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HomeMy WebLinkAboutMiscellaneous - 135 BLUE RIDGE ROAD 4/30/2018 Q, 135 BLUE RIDGE ROAD 210/065.0-0199-0000.0 Location/156r06 1-6-e /��ortn l�l No- q (/ Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee ""r Foundation Permit Fee $ � Other Permit Fee $ • ������ TOTAL $ • Check# V S 25372 Building Inspector t ' The Commonwealth of Massachusetts a Re tlations and.Standards Board of Building g' Code,780 CMR Massachusetts State Building Renovate Or Demolish a Revised Building Permit Application To Construct,Repair, March 2011 One-or.Two-Family Dwelling s Section For Official Use Only Date Applied: Iailding Permit Number: 7r'1 Signature a�g fficial(Print Name) TION SECTION 1:SITE FORMA &parcel Numb s Nc 1.2 Asse sots Map LProperty Address:. C, Q parcelNuryiner \U 6Map N no umH Ila Is this an accepted street?yes 1,4 Property,Dimensions: 13 'ring f rmation: Frontage(ft) Lot Area(sq ft) ping District Proposed Use Setbacks(ft) Rear Yard Lrs Building Front Yard Side Yards provided Required provided Provided Required . R�t"red 1.8 Sewage Disposal System: c. ,§ 4) 1.7 Flood Zone Information: Municipal site disposal system G.L ❑ at (M• 405al❑ On 1j Wer Supply: Zone: _ Outside Flood Zone? p Check if yes private❑ ❑ 1 Ptslic PROPERTY OWNERSMP SECTION 2:. � L r ®owner'of Record: ;� n , 1 City,State,ZIP Nene(Print) �O „Q; �� �j'� Telephone Email Address U 1 lJ�t l— Bim( ✓ and StreetROPOSED WORKZ(check all that apply) SECTION 3:DESCRIPTION OF P [3 Alteration(s) 13 Addition ❑ w Re Tai Accessory Building❑ Owner-Occupied ❑ P Nnw Construction❑ Existing Number of Units Other [3 Specify: � Danolition [3Accessory Bldg.❑ 2: Bfef Description of proposed Work r 11 TIMATED CONSTRUCTION COSTS SECTION 4:ES Estimated Costs: Official Use Only RIM abor and Materials Permit Fee:$_—Indicate how fee is determined: 1. Building Application Fee l.luilding $ [3Standard CitylTown App x $ E3ta Total Project Cos (Item 6)x multiplier 2.Ekctrical $ 2. Other Fees: 311umbing List: 4.Bechanical (HVAC) $ 5.Nechanical (Fire $ Total All Fees:$ Cash Amount:-- S ession Check No..Check Amount Ba—Balance Due:_ 6.Total Project Cost: $ ❑Paid in Full ❑Outstanding SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 0 122 1?- t License Rumber Expiration Date i e of CSL Holder C �j i List CSL Type(see below) - R&-C No.and Street l •I I n T Description Y J U Unrestricted(Buildings up to 35,000 cu.ft. R Restricted 1&2 Family Dwelling City ,Sta Z M Masonry RC Roofing Covering WS Window and Siding , SF Solid Fuel Burning Appliances V(.P�.P (Dl I Insulation Telephone Email address D Demolition 5. Registered Home Improvement Contractor(HIC) an fcx� (,Q 7- i 11 ►-)q-i HIC Registration Number Expiration Date HIC Co an Name or HIC$e 'strant Name C E— X o.and Street. Email address �Ld& M �50-1..SOD Ci /Town,State,ZIPJ Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(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 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize ��� HjG�'1 to act on my behalf,in all matters relative to work authorized by this building permit application. C P C N LIQ Print Owner's Name(Electronic Signature) Date J, SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION vvv By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. �01hee 5��n �� a Prin er's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program.can be found at www.mass.gov/oca Information on the Construction Supervisor License,can be found at www.mass.gov/dys 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" Masoachuuem- Department of Public Safet" Board of Ruildinf: Rcitulationv and Standard• Construction Supervisor License License: CS 91377 BRIAN F HESSION • �:�� ' 2 PATRICK RD TEWKSBURY, MA 