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Location
INo.Date-'•"'`
TOWN OF NORTH ANDOVER
of ,.•� • ,�o
i? • °t _.... -
A Certificate of Occupancy $
Building/Frame Permit Fee $ —�—
t
6258
Foundation Permit Fee, $
0ther P mit FZ $ 0
Sr Connection Fee $
Wter Connection Fee $
TOTAL
$'"
Building inspector
Div. Public Works
_. sdA P No. oc
C
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
6/PAGE 1
MAP 440.
LOT NO.
I
2 RECORD OF OWNERSHIP (DATE
BOOK .'PAGE
ZONE
SUB DIV. LOT NO.
-I
OCATION baG Nar'C� lo {,a con,g
C1It.
PURPOSE OF BUILDING 1 /
_ /6 a�$� ingropd vinyl/� (aoo/gndfZACE
O/WNEWS NAME //J� 'I j
! / au/ ani �n Ioe- 11—
NO. OF STORIES SIZE
OWNER'S
OWNER'S ADDRESS /0 D l /�.�
l V j\ C•/
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
'BUILDER'S NAME/ lber-1 C P,� p. (' �-
�l
SPAN
'DISTANCE TO NEAlR7ESTTBUILDING�i//O,J.F�*c./�
DIMENSIONS OF SILLS
,DIS 0 NCE FROM STREET 6 ��
Vel
POSTS
ISTANCE FROM LOT LINES — SIDES �^ .�-L REAR
�J T
/ ,G-_�_
—�
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
ILL 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
SEE BOTH SIDES
INSTRUCTIONS
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
t /PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
v -
//f//DATE FLED
`' SIGNAT OF OWNER OR AUTWORIZIED A ENT
FEE t Ur
�NER TEL. #-�; O )- 7it- �%)
PERMIT GRANTE G� �CQNTR. TEL.
CQNTR.LIC. # doD �kq
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PE SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING INSPRCTOR
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-
APARTMENTS4-1RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE
CONCRETE BL'K. --.I PINE
BRICK OR STONE I HARDW D
5 ROOF II 10 PLUMBING
TAR 8 GRAVEL
6 FRAMING II
I
DRY WALL
PIPELESS FURNACE
FORCED HOT AIR FUI
TIMBER BMS. 8 COILS.
UNFIN.
3 BASEMENT
STEEL BMS. 8 COLS.
AREA FULL
HOT W'T'R OR VAPO
FIN.B'M'TAREA
_
7, 1/7 %
FIN. ATTIC AREA
_
NO B M'T
FIRE PLACES
_
HEAD ROOM
ELECTRIC
MODERN KITCHEN
_
4 WALLS
I 9 FLOORS
j CLAPBOARDS
B
1
2
�_
3
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
HARDIV D
COMMON
VERT. SIDING
_
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASUN'RY
BRICK ON FRAME
ATTIC STRS. 8 FLOOR I_
CONC. OR CINDER BILK.
I WIRING
STONE ON MASONRY
5 ROOF II 10 PLUMBING
TAR 8 GRAVEL
6 FRAMING II
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FUI
TIMBER BMS. 8 COILS.
STEAM
STEEL BMS. 8 COLS.
HOT W'T'R OR VAPO
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
GAS
7 NO. OF ROOMS
OIL
B'M'T 2nd _
1st 13rd
ELECTRIC
NO HEATING
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.
****************Applicant fills out this section*****************
APPLICANT: 4 ea h ae— l) r I� n e Phone
22V % Z
LOCATION: Assessor's Map Number Parcel
Subdivision Lot(s)
Street ��!CO ) Cl2 St. Number /00
************************Official Use Only************************
��
RECOMMENDATIONS OF TOWN AGENTS:
Co servation A inistrator
Comments
Town Planner
Comments
Food IInspector-Health
Septic Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector
Date Approved IV
Date.Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved _.zAh,_3
Date Rejected
Date
C;Atlyl.lt &V,. UUNL)Ar101V PLAN �
LOCATE® AN.
SCALE"/"- ,tet DATE.'
•
S.L.GILES R.L.S, c-
t r
LAWRENCE a NORTH ANDOVER N
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Co'oP 3A.3i.
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E'�t►E��NT� isc, o o I sJ A. FrL o ot7 uarArX)
She BG
/ CERTIFY THAT ME OFFSETS- SHOWN ARE FOR THE USE OF
OFFSETS SHOWN THE SU/LD/NG INSPECTOR ONLY, S SUCH
CONFORM TO THE USE IS FOR DETERMINATION OFZONING
ZONING B Y L A W OF CONFORMITY OR NON CONFORMITY
sJatc.-rN Qa���, WHEN TAKEN.
