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Miscellaneous - 875 DALE STREET 4/30/2018 (2)
U c� HORrM ,� � 9 41� .�y s S. •' a ,SSACHUS� Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....�` f`�.�� i� °.,. �( .� 6t. `.G....... . has permission to perform ...tt .lW.��'.. `?!�.'. .l`e ................ plumbing in the buildings of....A, i. ..................... at ... IVY. .............. I North Andover, Mass. C— Fee. Lic. No.1.9t L.4 ... .......� ... �-c !)........ . PLUMBING INSPECTOR Check # 6871 'IQ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Lo of New ri Renovation rl Replacement i Date Qe-- F Z�-g Permit # Al2 Amount Plans Submitted Yes 1:1 No ❑ (Print or type) Check one: Certificate Installing Company Name, h t C�P�1/'K P� ❑ Corp. Address -_ D)4-- 2 5 ❑ Partner. Business Telephone Firm/Co. Name of Licensed Plumber:nk�vrto,� Insurance Coverage: Indicate the *e of insurance coverage by checking the appropriate box: 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 thr surance 6 fl— R", , ignatur Owner 111J��11 � 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 Mass setts State Plumbi od d Chapter 142 of the General Laws. By: igna ure M Licenseaum er Type of Plumbing License Title (, City/Town License umGer Master Journeyman APPROVED (OFFICE USE ONLY 1' .J 7 " M. / -----------------------M- a / .-.--m------------------- 1 1 1 / -.-.-----MM.--.---W---M-- 1 1 -.----.----.M-.W.--.--.�- / 1 / 5--M-.®----------------M- (Print or type) Check one: Certificate Installing Company Name, h t C�P�1/'K P� ❑ Corp. Address -_ D)4-- 2 5 ❑ Partner. Business Telephone Firm/Co. Name of Licensed Plumber:nk�vrto,� Insurance Coverage: Indicate the *e of insurance coverage by checking the appropriate box: 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 thr surance 6 fl— R", , ignatur Owner 111J��11 � 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 Mass setts State Plumbi od d Chapter 142 of the General Laws. By: igna ure M Licenseaum er Type of Plumbing License Title (, City/Town License umGer Master Journeyman APPROVED (OFFICE USE ONLY CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED O MAY BE OCCUPIED AS S IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHU TTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 0q. "T ; �, CERTIFICATE ISSUED TO ,o p ADDRESS to C\ r-4 CD CD t; Z a) CL 0 0 CO2 CD CM CO2 co L** E CD CO M CD L— CL 0 CD �. = (D Q Ca m 2L 0 ca CL. CO) 0 z CL ca CO2 CL m cc CD cc co CA CO n 0 z E.S (! S S .1-. E COL ca 77 • ca cm 40.5 ca 0 cc go C Co E 0 u 0 CLU L CD C/) LOi 0 CD 21, = C/) :5 0 CD • 0 A v C3 0 z Coco tg CL Cl 0 CD CD W M 3: r 0 CA) L U 0 per...CD pc P Ed CLM = 4.. 0-0 ca z CD w u 'm Im .0 I. -- C* 0 :6 015 .0CD E:a = 4-0 CL *.Cc ro CD E t; Z a) CL 0 0 CO2 CD CM CO2 co L** E CD CO M CD L— CL 0 CD �. = (D Q Ca m 2L 0 ca CL. CO) 0 z CL ca CO2 O:M/ Permit Na 9 Pa�Uc Sa�tgr Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code 527 CM5,42:OC (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location Owner a Owner's C,1te_ ., To the Inspector Is this permit in conjunction with a building permit yes I No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts New Service 90 0 Amps t> �oils Number of Feeders and Location and Nature of Proposed Electrical Overhead ❑ Overhead Undgmd ❑ Undgmd ❑ No. of Meters No. of Meters OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Vability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Worki Work to Start Inspection Date Resquested Rough Final Signed underth nalttps of perjury FIRM NAME V 'L "if LIC. NO.,(,( Ucensee Signature L�ICQNO^. ` �4d Bus. Tel No. 27 r? Address �PrZ Alt Tel. No. - OWNER'S INSURANCE RIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass achusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $______.- (Signature of Owner or Agent) Total No. of Light8rig Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimminq Pool gmd ❑ gmd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cord Tons Initiating Devices Heat Total Total No. of Oiposal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers S ace/Area Heabnq KW DetecborvSounding Devices ❑ Municipal ❑ Other No. of Dryers Heatinq Devices KW Local Connection Na of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Vability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Worki Work to Start Inspection Date Resquested Rough Final Signed underth nalttps of perjury FIRM NAME V 'L "if LIC. NO.,(,( Ucensee Signature L�ICQNO^. ` �4d Bus. Tel No. 27 r? Address �PrZ Alt Tel. No. - OWNER'S INSURANCE RIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass achusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $______.