01876 Expiration: 1019/2012 Q'omme.vinncr Tr#: 4623 C ` w4a 6a Office of Consumer Affair anBuSlness Regulation 10 Park Plaza m Suite 5170 Boston9 Massachusetts 02116 Hoarse Improvement Contractor Registration Registration: 162111 Type: Supplement Card NEXT STEP LIVING INC. Expiration: 1/14/2013 BRIAN HESSION 25 DRYDOCK AVE. 5TH FL BOSTON, MA 02210 - Update Address and return card.Mark reason for change. -04/04-G 1216 Address F—] Renewal )Employment � ]Lost Card 11j0// p �/3ZE TpG�7Y�IZO I2Gl�E�G(/2 �✓I�GLCdddTi>�d�b ffice of Consumer Affairs&Business Regulation ]License or registration valid for individul use only DME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer affairs and Business Regulation Registration:-'162111 Type: 10 Park Plaza-Suite 5170 Expiration 1/:14/20`13 Supplement Card ]Boston,IVIG 02116 :P LIVING INC" , :SSION )CK AVE 5TH FL MA 02210 ''' Undersecretary Not valid withouF-S ature The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.00v/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers and Gas Applicant Information Please Print Leaibly NAME(Business/Organization/Individual) SkERL-Im L ADDRESS: CITY/STATE/ZIP: Are you an employees Circle the appropriate number: Type of project(required) rWF7 1.1 am an employer with 4. 1 am a general contractor and I have hired the 6.New construction employees(full and/or part-time)• subcontractors listed on the attached sheet.These 7. Remodeling subcontractors have workers'comp insurance. 8. Demolition 2.1 am a sole proprietor or partnership 9. Building addition and have no employees working for 10.Electrical repairs or addition mein any capacity(No workers'comp 5. We are a corporation and its officers have 11.Plumbing repairs insurance required). exercised their right of exemption per MGL 12.Roof re � c.152,section 1(4),and we have no 13.Other (JJ a1V`t \ 3.1 am a homeowner doing all the employees (no workers'comp insurance work myself(no workers'camp required). insurance required). Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work&then hire outside contractors must submit a new affidavit. Contractors that check this box must attach an additional sheet showing the subcontractors&their workers comp Policy info I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. ATK Insurance Company Name: L.�ce_CcD. 197V*AW— 111Policy#or Self-ins Lic#: ;• r Expiration Date: / ' / 1 Z Job Site Address: City/State/Zip ; Attach a copy of the workers'compensation policy declaration page(showing the policy#and expiration date). FAILURE TO SECURE COVERAGE AS REQUIRED UNDER SECTION 25A OF MGLc.152 CAN LEAD TO THE IMPOSITION OF CRIMINAL PENALTIES OF A FINE UP TO$1,500.00 AND/OR ONE-YEAR IMPRISONMENT,AS WELL AS CIVIL PENALTIES IN THE FORM OFA STOP WORK ORDER AND A FINE OF UP TO$250.00 A DAY AGAINST THE VIOLATOR. SE ADVISED THAT A COPY OF THIS STATEMENT MAY BE FORWARDED TO THE OFFICE OF INVESTIGATIONS OF THE DIA FOR INSURANCE COVERAGE VERIFICATION. 1 HEREBY CERTIFY UNDER THEP 13PENALTIES OF PERJURY THAT THE INFORMATION PROVIDED ABO VE IS TRUE AND CORRECT. SIGNATURE: r DATE I I2 TELEPHONE#;( Go3) IM-%SS ep a Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License#: Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.CitY!Town Clerk 4.Electrical Inspector 5. Plumbing&Gas Inspector 6. Other Contact Person: Phone#: CERTIFICATE OF LIABILITY INbUKAN6t 11/29/2011rr,Y, R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIIQATION gher Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICgT6 Ga a HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Ice Brokers,Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES SFLOW, antic Avenue MA 02210 INSURERS AFFORDING COVERAGE NAIL- INSURER A: One Beacon Insurance Company 21970 Next Step