•�'►k � ` r tar. Y��*L~r .cv.: "*'f'y`.
�l
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P.'.^
'
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3 Receptor - Allows concrete deck material to be attractively brought to
edge of pool.
H 4 Automatic Skimmer Continually skims surface to remove floating
leaves and debris.
+ ' 5 Tile Design Liner Heavy duty winterized liner is 100% virgin vinyl with
integral the motif.
! 9
r
6 Handrail Assures safe, easy entrance and exit of walk-in steps.
7 Pool Steps - Durable thermoplastic steps come in 4', 6' and 8' widths.
{ .w
Steps are the most popular option, providing accessabilitY Plus a
..�:_ comfortable place to sit and relax.
t 8 Radius Corners - On rectangular pools, this graceful, sweeping radius
section adds strength and makes cleaning your pool easier. (Available
1 in 6" or 4' radius).
t e 9 Print Bottom Liner - Creates an attractive appearance.
10 Through -Wall Fittings - Proper placement and adjustable directional
control provides efficient pool water circulation.
1 Structural Polymer Walls - Reinforced grid design provides superior 11 Safety Rope Delineates shallow and deep water. (Included with all
strength. hopper modles.
2 Monolithic Design - Every major component is tied to another for 12 Pool Ladder - 3 -step stainless steel ladder provides easy exit from
maximum integrilty and strength! pool.
a. Brace - Unique polymer brace locks into concrete footing and 13 Main Drain - Supplies filter with water from deepest part of the pool
deck around entire perimeter of pool. (Optional).
b. Concrete Footing - Permanently secures pool walls in place. Construction techniques depicted here are suggested standards only. Soil
bearing conditions, water tables and local building codes may allow or re -
c. Concrete deck - Locked into deck support braces. quire variances.
PAGE 5
0
. ..-. —%0A i&—A ibob v i vv�V
& GENERAL CONTRACTORS, INC.
Larry's Country Square
326-B South Broadway
SALEM, NEW HAMPSHIRE 03079
Telephone 603-893-1212
SWIMMING POOL CONSTRUCTION AGREEMENT DATE
The general terms and conditions on the reverse are part of this agreement
This AGREEMENT made as of the date of written acceptance of Pleasuretime Pools & General
Contractors, INC. herein determined "Contractor"
herein termed "Owner".
Mail Address
, `���r, n• 1ixc,;t �, a d. g�� .. — —Home Phone Sif <<•
t ,City n/0, i4etela'4 �I�55 L /,FU Bus. Phone �
-
` 5 �M , ' F+ + ' "^M f°$ r* h "°°,'4-,xr . npd ;+ S?ti„Nab+iRa:-., .trti5'n e^*aaty".•W a TNES S ETH : ,,, R . +� !`� •:.i-„
Contractor agrees to construct for Owner, in substantial conformance with the speci-
fications
��set forth hereinafter, the following described swimming pool, herein called
the work"I, to be located it -; ,.� ,. r.
The owners herein agree to purchase and the contractor herein agrees to self 1 sad in-
stall a SWIMMING POOL in an excavationon the ��o�rstproperty suitable. to contain a
pool appsoximately_ft. wide ��1t`�ft. long, for the principal sum of
-To 4-i-�, ,`(• %6'� L, —1 i l
ze
__......__ DOLLARSII
TO BE PAID AS FOLLOWS:
�{ _ c%i�, -
.rL upon signing of this contract, receipt
Aersof by cash or check subject to collection) is -hereby acknowledged, the balance
to be paid as follows:
I'ERTIFIED ($ �- � �� <`��;� '' 1 ..,
HECK— �� 'A 1 ) of the contract on day of delivery of pool.
Certified check or money order only.
ERTIFIED i$ / d, f •',. )
HECK of the contract day liner is placed into
_
pool.
�$ `�'` ``%r`✓4" ) balance, immediately upon connection of
filter.
CONSTRUCTION SPECIFICATIONS
1. Type of Pool 8, Certificate of $125 for Chemicals ,/..
2. Max. Approx. Wdth. i` Lgth. 5.. 9. Automatic Chlorinator�r c.
3. Filter Systema ItF i); ,t / (; 10.
rl , : 1`� :J Steps `�/��" i; r- M' ,,, ,a -,/r r:• rs,r� :;.