- (Signature of Owner or Agent) .� ,Nu � o J 6 Date ............ .... /'� .... . o, TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that 2 t a L a v ............................................................................................. has permission to perform wiring in the building of .....f �.`�! �`, P� S at .... 0,7/ ... �................................. . North Andover, Mass. Fee..�.71KJJ. Lic. No/1..//�`�4............................................................... ELECTRICAL INSPECTOR C \- uMM(� -09:05 277.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Focation �je JT. ; /0 No. Date / i� "!1r ? �. ra TOWN OF NORTH ANDO�ER Certificate of Occupancy $ �� Building/Frame Permit Fee $ J16 0 Foundation Permit Fee $ Other Permit Fee 1$ Sewer Connection Fee $ Water Connection Fee $ %o,32. co TOTAL $ 3.97• ` y Dv nspe 40M.00 PAID �•�^�" "". ----�� Div. Public works I Location No. Date E TOWN OF NORTH ANDOVER 12j'U197 13:32 1, DB2--m—P 'Idling Inspector "I Div. Public Works Certificate of Occupancy $. Building/Frame Permit Fee $ �' < Foundation Permit Fee $ r l L Other Permit Fee $ �- Sewer Connection Fee $ -------- "- Water Water Connection Fee $ TOTAL $ 12j'U197 13:32 1, DB2--m—P 'Idling Inspector "I Div. Public Works 1 1 a 1 : � 1 r � r . r it 0 m 0 a w n n A L 2 0 > > n �n • N 0 z r r w r r . v n c c N • w n n n n z z Y N Z C n 0 z N Y 0 1 to i 0 A J z • f M w 0 0 0 2 30 0 0 ; a r C C C >>>> n = i s Z o• p 0 r 0 O r O 0 z n Z w z rni a w • O C * O O O r 0 s a 0 2 0> G O r o s L i n z> N 0 o f 0 i .� w !� > Z '9r > p z 'i � 4 n n M 004 z 19 Z O W I r 0 C a O -1 C o 9O 2 Z a � r z C Z M 0• 0 w 7. n 0 a 00 n z a n a O .► f0 • � C� I L• z O w•. 2• c N • C • C • C • .� n 0 p = A 2 Z 0 A = O 0 0 O 0 > r , O , , w 0 A , z. M w PI o a o p 0 8, : g 0; 3 0 0 0 0 z n= c ; s A Z Z z•= z n z n z , 0= s 4 n n n; z .� w O O O Z 0 0 0 , M p C Z Z i • f �a -0` n r n z - w r 2 Vi M Z _ O ZL -4 PI n "1 N w � — 0 d, °v. rz Vi C" c-� v■ y C � ■ � d 'O O CD n Z y O. O =. O CL= y a� � o d o v CD CDCL cr O �F �_ CD r�F CD O CD C CD y� dv y CO CD S v CO) O CD Z o CD 0 C C � � p _ CA O Q H Em aom .� CO � o n Z =-o V! 0 n o ? m . � of ti CD -40 0 H p N O?m m Z 7 O O y: O .0 m a -► O 0 o H • O Er 5 o C m ?: CD a Ce C/) m n� o m ll a l"} Ol l 1., �. H a N a p�j cr C ^� CIO a=a �1 N m C N �.m H y Im !� .r H W 50 0 za O Cl c„ z y D CY c' d . _m CD N .` Im a � c CD _ ro O ollr� y� ro A Pri � w O- O w c C w 0 v r G- 0-4ro d CA O n' O CD , v GENERAL BUILDING NOTES/CHECKLIST 8/95 0+ POST ALL LOT NUMBERS AND PERMITS (copy ok)..or no insps. INSPECTIONS: (Minimum) Excav, Ftg, Fnd, Frame, Insul, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior piers FOUNDATIONS: Rebar as required Anchor bolts or straps Damproofing Foundation drain- pipe/stone/fabric filter cover FRAME: Fireblock - over girts/plates between floor joists Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters- watch bearing at walls. Ridge & Hip-- Provide proper connections. Cathedral roof rafters- Use "Hurricane Clips" tie to plate. Stair stringers- watch cuts and heal support Joist hangers- fully nailed w/ hanger nails. Sill plates 2-2x6 (1pt) w/ sill seal. Girts- solid brick or steel plate bearing at foundations 1/2" air space at sides in foundation pockets. Lateral bracing at ends. Certified calcs. required for Beams/LVL's/Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances- stairways, under beams. Attic Access. (min. 22x30 w/3'headroom above). Crawl space access. (min. 18x24) Bath exhaust fans to have metal duct. Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. 1/2 of required glazing shall be openable. Bedrooms require min. 20x24 egress window or door. Vent attic spaces- "proper vents", soffit and required ridge vents Firecode under stairs if used for storage. FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. surf. DECKS: Lag to house, provide flashing. Rails min. 36" high, Balluster max space 6". Over 8' abv. grd., use 6x6 posts w/ lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Ready to move -in ! > CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE. -I"=50' DATE 4117198 Scott L. Giles R. P. L. S. Frank. S. Giles r,. 