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Miscellaneous - 91 MARBLEHEAD STREET 4/30/2018 (2)
N � m O O > O D f0 ;o O m m D o � o m o m m Location Py'e�/� No. 3 ` Date )" _3� _U NORTH TOWN OF NORTH ANDOVER f D + Certificate of Occupancy $ �'�s' •° Eta' Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ` f3y Check # o;,-0 16088 /,Pf /V (Com- --- Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT& OR DEMOLISH A ONEOR TWO FAMq�ILY DWELLING , ,. ., ..�. �E"�� kT�� �1� iVil�i�� �+�4 111 � • sck��i � s i � ': 1 M BUILDING PERMIT NUMBER: �/ DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION i- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: Public 0 Private ❑ ,Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record P� � -dame (D� Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: r , ' f? � w /Lice'nsed Construction Supervisor: 62?2License Address �O Signatuk Telephone R Not Applicable ❑ Number Expiration Date 3.2Rei tiered Home Improvement Contractor Not Applicable ❑ Company Name Address Registration Number Expiration Date Signaturt Tele hone T M ic z O SECTION 4 - WORKERS COMPENSATION (M.G.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 ....... ❑ SECTION 5 Description of Proposed Work check all licable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: of o e oUT f SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by pen -nit applicant OFFICIA)�; 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: (Location of F Sign Date Applicant NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Q � 33— Board Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR j Registration: 133522 Expiration: 07/05/2003 Type: individual PETER J. JEGOROW PETER JEGOROW ' 22 AYER ST. HAVERHILL, MA 01832 Administrator f1e '�mm�rzan�.ucal� �:/a!�iiauaal�uf� BOARD OF:'BUILDING REGULA71ONS License: CONSTRUCTION SUPERVISOR Number; CS, 077192 BlrthdaW ° 03/16/1971 Expires: 03/1W2004 Tr. no: 77192 Restricted To: 00 PETER J JEGOROW c 22 AYER STREET HAVERHILL, MA 01832 Administrator Jegorow Carpentry/Painting Peter Jegorow 22 Ayer St. Haverhill, MA 01832 978-374-9306 NAME/ADDRESS Beverly Donovan 91 Marblehead street N. Andover MA. Estimate DATE ESTIMATE NO. 7/31/2002 19 PROJECT DESCRIPTION QTY RATE TOTAL Renovation of complete first floor less the existing bedroom. Gut all 43,000.00 43,000.00T walls down to studs, frame in stairwell to second floor and basement. Remodel to match your floor plan layout. Replace both exterior doors. install all cabinets. trim all windows and doors with colonial casing (unless otherwise specified) All electric will be replaced and brought up to code. Also all plumbing will be replaced from the basement up, including central heat and AC to be installed on the second floor. All fixtures, sinks ,shower, kitchen cabinets, contertops, toilet and finish flooring to be chosen by owner and price for these items not included in this estimate. Siding installed where bathroom door gets removed(extenor) Closet built with raised panel sliding door Shim floor to approximate level. Finish ceiling height 7-6' or greater Extras to be billed accordingly(not included in original estimate) Replace two cellar doors in the basement Rot to be repaired behind the washer One new cellar window One new cellar vent window Pocket door kit for bathroom Painting to be coordinated with Tom Coultas or done by myself. No Tax 0.00 0.00 Estimate only. Please contact me to go over any details. TOTAL $43,000.00 Contract Jegorow Carpentry & Painting 22 Ayer Street Haverhill, MA 01832 To: Beverly Donovan 91 Marblehead Street North Andover, MA 01845 Job Includes: All listed on attachment page (Estimate revised with Beverly) ** Any changes to the contract will be discussed and priced accordingly. Total $43,000.00 Deposit required upfront $15,000.00 Balance due upon completion of job description Authorized Signature 2/3 due $15,000.00 3/3 due @ completion $13,000.00 Extras due accordingly Date All estimates good for 30 days only! (Start date approximately October 1St, 2002) Authorized Signature Date 33" 136" .. ........ 