4. Pump 1 f/ y' ,5 t. <<;' „� • �� 11. Rope and Float v'`?
I5. Ladder .1 / t v 6 � 12. Liner
6. Diving Board 13. Other `c �,�' (1 •,Ft Lr:r.eaf' it <� 5't r i�
7. Vac Kit, Leaf Skimmer, 18" Curved Brush 'rS, 14. Warranty 1 r c•c' 4 c'; ; >� +r„ -. ( �.; _' _ r", ,
15. Pool Sweep IVO
` J
nstallation includes: Hard Bottom, Concrete Collar, Main Drain.
he owners and contractor agree that the contractor will backfill and return
and to rough grade to minimum of four Ft. around perimeter of pool and (4)
o (6) inches down from top of coping, contractor will not be liable or
'esponsible for damage to lawns, shrubbery, trees, flowers, walks, driveways
r patios, etc. Owners responsible for supplying WATER for filling the pool.
he parties hereto agree that this does not include electrical wiring of
zy kind.
ie OWNERS and the CONTRACTOR FURTHER AGREE to the ADDITIONAL TERMS,CONDITIONS
ld COVENANTS of this CONTRACT SET FORTH on the REVERSE SIDE of this DOCUMENT,
ITCH are HEREBY INCORPORATED in this CONTRACT, and WHICH ALL PARTIES HERETO
XE to READ and UNDERSTAND.
IN WITNESS WHEREOF, the parties hereunto have below -subscribed their hands and seals
the day and date.,above written, ..-
CONTRACTOR OWNER
<; it i Z.
REPRESENTATIVE OWNER J
YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN CONSUMMATED BY A PARTY THERETO AT A PLACE
OTHER THAN AN ADDRESS OF THE SELLER, WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF PROVIDED
YOU NOTIFY THESE LLEA IN WRITING AT HIS MAIN OFFICE OR BRANCH BY ORDINRAM
THIS AGREEMENT' ARY MAIL POSTED BY TELEG
SENT CR By DELIVERY, NOT LATIN THAN MIDNIGHT OF THE THIRD BUSINESS OAY fOLLOWINO THE 1t10NINOOP
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Date ....../
............................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...
has permission to perform .....4.
..[...1.. .. ..................................
........................................
wiring in the building of %L -.K ..... .....................................................
at ................ e—
rth Andover, Mass.
Fee....... ...... Lic. .....................
ELECTRICAL INSPECTOR
Check #
'--.Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit Nos J
BOARD OF FIRE PREVENTION REGULATIONS Occuparcy and Fee Checked
[Rev. 11 9] leave blank
APPLICATION FOR PERMIT TO PERFORM�ELE E RICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Cod , IMEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYP ALL INFO ATION) Dat, 27 Z®vy
City or Town of- —'---�(i�i/ To the nspector of Wires:
By this application the undersigned gives notice his or her intention to perform the electrical work described below.
Location (Street & Number) )
0
Owner or Tenant Telephone No.
Owner's Address
Is this permit in conjune4ion with a building permit? Yes ❑ No E (Check Appropriate Box)
Purpose of Building s_/aC%GzG Utility Authorization No.
.Existing Service- Amps/ /Jd 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:–77; .,z
rmmnlotinn nfthn fn17—i— mM, —, h. —;—d l... tho 1„0. � 1—..,rAR.
No. of Recessed Fixtures
No. of Ceil: Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
f
Generators KV I
No. of Lighting Fixtures
Swimming Pool Above n- rnd. ❑ Id. El
o. o mergencytg Batte Units ng
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of nes
No. of Switches
No. of Gas Burners_
o Detection and —moi
No. imthatin Devices
No. of Ranges
No. of Air Cond. otal
Tons
No. of Alertin Dedes
g
No. of Waste Dispose
Heat Pump
Number
ons
KW
No. of Self-Contai ed
Totals:
Detection/Alerflilk Devices
No. of Dishwasher
Space/Area Heatin KW
Local. El Mu �%ipal ❑ Other
Co nection
No. of Dryers
Heating Appliances Kms,
Security Sy ems:
No. of evices or Equivalent
No. of Water
KW
No. of No. of
Data Wiping:
Heaters
ns Ballasts
of
Nof
No/evices or E uivalent
No. Hydromassage Bathtubs
No. of Motors ` Total HP f/�
Tele
No. of Devi es or E uivalent
OTHER:
Attacn aaamonat detail q desired, oras required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage'is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:)
Estimated Value of Electrical Work: W-6(When required by municipal policy.) (Expiration Date)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the p�n nd penalties of perjury, that the information on this application is true and completes
FIRM NAME: LIC. NO.:,�_
Licensee: Signature LIC. NO.: Z"J
(Ifapplicabl , n er ' pt" in the license number line) Bus. Tel. No.aa_ G
Address Alt. Tel. No.:
OWNER'S INSU ANCF WAIVER: I am aware t at the icensee does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: S
Date.; -:..1- .........
