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HomeMy WebLinkAboutMiscellaneous - 95 HILLSIDE ROAD 4/30/2018N OO O f0 O 0 O O Ln 9D O O O O O N° 4316 Date .'. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ./S, ... :. �-- {-�-�3.......... . has permission to perform ............... plumbing in the buildings of .�!.z...2.......................... . at ��3`�..... Y- -?-- -� .,% .. %.... , North Andover, Mass. Fee-�'.`... Lic. No..9... / T PLUMBX E .. WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) 0 2Z -H- /AA/DO r/��Mass. Date 1' 3 1 Permit #_ / Building Location 9 %`c (-C-IsI ✓�71 Owner's Name /VS i (/S "� A/AJ(Z- %J 4 P--Cflf Vq A/a0 t/& -e /V1 ✓r -L Type of Occupar y ' � i D E � Ti Vi New ❑ Renovation ❑ ReplacementPla Submitted: Yes ❑ No ❑ FIXTURES Installing. Company Name () tMe,-r �2 - LAW r'►'1 A T A e 7 Check one: Certificate Address � (` _C040-01416 /- pi ❑ Corporation Ir C Ta L, ic,--n 1-, W r4 O IT ❑ Partnership Business Telephone_ (,:If Z - 11'97 1 ©-h/Co, Name of Licensed Plumberf'r-3 r -,P 7 - INSURANCE INSURANCE COVERAGE: I have a current I' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. A liability insurance policy 1d 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: Owner ❑ Agent C1Sianahira of r'hwnar nr rn..—.. A...._. I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations ormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e and qapter of the eral laws. Title re of Licensed lum r City/Town Type of License: Master Joumeymab E] _ APPROVED OFFIC US ONL License Number�5 Y • • • NONE 0 EN MEMO ENIMEM Installing. Company Name () tMe,-r �2 - LAW r'►'1 A T A e 7 Check one: Certificate Address � (` _C040-01416 /- pi ❑ Corporation Ir C Ta L, ic,--n 1-, W r4 O IT ❑ Partnership Business Telephone_ (,:If Z - 11'97 1 ©-h/Co, Name of Licensed Plumberf'r-3 r -,P 7 - INSURANCE INSURANCE COVERAGE: I have a current I' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. A liability insurance policy 1d 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: Owner ❑ Agent C1Sianahira of r'hwnar nr rn..—.. A...._. I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations ormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e and qapter of the eral laws. Title re of Licensed lum r City/Town Type of License: Master Joumeymab E] _ APPROVED OFFIC US ONL License Number�5 _m z a r Z N m A O Z N A 0 V m a m � I, e D Z a z OO .n m N z � � � m m A I � O _m z a r Z N m A O Z N A V m I, n D p OO .n m z � v � O 0 70 a v ; � z � O C m o 0 O C i Location Ft°t t fJ PZ. No. S Date TOWN OF NORTH ANDOVERO A F :o Certificate of Occupancy $ a • '. Building/Frame Permit Fee $ -? Foundation Permit Fee $ s�C14 Other Permit. Fee�/ ., Sewer Connection Fee $ M -Water Connection Fee $ TOTAL $CU 1st" ` � e 6.9` - Building Inspector r38 3 3 7 Div. Public Works PEWMIT NO. 7Z C APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP h40. QGTg I LOT NO. LJ 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE �olo�7 ZONE SUB DIV. LOT NO. — IOO13 l LOCATION . T �! {� i ��5/ P R� PURPOSE OF BUILDING �QcK �yil�l -dl0y� OWNER'S NAME 7CLU t C motAn;kll NO. OF STORIES SIZE y )�p / l�! C/9-INWNER'S ADDRESS s' S/J'P Rd. BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME - SPAN DISTANCE TO NEAREST BUILDING �� ' DIMENSIONS OF SILLS "' POSTS DISTANCE FROM STREET S ,ee DISTANCE FROM LOT LINES - SIDES `i REAR ags GIRDERS �+. AREA OF LOT I / O �C,r.es FRONTAGE 3�^ �'1". J' HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X ' IS BUILDING ADDITION /S .` MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 5 / `. IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF OWNER OR AUTHORIZED AGENT F E E PERMIT GRANTED 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. CJ EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # (S`°8) 6 kk 16 9 3 CONTR. TEL. # CONTR. LIC. # H.I.C. # �3 ?7-� % 6 %--? (a BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY !C STORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH CONCRETE PINE 3 1 2 13 CONCRETE BL K. BRICK OR STONE PIERS 211,t C `' HARDWD • _ _ PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL r^ FIN. B'M'TAREA _ V, v, t/, FIN. ATTIC AREA _ N_O B M'T FIRE PLACES HEAD ROOM t/ MODERN KITCHEN v 4 WALLS I 9 FLOORS CLAPBOARDS B ;7- 1 ✓ 2 �_ '� 3 _ DROP SIDING WOOD SHINGLES ✓ CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDW'D COMMON ASPM. TILE STUCCO ON MASONRY STUCCO ON FRAME ✓ BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY _ STONE ON FRAMESUPERIO ADEO ATE I -i LOOR ONE 5 ROOF 10 PLUMBING GABLE I I HIP BATH 13 FIX.) GAMBREL FLAT r MANSARD TOILET RM. (2 FIX.) SHED WATER CLOSET _ ASPHALT SHINGLES ✓� LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST ✓ PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. ✓ STEAM STEEL BMS. & COLS. Vk HOT W'T'R OR VAPOR I/ WOOD RAFTERS V AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL ELECTRIC B'M'T �I 2nd I _ t.r 3rd NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. V O 0 tv x w a aG .0 w cn °. cn O C/) z z a C w° o 0� v Ei ^c U c w Z w°' c w a O u U W C2 cn r. w" a o wa d t a° `° w w w W d W ° m °sw w v cit D o cn LLI I 2 � � C G O E m C i O � O O Z co p_ C V O D H � z C, CD cm C) C ` O H > M .� m Co C CD wv � a� CS G� CL. O C O o O Off. CD c H S r o •-� O //��C� cc ;o CD tJ'CD Co EQ O . m C Z V h C !d Q: • t O d CO) G 3 Z o m c� Z Z o O cm ca = o a C VJ 2: H �- �' m cq c m � O YY^ W 3y Jam: Cc o .E H O R Umo 5 CD �Co- CD c Q � y a c t O a} V H O m C Z o ' cm CL c O �_ N m NJ 4 -6_.,. t O ev v.. W h E at , =mac Z O Q31 cm = y _ O. v O O 'd O = O �� aco :IN I 2 � � J a z O E O i O � O v Z co p_ O D H � z iCD CD cm C) O > M .� m Co W co Z2M CD � O � CS G� O C O R O Off. H S O fes -'C R O CA O Qi Z V h C !d C CO) G 3 Z Z Z M ton\ TOWN of NORTH ANDOVER AFFIDAVIT EtHe bprvMnant Gmtractar law awim ait to lit t%ucatim lip • :11-1 ZZ116,771111110-:1141 ■ • * W60 ll.imal wfor* XV, 1 zc.666111•1 :• ■ • r= � r� � Type of Work: l/P C1� i�� c�, Est. Cost�s��� Address of Work �r S, /l S "��e �cC' Owner Name: E. Aid,-nKtPt J Date of Permit Application: �u� P �j 02 S I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Lib� under $1,000 Building not owner -occupied L. --Owner pulling own permit Other (specify) Notice is hereby given that: Far affine Use Only lit ND. Date OWNERS PULLING THEIR OWN PERMTT OR DEALING WITH UNREGISTERED OONTF ACLORS FOR APPLICABLE HOME DfiWVEMEINT WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed uiJer penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above proper rope ty: a Y ate Owner Name. i I , Town of North Andover BUILDING DEPARTMENT Homeowner License Exemution (PlEase print) pad ww-2 � �S �vumcer Strae_ pl� I Address .Fa c4 A4hn Na: - e HcmE hone SEC:iOn of tCW1_1 G Ai;Z IR ZES Sfir"" ca5 �.wp. /V• ;cJav� A-1 /9- y State Zip ccC_ e:.c _On for "homeo,,m:ers" was extendE^ t_0 inCludE 01�ne_ of s4.x units or Less and to allow suc. l ilOmEC`•�i,Ers t'^ sric-.:ai for hire who does not possess a License prc'. �rj e^o�•n__ ac_. as super•�iso_. (State Building Code, SEC:_on lel L.. N iv Owns a parcel of Land on which lne/slte r'es l.^. ...5 Or 1='•--�­=s there is, or is in_ended to be, a one to sJ:c Luh_ _. - G_ _aC.tEC Or QE_GcnEd strut .ures ac :essor• to suci- use ai cl/ cr LG�a - =s A OErsOn who construc_s more than one home in a t`•:C-•=Gr oeri �J�hali nc- be considered a homeowner. Such "homec- ner" sha'__ =..= 3u_ld_..� Ofc-a!, on a form acceptabie to the Buid_n'� Of bEre�oonsibiE fc_ all suc" �.�or'... performe^ u:,c__ �.._ (SECtion 109.1.1 _.._ :;:,_.==r•' .E'_ ,i07.. NitEr aS_.i:uE_ re vC'1 _ -L71 l.^ z c a and o:nEr aC:�y_cacLe .zcce: 0`'-__'�s _ :_ .::.._.�__ .�_ t'.ZO:::C�.•rii,er" Cc_ _��=�.s t::at ne, s;.E 1i C�.r.yi.c .C. r.._ __ ... _ E,`s..L z