Living,Inc. INSURER B: A.I.M.Mutual Insurance Co. 33758 25 Drydock Avenue INSURER c: Riverport Insurance Company 36684 5th Floor INSURER D: Hartford Fire Insurance Co. 19682 Boston,MA 02210.2600 INSURER E: AGES )LICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING EOUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR ES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED RI ED HEREIN IS CLAIMS-SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH TYPE OF IN URANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABIUTY 792000560 1111112011 11/1112012 �&AcHuRRENCE s�00(01�� O RENTED S X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MED EXP(Any an POMOTI) S10 000 PERSONAL BADV INJURY $1.000,000 GENERALAGGREGATE 1$2.000.00 . GEN'L AGGREGATE.LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $1 000 000 POLICY PRCT LOC AUTOMOBILE LIABILITY 390001209 1111112011 1111112012 COMBINED SINGLE LIMIT (Ea accident) 51,000,000 ANY AUTO ALL OWNED AUTOS 8001LY INJURY $ (Perperean) X SCHEOULEDAUTOS X HIRED AUTOS BODILY INJURY S (Per accident) X NON-OWNED AUTOS PROPERTY DAMAGE S (Per accident) AUTO ONLY-EA ACCIDENT S GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESS!UMBRELLA LIABILITY 792000561 711/1112011 1111112012 EACH OCCURRENCE 1_3.000.000 X OCCUR CLAIMS MADE AGGREGATE a3 OOO 000 I . S DEDUCTIBLE S S RETENTION S WC STATU- OTH- 'ORKERS COW0118ATION AND 71733286 1111112011 1111112012 X MPLOYER3'UAIRM NY PROPRIETOWPARTNERIEXECUTNE TBD106767 1111112011 1111112012 E.L.EACH ACCIDENT iSOO OOO 95601-AW EXCLUDED? E.L.DISEASE-EA EMPLOYEE 3SO0.000 yes,dexdbi,uu�^Mde� r E.L.DISEASE-POLICY LIMIT 90,000 PEiCIAL PROVISIONS below 1THEIR .: 'roperly DSUUMHX5485 1111112011 11111/2012 $212,594 IPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS nFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Evidence Of Insurance DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL ,_.30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL . IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE' IRIO 25(2009101)1 of 2 $tS2394911M239489 © 8 -200 CORD CORPORATION. All rights reserved. next step living own home efktency,made Bary This agreement is made by and among Not Step Living,Inc.('NSV) Cornelius Cronin 25 Drydock Avenue tic floor 135 Blue Ridge Rd Boston,MA 02210 North Andover,MA 01845-2149 Customer ID:C00000061382 Cetttraet ID:20120321 ASEAL Site ID:800002051366 — 1. DESCRIPTION OF WORK TO BE PERFORMED NSL will perform orcause to be performed the folbwing work on the crrstomees address above,In a professional manner and In accordance with the terns of this Contra4 including the attached reoommendatbnslwork order describing the work in detail(the'Work')which are Incorporated herein by.reference: Description Quantity Location Therr a-0ome(1119)with carpentry(Attic) 1 LMng Space $209.63 Perform Air Seating at Estimated 62.6 CFM50 Per Hour 18 LMng Specs $1,364.60 Sub Total: $1,664.13 Energy ENlclenay Incentive $1,564.13 Not Sales Tax After Incentive $0.00 Total $0.00 Printed:3121f2012 Page 1 of f 2. PAYMENT:CUs OMER agrees to pay NSL for the work as follows: Payment#1:$ Credit Card or E�ch deposit Is due at the Ume the Work is tom.Required payment Information will be collected over the phone by a customer service representative at the time of scfadulirg.Deposit Is not to exceed 113 of the total retail costs.This contract is not in effect until this deposit Is paid by the Customer.(Note:Mastercard,Visa,and Discovera�ocyelp��d) -- AdditlonalPayments and Finallnvoba:$�) Addido I payments for the Work shall be due upoK completion of the Work 4s C.toN:ti Mar 22, 2012 rS re to N Sig re Date Name of NSL Representative The Terms of this Agreement are contained on both sides of this page Next Step Living 25 Dry"Avenue-5e floor•Boston,MA 02210-(666)867.6729 Inqulry@nexbteplMnglnacom o www.nextsteplivinginacom Document Integrity Verified EchoSign Transaction Number:LEIPCB7B2N7XXE NORTH , 0 0ndover 0 No. 4}.