49 35" 55, 64 24" W 1 V93315 9340 TB 33REF-2D ID 60' Name The Commonwealth of Massachusetts Department of Industrial Accidents K Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print "T'F� I am a nomeowner pertorming all worK myselr. I am a sole proprietor and have no one working in any capacity -F2� I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone Incijranre C`,n_ ,,�-. Ar /boy M41601 M -Z yam_ Policv # �1-21 Company name: Address City- Phone #: Insurance Co. Policy # Failure to secure coverage as required. under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment_as well_as_cMi penalties inibel=-&a_STOP WORK ORDER.and-a.fine_of.($IJDD-0D)-asJayagainstme I understand that a copy of this statement ray be forwarded to the Office of Investigations of the DIA for coverage verification. ! do hereby certify under 491111 s anglW allies of perjury that the information provided above is true and correct. Official use only /� �] ,deo not write in this area to be completed by city or town official'! Q City or Town � 1/ y /C ih IY IV til ,0 (1-C � PerrnitlLiaensiaa 0- y i /of t Nu 3:)G p4 ` .t . /14 Building Dept ❑Check if immediate response is required E] Licensing Board p Selectman's Office Contact person: Phone #: ❑ Health Department ED Other Cl) m m C/) 0 m C �h CO) CD.0 CD O CL a� O OCD v CL Q CD CD .... Q O O O �Q CD co) 10 CD a O BMJ CO) d d O 'v C7� C O C CO! d CD O �F CD CDa y CD CO) O O CCD O CCD [O �• y ® t7 N a O:O C® fl CO) o ® 0 ® Cl)mnaA ® CLm z C = O N S'G N _I �. .=r .O.► O H T s a ,+ a c CD --lo CD W m N p y O =' S m m O y !9 CL am O W m O N C O m d a� m V R O• =r H :1 cr CcC O 7 a H O O m ? 3E O N N N Q CD m CD 4*w CAT: ® o :c ciu A o � �o C z 02 Z CD C Wim: il) -, y d W � CD CL= = p nW CAo: c o C, rD R='- d ►z-3 aq G) cC) � �' OQ Cr7 n y O °� oda , O °= arc O O ^• ` a. x O d O OTIx E-� w 3983 It Date.................................. O't.�•o i• '4' e�,r -•. !s �o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ....`.::'':::a"........................................................................... has permission to perform ........... '-.:`..`.`'.....--.-.r.:��............................ wiring in the building of .. -14611 •-�c. .•............................................ at ...... ..... �`"'•�t' G- e` .c`.'-o!�'�... North Andover, Mass. ......................................... ............. Fed ....�N......... Lic. No/ 714- . �.. c �...................... /,'� ELECTRICAL INSPECTOR Check # 7� 6/ �i The Commonwealth of Massachusetts Office Use OnlyGy G /7� Permit No. ,) Department of Public Safety Occupancy & Fee Checked AV,( f BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date July 25, 2002 N. Andover To the Inspector of Wires:. The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 91 Marblehead Street Owner or Tenant Beverly Donovan Owner's Address 1 Fern Street, Windham, NH 03087 (603)434-2127 Is this permit in conjunction with a building permit: Yes ❑ No E3 (Check Appropriate Box) Purpose of Building Residential Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Wire replacement water heater No. of Lighting Outlets g g No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool A9md ❑ gmd. [] Generators - KVANo. . of Emergency Lighting No. of Rece Receptacle Outlets p No. of Oil Burners Bat Battery Units No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection andtons Total No. of Ranges No. of Air Cond. Initiating Devices Heat Total- Total No. of Disposals No. of Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal Local ❑ Connection f❑ Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW ;Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. I have submitted valid proof of same to this office. YES ® NO ❑. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE IR BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Signed under the penalties of perjury: FIRM NAME CROWE & SON Inspection Date Required: Rough ECTRICAL CORP. YES ® NO ❑ (Expiration Date) Final LIC. NO. 1716 8A Licensee JAMES B. CROWE Signature f LIC. NO.1716 8A 543 MIDDLESEX STREET LOWELL, MA 01851 Bus. I -Tel. No. 978) 453— Address � Alt. Tel. No. 9 7 8 OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. PERMIT FEE $ 35 .00 (Signature of Owner or Agent) v� Location `a / &Z,.� 4 47--->;,,) e'7— No. Date.z �uA,- 2__ TOWN OF NORTH ANDOVER Cf��I.``. 16 p Certificate of Occupancy $ B ilding/Frame Permit Fee $ dation Permit Fee $ OtheiPermit Fee ✓ ^ r /l irr"$ 'p�= Seweror nection Fee , $ Water Connection Fee $ 01 TOTA�t=, vN; $ l 1, (r ,/ Building-Inslyeclor 5032 Div. Public Works / PER -MIT NO. ..