3=0� ...o .•�e �L
TOWN OF NORTH ANDOVER
• PERMIT FOR GAS INSTALLATION
SAC HUSE�
i
This certifies that . �.: � J:! �/.'� � e- ...... j � J7 � ................
has permission for gas installation .... Uk.1 f ..................
in the buildings of ... �.r.J�l.� ............................ .
at . Xe-, � .r.. /r ......,;"North Andover, Mass.
Fee.Lic. No. .?r., -.C.. ��:.;..-. ....
INSPECTOR
Check # r 7
4291
�L\
MASSACMSETTS UNIFORM: APPLICATtON FOR PERMFT TO DO GASFITnNG
(Print:or
RDate_LLC�_20 T.
Mass. kr 0 n'L pe=,t
a.m. L..m._4 _,f'C�n'L C'j Owners Narr*2SLL�__
Larfieh Type- of Occupancy.RQ:S
A
New p Renovation C] Replacement Plans Submitted: YCSC3 NO Ej
Installing Company N!=_��
Business
Name of UcensW Plumber or Gas Fitter
Check one:
13 Corporation
13 Partnership
P Firm/Co.
iNSURARCE CaWE_j4A_Ga_r__
I have a curreA liability Wwaaace policy or ft. substantial equivalent which meets t1w mqUIreMeRtS, of MGL. Ch. 142.
Yes )q No- 0
If you have checkedygr plum Indicate the- type coverage by d.m,=MV the appropriate - bo3L
A liability Insurance- policy Bond, 0:
OWNER'S INSURANCE WAMEW. 1: am, aware tilt. Um licensee does not have the insurance coverage. required by,
Chapter 142 of the Mass: General, L• aws. and that my signature on tift permit application- waives this, reqwrernent,
Check one:
Signature,of Owner or Owner.'s Agent, Owner[j Agent,0
I hereby certify that. aftiot.tire- datails and. information: L have submitted (or entered) in. above: application- are true. and accurate to the bed..of my
knowledge and: that all plurnbinqwork and installations.performed under the permit -issued folu—Una- -1 bel m' c=pilw= with all:
Pertinent provisions- oftheMassachusetts Stab Gas Code and Chapter 142 of the r
"eneral
Tyu of License:
Plumber ginature of UcerfWd Plu_m6er W®r fitter
Title— Gasfitter
IMaster license Number oco,
City/TownJourneyman
•..
®���o�s�■®�®®®�®®its®®�®®®®
Installing Company N!=_��
Business
Name of UcensW Plumber or Gas Fitter
Check one:
13 Corporation
13 Partnership
P Firm/Co.
iNSURARCE CaWE_j4A_Ga_r__
I have a curreA liability Wwaaace policy or ft. substantial equivalent which meets t1w mqUIreMeRtS, of MGL. Ch. 142.
Yes )q No- 0
If you have checkedygr plum Indicate the- type coverage by d.m,=MV the appropriate - bo3L
A liability Insurance- policy Bond, 0:
OWNER'S INSURANCE WAMEW. 1: am, aware tilt. Um licensee does not have the insurance coverage. required by,
Chapter 142 of the Mass: General, L• aws. and that my signature on tift permit application- waives this, reqwrernent,
Check one:
Signature,of Owner or Owner.'s Agent, Owner[j Agent,0
I hereby certify that. aftiot.tire- datails and. information: L have submitted (or entered) in. above: application- are true. and accurate to the bed..of my
knowledge and: that all plurnbinqwork and installations.performed under the permit -issued folu—Una- -1 bel m' c=pilw= with all:
Pertinent provisions- oftheMassachusetts Stab Gas Code and Chapter 142 of the r
"eneral
Tyu of License:
Plumber ginature of UcerfWd Plu_m6er W®r fitter
Title— Gasfitter
IMaster license Number oco,
City/TownJourneyman
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