivalent. Yes ou nave checked M, please i crate the type coverage by checking the appropriate box. bait insur-ance policy Other type of indemnity ❑ Bond ❑ -ner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the .lass. General Laws, and that my'signature on this permit application waives this requirement. Check one: enarure of Owner or Owner's Agent Owner ❑ Agent ❑ erect. certify that all of the details and information 1 have submitted (or entered) in above application are.. and accurate to the „i my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in moiiance with all pertinent provisions of the Massachusetts State Gas Codd Chapter both General Laws. rv; To w n _uPR�J� ED i()hncf. USEONI.Y) ature of Licensed`Plumber Or Gas Fitter Plumber 9983 ❑ Gas Fitter License Number asler IIID❑YVYVYYIII�I7 l o u rney ma n i' aii•���i�■�i�i����i�i�ir�i®i�i�i��� ��ii•iii•i�ii•�i��i�ii•ii•i�i®®�r���■� or rypeJ C4,one: Cerciticate Installing Company Andover Plb4. & Hta. Co.. Inc. Corp. 7199 -.adr�ss 20 Agean Dr., Unit -10 ❑ Partner. .pus ness Telep amt of Licensed Plumber or Gas Fitter Ceorae LagaSe ❑ Firm/Co. : `, S l; R.-kN C E COVERAGE Chec i2`;aveNon a current liability Insurance policy or it's substantial equivalent. Yes ou nave checked M, please i crate the type coverage by checking the appropriate box. bait insur-ance policy Other type of indemnity ❑ Bond ❑ -ner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the .lass. General Laws, and that my'signature on this permit application waives this requirement. Check one: enarure of Owner or Owner's Agent Owner ❑ Agent ❑ erect. certify that all of the details and information 1 have submitted (or entered) in above application are.. and accurate to the „i my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in moiiance with all pertinent provisions of the Massachusetts State Gas Codd Chapter both General Laws. rv; To w n _uPR�J� ED i()hncf. USEONI.Y) ature of Licensed`Plumber Or Gas Fitter Plumber 9983 ❑ Gas Fitter License Number asler IIID❑YVYVYYIII�I7 l o u rney ma n J J _ Date ....................... TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION A i " + This certifies that ........................................... has permission for gas installation ............................ in the buildings of .......................................... at .................................... North Andover, Mass. Fee.......... Lic. No........... .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UVIFORM APPLICATOV FOR PERMIT or print) Iwrc!'H ANDOVER, MASSACHUSETTS Building Locations wi Owner's Date ` /, New ❑ Renovation ❑ Replacement Plans Submitted' � '.:.fes `�•� k��� has - Prim or type) Chec ne: Certificue.Installing Company dame Andover Plbd. & Ht4. Co.. Inc. Cdrp.. 19329 Address ' 20 Agean Dr. , Unit -10 ❑ Partner. Methuen. Ma. 01844 Business jelephone (978) 685-8383 ❑ Firm/Co <ame or Licensed Plumber or Gas Fitter George LaRose ItiSUR.AiNCE COVERAGE Check on . have a current liability Insurance policy or it's substantial equivalent. Yes No❑ !!'you have checked ves, please in 'tate the type coverage by checking the appropriate box. b lic, 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 N1 ass. General Laws, and that my'signature on this permit application waives this requirement. Check one: Si_nature of Owner or Owner's Agent Owner ❑ Agent:-' ❑"; herebv certify that all of the details and information 1 have submitted (or entered) in above appli=tpn; ; is and accurate to the ,)est of m•v knowledge and that all plumbing work and installations performed under Permit issued for tbis•a llication will be in _ompiiance with all pertinent provisions of the iVlassaehusetts State Gas de and C 143 of the GenCr Laws. By: Tllle Ciry;T�wn ILPPR0VEDwFr•Ich USE ONLY) x;kr 0 PIgnature of Li ensed Plumber Or Gas Fitter. lumber 9983 ❑Gas Fitter License Number w: Eff lasfer ❑ Journeyman y ' f . •1W' YyH .