� 0 5 s15 a APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 I LOT NO. 2 RECORD OF OWNERSHIP IDATE BO PAGE Z9NE SUB DIV. LOT NO.I L(SCATION���PR�E el4 DStRC—C \��CC — PURPOSE OF BUILDING L/jv1. S "e IcL-ON 6 - OWNER'S OWNER'S NAME AIPA/C -4 a^rneS U IV N NO. OF STORIES SIZE b STK 1 1) OWNER'S ADDRESS ' Al %S L -e 4eKV &-f IR G BASEMENT OR SLAB ARCHITECT'S NAME _ SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �em �V / SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY f< IS BUILDING CONNECTED TO TOWN SEWER I IS BUILDING CONNECTED TO NATURAL GAS LINE SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 INSTRUCTIONS ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING • TTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS ,/PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR J ,ATE FILED EA � v/ SIGNATU O U H ENT FEE '/" lS ' PERMIT GRANTED 94 R12. 19 ?,Y/ CONTR. TEL. #_ CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 773 e ` EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN 'NV -Id 101d S30V1d3M SIHl 'a350dWIM3dnS '013 'S39VM -V9 'S3HON0d HIM 'SEMa11n8 d0 SNOISN3WIa lOVX3 aNV S3NM 101 WOMB 30NV1SIa aNV 101dOSNOISN3Wla 10VX3 MOHS1SnW N01103S SIHl Zl I AONVdn00o L aNOD3V JN1aiins 0N11V3H ON _ PJC +'L P"Z DWD313 110 SWOOV i0 SVO SN31V3H 11Nn O.1.H 1NVIOVd ONINO1110NOJ d1V_ NOdVA NO b.1.M lOH WV31S _ sd3AVd (loom 'S10D T 'SW9 1331S 'S1O7 8 'sw9 b39W11 'NNn4 d1V lOH 03O210d 3JVNNnj SS313did lslor (l00M DNIlV3H LL I ONIWVIIi 9 00VO 3111 Noold 3111 S301X1i N4300W ONHOOd 11021 _ N3MOHS 11V1S ON19wn1d ON 13AVNO 8 NVl 31V1S _ ANIS N3H:)11JI S30NIHS DOOM ANOIVAVI S310NIHS 11VHdSV 13SOID N31VM 03HS 1V1j 13N9WVO 1'X14 ZI 'WN 131101 ONVSNVW 'Xlj Cl HIV9 dIH 319VO oNI9Wf17d OL + dooa 5 �I 3 NOOd N0183dns ONIHIM _ 3WVdJ NO 3NO1S ANNOSVW NO 3NOlS 'X19 N30NID NO 'DNOD _I 210014 B 'Sdis 7111V 3WVNj NO X:)IN9 AdNOSVW NO XDIb9 —� E L 1 SbOOIi 9I 3111 'HdSV NO OD 3W"4 NO oDDnis AW » NNOSVNO Onis1S ON101S '143A ONWIS SOIS39SV O.Po\ONVH ONIOIS 11VHdSV HldV3 S31°ONIHS DOOM 313NDNOD ONIOIS dONO 6 I I SONV09d71D S11VM V N3HDllA N830OW Wood OVAH S37Vld 3N1J 1.W.9 ON V 321 V 7111 V N l l '/i 1/1 V3NV .1.W.9 'NIl Ilnj V3NV 1N3W3SV9 E E _ 9 NlJNn 11VfA ANO 831SVld SN3ld O.MONVH 3NOlS NO ADLd9 3NId 'X,19 9138DNOD 313NDNOJ HSINIi H01831NI 8 NOI1VONnoi Z NOuonNISN00 S1N3W1NVdV _— s3Jljjo—_ AIIWVj 'I1lnW S31NO!S kIIWV4 310NIS Zl I AONVdn00o L aNOD3V JN1aiins z O IN CD U) d < o m z m 1 (p m v CD , 2'� 7m 7 T m v T T m S n a fA Z M TZ 0 T fA M S T T n D '' M T 00 � T1 m S r c W Z �_ Z T 70 1! 0 7 m S c c n _ Z n 0 70 p y O T D 0 c cD Pq 5 I Location 9/moi' No, Date C� TOWN OF NORTH ANDOVER R Certificate of Occupancy $ g Building/Frame Permit Fee $ Foundat' . n Permit Fee $ ermit Fee $ 4 Sewer Connection Fee $ _ate Water Connection Fee $ s� fi TOTAL $ AA Building Irispector 1Y- 10431 Div. 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Y f fir, # .! _ ! + Ise, Zt�; T_ t ! - ) ,1 }: NORTN O� ��•o ,•140 O 9 �1 +O"• *moi o "A`�'� ,SSACMUS� This certifies that Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ................ has permission to perform .... RC. /A.0. �In�i a -. .I . . . . . . . . . . . . . plumbing in the buildings of ....� .................... at .!�... �`'b �.�% ��.�. v�...... f;.., North Andover, Mass. Fee..S7e� ... Lic. No.. ,%?.. ... f..... ......... ,/PLUMBING INSPECTOR Check # ? ` 5492 MASSACHUSETTS UNIFORM APPLICATION FOR TO DO PLUMBING (Type or print) NORTH ANDOVER, ASSACHUSETTS C� Date I Building Location Owners Name Y47 2V Permit # Amounts Type of Occupancy �L S))r � Acl-- New Renovation Replacement Plans Submitted Yes No FIXTURES (Printor type) Installing Company Name Address Name of Licensed Plumber: %► (_:?{✓-h" b-�F. Z-L-rtf\ 4 ) Insurance Coverage: Indicate the type of insurance coverage by checki Liability insurance policy I Other type of indemnity Check one: Certificate Corp. Partner. ElFrm/Co. box: 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 ❑ I hereby certify that all of the details and information I have submitted (or entered) best of my knowledge and that all plumbing work and installations pe rfo d unde compliance with all pertinent provisions of the Massachus is St 1 ing By: Igna ure o is se um Type of Plumbing License Title City/Town r7cense Num5er Master APPROVED (OFFICE USE ONLY Agent in above application are true and accurate to the r P t sued for this application will be in and pter 142 of the General Laws. Journeyman