( o ; dover, Mass., b • 6' Y O - LAKE COCHICHEWICK 7�ADRATED p �C2 S BOARD OF HEALTH Food/Kitchen Septic System ..PEnMIT T .. BUILDING INSPECTOR THIS CERTIFIES THAT............................... .. `........................... Foundation A 4 has permission to erect..... .... :.......................... buildin s on .... Rough ......................................................................... to be occupied as �. �.... Chimney . . . . . . . . . . . .. . ............... ... ... provided that the person accepting this permit shall in every res ct 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 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC TS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do- Not Remove Final No Lathing or Dry Wall To Be Done FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner a Street No. SEE REVERSE SIDE Smoke Det. r t �y� Xocation No. DateOf AOR, TOWN OF NORTH ANDOVER p Certificate of Occupancy $ /" 3 . � Building/Frame Permit Fee /.D cJ ��� ^°•''t�' Foundation Permit Fee -�- Ss�cMuse Other Permit Fee $ Sewer Connection Fee Water Connection Fee TOTAL $ /�o'!1 Building Inspector 5194 (79;19 "M-00 RAID 1 7030 Div. Public Works PF�ait1T NO. APPLICATION R PERMIT TO BUILD — NORTH ANDOVER, MASS. tZ PAGE 1 MAP 4-40. LOT NO. -� 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE — ZONE I SUB DIV. LOT NO. �I LOCATION RPOSE OF BUILDING _ OWNER'S NAME A NO. OF STORIES SIZE OWNER'S ADDRESS 'T BASEMENT OR SLAB /-" ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1S ��1!!D 2NDG/�!/�! !U 3RD BUILDER'S NAME SPAN /L�� DISTANCE TO NEAREST BUILDING /�/� DIMENSIONS OF SILLS DISTANCE FROM STREET ` `�/ POSTS v� DISTANCE FROM LOT LINES—SIDES /� �/REAR �J�/Y GIRDERS T AREA OF LOT �� 7- U AA/ FRONTAGE //�j / HEIGHT OF FOUNDATION /0 �' THICKNESS IS BUILDING NEW { y s v SIZE OF FOOTING 7Sx �, X IS BUILDING ADDITION 7 MATERIAL OF CHIMflrEY I� IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 'may WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY eolT 7 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE/ INSTRUCTIONS 3 PROPERtY INFORMATION % LAND COST l D SEE BOTH SIDES EST. BLDG. COST ��0 EST. BLDG. COST PER SQ. FT. O .y� PAGE 1 FILL OUT SECTIONS 1 - 3 rI' EST. BLDG. COST PER ROOM rya PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. Q ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROvpb BY BUILDING INSPECTOR DATE FtIeEl BOARD OF HEALTH SIG URE OFWNER O THORI D AGENT F E E zo, U PLANNING BOARD PERMIT GRANTED 11-1 S 19 1 BOARD OF GELECTMIEN OWNER TEL.# CONTR.TEL.# CONTR. LIC.# .q (`,��/ 6 BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY siORIES 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 —I 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D —— PIERS PLASTER — DRY WALL UNF!N. 3 BASEMENT AREA FULL FIN. BM'TAREA _ 7, 1h 'l, 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 HARD"J D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR If POOR p ADEQUATE 1 NONE 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) _ GAMBQEL MANSARD TOILET RM. 12 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 6 FRAMING II 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 -_ IL B'M'T 2rd O _ ELECTRIC 1st 13rd NO HEATING a'7 } 'tocation '61' ,lo/ /ZV No. S�c�' Date /- L ,.ORTFTOWN OF NORTH ANDOVER O?C'tt. e '•��ow Certificate of Occupancy $ d C)40'r 5111F c) Building/Frame Permit Fee $ `�- r►�s°+,"°'�t�' CH Foundation Permit Fee $ /00• y b s� e Other Permit Fee $ a Sewer Connection Fee $ - — t Water Connection