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HomeMy WebLinkAboutMiscellaneous - 120 SALEM STREET 4/30/2018 (5) �` i a 1 f I %, I � i f � ��. �-- BOARD OF HEALTH 27 CHARLES STREET NORTH ANDOVER, MA 01845 TELEPHONE# (978) 688-9540 APPLICATION FOR ABANDONMENT OF SUBSURFACE DISPOSAL SYSTEM (SEPTIC SYSTEM) Pursuant to Section 310 CMR 15.354 of the State Environmental Code, Title V Name jrLke Phone Address Contractor hired for work: Name 3Phone D Address o t Date for scheduled abandonment___// p The septic system at the above addr s as been a andoned according to Title V specifications. (5Sqnature of Co ac o MetW of septic tank abandonment (check one). ( ) removal ( ) sandfill ( crush ( ) other Name of Offal Hauer This form must be returned to the North Andover Board of Health. PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH REPRESENTATIVE'S USE ONLY. l^ Inspecting Agent Date DEC Z Location Date "ow 11 40RTN TOWN OF NORTH ANDOVER f 9 ` Certificate of Occupancy $ s i ,SSACMUSEt'� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ov TOTAL Check # I 7 " --Building Inspect r' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: 4 c SIGNATURE: Building CommissioneKnspector of Buildings Date SECTION 1-SITE INFORMATION I O 1.1 PropeRy A dress: 1.2 Assessors Map and Parcel Number: c� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 3 Zoning District Pr osed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private .❑ Zone Outside Flood Zone P/ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHMAUTHORIZED AGENT 2.1 Owner of Record Name nt) Address for Service Sighature Telephone 1�2 Owner of Record: Name Print Address for Service: O Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor- Not Applicable ❑ F Licensed Construction Supervi r. CS ew��9� O / License Number ly Address Expirati Dat ign re Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone �I 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.......0 No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Tdition ❑ Accessory Bldg. ❑ Demolition [ice Other ❑ Specify Bri scription of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beUFFICIAL USE(3NLY Completed by permit applicant 1. Building (a) Building Permit Feeµ Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee(a) X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Q Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/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 OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized 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 Name Signature of Owner/A§ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORINT ` INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT r Z�o PHONE M� '���/s-,�� ASSESSORS MAP NUMBER LOT NUMBER _� � SUBDIVISION LOT NUMBER STREET .,/ ff STREET NUMBER OFFICIAL USE ONLY RECONMENDATIONS OF TOWN AGENTS DATE APPROVED U i/ O SERVATION ADMINISTRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECT 3 DATE REJECTED DATE APPROVED 3a a ti/ SE C PE R-HEALTH f DATE REJECTED CONN ENTS .�vim PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Town of North Andover a� p►ORTH SS LlD 116 Building Department �,� y�..� *e °0 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 <oc wcwc wcr �4R4TE0 I•Pa .�� Building Demolition Affidavit �SSACHU`��� DATE OWNERS NAME&ADDRESS 7 PROPERTY LOCATION DESCRIPTION S CONTRACTORS NAME &ADDRESS �� S' DEPARTMENT SIGN-OFFS D.P.W./WATER SEWER GAS ELECTRIC TELEPHONE CABLE TAXES POLICE ,�• Za a D FIRE EXTERMINATOR DUMPSTER-ON/OFF STREET DIG SAFE NUMBER DDD .ZD Z��o2 BLDG. INSPECTOR DATE RECD DATE OF INSPECTION I RESIDENTIAL PEST CO TROL ONE-TIME SERVICE AGREEMENT PURCHASER PREMISES I Name aa1tV t n w Go rr"� I)M�"J Name Address PI) ?