HomeMy WebLinkAboutMiscellaneous - 136 RALEIGH TAVERN LANE 4/30/2018 136 RALEIGH TAVERN LANE
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9061 Date. � .:� �� . .f�.
TOWN OF NORTH ANDOVER
p PERMIT FOR PLUMBING
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This certifies that . . .r -.QL4. . . . S.tn.�'►'��r`.�o �:�� `,
has permission to perform . P.:.s.ku -A
plumbingin the buildings of . . .�C-r°.7. . . . j .. ... . . . . . . . . .
at .) If-).�k . . ., North Andover, Mass.
Fee.33•civ. .Lic. No..�33. . . . . .!.� . . w
PLUMBING INSPECTOR
Check # Wi 32
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: , MA. Date: �lPermit#
Building Location:L5(0 I
/wtiers Name:Ak'
Type of Occupancy: Commercial ❑ Educational❑ Industrial ❑ Institutional ❑ Residential
New:❑ Alteration:❑ Renovation:❑ Replacement: [I]� Plans Submitted: Yes❑ No❑
FIXTURES
DEDICATED
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3 3 3 o a 3
SUB BSMT.
BASEMENT
1 FLOOR
2N"FLOOR
3"FLOOR
4T"FLOOR
S FLOOR
6T"FLOOR
7 FLOOR
8 FLOOR
L r.
Installing Company Name: G Check One Only Certificate#
T
C rporation
Address
City/Town: State:
❑Partnership
Business Tel010� " a37' Fax: ElFirm/Company
Name of Licensed Plumber:
A be-r�-
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yes VAIIO�❑
If you have checked Yes,please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Signature of Owner or Owner's Agent Owner ❑ Agent E]
1 hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my
Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Cha ter 142 of the General La
By Type of License:
Title ❑Plumber S6ifature of LicensedMumber
City/Town ®�IOlaster �1
APPROVED OFFICE USE ONLY) ❑iourneyman License Number:
Location /36—
No.
36—No. /4 'S Date Y A< Z
NORTN TOWN OF NORTH ANDOVER
F A Certificate of Occupaw $
�e Building/Frame Permiree
cHusEs Foundation Permit Feep- $ 10—
O
Other Permit Fee m
Sewer Connection Fee o $
Water Connection Fee -$ tr
TOTAL �$
Building Inspector
Div. Public Works
1 {
PERJtrI NO. 1; APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP "DATE BOOK "PAGE
ZONE I SUB DIV. LOT NO.
OCATION f"� -�_� - _ nom PURPOSE OF BUILDING E•/�00\- ,WC`LIV�- (DV�Y(� -/�gi��'jZ
vOWNER'S NAME NO. OF STORIES SIZE
_,OWNER'S ADDRESS BASEMENT OR SLAB
414
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD
,,BUILDER'S NAME SPAN
—
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET "' POSTS
DISTANCE FROM LOT LINES-SIDES 'REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION - IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
s PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES -'-bLEST. BLDG. COST
PAGE 1 FILL OUT SECTIONS i - 3
EST. BLDG. COST PER 94. FT.
PAGE 2 FILL OUT SECTIONS 1 - 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 FILE -
/ BOARD OF HEALTH
SIGNAT E OF NER OR AUT ORI D AGENT
—
F E E
OWNER TEL.# s / / PLANNING BOARD
PERMIT GRANTED
CONTR.TEL.
19 y CONTR.LIC.#
BOARD OF SELECTMEN
MP 15 1992
BUILDING INSPfiCTOR
7. f!` F -I(. F r--1 SIS^f^0
�I � n
BUILDING RECORD
1 OCCUPANCY _ 12
SINGLE FAMILY STORIES ✓ r , ` A
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 `
t
2 FOUNDATION _ 8 INTERIOR FINISH
CONCRETE 3 1 2 13
CONCRETE BL K. —{ PINE
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY WALL
UNFIN.
3 BASEMENT
AREA FULL FIN. B M AREA _
Y. '/i 1/1 FIN. ATTIC AREA _
NO B-M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS II 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDY-/'D _
ASBESTOS SIDING COMLACN
VERT. SIDING ASPH. TILE —{I_
STUCCO ON MASONRY �—
STUCCO ON FRAME
BRICK ON MASONRY l \ ATTIC STRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I--1 POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE I HIP BATH (3 FIX.) _
GAMBFEL MANSARD TOILET RM. (2 FIX.( _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK r 1
SLATE NO PLUMBING _ \
TAR & GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES -
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPE LESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
1
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 t
1st 13rd I NO HEATING
�1
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0
i
ANDOVER CHIMNEYS
640 South Union Street
LAWRENCE, MASSACHUSETTS 01843
September 10, 1992
Brooks Ferguson
136 Raleigh Tavern
North Andover, MA 01845 682-6851
Roof Contract
Install a new roof with GAF 25 year Fiberglass Shingles
Install 5" aluminum drip edge on horizontal and vertical
perimeters
Silicone chimney with materials provided by Mr. Ferguson $2100.00
Deposit required - half
Balance upon completion
Andover Chimneys is fully insured
for Workers Compensation by Liberty
Mutual Ins. Co.