Fee $ -"'"-- TOTAL $ a Building Inspector lOtI9 (53.03 PAID J 674 ■7 ` Div. Public Works -Location 35 2U R:e( No. � r Date( lb-z7--93 NORTH p TOWN OF NORTH ANDOVER ���eo ,e1�0 Certificate of Occupancy $ . °, . . , Building/Frame Permit Fee $ Foundation Permit Fee $ sACMUs Other Permit Fee $ /Ilb Gly Sewer Connection Fee $ /6YO A&a>Z Water Connection Fee $ la29 TOTAL Building Inspector. t .. i'[ 2.t7(?. XW a 6501 Div!Pubfic Works PER:111'C NO. i`� S APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. �f� fU 9V 1'-'e Lell PAGE 1 MAP d40. �" I LOT NO. �L� 2 RECORD OF OWNERSHIP jDATE BOOK 'PAGE ZONE ✓� SUB DIV. LOT NO._/y� ` LOCATION PURPOSE OF BUILDING S;Y► ��Q_ .�/1 L`U,NI Q OWNER'S NAME — NO. OF STORIES SIZE Y�L 1T r�„O`ysF�i�y�. s � OWNER'S ADDRESS t d BASEMENT OR SLAB n/k„ ARCHITECT'S NAME ` -� �7-/ SIZE OF FLOOR TIMBERS 1lS�TI�YC2 'D 2N�,o 3RD ax_ BUILDER'S NAME AAAK R� /L.1.- SPAN -- �) DISTANCE TO NEAREST BUILDING &C)/ DIMENSIONS OF SILLS DISTANCE FROM STREET � / POSTS DISTANCE FROM LOT LINES-SIDES _7 a•G _f,'REAR GIRDER'S ) AREA OF LOT 4151�jq// -�r FRONTAGE �l�) HEIGHT OF FOUNDATION THICKNESS �Q IS BUILDING NEW - . Yoe SIZE OF FOOTING X IS BUILDING ADDITION r MATERIAL OF CHIMNEY �" IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE v 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 LAND COST SEE BOTH SIDES _ NNi Y" r t"lr..w��jy EST. BLDG. COST Ir/ar��rrrrr.r..� _ am PAGE 1 FILL OUT SECTIONS 1 - 3LM JM i] EST. BLDG. COST PER fQ. FT. / /� PAGE 2 FILL OUT SECTIONS 1 - 12 DW fWM EST. BLDG. COST PER ROOM VV r• 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 FILED a vlow-- BOARD OF HEALTH " SIGNATURE OF ONNO OR ZAUTHZE T Ir / F E E OWNER TEL.# PUNNING BOARD PERMIT GRANTED Y CONTR.TEL.# 19 CONTR.LIC. BOARD OF GELECTMEN BUILDING INSPECTOR r t � BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOF 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 t 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER t _ DRY WALL 1 UNFIN. ` 3 BASEMENT I �, AREA FULL FIN. B M AREA _ 14 '/l 1/ FIN. ATTIC AREA _ N_O B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDtU'D ` ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. 6 FLOOR _ ^r�'.-- BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING �e,,�� STONE ON FRAME ....�,....re-4y���CrT.$'tV� IMAM 30 SUPERIOR 1_1 222R ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEP BATH 13 FIX.) GAMBREL HIMANSARD 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 1 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'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING t FORM U - IAT 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: Mgt<�R E Phone i i LOCATION: Assessor's Map Number _ Parcel Subdivision �'�ax- �� Lot(s)�) Street 1t �1 �� St. Number r J - ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: c�4}(e Date Approved r0 Z Conservat' mi istratorr Date Rejected Comments e IBeC. )A-3 .10 I �P gay 5�t1JW,t C�'��'''.V&g G�re3s���taks� e° tet a�x 5c D t/ 1 n St�f i• Date Approved 1 24 BrYr�-�A C�t�.rP Q 0 Town Planne Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Jeupotic Inspector-Health &�,_ n Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date �U aLQ TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET,01845 ti GEORGE PERNA TELEPHONE(508 °' .... ..,`�° )685-0950 DIRECTOR o• = ••x °^ FAX(508)683-9381 i DRIVEWAY ENTRY PERMIT r Date: Highway Department Telephone : 685-0950 LOCATION l 5 1310e 10:�e- 4�,( BUILDER L/� TEL: 0 -:5— 79 7 ovam TEL: The North Andover Superintendent ofHigbway Utilities&Operations MUST be notified of the de and set-bac„khvm street established is any driivewayentry onto any street or way maintained by --- dieTown _�the.HighwMy Superiatendeat's OA'Wcc beforc finish grading_sad-surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Superintendents Remarks &Approval Below Remarks: Approval: oQ:a- i p _ \ r � _ R 60.00 L 88.65 _ rh Y f �cp Z _ P_POSED DWELLING FFF 166.5 � .Q FBF = 158.5 ) �OAM SEED — COLS Z-5 o112 n h PT 146 48,704 S.F. A 71 ,A� CERT/F/ED f'O�lt/DfN P: LQN -� LOCATED /N SCALE:/ .