=, 3 ► Address 1 Sq M ST- City ► I n /� City oink NI1 Aok to s Citit ty - Nbv-w &Uff i I State M Zip _ 1 State Zip rl ►1j► � y 23 Telephone _ �7�6�� �,� � Telephone Sa 36()q j j Terminix Office c3y14 Telephone ft ) t Route Grid Same Day TERMINIX WILL PROVIDE SERVICE FOR THE PESTS CHECKED BELOW: SERVICE CHARGES FOR YOUR TERMINIX PROTECTION ARE SPECIFIED BELOW: El House Ants ❑ Brown Recluse Spiders ❑ Indocczor Tick/Control ❑ Carpet Beeth .❑ Indob.. Fl a-Control ❑ W46 -ackets regular charge ❑ ClogSOthS ❑ Y $ amount remitted with agreement ❑ Indoor Mlfe Control ❑ House Crickets METHOD OF PAYMENT: ElBlack Widow Spiders ❑ Bees LJ Pre bill AW ❑ Remit to Service Technician -- ❑ Visa/Master Card SPECIAL INSTRUCTIONS: E P 1-c ✓!<� 0/fit"9- YP i+ of,n&r ` Q Effective for a period of thirty (30) days from S' t�.► !I�.F_ , for the sum of$ e_05D00 (subtotal 1 556 p plus sales tax ), Terminix will service the identified property for the pests checked above. This agreement terminates in thirty (30) days. If additional service is requested during the thirty (30) day period, service will I be performed at no additional cost to the Purchaser. I This agreement does not guarantee against present or future damage to the building, or contents, nor provide for the repair or compensation thereof. This agreement does not provide for the control of subterranean termites, dampwood termites, drywood termites,fungus, wood boring beetles or other pests not checked above. Upon request Terminix will provide the Purchaser with a copy of the manufacturer's specimen label of the pesticide(s) which will be used to treat the premises. NOTICE: YOU, THE PURCHASER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT. May TERMINIX REPR TI VN'i VL SrNiON URE !DATE t CUSTOMER SIGNATURE DATE THE TERMS AND CONDITh THE REVERSE SIDE, INCLUDING ARBITRATION AGREEMENT,ARE PART OF THIS AGREEMENT. www.terniinix.com Key#33218 REV.6/98 R/P 6/98 ©1994 The Terminix International Company L.P. CUSTOMER COPY O I TERMS AND CONDITIONS 1. FUTURE DAMAGE. Terminix is not responsible and does not guarantee against present or future damage to the building or contents, or provide for the repair or replacement thereof. This Agreement does not provide for the control of termites, fungus,beetles, or any other pests not indicated herein. 2. LIMITATION OF LIABILITY. In consideration of the sums, charged by Terminix hereunder and as a liquidated damage and not as a penalty, and NOTWITHSTANDING ANY CONTRACT, TORT OR OTHER CLAIM THAT TERMINIX SHALL HAVE BEEN NEGLIGENT IN THE PERFORMANCE OF ITS DUTIES TO PURCHASER, (I) THE SOLE RESPONSIBILITY OF TERMINIX TO PURCHASER OR ANYONE CLAIMING THROUGH PURCHASER UNDER THIS PLAN OR OTHERWISE IS TO RE-TREAT THE PROPERTY AND (II) PURCHASER AND ANYONE CLAIMING THROUGH PURCHASER EXPRESSLY RELEASE TERMINIX FROM, AND AGREE TO INDEMNIFY TERMINIX WITH RESPECT TO,ANY OTHER OBLIGATION WHATSOEVER TO PURCHASER OR ANYONE CLAIMING THROUGH PURCHASER. THIS PLAN DOES NOT GUARANTEE, AND TERMINIX DOES NOT REPRESENT`, THAT PESTS WILL NOT RETURN. 3. NOTICE OF CLAIMS, ACCESS TO PROPERTY. Any claim arising out of or relating to this Agreement must be made during the term of this Agreement and in writing to any Terminix office;failure to make such written claim during the term shall be a waiver of said claim.The only obligation of Terminix to Purchaser or anyone claiming through Purchaser arising out of or relating to this Agreement is to re-treat and then only if a valid claim is made during the term or this Agreement. in the event of any claim.by Purchaser or anyone claiming through Purchaser for anything other than for Terminix to re-treat the identified property. Purchaser and anyone claiming through Purchaser shall pay all of Ste costs and expenses of Terminix,including but not limited to,attorneys'fees,relating to or arising out of such claim. Purchaser must allow Terminix access to the identified property for any purpose contemplated by this Agreement and failure to allow Terminix such access will terminate this Agreement without further notice. 