50 Deer Meadow Road J OOti North Andover, Mass. O� 00 00• X K 3211 NV ao QSCb aw �O v fro, ti �s 'OO I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY or SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING ' 139M H BYLAWS OF NORTH ANDOVER CONFORMITY OR NON -CONFORMITY j p � WHEN BUILT WHEN CONSTRUCTED. / t r Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit (below) Address of Property for Permit (below) Ce_it r«f�_4 /1r[Jf^ . T, c dor / z . ��S" /�u �e S7- Map TMap and Parcel : low C Purpose of Application (check below) PnJe Number of Applicant: ✓Single Family _ Two Family h I e undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in exfste ce as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.r.,are met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior' shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. nQnz� a /�Oj\ I I hs -19 --) Signature of Owner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit. 0 .,_ii.. IQ 6%)LTIdd'Jl![IPQ-�� Q,�. fJ.iJIlC if/..P ✓! DEPARTMENT OF PUBLIC SAFETY Restricted To: 00 CONSTRUCTION SUPERVISOR LICENSE 00 -None putber Expires Birthdate lA - Masonry only CS 851254 04/17/1999 04/17/1962 16 - 1 S 2 Faoily Noes Failure to possess a current edition of the Restricted To 00 Massachusetts State Building Code 4� GLENN T SABA is cause for revocation of this license. 'w PO BOX 907/33 CLEMENTI LN f TNUEN, MA 01844 t 0 .,_ii.. IQ 6%)LTIdd'Jl![IPQ-�� Q,�. fJ.iJIlC if/..P ✓! DEPARTMENT OF PUBLIC SAFETY Restricted To: 00 CONSTRUCTION SUPERVISOR LICENSE 00 -None putber Expires Birthdate lA - Masonry only CS 851254 04/17/1999 04/17/1962 16 - 1 S 2 Faoily Noes Failure to possess a current edition of the Restricted To 00 Massachusetts State Building Code 4� GLENN T SABA is cause for revocation of this license. 'w PO BOX 907/33 CLEMENTI LN f TNUEN, MA 01844 The Commonwealth of Massachusetts Department of Industrial Accidents Office o//nyesdonfoos r 600 Washington Street Boston, Mass. 02111 ' Workers' Compensation Insurance Affidavit name _ C e f'1 r►1 y A—.j t location: /t� city r ` e U �/1 t A D t-1 �i 0 1 am a -sole proprietor, general contractor, or homeowner (circle one) and have hired t i the following workers' compensation polices: contractors listed below who - - - --- - - - - - --o- --- - - -. --- --.- .---- ._ ..._ ................. ... .• .......�. ,....�.......... ....a ..p .V JI,..W.W -u1 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 Office of investigations of the DIA for coverage verification. Ido hereby certify u der the pains and penalties of perjury that the information provided above is true and correct. Signature / L Date Print name _ Q-2 [ e i1.121 T ,S C, O c Phone #��r %?'� �q TS" Ny official use only do not write in this area to be completed by city or town official city or town: permit/license q nf3uildiog Department C]Licensing Board O check if immediate response is required 0selectmen's Office ❑Health Department contact person: phone q; nOther (revised 3/95 PJA) phone #: policy # ' - - - --- - - - - - --o- --- - - -. --- --.- .---- ._ ..._ ................. ... .• .......�. ,....�.......... ....a ..p .V JI,..W.W -u1 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 Office of investigations of the DIA for coverage verification. Ido hereby certify u der the pains and penalties of perjury that the information provided above is true and correct. Signature / L Date Print name _ Q-2 [ e i1.121 T ,S C, O c Phone #��r %?'� �q TS" Ny official use only do not write in this area to be completed by city or town official city or town: permit/license q nf3uildiog Department C]Licensing Board O check if immediate response is required 0selectmen's Office ❑Health Department contact person: phone q; nOther (revised 3/95 PJA) Town Of North Andover Building Department 146 Main St. Town Hall Annex 508-688-9545 APPLICANT: RE: DA Title of Plans and Documents: Project: Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following reasons: Zonina Use not allowed in District Not in conformance with Phased Development Violation of Height Limitations Sign exceeds requirements Violation of Setback Front Side Rear Insufficient Lot Area Insufficient Parking Violation of Building Coverage InsufficipM Open Space Use r es permits prior t0 Building Permit Si aquires permits prior to Building Permit orm U not complete by other departments oflot in conformance with Growth By -Law Other Remedy for the above is checked below. Dimensional Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign -offs Copy of Recorded Variance Information indicating Non -conforming status Copy of Recorded Special Permit Other Other Plan Review The plans and documentation submitted have the following inadequacies: 1. Information Is not provided, 2. Requires additional information, 3 !nfrxmation renuirec more clarification. 4. Information is incorrect. 5. All of the above. • Administration The documentation submitted has the following inadequacies: 1. Information Is not provided. 2. Requires additional information. • 3 Information r uires more clarification. 4. Information is incorrect. 5. All of the above Health oundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure .Construction Plans 116 Affidavit Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details ra ing Plan Fire Sprinkler and Alarm Plan Roofing Footing Plan Plans to scale Utilities Site Plan Water Supply Sewa a Disposal Waste Disposal Other PLANS DO NOT MATCH APPLICATION ADA and or ABBA requirements • Administration The documentation submitted has the following inadequacies: 1. Information Is not provided. 2. Requires additional information. • 3 Information r uires more clarification. 4. Information is incorrect. 5. All of the above 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 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 depRaynentG tyw f retain all plans and documentation for the above file. You must file a new building permit applicayah fit an� th �ittinaorwass. BXIng partmpVOfficial Signature Application Received Application Denied If Faxed : Denial Sent Referral recommended: Fire Health Water Fee State Builders License Sewer Fee Workman's Compensation Buildin Permit Fee Homeowners Improvement Registration Building Permit Application I I Homeowners Exemption Form Other I I Other 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 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 depRaynentG tyw f retain all plans and documentation for the above file. You must file a new building permit applicayah fit an� th �ittinaorwass. BXIng partmpVOfficial Signature Application Received Application Denied If Faxed : Denial Sent Referral recommended: Fire Health Police Zoning Board OVER Conservation Department of Public Works Planning Historical Commission Other BUILDING DEPT cc: William Scott V) FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve . the applicant and/or landowner from compliance with any applicable or requirements. '"""""APPLICANT FILLS OUT THIS SECTION APPLICANT LOCATION: Assessor's Map Number 109 L SUBDIVISION STREET Lora, �c4le ST �"`***"""OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: ATION ADMINISTRATOR COMMENTS N PLANNER PHONE G-) B' 6 8,S' VY1 PARCEL / S3,_ LOT (S) / Z ST. NUMBER T _.5- DATE APPROVED I Q DATE REJECTED -h DATE APPROVED j . ( DATE REJECTED COMMENTS_ FllYl Ia\it Vii/"c FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPYC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS �w . 17 1¢ 1,5 tis4L [ _ 15e DRIVEWAY PERMIT 1 ) 1( 4 /,� 7 FIRE DEPARTMENT 1 �- c��tmro0- 1�'r`�.invl`l�i ( �/� �� Q p 0r c� I ►�S���p�a RECEIVED BY BUILDING INSPECTOR DATE �� 4 � lit fi it � � � t l v�5 � ��� T 3 S N� t VIN `JaAOpUV gpON VISI `U011 SIN 1004S aIleCI `Z 1101 L06 xOg Od L66I `lOquraAON oui `sioptrng ,kmmuoD O i r 1 I fV `M1n ' M I ' I ` I I I t I I I I ---------------------------------------------------- 13 I N CD m • 1v Zr \j V T 1 w = N I 1 1 Ila LL Y •- 1 I` Oi co •- I _JI I I I � N M N lh I I I 1 I i I 1 1 . Y ---'--- I I I I I � I I I U i I I I m I LL S C �< c J CA G IU i r 1 I fV `M1n ' M I ' I ` I I I t I I I I ---------------------------------------------------- 13 VINT JQAOPUV qVON Vj/*j "u3nqloW . 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L06 xOR Od' JQqUIQAON L66T oul siopllnq AmijuoD 0 ....i�GlUlil....... ...... ------------------------------------------------- -- u ------ u u ----------------------- --------------------------- --., ---------------- a . 0 1 a a 0 E U. 4- 0 0 w E a S IT I �i I L I LL ;. 