= DATE ' 2 9 S Scott L. G//es R.L.S. 50.Deer Meodow.Rood North,Andover,Moss: c i L0T t 1 `t I 3 � 7..:'50 ♦ . vE R 174-.&0 o WING DEPARTMENTi i / CER T/FY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE SU/L DING/NSPEC TOR ONL Y , SHOWN COMPLY - Q SUCH USE/S FOR THE; :.- WITH rHEZON/NG ;DETERMINATION OF ZONING-. 'te t SY'L AGYS OF CONFORM/T Y OR`;NON-GONFORNI/TY :11tO.�WC�NCR ht'A► EN .COWTA UC' . WHEN 901L t :��: "i� i�'; I'..�y� � l i �` � � . J � !4 � �� {y�+ we..a.r..... -v.. « �r�..�a�7 %O So�� ��. or���t�1/U NpRTN Town of Andover O0% No. 5 5 S �;r�Y r��,y`L,i: f F dover, Mass., N&06 .2 IF 1993 ' COCHICHEWICK V ORATED Cl S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ! BUILDING INSPECTOR THIS CERTIFIES THAT........ ........A.�. �.,c��`.C.����7 �i`.�.�..�.y.. Foundation has permission to erect #*".. buildings on .. �iS �.�+ .1. ..."••"•'•• Rough to be occupied as%f.I..> ............. .1.40.. . .. .. �.� � � .. Chimney provided that the person accepting t s permit shall in every respect conform to th n %fin Final this office, and to the provisions of the Codes and By-Laws relating to the Inspe f Buildings in the Town of North Andover. 4•$-S. &C. 9 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. _ Rough D 2/ FE PPJD � Final PERMIT EXPIRES IN 6 MONTHS. 'd v ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS PERMIT FOR FRAME/BUILDING40 YJ Rough �]...... . . ... .. ......4b... ... .. ... ....................... Service . y 0 it�G'! BUILDING INSPECTOR Final DATE: 25. FEE PAIrILL .,r. � 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. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FI NAL DRIVEWAY ENTRY PERMIT - �i, l'..id_..acaa_:.ILw L'.T.a...a�U1i:l,iuSa4•I�..� .1:':1:. A._al= __—I _ - rie.........�......�._ _ CERTIFICATE OF USE & OCCUPANCY ,.--� y►,.� Y/*szf:Jin r� �:,tee•,a'A� ' a' n Building Permit Number 558 (1993) Date AUGUST 24,_1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON 135 BLUE RIDGE ROAD (Lot #146) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR GARAGE IN ACCORDANCE WITH THE PROVISIONS OF THE ONS AS MAY APPLY. STATE BUILDING CODE AND SUCH OTHER REG CERTIFICATE ISSUED TO Tos�TIh Rarhaaa110 120 Duncan Dr. ADDRESS nth Andmmr, MA - Building Inspector .' RTf,� TO" o .ori ;_ over No.5 5 8 PPPPPP` 0 �Nort Y dover, Mass., NOy• � �1977 4— <°r. rEo =.IU BOARD OF HEALTH ` Food/Kitchen .; Septic System .i PERMIT TO ILD © BUILDING INSP CTOR THIS CERTIFIES THAT........�i ....... . �.,G.,�s... j �.I... .. .y. Fo t � r. has permission to erectA*��... buildings on .. . ..... Rough 4L11 Ch �l imney to be occupied as1�. .+t `.t!!..... .ft /.. r.. �.�!l .......... x pr�uvided that the person accepting t shall in every respect conform to th n Final O>X' Z3 this office, and to the provisions of the Codes and By-Laws relating to the Inspe ol 4.8-5. B.C. --- Buildings in the Town of North Andover. R�u1A►¢.B3I 7 I sy TOR VIOLATION of the Zoning or Building Regulations Voids this Permit. DATE ��_ FEE PAID : _1P d mWY0 1 EL CTRIICAL OR I& PERMIT FOR FRAME/BUILDING1 .11010 Rough .......................04M. .........C Servic� BUILDING INSPECTOR DATE: ` FEE PAID• �' v Final 0CCIq-)C7.,tcy I C1"??1 r C Reqi ()ped to GAS INSPECTOR Rough / Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner 6/2,/ �— ® F-q L CONSERVATION �I a FINAL street N°. 14 �} PLANNING , � � Smoke Det. l '+ QMAMP /IAIOTFR ti r FINAI DRIVEWAY ENTRY PERMIT