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Home My WebLink AboutMiscellaneous - 45 Pleasant Street P-5 PLEASANT ST, -\MAg US TTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) F NORTH ANDOVER, Maas. Building Location s"UT? �-- Permit # � i NameOwner,ss A/I,Ai C e j2/" New Renovation O Aeplacefnent O Plans Submitted: Yea p No . n - „ 0 dc R ri rr N C N = « W w M q O rJ e! h h b O O p IK r N tl o t = h h o W p M s sO 0C OM 11�sr�CC M ' p > IL 'i 'o v 86 20 10. a 3 u° 0 f o d i- �, sue—asMT. • 6AIIEMENT + 1sT FLOOR !NO FLOOR SROFLOOR 4tH FLOOR 8TH FLOOR ! 8TH FLOOR TTN FLOOR + 8TH FLOOR Check one: Certificate Installing Company Name_ /Corp G- Address if 96e/D 64C Z,¢/1ZE1 d Partnership 7b M A,/�7- O Firm/Co. Business Telephone Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: Check on have a current liability Insurance policy or Its substantial equivalent. Yea No O If you have checked yes. please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Ids Other type of kxfemntty O Bond O 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: %naluts of Owner or Owne-(14,en-F Owner O Agent O I hereby certify that all of the details and Information i have submitted(or entered)In above application are true and somrals to the best of my knowledge and that all plumbing work and Installations performed under the pe rmR Issued for this application will be In compliance with all ' pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the OMo s, p T nss. Tftb umber nan r or as er aslitter City/Town Master License Number Vr�P S'lP . Q Journeyman APPIFIOVE0(OFFICE USE ONLY) BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES �,,,� PROGRS"fNSPECTIC FEE N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFIT•TER LIC N0. .. _. . . .. _ .. _. _ ... PERMIT GRANTED DATE 19 4 GAS INSPECTOR Date. . . . .. ..�. 1.i: . . . . . . . N�� h• i�`,�i TOWN OF NORTH ANDOVER - Ado ^ •� . o p PPRIiaT FOR GAS INSTALLATION SSAC This certifies that . . . . . . . . .� . . . . . . . . . . . . . . has permission for gas installationfT11.�� . in the buildings of L ; "-6. at :t'�t ? �� . .�—{. .. . . o= � rh Andover, Mass. G� `"' t J - s�• ..- 1 Fee. . . . No.. . . . . . . . . . �. . . . . . .. . . . . . . GAS INSPECTOR it WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File r _ ,acatrn No. Date 3?p: „pRTI{ TOWN OF NORTH ANDOVER 4 .ao a,�OpL p Certificate of Occupancy $ i > Building/Frame Permit Fee $ ,SSACNUSE� Foundation Permit Fee $ Other-Permit Fee $ Sewer Connection Fee $ OCT i a9er Connection Fee $ TOTAL j $ Building Inspector Div. Public Works APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. t/ PAGE 1 MAP 4d0. LOT NO. 12 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZONE SUB DIV. LOT NO. 1) 1 PURPOSE OF BUILDING R t/OWNER'S NAME � � NO. OF STORIES !/ SIZE OWNER'S ADDRESS '7� /� y BASEMENT OR SLAB - ARCHITECT'S NAME oC ,J SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �� a 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 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAN COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER 9CJ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 t SEPTIC PERMIT NO. 1 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGYLATIONS PyLSKNS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR TFILED �.. E C26* BOARD OF HEALTH SI RE OF OWNER OR AUy4CjRIZED AGENT 4"�„N F R T F I #0.12 ��G � G� F E E ® --CONTR.TEL.# v - Q f0 � NTR.LIC.# PLANNING BOARD PERMIT GRANTED v 19 _ j9® BOARD OF SELECTMEN �6 02- BUILDI d INSPECTOR BUILDING RECORD 1 OCCUPANCY, 12 SINGLE FAMILY S-ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY oFFICEs _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS,REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH ` CONCRETE 3 1 2 13 _ \ CONCRETE BL K. --II PINE _ _ BRICK OR STONE H PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. BIM'TAREA _ V. 1/1 �/ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME, 4 I BRICK ON MASONRY - ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ t SUPERIOR (� POOR _ I ADEQUATE 5 ROOF 10 PLUMBING 7 GABLE I HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. 12 FIX.) f�!* FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK \ 1 1 SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR , TILE DADO w 6 FRAMING 11 HEATING ? WOOD JOIST PIPELESS FURNACE \ -. FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'GC'� C f UNIT HEATERS 7 NO. OF LOOMS GASOIL B'M'T2nd I_ ELECTRIC t 1st 3rd NO.HEATING ' a Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption 4 (Pleaserint I p ) DATE /C, JOB LOCATIONS Number Street Address Section of town "HOMEOWNER" Name Home Phone Work Phone PRESENT MAILING ADDRESS 5 zv City Town State Zip code The current exemption for "homeowners" was extended to include owner occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor. (State Building Code, Section 109 . 1 . 1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be, a one to six family dwell- ing , attached or detached structures accessory to such use acid/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the 'building permit . (Section 109 . 1 . 1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and . .regulations . The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements . HOMEOWNER' S SIGNATURE . , APPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 , 000 cubic feet , or larger , will be required to comply with State Building Code Section 127 .0, Construction Control . s HNAL PLANNING _.*..-.----. FINAL gE1N /WATER FINAL T :�o la rE-o _ _.� _.._ oven of �� An3over T � LerM 19fxoCUARIVEWAV ENTRY PERWAIT ? L oA? ? f' F BOARD OF HEALTH THIS CERTIFIES THAT... �. ..�.. .... ................................................................. A) UILDING INSPECTOR has permission to SIA. ............. Rough Chimney tobe occupied as.......:... V„ ,,, .,,, s, ,T,•„ ., Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. n PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRUCTION START Service ..'� ....... ........... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. N Lathing to Be Done Until Inspected and Approved by Smoke Det. 6 .3 Building Inspector - r 'I OFFICES OF: . ° Town of 12()Main Street APPEALSa North Andover, s"�:,-r NORTH ANDOVER BUILDING � -.'a Miltitillc'hIIS(;ttS O l ti4 i CONSERVATION ss "" DIVISION OF (6 17)6H)-477G HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIREC"I"011 • i 0z f In accordance will the provisions 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 c 111, S 150A. 71e debris will be disposed of in: -V/ (Location 6Y/Facility) ignature of Perm A licant &V/4�/t ' Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector.