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HomeMy WebLinkAboutMiscellaneous - 10 NADINE LANE 4/30/2018Date 6 . ........... N2 2219 ...... TOWN OF NORTH ANDOVER 0 #- . .. % PERMIT FOR WIRING r This certifies that��---d' has permission to perform P . ............................................................ 'A wiring in the building of ............................................................ at<� ....... North Andover, Mass. Fev:& .................. Lic. Na ..................... LECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Rough ;,� Service Final Of 4r TOI1TI1 onwralt4 of Massar4t etu Office Use Only Department of Public Safety Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy 6 Fa Check 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) Dat ?k -/00t City or Town of /t/, , To the Inspector of Wires) The undersigned• applies for a permit to perform the electrical work described below. Location (Street & Number) 1A / �[.c�-+�cp�/ii� L-. ay �" Owner or Tenant i l�) GTid�G' 4 Al d e isf Ll Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building 114_ /� Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work IC C�-�GX2d"t� �� �' ��4 $L �vt S�� �` — 20 Q.:wQ / ac, C OZHER: ,� 1k Is INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 0 NO O 1 have submitted valid proof of same to this office. YES U NO (J If you have checked YES, please indicate the type of coverage by checking the appropriate box. e INSURANCE lfJ BOND ❑ OTHER❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Signed under the pe alties W perjury: Rouge CC?-/,// Final (Expiration Date) FIRM NAME LIC. NO. c Gy Licensee ej _Siign_atter LIC. NO.�T` 1 ~ Address c GtJ t��l r© Bus. Tel. No. 172 CC` —7 Alt. Tel. No. 12 S/ / OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusem 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 Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above No. of Lighting Fixtures Swimming Pool grnd. ❑ 9rnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units `IVo. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones of Detection and TotalNo. Pio. of Ranges No. of Air Conditioners Tons Initiating Devices No. of Sounding Devices. — eat I otal I Otar No. of Disposals No. of Pumps Tons KW No. of Self Contained DeiectiorvSounding Devices No. of Dishwashers Space/Area Heating KW Municipal ❑Other Local[:]*Connection No. of Dryers Heating Devices KW No. of No. o Low Voltage No. of Water Heaters KW Signs Ballasts I Wiring No. Hydro Massage Tubs No. of Motors Total HP OZHER: ,� 1k Is INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 0 NO O 1 have submitted valid proof of same to this office. YES U NO (J If you have checked YES, please indicate the type of coverage by checking the appropriate box. e INSURANCE lfJ BOND ❑ OTHER❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Signed under the pe alties W perjury: Rouge CC?-/,// Final (Expiration Date) FIRM NAME LIC. NO. c Gy Licensee ej _Siign_atter LIC. NO.�T` 1 ~ Address c GtJ t��l r© Bus. Tel. No. 172 CC` —7 Alt. Tel. No. 12 S/ / OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusem 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) 14 Location A)WIlve- No. Date I�P74� AORTII TOWN OF NORTH ANDOVER 0 41 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ cmust, Other Permit Fee $ Sewer Connection Fee $ LD Water Connection Fee $ TOTAL $ - I&D Building inspector 12915 Div. Public Works e " ts ? Z a z z m J LA � � R i .r»,> I z — n T � m � Z rn v: z N N W m m i X � m � z co 2 m z I al I N ¢ W 6 A D ' Z ml T, ae z A N C C Y ? '(� v m r=. m � m V: 07 N C N Q T V, V V, _ z vzi Z N 7 T = = = D Y Y D - T y " rr Z N n p z. S z Z OZ T ^. V I D V Z Z z rI yy t- m i rzr�� z '� z p m { -� m z V,, rr, zn w v 1 rr� �^ z m N T J. ! m m. - C q O O Z D O O ^. o ci £O m f Z CZLA _ 7 1 N f D A A 61 7 m Y m c r OQ , �F rn 4" (.A N /� �.. oll 4� rx OIL :n N c � H Z t N Oo W 6 A D ' Z ml T, ae z A N C C C c m '(� � m r=. m � m 6 r1 V P }... O / z F. vzi N _ N T Lntt. m .� ZL) T y n p oo S ....yy I m z m z m> N z - p m { m z ? T w �^ T - O Z D O O O o £O m f Z 7 1 D A A m i �F 4" (.A N /� �� - d r' � a 5 q ( Q o c M a L ' � ae -y z A M f1 � 6 R n S ....yy IS: N M TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units ... or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Est. Costes 5b. Address of Work u �•�� �� Owner Name:���- Date of Permit Application: VI-2°4� I hereby certify that: Registration is not required for the following reason(s): For office Use Only VV,efk excluded by law Job under $1,000 Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby -given that: Pemit No. Date OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL C. 142A. Signed under 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 property: i1. lr • C-'� Date -Xmer Name �0 Now 1 ImsIs Ii ME 1 W H d d CO) Cl) 10 0 CD n Z CO) CL o 72. O CL =• y O C-) CD o p CD O CL c� s CD CD O CD ca w C CD y� �O y to CD F p CA O 'C Z CD O CD O CD C CM- m S N O Q N m !! m COCL CA N r o 'C r cn O m Icn m?m m G lJ � r_ o �. O o g co, H COD �� c / O ca Z n cn s ..,,m CL??i q C CM- m S N O Q N m !! COCL CA N r m 'C r CO) O m 2 m?m G o g co, COD �� � Z ..,,m CL??i m N Cl d m CD3 CO) d N CL C �\ `- 7 d �m CD N� �O N �l 1 CDcc V �. A O O 53 N 0 3 O m � m m N o m m m a� o' O b . ?i 0=3 0 0 c o w r 'C r r. a C7 n c ?i 0=3 0 0 c V t Location No. Date K 9-MAM TOWN OF NORTH ANDOVER Certificate of Occupancy $ 0,06) Building/Frame Permit Fee $ 14US Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee Water Connection Fee TOTAL 1�12 J 2 2,81 08/24/98 15:24 ctor Div. Public Works Location t No. Da e TOWN OF NORTH ANDOVER Certificate of Occupancy $ or-) Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Ruilding Inspector 03124/33 15:24 / MW P'All) Div. 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"o co '-- - - Ii CO2 �iI , I i •I I 00 ol_ j - I- ' 1-4 + V i i i I Cl I TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units ... or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: _t> e- I��,�nbr, Est. Cost Address of Work \Q g'�,".- LGA Owner Name: ?�. � C.-_-C� t -F'&' --;z 's s Date of Permit Application: "�_ _�6.CXb I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. ✓ Job under $1,000 Date Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND UNER MGL c. 142A. Signed under 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 property: Date er Name 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 a,^tL Q0.Q $4�° PHONE 610 03-`03 LOCATION: Assessor's Map Number PARCEL. SUBDIVISION Mek. 6,, oob s� LOT (S) _ STREET �O 1Vu�� ST. NUMBER kQ ************************OFFICIAL USE ONLY`**************** RECO NDATIONS OF TOWN AGENTS: WaCON ERVATION ADMINI$ RATOR DATE APPROVED — o DATE REJECTED p COMMENTS '/W�-� I D Cl 0- NO a TOWN PLANNER DATE APPROVED M l� DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENT PUBLIC WORKS - SEWER/WATER CONNECTIONS DRJVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 342 N. MAIN STREET ANDOVER MA 01810 TEL: (508).474-,4410 FAX.