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HomeMy WebLinkAboutMiscellaneous - 82 BERKELEY ROAD 4/30/2018i N Op_ .P N J m m o m O 9, < p 0 0 0 Location 3 2 Date, NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ 16. 41 ♦ i Building/Frame Permit Fee $ x0y C� r+S�a'•�•e'e<� Foundation Permit Fee $ s�cMust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL �ZZ/M of Building` Inspector 12771 09/03/98 09.04 ��Div. Publi %Yorks }AI Location �r t derC 'pyo, Date TOWN OF NORTH ANDOVER p Certificate of Occupancy $ ` Building/Frame Permit Fee $�� Foundation Permit Fee $ s�CMU Other Permit Fee $ ., Sewer Connection Fee $ Water Connection Fee $ x TOTAL $4r,; f Building Inspector r7 +} 09!03/98 09:04 / I i Div`' i -lic V ddks d o o W � O d Q it uj F a U �a N N M©l �, x J o o � 40 it uj F a U z LLI W z z F 4j w 0 O C Z w N •� t2i.t w �yy. ` z �! Z N w In N u C z¢ vC-i twit Z O F � " } w Z z C; � cc�� G C 0 C w z C7 � z D tFa. u Q F U m m M a z o o � 40 uj F a U j Z ri Z J CL G _ 0 A z z z_ Y' LU w C w c LL C z } Z F O C LU LU �n LL Q\ W O = z Z v M N Ln w Z N w n _ w Z m J Z L z Q z Jd z z a p c F F C ✓ z Z Q ` rn W W Z Z Z r u V N = — _ _ — C r Z Z Z C m N _ Z Q C1 y ¢ a 0 FM4 r Rob ON Q W U T U)"O a a Q 0 o .G o v CT x U G iz a aC o n: G w a � W o C � o c a w as z V) J2 �. O z :a .0 f3a co O co C) coQts CA tip Z p„ CQ1 C O E a a � O co cn C 4) CD G O 0 L Z m o Q, O o- CM< w U Cc U)�� c Z c Cy Occ CL � Y C C m C C t5 O LZ C H O C : �. AA V •d,m CL C :M� m c `oCD CD u1 q� t•k o c 1 EE m V la IIS a E N A CD m a. O �' N m 3 N L ca O N C N •O ECD O LO)' C 3 CD m Ile: 35 Z 81 C=3C=OC •O a m � m C d m COD LUmg m mg o •ty/� ra ac •ECZ at�c c H Z o � a O�oc g �•.�c. y•� � = eyo �= a�m> :a .0 f3a co O co C) coQts CA tip Z p„ CQ1 C O E a a � O co cn C 4) CD G O 0 L Z m o Q, O o- CM< w U Cc U)�� c Z c Cy Occ CL � Y The Commonwealth of Massachusetts S - Department of Industrial Accidents — Mice 0//UYCSyffideas 600 Washington Street w Boston, Mass. 02111 Workers' Compensation Insurance Affidavit city phone � I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0 I am a -sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name* - Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a flue up to S1.500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a COPY of this statement may be forwarded to the 011Yce of of the DIA for coverage verification. I do hereby Print name fund h sins an ena1des/f perjury that t rmation provided above is true and correct. Date /-GP�l1 Phone # /di4 ^04f I fficial use only do not write in this area to be completed by city or town official city or town C] check if immediate response is required contact person: (remed 3/95 PIA) permit/license q riguildiag Department ❑Licensing Board C]Selectmen's Office C]Health Department phone q; r7Other Town of North Andover ,,ORTol OFFICE OF °� •.;�< COMMUNITY DEVELOPMENT AND SERVICES 10. - 146 Main Street North Andover, Massachusetts 01845 �'•�,;; " WILLIAM J. SCOTT Ss�CH s�t< Dimaor 13 In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NiGL c 1 11, S 150A. The debris mll be disposed of in: (Location of Facility) Sign e Permit Applicant 3 � Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. BOARD OF APPEALS 699.9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9340 PLANNING 688-9535