�.. if JJ ZZy� Z iii C v1 M C F r In jz N (� Z L Z• !" Z C St.; SEM ENT Ii,k SE.N ENT :n is r. FLU'AK :S 2ND FLAUR au 3R U. FLUAR JT II . F L A A K 5'r if FLUOR 7T 11. FLUAR Prim or type) Chec ne: Certificue.Installing Company dame Andover Plbd. & Ht4. Co.. Inc. Cdrp.. 19329 Address ' 20 Agean Dr. , Unit -10 ❑ Partner. Methuen. Ma. 01844 Business jelephone (978) 685-8383 ❑ Firm/Co <ame or Licensed Plumber or Gas Fitter George LaRose ItiSUR.AiNCE COVERAGE Check on . have a current liability Insurance policy or it's substantial equivalent. Yes No❑ !!'you have checked ves, please in 'tate the type coverage by checking the appropriate box. b lic, 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 N1 ass. General Laws, and that my'signature on this permit application waives this requirement. Check one: Si_nature of Owner or Owner's Agent Owner ❑ Agent:-' ❑"; herebv certify that all of the details and information 1 have submitted (or entered) in above appli=tpn; ; is and accurate to the ,)est of m•v knowledge and that all plumbing work and installations performed under Permit issued for tbis•a llication will be in _ompiiance with all pertinent provisions of the iVlassaehusetts State Gas de and C 143 of the GenCr Laws. By: Tllle Ciry;T�wn ILPPR0VEDwFr•Ich USE ONLY) x;kr 0 PIgnature of Li ensed Plumber Or Gas Fitter. lumber 9983 ❑Gas Fitter License Number w: Eff lasfer ❑ Journeyman N° t " 7 ,Uv, M1ot:'tio TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING \._ a •" a ,I -- This certifies that ......... ...:.................... x ...... . has permission to perform ....:. ............ "...........�.... . plumbing in the buildings of ...... ........... . at.�'........ -<`�-- ' , North Andover, Mass. Fee ......... Lie. No. :� ... .. <� ............ PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM 'APPUCATION FO PERMIT TO DO PLUMBING f):'rfnt orType) / AZ '1 A drv�� Mass. Date Permit # Building Location � �v, Ownerfs Name/ C A2Ae_4 Tye of O panty e s .' New ❑ Renovation ❑ Replacem nt Pians Submitted: Yes ❑ No 13B.P.-4SEWER# F1XTU SEPTIC# sue—BSMT. BASEMENT IST FLOOR 2ND -FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR N h- Cf N Z N Y J 1.<1,1= OF=- C� Z Q m N �. Q W > W v W �° f= W O W � 41 � O Scc Z N? > ►- o O 97 = N .4.11 U tJ v W y V a (n w '• a 2 Installing ,Company Name_Adoyer P1 bg. & Htq. Co. , Inc.1Check one: Certificate Address_ 20 Aaean Dr Unit -10 LJ Corporation 2122 11 Methiien Ma 01844 ❑ Partnership Business Telephone (978) 685-8383 ❑ Firm/Co. ' Name of Licensed Plumber George LaROSe INSURANCE COVERAGE: I have a current bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes CE No ❑ It you have checked Yes; please I Icate the type coverage by checking the appropriate box. A liability Insurance policy Y Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the In coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ -4gnature of Owner or Owner's Agent 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 cnowfedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all >ertinent provisions of the Massachusetts State Plumbing Code and Ch ter 142 of the Gener Laws. rtle Signature o Ucensed umber :AY/Town Type of License: Master Joumeyman ❑ LVED OFFI US ONLY) License Number 99R3 Z YAC y o X 1 > v N W � 41 � O Scc N? O = N .4.11 U tJ v W y V a (n w '• a 2 W X . <W Z O < N 2 Q d cZ O Cxa J y C Q J .. p p .� L F -d Y d O W LL W Y J CJ N o y __ .. W~ < J J < Q 2 < 7 Installing ,Company Name_Adoyer P1 bg. & Htq. Co. , Inc.1Check one: Certificate Address_ 20 Aaean Dr Unit -10 LJ Corporation 2122 11 Methiien Ma 01844 ❑ Partnership Business Telephone (978) 685-8383 ❑ Firm/Co. ' Name of Licensed Plumber George LaROSe INSURANCE COVERAGE: I have a current bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes CE No ❑ It you have checked Yes; please I Icate the type coverage by checking the appropriate box. A liability Insurance policy Y Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the In coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ -4gnature of Owner or Owner's Agent 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 cnowfedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all >ertinent provisions of the Massachusetts State Plumbing Code and Ch ter 142 of the Gener Laws. rtle Signature o Ucensed umber :AY/Town Type of License: Master Joumeyman ❑ LVED OFFI US ONLY) License Number 99R3 3933 Date..:! �...%� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ..,lir. �.?!:'....! has permission to perform ..... ................... . plumbing in the buildings of ..�U�1/�. /�`................... at ............. , North Andover, Mass. Fee. Lic. No.. PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer s a FN%-+lurt t t�i urvll-uHM APPUCA11UH FUR PERMl l 1 U MLJ r &_QIV11"'Ob I %+ (Print at Type) NORTH ANDOVER, , Mass. Data Building p Permit 0 Location owner's Name New ❑ nenovallon ❑ Replacement o Plana Submitted: Yea ❑ No ❑ FIXTUAE3 :>i O ar x ~ W J w a- u r w s s a= N r at R at h w s O w` 0 U w w e w aL = st s it u= s w s M w �' r ue s a bl e es ; ert q a K M w M r w a # 11 a w n 11 rc r O 1- a art r+ Is. u F sr q q w— .. F - i< ar � w w o o J j• h ei �' a p s w o tUa-26MT. 11ASSURMT IOTFLOOR 11,110 FLOOR 3RD FLOOR 4TH /0-0001 •TH FLOOR OTH FLOOR 1TH FLOOR -OTFLOOR Check one: Cert)ncAte Installing Company Name ANDOVER PLG. & HEATING CO.. INC. 0-61*10"tp. 2122 Address 573 1 /? SO _ 11N I ON S T ❑ Partnership LAWRENCE, MA. 01843 ❑Firm/Co. Business T61ephone 508 685-8383 Narne d Licensed Plumber GEORGE LAROSE INSURANCE COVERAGE: ChecX I have a current ilablilty Insurance policy or As substantial equivalent. Yet 9 No ❑ It you Mve checked 10, please indicate the type crrierage by checking the appropriate box A ItablMy Insurance poilcy f—/Other type of WemnRy ❑ Bond ❑ OWNER'S INSUnANCE WANER: I am aware that the licensee does not hate_ the Insurance coverage required by CluFiler 112 d Ilia Mass. General Laws, and that my algnalure on thla permit application waives this requirement. Check one: Owner ❑ Agent C]nstur• ol Ownei a Owner s kent I hereby ewilty that all of the del&Ms and Information I have aubmMW tot entered) in &bow application we true and somata to the best of my ►nowtedpe aM that aA plumbina wet and Imlallailone Wormed under the permA Issued toe W14ppkallon rn7 be In compliance with all pwtlnent provisions of the AlsssachuseHs Stale Plumbing Code and Chapter 112 of !rat CWW Tina aty/T own IU'1TUPAD IN F10E USE ON01 Ucen s. f fumbw 9983 Type of Mmbing License: Maslen [r�� Journeyman ❑ 3 1 2 0 Date.....��..1��. .. a TOWN OF NORTH ANDOVER �? '�.. ��PERMIT FOR GAS INSTALLATION N ,SSACHUSE� ti Q1 .r This certifies that�..... C. ............ has permission for gas installation ..U.. q ................... . in the buildings of . s/J!J/'? c . .......................... at ... .CZ< <.,; c . ..�............. . , North Andover, Mass. Fee. .% .,.:.. Lic. No.::: �' .E. j . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T O GASFITTING (Print or Type) NORTH ANDOVER Mass. Date / 3 �uilding Location Y/ � �W;C,(/ Permit # -� — ^ Owners Name '0 4A.