Agency: Howe Agency
Andover
Limited Warranty enclosed
vid AHawk ns 1
G.B. Ferguson
136 Raleigh Tavern Ln.
N. Andover, MA 01845
(508) 683-5139
Sept. 10, 199Z
ENTER DATE OF TRANSACnON
G
NOTICE OF CANCELLATION
You may cancel this transaction,without any penalty or obligation,within three business days from the above date.
If you cancel,any property traded in,any payments made by you under the agreement,and any negotiable instrument
executed by you will be returned within ten business days following receipt by the Contractor of your cancellation
notice. And any security interest arising out of the transaction will be cancelled.
1 the Contractor at our residence
in substantially as good condition as when
If you cancel you must make available to y Y
Y �Y
received,any goods delivered to you under this agreement;or you may,if you wish,comply with the instructions of
the Contractor regarding the return shipment of the goods at the Contractor's expense and risk.
If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty days of
the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you
fail to make goods available to the Contractor,or if you agree to return the goods to the Contractor and fail to do so,
then you remain liable for performance of all obligations under the agreement.
To cancel this transaction,mail or deliver a signed and dated copy of this
Notice of Cancellation or any other written notice,or send a telegram to
Andover Chimneys
(NAME OF CONTRACTOR)
at 640 South Union Street Lawrence, MA 01843
(ADDRESS OF CONTRACT'OR'S PLACB OF BUSINESS)
NOT LATER THAN MIDNIGHT OF .
(DATE)
I HEREBY CANCEL THIS TRANSACTION.
(DATE)
(OWNER'S SIGNATURE) (OWNER'S ADDRESS)
[Two copies of this form to be attached to the Residential Contracting Agreement]
H-GG 25M 6/92
4
LIMITED WARRANTY `
Andover Chimneys warrants , for a period of five ( 5)
years , that its labor has been done in a reasonable and
workmanlike manner relative to the installation of roofing
materials .
Andover Chimneys is not responsible for any
pre-existing conditions of the premises including , but not
limited to , rotting , insect infestation , general
deterioration , improper venting, flashing or any other
conditions which were not directly caused by Andover
Chimneys .
Andover Chimneys shall not be responsible for any damage
done to the roofing shingles as a result of excessive winds ,
storms , excessive rains , ice backup , tornadoes , hurricanes ,
or other weather or acts of God which is excessive, unusual
or unanticipated.
Andover Chimneys shall not be responsible to repair any
conditions relative to the premises worked upon other than
the installation of roofing materials or other labor and
materials specifically referred to in the contract entered
into between the parties .
The materials provided by Andover Chimneys shall only be
subject to. the manufacturer ' s warranty . No warranty either
expressed or implied has been made by Andover Chimneys .
LANNtNIG ANAL . N ERVATION y_: 4�° 1NA�. SEWER/WATER , FINAL
own of ndover
`0
Na fr �+
415
DRIVEWAY ENTRY PERMIT to 1999
-
DRIVEWAY Mass., 19
0/F
ld
I BOARD OF HEALTH
PERMI
1 LD
THIS CERTIFIES THAT........... ` 1�t�Zf .. ......... .................................
Cs•...IV
BUILDING INSPECTOR
has permission to R .. `ft... ........ buildings on `
Rough
�! 0"Dw ,a / IN. �� / Chimney
tobe occupied as... ............�............ ....... ..... .....�.`.!� ............. 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
Rough
UNLESS CONSTRUCTION STA TS Service
Final
....... .. ... .. .. . .......... ..... ..... ........
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, Done Until Inspected and Approved by Smoke Det.
Building Inspector
Xe
HOME IMPROVEMENT CONTRACTOR
Registration 101752
Type - DBA
Expiration 06/29/94
t
Andover Chimneys
David A. Hawkins
640 South Union St
ADMINISTRATOR Lawrence MA 01843
II
Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use Only NAME OF CITY/I'OWN
Permit No. 4 1 S tV o E'vy;c Pv%a-t,.0 1_
Date 4• I —9�
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the"reconstruction alteration renovation repair,modernization,conversion,inprovement,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 exceptions,along with other
requirements.
Type of Work: Est.�ac>t� 1)t�C��aCv� Est. Cost 1 r�
Address of Work____L
Owner Name:
Date of Permit Application: 0' —
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
_Job under $1,000
_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 FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a per a e agent of e own
`��6-9y io i 76,2,
Date 7- Co?� actor Mafne Registration No.
OR:
Notwithstanding the above notice, I herebyapply for a permit as the owner of the above property:
Date Owner Name