0 CLco 0) S Y a 0 E U. 4- 0 0 w E a S IT ic 2 942 Date .... HORT)i TOWN OF NORTH ANDOVER py .ao ,a,tiOL p PERMIT FOR GAS INSTALLATION This certifies that ,. has permission for gas ristallation. `... . �*!ll f! in the buildings of {:..-Q' ��� ... .................. at . !. `�-s �`• . • • • • • • • ... , North Andover, Mass. aFee-� . Lic. .......................... 09/17/98 15:33 GA§Q EO%W WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING or print) JNVKIH AIN DOVER, MASSACHUSETTS Building Locations 8-2 `5— v ) ,,4 -� \ N0V_,;Pk `, 4L �)o J e,� Owner's Name Newco Renovation ❑ Replacement ❑ Date g j J 19 Permit # VGACtA7nt't$ �� Plans Subm ed ❑ o p Namecrs J f `*i Address, `t 7 I/ [ l 1 `ii Business Name of Licensed Plumber or Gas Fitter D-L"i IN is 'SO S I I L/t c S Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check o e: I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Z_ 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's A Check one: Owner ❑ Agent ❑ `I hereby certify that all of the details and information I have submitted (or entered) in above application are true ano accurate to the 'gest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in _A�mpliance with all pertinent provisions of the Mass us tts State Gas Code and Cpter 142 othe Genesi Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ® Plumber �/ c� d �as Fitter icenseI Number ® Master Journeyman W � a _ N z o 4 z .. _t z w H u Gx w -t w w z W Z n w w �- z � -t z w C �.. Zz cG ` w ` w i c: C : z - C i C vFi m z '� C =� C C w C w r SUB-BASEM ENT BASE M EN"I 1ST. FLOOR C 3RD. FLOOR 4T 11 . F L O O R 5T If F L O O R 6T 11. FLOOR 7T 11. FLOOR 8 T[I. F1, O O R o p Namecrs J f `*i Address, `t 7 I/ [ l 1 `ii Business Name of Licensed Plumber or Gas Fitter D-L"i IN is 'SO S I I L/t c S Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check o e: I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Z_ 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's A Check one: Owner ❑ Agent ❑ `I hereby certify that all of the details and information I have submitted (or entered) in above application are true ano accurate to the 'gest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in _A�mpliance with all pertinent provisions of the Mass us tts State Gas Code and Cpter 142 othe Genesi Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ® Plumber �/ c� d �as Fitter icenseI Number ® Master Journeyman MASSACHUSETTS UNIFORM APPLICATION FO ERMIT TO DO PLUMBING Cype or print) 6 � � (.7 a NORTH ANDOVER;.$sA£ITTS �— Date VU Locations J �t ( Permit #�, 3 a-3 1�o Owner's Name NewE_ Renovation El Replacement 13 Plans Submitted I J Amount (Print or type)f Check one: Certificate Installing Company Name /40( C t�� �' Corp. Address - W 0 O ��-� � � � Partner. oma✓ •L. 1 � Business Telephone ' 91i %,)—[Q (( Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate t e type of insurance coverage by checking the appropriate box: ❑ 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 11 Agent 11 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 installations performed under Permit issued for this application will be in compliance with all pertinent provisions of th husetts State umbing Code and pier 142 of the General Laws. By: a re ot L-f;msea riumDer Type of Plumbing License Vel I— City/Town/Town Ticense NumnerMaster Journeyman ra APPROVED (OFFICE USE ONLY 1.� • • t low low low (Print or type)f Check one: Certificate Installing Company Name /40( C t�� �' Corp. Address - W 0 O ��-� � � � Partner. oma✓ •L. 1 � Business Telephone ' 91i %,)—[Q (( Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate t e type of insurance coverage by checking the appropriate box: ❑ 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 11 Agent 11 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 installations performed under Permit issued for this application will be in compliance with all pertinent provisions of th husetts State umbing Code and pier 142 of the General Laws. By: a re ot L-f;msea riumDer Type of Plumbing License Vel I— City/Town/Town Ticense NumnerMaster Journeyman ra APPROVED (OFFICE USE ONLY 1.� Date ........... 3723 + 4,0 TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING V71"11I 5,SSA44 CHU This certifies tha4--. . . ..... . ......... has permission to perform. .............. plumbing in th5AI,uildings of. ...... at R.,?J - - . .... ....... Nort%ndover, Mass. FeP2A .4. . Lic. Nov;/."