�_ 6'4 , ';Oz_ New .7 Renovation D Replacement U Plans Submitted D 9 FIXTUR=S (Print or Type):; j;;' Check one: Certificate y.. Installing Compaq. ,Name ANDOVER PLBG. & HTG. CO., INC® Corp. 2122 Address 5731SO. UNION STREET Partner. LAWRENCE, MA. 01843 Firm/Co. Business Telephone: 978 685-8383 Name of.,.Lice s u berg, or Gas Fitter —R.EORGE ILAROSE . Inerage: Indicate the type of insurance coverage by''�CheCking the appropriate box: ' Liability insurance policy dOther type of indemnity 0 Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application sloes not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent 1 hereby certify that all of the dcuils and information 1 have submitted (or entered) In above application are true and accurate to the best of my knovvicdge and that aU plumbing work and InsaLLations performed under' Permit iuued fox this •ppticatian will -be to compliance with alt pezttaeat Provisions of the Massachusetts Slate Cas Cuda and Qaptet 142 of the General Lawa. • .. By T -PE LICENSE: Plumber Title Title Gasfitter Signa ure of Licensed City/Town• Master Plumber or Gasfitter APPROVED (OFFICE USE ONLY) Journeyman License Ilumber Y • • ■■No■ MEN ■ ■■■. MEMNON■OEM MOE son MIKENONSIONNEIREENO no noun ENNEEMENNEEMENNEENE .. ■MONEENamMENEENNIONOMMENION MEN (Print or Type):; j;;' Check one: Certificate y.. Installing Compaq. ,Name ANDOVER PLBG. & HTG. CO., INC® Corp. 2122 Address 5731SO. UNION STREET Partner. LAWRENCE, MA. 01843 Firm/Co. Business Telephone: 978 685-8383 Name of.,.Lice s u berg, or Gas Fitter —R.EORGE ILAROSE . Inerage: Indicate the type of insurance coverage by''�CheCking the appropriate box: ' Liability insurance policy dOther type of indemnity 0 Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application sloes not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent 1 hereby certify that all of the dcuils and information 1 have submitted (or entered) In above application are true and accurate to the best of my knovvicdge and that aU plumbing work and InsaLLations performed under' Permit iuued fox this •ppticatian will -be to compliance with alt pezttaeat Provisions of the Massachusetts Slate Cas Cuda and Qaptet 142 of the General Lawa. • .. By T -PE LICENSE: Plumber Title Title Gasfitter Signa ure of Licensed City/Town• Master Plumber or Gasfitter APPROVED (OFFICE USE ONLY) Journeyman License Ilumber Date.,7-.,,2 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .....N.. .................... has permission to perform .... rAt� q -rl'. . . . . . . . . . . . . plumbing in the buildings of ... ..................... at. . 1�/ /-- r—., North Andover, Mass. — ........................... ;> )—�- I A,."\\ Fee? ........ L i c. No.. e:l'.C- . ......7. . . I --) 15� ----------- PLUMBING INSPECTOR Check # -S 61u1 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN (Type or print) NORTH ANDOVER, MASSACHUSETTS f1 I I n , I Building Location New Renovation ')—Owners Name of Date _a ^ C) Permit # O 0Amount ?') Replacement ® Plans Submitted Yes 0 No ❑ (Print or type) Che one: Certificate Installing Company Name v 1 Corp. .-- -- Address � Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the ype of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond ❑ Insurance Waiver: I, the unersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submit or a ed) in above ap . . n e and accurate to the best of my knowledge and that all plumbing work and installs ' s pe ed nder rmit sued r is pplication will be in compliance with all pertinent provisions of the Massachus s SS I mbi g Co nd t 4 he General Laws. VED (OFFICE USE ONLY ��Type ofPlumbing c_e e License eti> r Master 6 Journeyman El Location No. .5 (8I C�'Jwie lC SA , Date - f c; - C q NORTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ 04 ... CMus Building/Frame Permit Fee $ 1 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 17 r2o Check # ` S c )A ( -- Building Inspector 0 0 s t SHED ACK MAF 80 LOT 1 ROBERT & PATR-k COPPETA BK 5-874 PG 21 10,140 S,F 0.223 Ac. NEiti' FOUND?