- (509) 474-5067 MORTGAGOR: DANTE A.PAPPANO & ELLEN S.BASS DEED REF. 4143/00.71 LOCATION: 10 NADINE LANE PLAN REF. 12487 CITY,STATE: NORTH ANDOVER ,MA SCALE: 1 = 20' DATE: 6/7/96 JOB #: 96/2425 1 t) q o, o a L L1ti a c' -F 4 a-\ M L A O sMw\41-v t?wsws L 0 T 8 5,000 S /- �6 ,A.. 7 V& .9 k � No LOT 9 ,D H a Z O0 CLd p.p CL =. O p CL � cr CCD O .. w .7 H 10 CD 0 O CA "0. O CA CD 0 CD Iml CD a H. CD y O co CD O ^' �i tz d C CO O m S W G r C� b O O c7� -•in O Q H a0 1 / `° r T C CL w O Gy � a O m 7 n .o C4 n y O O Cl) ywaC m Z e1. O Mn =r m � O H m O �_ ? m O --1 m > > O 0 n O C, n .o (A : ..�;G 3 CL V I m Co y �1 cc Ci -CODc lJ CL O rr, O L,40 =: z y w �� C a .:�y� H yO ti / � < I \� tO l C4 V� CO) f �■ m C9CD Co CA 1 - D O -• 0 O wo : z a 3 COD �: p oCO v4 co C C C1 0 : r 0 r, CD : r` C-) C') o COCA :P O : CD • (.. �A =• : :0 77 O ^' �i tz d w 0 G c>nd C6 y W G r C� b O w G C'' O ro O a0 1 / `° r T C CL w O Gy � D n Cn O a x n 7 y O V, M V Ev omi 0 0 c Location No. '* 9 17 Date 3-16 TOWN OF NORTH ANDOVER + Certificate of Occupancy $ Building/Frame Permit Fee $ CH Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Ch�ck # 13 6 u 5 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: �100 SIGNATURE: BuildincommissioEELns =tor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: MC9j Lo-,-sem- i n e- / ;, & Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Disi6c_t Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Requred Provided Required Provided 1.7 Water Suppty M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 4 2.1 Owner of Record at^ C, it L �J� I, - Name Name (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: Not Applicable ❑ psU) Ly Licensed Construction Su rvisor: 7 ( 3 C -C -OSS PJ t J(/l f{ License Number Address Expiration Date Signature Telephone 3.2 Registered Home Contractor Not Applicable ❑ `Improvement a �0qq x Com ny Name //11 ,CJ Registration Number Address Expiration Date Si ature VTelephone U 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 applicable) New Construction ❑ Existing Building 'g Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work:, \ WO `I 6L1J. �(14 1 s17,14 1`J f 11. S YL SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant FFI(CIA, FTSE tNLY 1. Building �2 5 6D (a) Building Permit Fee Multiplier �- S0 2 Electrical �Gb (b) Estimated Total Cost of Construction h �� " 3 Plumbing O Building Permit fee (a) X (n) i 4 Mechanical HVAC 0 5 Fire Protection a> 6 Total 1+2+3+4+5 G 0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS A ENT OR CONT OR APPLIES FOR BUILDING PERMIT 7 I, O� , as er/Authorized Agent of subject property Hereby authorize to act on My behalf. in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION I, As Owfter4Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Nam Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB aV X 0— SIZE OF FLOOR TIMBERS 1 sr2NU3 RD SPAN DIMENSIONS OF SILLS Z` �" DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a n 0 M 0 oj S `� \` \ ( z 2 00 M m 0 > cn 0 � � | _ a 0 z cn CL w a .. Mcr .m . 0 > o000000!,L cn z cn L C, c X 0 K) c,4 o r- '1 :-di !02 o Z Z 0 Cco m M 0 ( -4 �� t 00 W X z W+ I rIv • K+ : G NI•I IN L.SULL i VHN i NSRGY 5083732281 P.01 AOR -D. CERTIFICATE OF LIABILITY INSURANCE 03/10/2000 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION William C. Sullivan Insurance ONLY AND CONFERS NO RIGNTS UPON THE CERTIFICATE 487 Groveland Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Haverhill, MA 01830 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2:978-372-2790 F:978-373-2281 INSURERS AFFORDING COVERAGE INSURED INSURERA: PHENIX MUTUAL FIRE INS. CO. Willow Enterprises Inc. INSURERB: LEGION INSURANCE COMPANY PO BOR 8344 INSURERC: INSURER 0: Ward Hill MA 01835 - INSURER E: rnveoAccc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY POLICY EXPIRATIONLTR DATE IMM100" LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 FIREDAMAGE(AnvoneLre) S A ® COMMERCIALGENERALLIABILITY CPPO702124 06/19/1999 06/19/2000 MED £XP (Anyone person) $ 5,000 ❑ CLAIMS MADE © OCCUR PERSONAL 8 ADV INJURY $ ❑ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMPIOP AGG $ 2 , 000, 000 OLICY ❑ PRO- LOC ❑PJECT AUTOMOBILE ❑ LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea aoddent) $ BODILY INJURY $ (Per pe) ❑rson ALL OWNED AUTOS SCHEDULED AUTOS ❑ HIRED AUTOS NON-OWNEO AUTOS BODILY INJURY (Peracadent) $ {❑ `—' ❑ PROPERTY DAMAGE $ (Per acaded) GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS LIABILITY ❑ OCCUR �❑ CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ S ❑ DEDUCTIBLE ❑ RETENTION S S WORKERS COMPENSATION AND WC STYTT$ OTIi- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S 100,000 X WC50285506 03/16/2000 06/16/2001 E.L. DISEASE -EA FMPLOYEI S 500,000 E.L. DISEASE - POLICY LIMITS 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDOR$EMENT/SPECIAL PROVISIONS CARPENTRY a•crc l lr R,m I C" VWtK ADDITIONAL INSURED; INSURER LETTER: CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN HALL ANNEX DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BLIT FAILURE TO DO SO SHALL 146 MAIN STREET IMPOSE NO OBLIGM(ON OR LIABILITY OF ANY KI UPON THE INSURER ITS AGENTS OR NORTH ANDOVER MA 01845– REPRESE s. RUTH RESENTATNE 0 28'5 10'7 17'10 6'11 6'3 48 - 14'2 Protect existing finished floor during construction. Match existing ;d finished floor height with subfloor UP for carpet Remove 1-P +/- of existing Remove existing passage door and non-bearing 4" wall Preserve for re -use, / fV L// ---------------------------------------------------------------------------- ----------------------------------------------------- ----------------- DOUBLE WALL TO ENCLOSE E COLUMNS 2666 LH DO SOFFIT ENCLOSES DUCTWORK HERE i 2668 LH DOOR SLEEPERS & 3/4" SUBFLOOR LAUNDRY ROOM / w/ VAPOR BARRIER CARPET BY OTHERS FURRING STRIPS ON FOUNDATION WALL OWH ' 2'4 13'6 4'8 7'11 20'6 28'5 o N C N 0 CM m m m m cn0 m CO) 00 CD a Z � o o CZ O o p CD a� cr0 CD o a: CD cmCD CA CD 0 d Cl) CO) Cl) O CO) CD 0 CD CD CO) 0 y O CCD 3 0 CD C_ OD �10 p = O C y 0 Q N = G.0 a 10 CO) O n m n O N ,n• C Z =y H O� = .�i a. 0 TI tea.. O �O m N p y M 01 m 2 > > O 0 m o o g' cp ►-� =r ='a: t b CL (n m C,3= e a + n yam: _ cn d SAP \ -J ' SL " . M CA: lb O y O 0: �: C =r - h-� ® O AV b� ... 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O O O N :� C d m y� O p� N: y G Cr C C) .