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00 N H H Date.... TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that At/G�A� .`.. . ............................. ................... has permission to perform .......�—-0a 4 .................................... ............................. wiring in the building of ST ................................................................................ 8y?i....Sf?�"................. . North Andover, Mass. Fee..F-5- .... .3 ................. .4 ...... ELEMICALINSPECTOI Check # 7824 4 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 7 ? 2—j7 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] leave blank 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: ! l // o I U '-) City or Town of: N �h To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) St Owner or'Tenantsi- Telephone No. Owner's Address Is this permit in conjunction Iwithl1a buil ing permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Sti (c, Utility Authorization No. OSI Z Existing Service LDO Amps . 2,0 / 2- {OVolts Overhead Undgrd ❑ No. of Meters q New Service LfOD Amps I Zy / 24W Volts Overhead Undgrd ❑ No. of Meters c Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Cmmnletinn nfthe fnllnwinv tahlo mm) by wnivvd by thn In cnnrtnr nfWiroc 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 Swimming Pool Above ❑In- 11o. 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 No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers eat Pum Totals umber Tons "" ' KW " "' """ No. o elf- ontaine 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 Kit Heaters No. of No. of Si ns 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 of Wires. Estimated Value of Electrical Work 7 2t�o (When required by municipal policy.) Work to Start: (� 20 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 coverage is in force, and has exhibited proof of same to the e it i suing office. CHECK ONE: INSURANCE 5�r BOND ❑ OTHER ❑ (Specify:) qac t I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: I J , Cc,, Cl e C+1 C L L C- LIC. NO.: Z0 $33 Licensee: r , (4,e Signature Ati K— �--� LIC. NO.: 3 9 51 :5� (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 2L C I Z '12.0 7' Address: R2^% Z C_— ot-g LLI A • 01-10 -t Alt. Tel. No.: *Security System Contractor License required for this work; if applicable, enter the license number here: 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 a ent. Owner/Agent PERMIT FEE: $ Q , �(7 Signature Telephone No. % O S r �- c -c- v s Fs Date. r TOWN OF NORTH ANDOVER o PERMIT FOR PLUMBING SSAG MUS This certifies that ...�. .:? .C6` ....��............... . haspermission to perform .... e -!ti ............. plumbing in the buildings of .... ....................... at .... . 2:-+1 ..6?,, ►I.A ............. . North Andover, Mass. Fee. .1/20 :.. Lic. No.. a.? .3.? .S. ...... PLUMBING INSPECTOR Check # ..� 7577 A MASSACHUSETTS UNIFORM APPLICATION (Print or Type) Massachusetts (978) 538-5791 AT: Q�j Location New ❑ Renovation Replacement ❑ FIXTtJRF1R 164.x.40 FOR PERMIT TO DO PLUMBING r , Date 20 Permit # J^7 7 Building Owne 's Name Type of Occupancy: Installing Company Name ❑ Firm/Company 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations All inspection appointments must be made by licensed plumbers only. a License Number of Licensed Plumber Type of Plumbing License ®'1G a�r ❑ Journeyman • �■loll■■■//I■■■■■■■■■■■■■■■■■■■■■ ••'■■■■■■■■�■■■■■■■MINE ■■■■■■■■ .••-loss ■MINE ■■■■■■■■■■■■■■■■■■■ now, "91 P12 MMS on: In MIN .■■■■■■■■■■■■■■■■■■MINES ■■■■SO MEACE Installing Company Name ❑ Firm/Company 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations All inspection appointments must be made by licensed plumbers only. a License Number of Licensed Plumber Type of Plumbing License ®'1G a�r ❑ Journeyman Date.