• .,u,. 5�1.25� 7-83 ,,3 7' 1 p 'N THIS ?tAN iS FOR THE USE OF THE BU'LD NG INSPECTOR OF THE T(Y%VN OF NORTH ANDOVER FOR 7HE PURPOSE CF CETERMiNATION OF ZONING COMPLIANCE. THIS PLAN IS THE RESULT OF A F.ELD SURVEY PERFORMS BY 'NFW ENGLAND ENGINEERING, SERVICES, INC ON 5/1C/2CO4. ^cD• ��, ZD. PUN DRAWN CHEC''CED 64C er: �3 BY: 47 95' SB�- B J..'C'�'3 G \N 20.4' OF � 1'M'1f1v�}JA N N� WI4d -wraww�-- F-OUNDATION AS BUILT 81 CHADWICK STREET NORTH ANDOVER, MASSACHUSETTS SCALE. 1 " = 20' MAY ' 1, 2004 NEW ENGLAND ENGINEERING SERVICES, INC. 60 BEE&WCOD DRIVE NORTH ANDOVER, MASSACHUSETTS (978) 686--1 i 68 O,AOFt7i"� Zoning Bylaw Review Form *" Town Of North Andover Building Department n�'�� 4, �<� �ssU$¢j 27 Charles St. North Andover, MA. 01845 Request: Phone 978-688-9545 Fax 978-688-9542 Street e f A w c K �S t- Map/Lot: 80 .J17 Applicant: Notes Request: d' X 15-1 Date: AI.... - r-lCaae ue auviseu mat after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning R —j Remedy for the above is checked below Item # I Special Permits Planning Board Item # Item Notes Setback Variance Item Notes A Lot Area Common Driveway Special Permit F Frontage Variance for Sign 1 Lot area Insufficient R-6 Density Special Permit 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies Li e 5 3 Lot Area Complies 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area /V/r4 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required \1 e S 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient Li 2 Complies 3 Left Side Insufficient 3 Preexisting Height 4 5 6 Right Side Insufficient Rear Insufficient Preexisting setback(s) 4 I 1 Insufficient Information Building Coverage Coverage exceeds maximum S N 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed 1( e -S 4 Insufficient Information 2 3 In Watershed Lot prior to 10/24/94 j 1 Sign 1 Sign not allowed N 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E 1 Historic District In District review required K 1 Parking More Parking Required 2 Not in district L( eS 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existing Parking Remedy for the above is checked below Item # I Special Permits Planning Board Item # Variance Site Plan Review Special Permit -a Setback Variance Access other than Frontage Special Permit Parking Variance. Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit -Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Independent Elderly Housing Special Permit Large Estate Condo Special Permit Planned Development District Special Permit Planned Residential Special Permit Special Permits Zoning Board Special Permit Non -Conforming Use ZBA Earth Removal S ecial Permit ZBA Special Permit Use not Listed but Similar Special Permit for Sign R-6 Density Special Permit Special permit for preexisting nonconforming Watershed S ecial Permit The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. You must file a new permit application form and begin the permitting process. Building Department Official Signatyf-e Application Received Application Denied Plan Review Narrative The following narrative is provided to further explain the reasons for DENIAL for the APPLICATION for the property indicated on the reverse side: Referred To: Fire Health Police Zoninq Board Conservation Department of Public Works Planning Historical Commission Other Other Building Department IVA. 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