4. DISCLAIMER. r A. The liability of Terminix under this Agreement will be terminated if Terminix is prevented from fulfilling its responsibilities under the terms of this Agreement by reason of delays in transportation.shortages of fuel and/or materials,,strikes,embargoes,fires,floods,quarantine restrictions,earthquakes,hurricanes,or any other act of God or circumstance or cause beyond the control of Terminix. B. This Agreement does not coyer and Terminix will not be responsible for damage resulting from or services required for the failure of Purchaser upon notice from Terminix to promptly cure at Purchaser's expense any condition which prevents proper treatment or inspection or is conducive to infestation. TERMINIX DISCLAIMS ANY LIABILITY AND SHALL NOT BE RESPONSIBLE FOR INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL, AND/OR LOSS OF QUIET ENJOYMENT DAMAGES.THE GUARANTEES AS SPECIFICALLY STATED IN THIS AGREEMENT ARE GIVEN I:N'LIEU OF ANY OTHER GUARANTEE, OR WARRANTY OR OTHER RESPONSIBILITY, EXPRESS OR IMPLIED, INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. t, 5. CHANGE IN LAW.-Terminix performs its services in accordance with the requirements of federal, state and local law. In the event of a change in existing law as it pertains to the services herein, Terminix reserves the right to revise the service charge or terminate this Agreement. 6. NON-PAYMENT, DEFAULT. In case of non-payment or default by the Purchaser, Terminix has the right to terminate this Agreement. In addition, interest at the highest legal rate allowed will be assessed to and,paid by Purchaser for the period of delinquency. 7. ENTIRE AGREEMENT. This Agreement,constitutes the entire agreement between the parties and no other representations or statements will be binding upon the parties. If any part of this Plan is held to be invalid or unenforceable for any reason,the remaining terms and conditions of the Plan shall remain in full force and effect. 8. ARBITRATION, The Purchaser (including anyone.claiming through Purchaser) and Terminix agree that all matters in dispute between them, including but not limited to any controversy or claim between them arising out of or relating to this Agreement or to the identified property in any way, whether by virtue of contract,tort or otherwise, shall be settled exclusively by arbitration. Such arbitration shall be conducted in accordance with the Commercial Arbitration Rules then in force of the American Arbitration Association. The arbitrator(s) shall be bound by rules of substantive law and shall not be bound by the rules of evidence, whether or not set out by statute, except for provisions relating to privileged communications. The arbitrator shall give effect to any and all waivers, releases, disclaimers, limitations and other terms and conditions of this Agreement. Therefore, the award shall not. and the arbitrator shall not have the power or authority to, hold Terminix responsible for(i)the repair or replacement of any damage to the identified property.