� n 03 C yCA cl) N m N N CD 1� CD N N 10 C;D O O CD O CD o CD � m a'fl C) 1 = ' A O O V m te cn 9 O (Dw O - z O c �-. 7i � w pc�`n O :r w 2 O am :r � n w O T Ix~ °r ca ar T 5J A. C t� �^ n O n . � x w y � H r y 0 0 c 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 local or state law, regulations or requirements. *************/*°**jApplicant fills out this section***************** APPLICANT: _ W��loi� �R��yo��-�' Phone 37y -003,V LOCATION: Assessor's Map Number a Parcel c Subdivision /Vi4 ,,h -`p (/Ur 1 t� q_/UC Lot(s) �rr Y /� Street / ft fze r 1 St. Number 10 i ************************Official Use Only************************ RECOMMENDATIONS OF T94N S: Conservation A ministrator Comments Date Aporoved Date Rejected US Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected Date Approved Se6tic Inspector -Health Date Rejected A Comments Public Works - sewer/water connections �h' j (,c> to- 30 95 - driveway permit by ,C 4 �9[. .hiAy*•' ' .:fAf�+.�' Yy�g�Y 'i S - A A Y :Il�f P•%� YS `. S S ..�fY. • J M • aCs A :Vf.{ v� � � :�w}a dpi'^ �" �. - p .,�� rv.. _ .-.`M$ w� S � it i .P JTf Yd rl l .. � Y g/'� .ri r • . �.f1 V11 OF G.' H 1+61 -.. • LOT 12 LOT 7 Z .18' �- OT 8 • � / LOT 9 5.48' Amor law SETBACK REQUIREMENTS: FRONT = 20 FEET T REAR = 15 -FEET . _:•. _ �� � � SIDE = 5 FEET :� WETLANDS = 25 FEET. T SITE PLAN OF LAND LEGEND `°R LOT 8 NADINE LANE OFFSETS FDR SEnv= Rmtourno a N. ANDOVER, MASS. P wm DMENSM MW P;�rAM yaw PROPOM UK OFPJET TO HOM I--jw--1 iP=0W TREE.- DEVML f"Nj PROPOSED EDGE` OF MUM �v . ocr AIM DOMMO EDGE OF PAVEMENT _ woravow� arMm�r CHRlSIUNSOY ROADWAY CENIEMM STATION 37+00 lei mro is w+a�aurt : mm > m. �,vsam ram ma "o13LOd N 0 75.6' LOT 8 1000 -S.F. 20,3• 0 II 93 j . FOUNDATION LOCATION PLAN CLIENT. • SCOTT CONSTR. THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT LOCATION: NADINE LN.NNO.ANDOVER,MA. SCALE: 1"=20' DATE: 316196 CHRISTIANSEN hSERGI PROFESS LANDSURVEYORSEERS 160 SUMMER ST., HAVERHILL.MA. 01830 TEL 508-373-0310 © 1995 BY CHRISTIANSEN & SERGI INC. I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS,WETLANDS,EASEM£NTS ORDERS OF CONDITIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE.EXCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. DWG. NO.: 94015014 )S / 1 ti I 1 � N 0 75.6' LOT 8 1000 -S.F. 20,3• 0 II 93 j . FOUNDATION LOCATION PLAN CLIENT. • SCOTT CONSTR. THIS CERTIFICATION IS MADE AND LIMITED TO THE ABOVE CLIENT LOCATION: NADINE LN.NNO.ANDOVER,MA. SCALE: 1"=20' DATE: 316196 CHRISTIANSEN hSERGI PROFESS LANDSURVEYORSEERS 160 SUMMER ST., HAVERHILL.MA. 01830 TEL 508-373-0310 © 1995 BY CHRISTIANSEN & SERGI INC. I CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE HORIZONTAL SETBACK REQUIREMENTS OF THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED. (THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER RESTRICTIONS SUCH AS COVENANTS,WETLANDS,EASEM£NTS ORDERS OF CONDITIONS,ETC.) THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY PURPOSE OTHER THAN THAT OUTLINED ABOVE.EXCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR- MATION CONTAINED HEREON. DWG. NO.: 94015014 )S 1-6cation 0 N,4ZI RCF - No. Date a T211/01/% 16:05 9309 101,33k1rif TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ V Foundation Permit Fee $ 1000 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL (D $ Building Inspector 870.0o PAID Div. Public Works PF&MIT Z#t, 7::>-r4- 13 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP KVO. LOT NO. a I 2 RECORD OF OWNERSHIP iDATEBOOK PAGE ZONE SUB DIV. LOT NO. LOCATION'O �p J�., f'� 16vF../© PURPOSE OF BUILDING A ( OWNER'S NAME ,. l ��'���•C � � P NO. OF STORIES SIZE OWNER'S ADDRESS Z ` BASEMENT OR SLAB 41c9slew; ARCHITECT'S NAME R SIZE OF FLOOR TIMBERS 1ST #IMO 2ND 3RD T1, fA ./ BUILDER'S NAME / co r /f©! SPAN / ° Q !