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HomeMy WebLinkAbout- Permits - 43 PLEASANT STREET I Y 1 y 0 CRUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS WMG �Y tType or print) Date , 19 NORTH ANDOVER, MASSACHUSETTS ��` 3- 1 Building Locations + `°� Permit# N �V 7 an Amount ( Owner's Name _ 0 New Renovation ReplacementEl Plans Submitted G zi O ^ C C z E+ .n x 5, z G W �h w -+ 0 h z a E~ x U o a �' co z 0 71 0 W > W � z '� a - c c w C W E✓ c w c 0 � u x � a a. �• c BASEM ENT 1ST. r L 0 0 R 2N D . FLOO It 3 R D . FLOG It 4"r11 . FLUOR 5TII . FLO0It 6T11 . FLOOR 7TU . FLOGR STU . 171,00R r (Print or N typ ) -� Check one: Certificate Installing Company ame /'� l s C �_ � Corp Address rje�l+ �-r` _ Partner. 12ZAC� Business Telephone '^ Firm/Co. Name of Licensed Plumber or Gas Fitter �� _ IP/ IV C _ INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes ❑ Nom if you have checked fires,please indicate the type coverage by checking the appropriate box. ❑ Liability insurance policy ❑ Other type of indemnity Bond Owner's nsurance Wa'ty r: a aware that the licensee does not have the Insurance coverage required by Chapter 142 of the iv a eral aws ag th t ignature on this permit application waives this requirement. r Check one: igna re 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 nay knowledge and that all plumbing work and instaliatio performed under Permit Issued for this application will be in compliance with all pertinent provisions of the ssa u tts ate as o e nd Chapter 142 of tlae Ge era] Laws. y. Signature of LicoWd Plumber Or Gas Fitter Title Plumber ' City/Town Gas Fitter License t um er Master Journeyman APPROVED(orrwr,uss ONLY) �EgSiIT 140. SOT NO- — �p dtO- PURPOSE O! BUILDING 5tz£ 65 1, � �� '� NO, OF STORIE5 BONE � r3 S 'n t gRD - - LOCATION i �.-r^�� BASEMENT OR SLAB +ST 2ND f j•81 � SIZE OF FLOOR TIMBERS OWNER'S NAME ADDRESS �� + .-r'"~ SPAN OWNERS --..�•r.^ �- " S+L .� ARCHtT-CT'S NAME DIIAENSIONS OF _ - . POSTS BUILDERS NAME DISTANCE TO NE ARE$T BUILDING - - GIRDERS TKICKNESS STREET REAR OUNDATION X ANC-FROM! --�""�` HEIGHT OF F S3i5T SIDES ROM LOT LINES` FRONTAGE OOTlNG OlSTANCE F �-�J� SIZE OF F _ ^� AL OF CHIMNEY AREA OF LOT �f��r" MA i ER: pR FILLED 1^ANE� . -r _err- ON 50LtP _r..�r^ �^-� IS BUILDING CONNECTED TO TOWN WATER 15 SUM-D NEW . i]ITION ��--f" YS BUILDING CON SEWER !S 9UlLDlNG AO � TO row+'+ Tc�PF CODE -,�-! IS BUILDING CONNECTED GAS LINE - ��^ .. t5 5I}1LDlNG ALTERATION TO Ft£RUI -MEN ATION r..� CONFORM pROPERI INFORM 15 BUILDING CONK ECTED TO NATtyRA yllyL 6UfyDlNG Y S - - ALS ACTION. IF AN BOARD OF AP PE LAND COST IONS EST, BLDG. GAST�_ �,- INSTRUGT EST- BLDG• CGST PER SQ. FT .. EST. BLDG.COST PER ROOM SEE BOTfl SIDES SEPTIC PERMIT 130- SECTIONS + " 3 AppRnVED BY pAG E + FILL OUT 4 PAGE 2 FILL OUT SECTIONS Ile ON OUTSIDE OF BUILDING v TwTE FIRE REGULATIONS ELECTRIC M£TEPS MUST GARAGES MUST CONFORM TO S UII-DIMQ81R . ATTACHED pVED BY 9UILDING INSPECTOR . PLANS MUST of-FILED wND APPR DATE FILED -'�.. AUT�IZED AGENT OWNEfcTE!-# O ER fl �]� -15 '92 atG. .xDRE �!! �". GONTR-TEL# C� GRANTED PERMIT 19 V i - The Commonwealth of Massach usetts - ^ Department of Industrial Accidents �+ - /li7ca Ill '9ltliQs 600 Washington Street Boston,Mass. 02.1.11 U Workers' Compensation Insurance Affidavit MM narncL location: city phone 4 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. addregg, �Jgpp'� in ur'. 1°t t qb �JS '�S C{inl C /tl o['ey# Lu' t � ❑ 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 na e: address, in uranee co: Comparly nam city- :. :... ins ur # bona ee necessu Failure to secure coverage as required under Section 25A of NIGL M tau lead to the imposition of eriminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of s STOP WORK ORDER and a fine ofS100.00 it day against me. [understand that a copy of this statement may he forwarded to the Office of investigations of the D[A for coverage verification. 1 do hereby ce i under the pain and penalties of perjury dhud the fnforn�fon provided above is true and correcd. Zy GY Signature � �, /c�-� bats /7 Print narttc_L rUOL L, < G fir,R C-21L Phone M '7 rY 7 Z orfidAl use only do not write in this area to be completed bn city or toga official city or town: permit(ticense'l f-iBuilding Department ❑Licensing Board []check if immediate response is required ©Selectmen's Office C]Hnith Department contact person: phone N;. __n 0ther (ra 4M Y91 P)A) - Town of.No(rth�+Andover , p ►{dRT ' OM,, l�E Ol' S�C r6 0 COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street +� _ K North Andover, Massachusetts 01845 WILLIAM J.SCOTT SSACHU`�E Director In accordance with the provisions of MGL c 40 S 54, a condition of Building Pori-nit 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 c 1 11, S 150A. The debris will be disposed of in: 73Fl (Location oeFacility) 7Kx1<z &- "I"/ Signature of Permit Applicant 1` Z 5� c Date NOTE: Demolition permit from the Town ofNorth Andover must be obtained for this project through the Office of the Building Inspector. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 1AMBERT ROOFING CO., TNTG Page No. of Pages 37 Steven-, Street HAVERHILL, MA 01830 Propo s al (508) 374.qP24 FAX (508) 521-5791 LICENSE NO. To: JO DATE 8 PHONE NO. JOB NAME INO, JOB LOCATION We herah"submit apeciflreiUmts and LvsUrnatas for: > C.r Yj 0 V r -?oerl j r P r., Al r:r t'S v(1 t?. y 0 -A 7 11 k- A A C C i1f%.110 k.0 0 1 j S 7, Z:"C'O(j r r -Y' > jj her6by to furnish material and labor-complete In accordance with We propOS112 All rnaterLit Is w"ALwd to be as specilled. M work to be above specifications,for the sum of., comopted In a workmanljkd manner accordr" to standard practices. Any alleiAtloh or deviation Itom above specificaflons tryMving extr6 costs will be executed only .......... "I written orders, and will become an extra chargr over and above the estimate. AD agreements contingoot upon s dollars($ strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our Payment to be made as follows: workeis are fully covered by Workman's Gonipewnlioo Insurance, You, the buyer, may cancel this transaction at any time prior to midnight of the third Note:ThIs proposal business day after the date of this trans- may be wRklrawn action. Cancellation must be done in writing. Authorized Signature by us If not aweplad YdIhIn days. Acceptance of Proposal: The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specilfed.Payment will be made as outlined above. Signature Dalo Signaturo Date IN �XX �V Q�l)?/J�'�fYj2LUeG?iG iI2 Q� �/�[��/,1�C?�Cil'GGf/,1 I _ - 396 1-4 =f DEPARTMENT OF PUBLIC SAFETY c� ` I� 39614 ONE ASHBURTON PLACE, RM 1301 BOSTON, MA 02108-1618 j 996 CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate: CS 026791 01/17/1998 01/17/1942 Restricted To: 00 LAMBRRT ROOFING CO. , INC. t ! 37 STEVEN ST, HAVERHILL, MA 01830 RDNALD G LAMBERT Detach bottom, fold , sign on 37 STEVENS ST back, and laminate license card. HAVERHILL, MA 01832 Keep top for, recei;pt and change of address notiflcationis HOME: IMPRbVE ME"NT CONTRACTnRS REGISTRATIONI � Boar0. ,of Rui .lding ' Ro Regulations and Standard Ono Ashburton Place -- 'Room 130 i F, Pos to ; MaE�4>mahue,3etr t s.. 02.t,48 HOME IMPROVNMEN CONTRACTOR - , Flo-qistrat,:ion 121.981 ,Expiration 07�05/98 Type -. PRIM TE CORPORATION !: HONE INPROVENENT CONTRACTOR : � Ilegistratian 12I981 , LAMBERTi ROOFING CO INC jYpe ;PRIVATE CORPORATION RONALD G,, L:ABEw'R £HRirat�on ,' 07105/9$ 37 STEVENS ST. HAVERHILL MA. 0183() LAMBERT ROOFING CO' INC i ! P VOWNALQG, LABERT A0M1N!$TPATQFR<; : 37':STEVENS ST 'MERHILL HA 01830 ' f - : ! i• + r ' ',,' � I is ................-............................................................................... .................................... ......... ..... NORTiy ovm o Andover No. * no_ � - �,R -- . d over, Mass., 1991 -71 C0C)qf BOARD OF HEALTH Food/Kitchen PERMIT T D septic system BUILDING INSPECTOR THISCERTIFIES THAT.............................................. ............. ..r..................................................................... Foundation ..... has permission to erect---- ............. 15tmi,196-0 ........ . ................................................... ..... Rough tobe occupied as............................................ -------------------------------------­'­­­­**­­**............... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application an file In Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR 4 Rough ..................... ............ .......... -----------------................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. Smoke Det- ................ . PAGE I APPLICATION FOR PERMIT TO RUILD -- NORTH ANDOVER, MASS. pEA_11IT h'O. -' — 2 RECORD OF OWIVERShSIP ipATE BOOK AGE MAP INO. LOT NO. � ,� � SUB DIV. LOT NO ZONE : i J .! I4, PURPOSE OF BU , 3' /LdGAT �L S (�2 - s' NO. OF STORIE SIZE y' ✓b�JNERIS AME u r ^G7 4iJ _...^.���. BASEMENT OR SLAB NER'S 2NO 3RD �eG. ESS '� �(f' O jam- �l SIZE OF FLOOR TIMBERS 1ST i/A�R'CHITECT'S NAME SPAN DIMENSIONS OF SILLS .� DISTANCE TO NEAREST BUILDING POSTS DISTANCE FROM STREET GIRDERS 61STANCE FROM LOT LINES—SIDES REAR1�FRONTAGE THICKNESS HEIGHT OF FOUNDATION AREA OF LOT SIZE OF FOOTING X 15 6UIL69NG NEW MATERIAL OF CHIMNEY IS BUILDING ADDITION IS BUILDING ON SOLID OR FILLED LAN i ERATION __-IS--BUILDING ALT �` -�(� 15 BUILDING CONNECTED 70 TOWN WATER -,_-W_lLL BUILDING CONFORM TO REQUIREMENTS O CODE i I5 BUILDING CONNECTED 70 TOWN SEWER BOARD OF APPEALS ACTION. IF ANY IS 11 BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST . BLDG. COST J eA, SEE BOTH SIDES EST. BLDG. COST PS SQ. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING �y ti ATTACHED GARAGES MUST CONFORM 70 STATE FIRE REGULATIONS O O PLANS MUST Be FILED AND APPROVED BY BUILDING INSPECTOR O m Q C U LTH DATE IZ Q � � � m SIGN AYU'tE OF NE OR AUTHORIZED AGENT it N GI Q v LLL cu a� O FEE Oca D CL , 0. m O O PERMIT GRANTED +?s LL Q m CL U U e� ur E _ O t13 C 0 3 T F.Il i 4- O 0 co c Z O - O O IF.N = (D U U O 0 _.. .O F+ N a O - N ca O U _0 • co .;. on vtR *�♦ ^ ot~F1cEs OR . Town of 120 Main Street APPEALS North Alidover, rit.IUX)1NCe NORTH ANDOVER ivl.tti;li( 1,u5c;tt501845 i:UNSEiI ATIUN s„" "` DIVISION OF Ui1 71(i85,4775 HEALTH PLA1\'NtNG PLANNING & COMMUNITY DEVELOPMENT KARE.N H.P. NELSON, UIREC'I'Olt In accordance w.01 [Ile provisions of MGL c 40, S 54, a condition of Building Permit Number � , is that the debris disposed of in a properly i1 nsce cd solid waste disposal facilily as defineulting from d work shall be 150A Y byMGLc111, 5 The debris will be disposed of in: (Location of Facility) ' Signature of Pcrrtlit Applicant ate NOTE: Demolition permit from the 'Town of North Andover must be obtained for this project through the Office of the Building Inspector. i DEPARTMENT OF PUSLIC SAFETY COMMOO EALTH. 1010 COMMONWEALTH AVE. MASSACHUSETTS SOSTON,MASS.mi6 LICENSE EXPIRATION DATE - CONSTR. SUPERVIS0 = k 6/30/199; ' RESTR-IC TI 'h75�" EFFECTIVE DATE LPC-NO. h0NE 06/30/1991 025565 ' ARTNUR L HERUBE 30 WILEY CT SS # 020-26-5418 N ANDOVER KA 01845 # P PHOTO SBLASTING OPR ONLYI FEE: i .. 100.00 E HEIGHT- NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED-OR SIGNATURE'-OF THE COMMISSIONER . DOB: ` 04/13/1935 THIS DOCUMENT MUST BE } CARRIED ON THE PERSON O� .f SIGNATURE OF LICENSEE THE HOLDER w.eN 'NGAG- COMMISSIONER �! OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION. I 2ppM-2$7-81429 ................ NORTH o O O xAndover 0 No. 532 0 dover, Mass., !7I ftr 19 f 0'4ATE 0 CJ BOARD OF HEALTH Food/Kitchen PE I D Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT........... . ... .. .. ........... ................ . ..... .. ... ... ... ........................ .......... .. .. ..... Foundation has permission to ......... .......W.... MS J?........ 9404d----------- Rough Chimney to be occupied as.................. . .......... ....;a. 3...... ........................................ conform to provided that the person acc ing this ermft shatirn, every respect co 2 tih rms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspect Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTR C ON STARTS ELECTRICAL INSPECTOR Rough r-A Service BUILDING INSPE Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT .Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. QUIAIF-:0 MIATF-P FINAI DRIVEWAY ENTRY PERMIT