//.A �/� . ? ..... 3? '` TOWN OF NORTH ANDOVER ° • PERMIT FOR GAS INSTALLATION SS�CHO This certifies that ...'' has permission for gas installation in the buildings of ... e/! at ...�... ... !?�.�!Y i ti North Andover Mass. Fee.A! .. Lic. No., GAS INSPECTOR Check # 2 6236 ,r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING — (Print or Type) Date 200q_ Ytill / Massachusetts (978)538-5791 Permit # /r L 3 6 AT: JBuilding Ow is Location Name� Type of Occupancy: New Renovation Replacement ❑ Plans Submitted: ❑ Yes ❑ No (Print or Type) Installing Company Name Business Telephone. Ch One: Corp. ,le -fly ,tJ ❑ Partnership O'L 96 U ❑ Firm/Company 3 (� Na of Licensed Pl ber Gas itter Z���.�M; Certificate 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations coverage. ❑ LINSE TYPE: Plumber ❑ G er aster ❑ Journeyman ALL INSPECTION APPOINTMENTS ARE TO BE MADE BY LICENSED PLUMBERS ONLY Signature of LicerAed Plumber or Gasfitter License Number RW �11 (Print or Type) Installing Company Name Business Telephone. Ch One: Corp. ,le -fly ,tJ ❑ Partnership O'L 96 U ❑ Firm/Company 3 (� Na of Licensed Pl ber Gas itter Z���.�M; Certificate 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations coverage. ❑ LINSE TYPE: Plumber ❑ G er aster ❑ Journeyman ALL INSPECTION APPOINTMENTS ARE TO BE MADE BY LICENSED PLUMBERS ONLY Signature of LicerAed Plumber or Gasfitter License Number TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING ": s Sectio® for ficial Use Onl �'. �... ..&�t rY:. �CS'•-�.�.. „.•ant?�}'' r'S�ro��."'x"''.xt �i�`gF-,� BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Buildin Commissiongj or dBuildings Date � X 1.1 Property Address: 1.2 Assessors Map and Parcel Number: e? nel c, iS f �e lo - d y o Ga /Va �z &0 ;--):LL4 Map Number Parcel Number C qA 1.3 Zoning Information: 1.4 Property Dimensions: C J3 4,4(&IJ)/I- Zonin District Pr Use Lot Area s /` -- Fror- 1.6 WELDING SETBACKS (ft) Front Yard Side Yard Rear Yard ReqWred Provide Required Provided Re red Provided S 1 c),j- i a -S 1 1.7 Water S ly M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone ❑ unic' On Site Disposal System ❑ L 5^:.€i, .,I � f .•1.-r r^s . S . N? },`..zySY - 2.1 Owner of Record -� �a,c � -� i L. �� c�..i ✓� �e�\ � y l/y.�j }� ��LS �6 � y�� fl�c� . � cQyc�i , �., � ���y� N (Print) Address for Service /J -J- 3 /11 lure Telephone '9/6e -4j �lC t✓! 2! 1.GL �/�S �� 2.2 Authorized Agent Name rmt Address for Service: I- afore rTelephone 7 Not Applicable ❑ 3.1 Licensed Construction /Supervisor J 110-4-3 Address License Number A,T`revt v N. 20- I, k s i Tn� / c)O G Licensed Consti1iction Supervisor: ExpiratioA Da Signature Telep one 3.2 Registered Home Improvement Contractor Not Applicable ❑ C mpany Name,. Registration Number Address Expiration Date Signature Telephone .0 0 Workers Compensation Insurance affidavi ust 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 Yea ....... No....... ❑ SECT om 5 :; PROf WON'A , i1> szGPr A fl 0" k c ric3 t IRVJC 1� # � SIA s u i li s Tt3 CONSTRii�'d'IOI� �`t1�TRt3�a 1�'Al T� � � I6 (+�(1►1�Ti�l� f� 'i�A��`,�,091} �.F£ OF El�CikS1�D 51pA 5.1 Registered Architect: Name: (J ///f cQ t'� e ���� j cA Address Signature Telephone Name: Address: Signature Total Name: Address Signature Telephone Name Address Signature Telephone Name Address Signature POIC/ 7K. Company Name: 7- r' Ki 'ey�'x CQ �� r Responsible in Charge of Construction Telephone Area of Responsibility Registration Number Expiration Date Not applicable ❑ Registration Number Expiration Date Area of Responsibility Registration Number Expiration Date Area of Responsibility Registration Number Expiration Date Not Applicable ❑ 'v New Construction L Existing Building Repair(s) Alterations(s) ©1 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brieff Description of Proposed Work: r^V AJ ,q ^ n /^) L n f CL ! �C iyt d'J',_tq C] f' 4 J / AM t CONSTRUCTION TYPE I, ,as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this gilding permit application Signature of Owner Date USE GROUP iCheck as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ All ❑ A-2 ❑ A-3 0 A-5 ❑ ]A 113 ❑ ❑ B Business ❑ 2A 2B 2C 0 0 ❑ C Educational ❑ F Factory ❑ F-1 ❑ F-2 0 H High Hazard ❑ 3A 3B ❑ 0 IInstitutional ❑ I-1 ❑ 1-2 ❑ 1-3 ❑ M Mercantile ❑ 4 0 R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A 5B 0 S Storage ❑ S-1 ❑ S-2 ❑ U Utility ❑ M Mixed Use - S Special Use ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Ad, + a Existing Hazard Index 780 CMR 34: Proposed Use Group: "t% Proposed Hazard Index 780 CMR 34: AA CkVLA BUILDING AREA EXIS if applicable) PROPOSED Number of Floors or Stories Include Basement levels , is 4 nS Floor Area per Floor s Total Area s Total Height ft a: Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner of the subject property Hereby authorize to act on My behalf, in all matters relative two work authorized by this gilding permit application Signature of Owner Date I, L hf S4A Q-,4 Zj as Owner/Authorized Agent ' Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury 9cic- 1t txc'-. ko r, i +� mitis Print Name 06 Si tore of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed b t applicant P Y Pew PP 1. BuildingC 50-s—/ ®8 css (a) Building Permit Fee Multiplier 2 Electrical - O O t , (b) Estimated Total Cost of Construction from (6) 3 Plumbing/,s i ©, r Building Permit fee (a) X (b) 4 Mechanical (HVAC) 5 Fire Protection Olt 6 Total (1+2+3+4+5) Check Number >.A ,.. ?kl ¢:4�J ) ask 3Yj 4.fs.SV�� l ':) 7%a�1`k2.is4.Ai, �wFv... �� t jSt I.y�y �, a• 5:_. f5.j 3T 17 y� 4�j '. r 't Sg,,lY } fii, t�rst ryS t) 3:T . L hGv:r} :' 1 ; }'. !• 'f'j 34 y$ �. ij} y(hk'i'r�`e'�t3A.34.h$I '5341 }iJ~i•.xf.. !� (i.`.'� iS a •4( \: r a �bY t �fu�..3 ..N.'��J'�5 K-QYC'U y'.a'.iri .tfi}'`i. U�'a'.:e ii K '4 'i.-•: �'y-'s F' ,C{.: r' , "' lar .'+ NO. OF STORIES SIZE \ /S' ,� EMENT R SLAB SIZE OF FLOOR TIMBERS 1sr 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ii� t c MN .?• 'c -S .a•` ns 3T .5 k ,y: R -, y i .r y c r - x h W t, " -rs,'. i;= _i�' 7 •3.r3 5,.. �.c<' .a. -s1 rt. _ a- +� :. I 3w vfi"es'.- 09/14/2013 23:14 FAX Lieansg CONST IGTI , "VP�FtVTSOR i tViitnl"fir Q836'60 g th'itat;"'.'1,' %9Jl/fi97$ ! IIEie[ns;j;QOIJ206 Tr. no: 83660 ANT10{�l`('I 'iBE �4�SM1 s 1.�2•t IBARTL!E'I �� �• r. CN4R[S7OWIV,',Il' 02'1x9a -- Admiiiistratar f l _ yI 2002 r. Driver's License ii Q9-0 9-x8 'O.s•0 I.44 'M 5'0Er• D S99597403 Date of Bifth Expires Sox Height Class NuMbOT B Restri0t �BEl:;k,�;S'5.WO ANI-H6N'Y aN r ,r 'a 121 19ARTtETUZ CHAMFSTM6'MA 01120.2418 Lieansg CONST IGTI , "VP�FtVTSOR i tViitnl"fir Q836'60 g th'itat;"'.'1,' %9Jl/fi97$ ! IIEie[ns;j;QOIJ206 Tr. no: 83660 ANT10{�l`('I 'iBE �4�SM1 s 1.�2•t IBARTL!E'I �� �• r. CN4R[S7OWIV,',Il' 02'1x9a -- Admiiiistratar f l _ yI 2002 09/14/2013 23:14 FAX dti-:So-ovw cr enciuseo spade }I 1 OO' L CA 17 S.GOL) 1A ' Mesony only I t & 2 Family Homes Fellure to possess a current edition of the ! Massachusetts Stale Building Codri is Cause for revocation of this license. 