(ii)loss of anticipated rents and/or profits,(.iii)direct,indirect.special,incidental..consequential,exemplary or punitive damages.or(iv)damages or penalties relating to or arising out of any claim alleging any deceptive trade practice. Each party shall be responsible for paying any attorney's fees, expert witness fees and other expenses it incurs on its behalf in connection with the arbitration, plus one half the aribitrator's fee and one half of any expenses incurred by the arbitrator, and the award shall assess the arbitrator's fees and expenses accordingly. Any award of damages pursuant to such arbitration shall be included in a written decision which shall state the reasons upon which the award was based.including all the elements involved in the calculation of any award of damages. The decision-of the arbitrator shall be a final and binding resolution of the disagreement which may be entered as a judgment by any court of competent jurisdiction. Each party consents to the personal jurisdiction and venue of the courts in which the identified property is located and the courts of the State of Tennessee and of the U.S.District Court of the Western District of Tennessee. Neither party shall sue the other party with respect to any matter in dispute between the parties other than for enforcement of this arbitration provision or of the arbitrator's decision and a party violating this provision shall pay the other party's costs,including but not limited to, attorney's fees, with respect to such suit and the arbitration award shall so provide. UPON REQUEST TERMINIX WILL PROVIDE THE PURCHASER WITH A COPY OF THE MANUFACTURER'S SPECIMEN LABEL FOR THE PESTICIDE(S)WHICH WILL BE USED TO TREAT THE PREMISES. 33218 oRT Town of Nor H To h Andover t �o E 0 Building Department f°- 27 Charles Street North Andover' Massachusetts 01845y : ti T O9 COGwGW K• 10 (978) 688-9545 Fax (978) 688-9542 9SSACHUSti� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a. 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'C.y .:` �1 s. c t- rA Y.. ` z-„ .r• +r ,+ nx t` a al �M17e •!M+° ✓ .'4 ts. � _, - ,, a:i A `f. Y f�hy'e'y�c:.� Y .YEN{ f?.. + "+' `X �r t t �'� :IA ! !g"�"} J�htmi�t'1�.S,j''x a..+- x _ r " .a t• tl, r P d S-. (� i W t l , _r� I r �f. , 7 / - . ( 'q I' ' 1'S' h J A/Rf sem.: h s I , �^�� J � ' �` ;_ ,• k' ,. a NORT#i Town of dover No. ZX3 ►- _ y T O - - LA E ori dover, Mass., COCMIC MEWICK SRATE D o'? C-1 1 BOARD OF HEALTH PERMIT T' Food/Kitche Septic System BUILDING INSPECTOR THIS CERTIFIES THAT . 4V 0... V Ww... Am- % ....A...z , Foun has permission to erect.... Sildings on ...... .. ...�....... All.... �..... Rough to be occupied as................ .. .... . �,... �r......:..�..A... .....N.......... .....rv.. ....... .... � Chimney Ch' provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and =MP ion ofBuildings in the Town of North Andover. BING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �` 146w1r) i ` Rough PERMIT EXPIRES IN 6 MONTHS P /� y/ s i 8 Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Roug ......... .. ...................... .................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 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NORTI{ ' lO�t�,,ao,aa u ? ,.,� .. .. ,� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING �SS�cHusE� This certifies that w V2.ti ' C E(r C ................. ........... ............... .............................. has permission to perform .....> t `^^ S `�t .............. ....... . ........................ . . wiring in the building of......... �.tZ.c>..c).�..v:.�.4') Co In I . . . ................................... • � ,� J �� 51_ ,North Andover, ass. at....... ll C.....................q............ Fee... Sl:�U.. Lic.No. 1..1. ��.......... .. P..�f2�',......... .... ..� fl.