/ 1X DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS 2x6 POSTS �Z It a (I %5 - DISTANCE FROM STREET D DISTANCE FROM LOT LINES - SIDES REAR GIRDERS ♦ �N t ° l r AREA OF LOT 50 o v SF FRONTAGE /J HEIGHT OF FOUNDATION of' 1O G THICKNESS «P� IS BUILDING NEW Yi SIZE OF FOOTING 2Y Ce x /7 P� 4 IS BUILDING ADDITION Na c MATERIAL OF CHIMNEY � IS BUILDING ALTERATION d IS BUILDING ON SOLID OR FILLED LAND `., d` Vt/(e� WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER j BOARD OF APPEALS ACTION. IF ANY Ala IS BUILDING CONNECTED TO TOWN SEWER M IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS ` SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY y PAGE 1 FILL OUT SECTIONS 1 - 3 REGULATED BY PARA. 114.8-S. B.C. PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDINGDATE Lo .gL c FEE PAID_. .,._ ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED AGI J O n �f,- _ G SIGNATURE OF OWNER OR AUTHORIZED AGENT �� t1 l - 3 {. PROPERTY INFORMATION LAND COST 549 K EST. BLDG. COST J i� EST. BLDG. COST PER SQ. FT. 6 S ,c EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY FEE Isz OWNER TEL. N 37 5PERMIT FOR FRAME/BUILDING, r PERMIT GRANTED CONTR. TEL. N ,9 DATE: FEE PAID ONTR.LIC.N al f/ &q' KM PERM f Fill t .r LESS FM FEE_....«.. DUEFIRAMEPLIM$ H.I.C. # . C� i Rs BUIt`DING RECORD 1 OCCUPANCY 12 -. SINGLE FAMILY I 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. PINE BRICK OR STONE HARDW D PIERS PLASTERS _ DRY WALL. _ UNFIN. - I �t 3 BASEMENT , I _ AREA FULL .FIN. B'M'T' AREA _ 1/1 1/1 % FIN. ATTIC AREA t _ NO BMT FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN _ s 4 WALLS 711,9 FLOORS Y CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDIV D _ ASBESTOS SIDING _ COMMON_ VERT. SIDING ASPH. TILE STUCCO ON MASONRY i _ STUCCO ON FRAME i BRICK ON MASONRY+_,, ATTIC STIRS. & FLOOR _ BRICK ON FRAME ( { CONC. OR CINDER ELK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORPOOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK f t SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO ~ ~ 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE J )- FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR I' 7 s WOOD RAFTERS AIR CONDITIONING t ri RADIANT H'T'G UNIT HEATEK 7 NO. OF ROOMS GAS OILS B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING 2 �� ]"I 3m Ln 0 Ln 0 N CD s w cr Ln 0 Ln 0 N CD MMIME No ME No ME ■■ ME no ....No .... .... NONE .... .. ..SEEN ME MEIN .... .. .. .... .... �iw. NIOIIIIIplllllll O 00 v rn D 00 CDcD S W� m c- CCA _� O CD O9' M o aCD CD ao vo�< o�n ch oQm a CDo�0 �gcn CA aD- :3 CD W❑ w `❑C =r CA n �-� o0 o O 0 0 S (A � y raSP O�+O O CD (D < cn CD CD o � CD CL < 'W'O o a W �' (D 3 CD CD p (D CD �• -� n O N r+- 00 _ Ln S C O '-r c W -N-O O o.CD � �� 000 ��p• CID N (D 5' v'g•�o N W N O O 0 c R' C> D < O 00 (D W 0 cD R�' 0. 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