6 i. F 4 p»'SAfiE:Ci4,LLC9N,T�-Rt {;88'8):34 -7233 .B: Corrective lenses Z003 a 09/14/2013 23:13 FAX April 8, 2004 North Andover Town Hall Planning Board/ Building Inspector 120 Main Street North Andover, MA 01845 Dear Sir or Madam: [A001 Please be advised that I, Anthony N. Bellissimo, Construction Supervisor license #083660 in. the Commonwealth of Massaeb.usetts authorize Albert P. Manzi III, signatory capacity of my name and license number. The purpose of this authorization is to procure a residential building permit from the town of North Andover. Also please note, I am including a copy of both by CS license as issued by the commonwealth and a copy of my driver's license. If you have any questions or concerns please do not hesitate to contact me at your earliest convenience at 617-406-8491. Thank you for your cooperation in. this matter. Sincerely, Ant. N. Belli.ssimo, J.D. CS #083660 Apr 22 04 03:19p NORTH ANDOVER 9786889542 r• % � Koxrk Zoning ' g B I w y a Review Form x 4 Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 ""r Phone 978-688-9545 Fax 978-688-9542 L.Date: Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: p.2 I ne 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_ ;Wl;�QepaftenlOfficial Signature Appl(catio Received Appli tion enie Apr 22 04 03:19p NORTH ANDOVER Town of North Andover Building Department 27 CHARLES ST 978-688-9545 4E ,kORTI{ I•i` ♦ t` a ."ra OF Y F 9786889542 P,1 Project: SA qeS APPLICANT: l�r�e . C-: c Iry-o't w Wfi RE: DATE: Title of Plans and Documents: Please be advised that after review of your Application and Plans that your Application is DENIED for the following reasons: Plan RevieW The plans and documentation submitted have the following inadequacies: 1. Information Is not provided, 2. Requires additional information, f_ 3. Information reauires more clarification. 4. Information is inrnmxt s 611 nr the et,Mro # 1 1# , 1 1 Foundation Plan 5 r12 Plumbing Plans 2 Subsurface investigation 13 Certified Plot Plan with proposed structure 3 Construction Plans 14 116 Affidavit 4 Mechanical Plans and or details 15 Plans Stamped by proper discipline 5 Electrical Plans and or details 16 rarning Plan - 6 Fire Sprinkler and Alarm Plan 17 Roofing Plan 7 Footing Plan 18 Pians to scale 5 8 Utilities 19 Site Plan 9 Water Supply 20 Sewa a Disposal 10 Waste Disposal 21 Driveway Entry App. DPW 11 ADA and or ABBA requirements 22 Other. Administration The documentation submitted has the following inadequacies: 1. Information is not provided. 2. Requires additional information. 3. Information requires more clarificatinn 4 inf„r-;W-1� it--# M All The above review and attached explanation of such is based an the plans and Information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal ellplanalions by the applicant serve to provide definitive answers to the above reasons for DENIAL 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 building permit application form and begin the permitting process. Bui-IdihirTepartment Official Signature Application Received 'A (12 (pC- If faxed: # Referral recommended: Date Se Application Denied 41f 3l e Sen Fire I Health Police Zoning Board J .1 2 Water Fee Sewer Fee 5 t 6 1 State Builders License crN 2 I Workman's Compensation 3 Building Permit Fee 7 t Homeowners Improvement Registration 4 Building PerfritA plication 8 Homeowners Exemption Form 9 Other: The above review and attached explanation of such is based an the plans and Information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal ellplanalions by the applicant serve to provide definitive answers to the above reasons for DENIAL 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 building permit application form and begin the permitting process. Bui-IdihirTepartment Official Signature Application Received 'A (12 (pC- If faxed: # Referral recommended: Date Se Application Denied 41f 3l e Sen Fire I Health Police Zoning Board Conservation Department of Public Works Planning Historical Commission C(;: rielul Vrimn Revised 9197 jm 7