�r ELECTRICAL INSPECTOR Check # 1p WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THE COMMONi E4071OFAMS94GMSE77S Office Use only z DEH9IZ711ffiVTOFPUI3IICS9FE7Y Permit No. Jr BOARDOFFMPREV MONREGUTATIONSS27C MI2i 0 Occupancy&Fees Checked APPLICATIONFORPERART TOPERFORMLZE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (l (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 7 0 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work desccrifbed below. AP PARCEL Location(Street&Number) 5 e'-4,fit J T Owner or Tenant Owner's Address P6 j6oe Is this permit in conjunction with a building permit: Yes M No r_1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead ® Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work rye .e I 14Vf Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 1:3and No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burnes No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Dctection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local a Municipal Other Cormcctions N^,I'of Water Heaters KW No.of No.of Bailasis I." Hydro Massage Tubs No.of Motors Total HP OTHER- hwaixeCayumWa Rnmttothrm4mmulso11V1 madmgcttC wdILaws Ihaw act=1Liabhyhst m=P61qurhxkgCm4*1: . Covaageaitssulista�ale4tivalart YES NO a Ihaw%hn&dvilidptoofofsurletotheOffice YES a aveNo Ifyuhd>�dYES,p� ir�th eety ofw—mFbydred the BOND o OTHER o ftm ) Eslima1edVa1ue lWak$ WaktoSlait hWacdmDa1eRe4x*d Rotiol Firial SigrledimcirTie%nhiesofpajtuy: c FIRMNAME ►—e ry Lio rwi b f l 1 Lioanw 1 r 1 S A w t-4W CJ2 Sigtlahne L==J1 o BtnumTelNa t� ' AlTeLNa OWNNERSINSURANCEWAIVER,I amawatethatthe Licarsedoes riot tuethemamre cmuaF crits stalsbmbalegxvaleritasregiredbyMasmdms&ClaxmlLaws arldtlrv2mysigtrabaecnthispamitapplwaiu�thisreq�manart - (Please check one) Owner Agent F-J ''\\ Telephone No. PERMIT FEE$ , C/ Signature or Owner or Agent l Location No. C"7 ( Date A 61,?l TOWN OF NORTH ANDOVER pttJ° ,'ti'O p Certificate of Occupancy $ '- ° Building/Frame Permit Fee $ 'ss� asks Foundation Permit Fee $ Other Permit Fee $ '7 Sewer Connection Fee $ Water Connection Fee $ TO, $ S PAID 13Y CHECK .,- -� Building Inspector MAR 26 -1 Div. Public Works rER111T NO. 0 21 4 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. r G�� PAGE 1 MAP K40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE I SLIB DIV. LOT NO. -I LOCATION 't PURPOSE OF BUILD159 ��0 rjL �(�/f I � IdE / ' 6" OWNER'S NAME A-70 4r /Q NO. OF STORIES " SIZ OWNER'S ADDRESS /1 ,/ SAA&MeIgT-M SLAB ARCHITECT'S NAME �.l / b"('("�E SIZE OF FLOOR TIMBERS IST Z� (� 2ND 3RD BUILDER'S NAMEoeff f O J G SPAN J/ D -— DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET 30 d / POSTS DISTANCE FROM LOT LINES-SIDES 0 t REAR / O / GIRDERS 2- AREA OF LOT , Q FRONTAGE S HEIGHT OF FOUNDATION 4.J j 6 THICKNESS / L/ IS BUILDING NEW /�'� SIZE OF FOOTING I/X X IS BUILDING ADDITION r. i+ MATERIAL OF CHIMNEY IS BUILDING ALTERATION C' IS BUILDING ON SOLID OR FILLED LAND �Z WILL BUILDING CONFORM TO REQUIREMENTS OF CODE i /-:� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 166 �"� IS BUILDING CONNECTED TO TOWN SEWER O r V IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS y /s 3 PROPERTY INFORMATION J� v�.�l ©T`T Al S O LAND COST SEE BOTH SIDES ��"'"�' EST. BLDG. COST PAGE t FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FI D BOARD OF HEALTH SIG ATF OWNER OR AUTHORIZED A E /Z W OWNER TEL II PLANNING BOARD PERMIT GRANTED CONTR.TEL.tl --777--, 9 •,, 9Afi�CLi dL 4 19 9/ CONTR.LIC.H BOARD OF SELECTMEN BUILDING INBPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I StORIES 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 Q FOUNDATION —I E1 INTERIOR FINISH ` CONCRETE d 2 13 �— CONCRETE BL'K. PINE BRICK OR STONE HARDWD PIERS PLASTER V✓ALL _ UNFIN. 3 BASEMENT AREA FULL i FIN. B'M'TAREA J, /1 3/, FIN, ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOD _ MODERN KITCHEN 4 WALLS r I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �— WOOD SHINGLES EARTH _ ASPHALT SIDING HARDV✓'D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH.TILE —{I_ STUCCO ON MASONRY �— STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) , GAMBREL MANSARD TOILET RM. (2 FIX.) ' FLAT 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 i 6 FRAMING I 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'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL _ .. B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING ' ORTIy N 9 own o 6Andover. 0No. 086S DRIVEWAY ENTRY PEE MIT - er, Mass. a `i 2G 19 q I K ' —/ C ME ICK OR ? SS. BOARD OF HEALTH PERMIT T LD THIS CERTIFIES THAT...1®A�. . .... ........................................................ • OBUILDING INSPECTOR has permission to erect ®� ........ buildings on 421 SAAW.Arooir...rt�................ Rough � to be occupied as a � t' ►.� .Q ..Ac, i. .. ... Chimney ' 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. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS .CONST ION STARTS Rough Service • 00 Final '0 =- : • BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Dore Until tnspected and, Approved by Smoke Det. Building Inspector p .y5,Y7'�.�w+i`.'�• T, t t T t } i!• 1 'b�l i(I Ir } I DEPARTMENT OF PUBLIC SAFETY x 1010 COMMONWEALTH AVE. MASS.p2215 ENCLOSE CHECK OR MONEY ORDER FE MMONWEALTH def yl OF BOSTON,M t ASSACHUSETTS ! FOR REQUIRED FEE, LICENSE MADE AY Q.: �-p �r-�,a CpySTR. SUPERVI50RBLETO 19f-r • PUBLIC SAFETY" ON DATE LIC-NO. °.° EFFECTIVE DATE "COMMISSIONEROF0/1991 . 013624 pO-NOT�SENcases). TIONS 0 613 0119 8 9 m,E j 'im DANIEL E N1CCCINAGH�f r >F�' INCREASE 59 A LETONNAT0J845 PLEASE N� SS p 022-26-956$ EF'F F 0IV E FEB. J FEE: 1 PHOTO(BLASTING OPS ONLY( 1 00.00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMP OR SIGNATURE OF THE COMMISSIONER HEIGHT: / / 'F DOB: �/ � SIGN NAME IN FULLABOVE SIGNATURE LINE 01 /2711937 1!/VV SIGNA RE LICENSEE - THIS ED ON ENT MUST BE . + P•(C` 1 TONER CARRIED ON THE PERSON OF CQMM SS ' THE HOLDER S`A'OCC HEN ENG ED IN I OTHERS-FIGHT THUMB PRINT ^ - 2pOM.2-87-81429 , �- . I FORM U >i TOWN OF NORTH ANDOVER f LOT RELEASE FOR11 SUBDIVISION A ASSESSORS MAP /ylgP 9 /j c, a. SUBDIVISION LOT(S) PERMANENT ADDR S SSIGNT U.P.W. STREET / 2 / , � APPLICANT /o /?/� e / � /� PHONE DATE OF APPLICATION — 2- TOWN TOWN USE BELOW THLS LINE PLANNING BOARD DATE APPROVED TOWN PL NER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH �. DATE APPROVED HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. L 1, h t Z M D %(� RECEIVED BY BUILDING INSPECTION DATE QJ I This form shall be signed by the agents of the Planning and Health Boardst CQ the Conservation Commission prior to the issuance of any building; permi.tshZit for the subject lot. This form shall not releive the applicant from the - compliance of any applicable Town requirement or Bylaw. vz+ N } . +`iSTro dd�': id wd�,j� r '14�: / �'�tes...' •41' :.W.t � c T ��r,,f V �� /*jc , ' r. .i.,•, vtir LO _ x i �ti •� v+k p,� a �t s� b, Q f, ,, � ,AO ` � A��.'•'. 1. 4~ eft^ it�'"!@i'9H1 �C �� Fr��� � r �A'. r ` � � pct Win.` .�! • L 5 1,,�`c y r 'M'•�+�!c�� �r`kp ,.p. .�,�p• f 1 �..y# E.�f E,�, �( / j• i i y "b� ,,,��• § �'t � " •�' "`.r br Cyt, `�� '.v.wtc�q �• +.Sy�as ' �3' ��� � �°' rs s' a+��"•• P y4 }�$ fib 9 i t ( N Y �tV n x a '8" � +1°,p,.M LE" #� ^w�r� `P,•, kj.�7 ."1 C:+. c, �x r x'S � t� Y �Y ��c' ::55,��tt��"�4. >.y,.f', a+�1i.x.t �( a t r` X ^��'^' �r;• 'r `� '3`h �i 41,�3''i`✓''F�:s � �i n .:;c; � t,��t�f.��, �: �kk ��„i�„ t" T \ ^\�. UA�..—� , F � M n t I POND