�. . .............................. PLUMBING INSPECTOR 06/11/9813:33 276.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer '2949�.. 'i Date..�J-- ............. v NORTH TOWN OF NORTH ANDOVER g 'py` ,.o ,s1MOL p PERMIT FOR GAS INSTALLATION a Ais certifies that '. - -'". '• : . • • • • • • '" hAs permission for gas installationf� ......., in the buildings of...:.: _�- !�--::-'.••••••••••••• at ... • . • • North Andover, Mass. Fee.:..... Lic. No........... .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer NA 0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date 19 Permit # t�qG] E Building Location Owner's Name /' Type of Occupancy S G NewK Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name pastern Propane -Ga.S Inc Check one: Certificate Address 131 Water S tr _et Corporation Danvers, NA 01923 ❑ Partnership Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter i"AA- '7' INSURANCE COVERAGE: I have a curt n liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes JA INo ❑ If you have checkedrtes, please indicate the type coverage by checking the appropriate box. A liability insurance policy A 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 the permit issued for this application will liance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General'Wws. s By T e of License: �� ) Plumber Signature of Lice ttd Plumber or Gas Fitter Title asfitter Master License Num er City/Town Journeyman APR/APPROVED OFFICE USE ONLY) WINK NOMMEMENESEEMMENE11 son Installing Company Name pastern Propane -Ga.S Inc Check one: Certificate Address 131 Water S tr _et Corporation Danvers, NA 01923 ❑ Partnership Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter i"AA- '7' INSURANCE COVERAGE: I have a curt n liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes JA INo ❑ If you have checkedrtes, please indicate the type coverage by checking the appropriate box. A liability insurance policy A 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 the permit issued for this application will liance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General'Wws. s By T e of License: �� ) Plumber Signature of Lice ttd Plumber or Gas Fitter Title asfitter Master License Num er City/Town Journeyman APR/APPROVED OFFICE USE ONLY) Q m m A. t, 7Date. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ................ has permission for gas installation . !'ti �! v' .............. i 11 n .the buildings of . ?'...! r ............... � �l�. •... ...........(J. , North Andover, Mass, —F�je.�e./?Xl. Lic. No....... ` !. ' �� 4 AS INSPECTOR g WHITE: Applicant CANARY: Buildin/Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT ZDOGTTING (Print or Type) Ag An doy F- r - , MA Date 06- C- 1 19� Receipt#Building Location g7� )Da- � �JL• OwneesNamA (� Map: Lot: Zone: Type of OccupancyI c A F- 17 C r New ❑ Renovation ❑ Replacement �( Plans Submitted: Yes ❑ No ❑ Installing Company Name �AS}t=rn j-�t'o oanlc -;*S Address 131 1t341F-T- EstimateValueof Work: Business Telephone I - Y O© - ` Name of Licensed Plumber or Gas Fitter q Rcy T) Checkone: Certificate Ig Corporation ❑ Partnership ❑ Firm / Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes CW No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Mr 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner ❑ Agent ❑ Signature of Owner or Owners 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of theI La . By Type of License: r Plumber S nature of Licensed PI u ber or Gas Fitter Title Gasfitter a Master License Number City/Town Journeyman APPROVED (OFFICE USE ONLY) IMADINA 41 RINA Installing Company Name �AS}t=rn j-�t'o oanlc -;*S Address 131 1t341F-T- EstimateValueof Work: Business Telephone I - Y O© - ` Name of Licensed Plumber or Gas Fitter q Rcy T) Checkone: Certificate Ig Corporation ❑ Partnership ❑ Firm / Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes CW No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Mr 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner ❑ Agent ❑ Signature of Owner or Owners 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of theI La . By Type of License: r Plumber S nature of Licensed PI u ber or Gas Fitter Title Gasfitter a Master License Number City/Town Journeyman APPROVED (OFFICE USE ONLY) I rn m D C A a a m m m O m 3 m > -1 -1 v ° 0 O Q > Q N s N O Q a rn m