HomeMy WebLinkAboutMiscellaneous - 137 WEYLAND CIRCLE 4/30/2018i
MetLife Auto & Home®
Homeowner Operations Field Claim Office
Mail Processing Center
P.O. Box 2201
Charlotte, NC 28241
(800)854-6011
MV 08-OL00630
March 11, 2014
North Andover Health Department
1600 Osgood St
Suite 2064 MAR 1 � 2014
North Andover, MA 01845C�,�:,n,
�iE_A; `n DFPARTMEN?
Our Customer: Christopher Conway
Our Claim Number: JDE13993 4X
Date of Loss: March 5, 2014
Dear Sir or Madam:
Pursuant to M.G.L. 139 § 3B, please be advised that a property loss at the address referenced below has -_
been estimated to have damage to the dwelling or other structures that will exceed one thousand dollars.
Please let us know within ten (10) days if there is a pending or existing lien against the property as =_
provided by M.G.L. 139 § 3B, or if there is an intent to initiate proceedings to perfect such a lien.
Loss Location: 137 Weyland Cir North Andover MA 01845-4935
Sincerely,
Larry Branco – FLD - DR
Metropolitan Property and Casualty Insurance Company
Senior Claim Adjuster
(800) 854-6011 Ext. 7177
Fax: (866) 958-0736 _
Email: lbranco@metlife.com
MetLife Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its Affiliates, Warwick, RI
MPL BLANK Printed in U.S.A 0698
MetLife Auto $ Home®
Homeowner Operations Field Claim Office
Mail Processing Center
P.O. Box 2201
Charlotte, NC 28241
(800)854-6011
e Li
March 11, 2014
North Andover Building Inspection
1600 Osgood St
Suite 2035
North Andover, MA 01845
Our Customer: Christopher Conway and Renee M. Conway
Our Claim Number: JDE13993 4X
Date of Loss: March 5, 2014
Dear Sir or Madam:
Pursuant to M.G.L. 139 § 313, please be advised that a property loss at the address referenced below has
been estimated to have damage to the dwelling or other structures that will exceed one thousand dollars.
Please let us know within ten (10) days if there is a pending or existing lien against the property as
provided by M.G.L. 139 § 313, or if there is an intent to initiate proceedings to perfect such a lien.
Loss Location: 137 Weyland Cir North Andover MA 01845-4935
Sincerely,
Larry Branco — FLD- DR
Metropolitan Property and Casualty Insurance Company
Senior Claim Adjuster
(800) 854-6011 Ext. 7177
Fax: (866) 958-0736
Email: lbranco@metlife.com
MetLife Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its Affiliates, Warwick, RI
MPL BLANK Printed in U.S.A 0698
Date ...�...�...
-,. '�� TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
This certifies that ............................. �-.. 2 `- z-,,. .� 1.. ! C
..................... ... � ..,....
a �4 .y� � .....
has permission to perform .......... ........................
wiring in the building of ............ Q. 4.'y .....................................
at .................I. 3..7......North Andover, Mass.
Fee..��� . Lic. No.IP 5'�q. -.. .. .......
y ELECTRICALINSPECTUR
ri Check #
7291
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Gommonwealth of Massachusetts Official Use Only .NEW /
Permit No.
--7
Department of Fire Services
Occupancy and Fee Checked
r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MET), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: V% ,Y 0 .
City or Town of: NORTH ANDOVER To the Insp etor of Wires:
By this application the undersigned gives notice of his or hgr intention to perform the electrical work described below.
Location (Street & Number) /37 W r -At
Owner or Tenant CA/ -,,S CUIh f,4 q
Owner's Address s wlp
Telephone No.
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building V;rM; I 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: r h�- � �; �� o v-,, Rr,
Com letion of the followin table may be waived hy the In ector nf Wires
No. of Recessed Luminaires ?0
No. of Ceil: Susp. (Paddle) Fans
o. of Total
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires -5-0
Swimming Pool Above ❑ n-
rnd. rnd. ❑
o. o mergency Lighting
Batter Units
No. of Receptacle Outlets aS
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches ,�-�
No. of Gas Burners
W-7-oTUetection an
Initiating Devices
No. of Ranges
No. of Air Cond. Total Tons
No. of Alerting Devices
No. of Waste Disposers
eat PumNumber
Totals
I Tons
KW
of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ cipal
Connection F1Other
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
Heaters
o. of No. Or
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
a ecommunicationsWiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of 6Vires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
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:)
/ certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: P`Cct.r), V -e --C- LIC. NO.: da, -W4
Licensee:`Signature 1 ,C�x.,, LIC. NO.:a`)
(If applicable enter "exempt " in the license ember line., Bus. Tel: No.:
Address: I S C? f't / � `i) :- <, ck✓CC) YV\ (N` 0 HCX1 Alt. Tel. No.: cS L/y-1C0
*Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 a ent.
Owner/Agent
Signature Telephone No. PERMIT FEE. $
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Date. .......
NORTH
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
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at .... North Andover, Mass.
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GAS INSPECTOR
Check 4
6600
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO oU UAS 1-11 TING
City/Town: WrAn /7Y7��Ub V Date: Permit#
yt`° 1/40 0 N 1.. AYDS
Building Locatic wners
Type of Occupancy: Commercial Educational Industrial Institutiona
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Residential
New: Alteration: Renovation: Replacementx Plans Submitted: Yes No
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INSURANCE COVERAGE:
1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy x, 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
Owner. Agent
Signature of Owner or Owner's Agent
By checking this box ; 1 hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and
accurate to the best of my Knowledge and tnat au purmomg worK and mstauauons pertormea unser LIM pn.......aaunu .W. uua OPPIN .aa.v.. ".I...v ...
compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
veype of License:
BY:...... _ Plumber
Gas Fitter
t r
TitleSign e o L' ensed Plumber/Gas Fitter
Master
Journeyman
Cityrrown I License Nu er:
.r,onn..rn .nee.r-c uee nuLP Installer
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .. . } .� �.. l!d!c-.� .�......................
has permission to perform .... C:A'.s. .................
plumbing in the buildings of ;!.....................
at ... �.% ... �` . * .i . '' . !. �:�....... , North Andover, Mass.
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Fee. . 7. . Lic. No. ? `'5 . ........ ..........: .,.,� ... .
PLUMBING INSPECTOR
Check
7324-01
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
lers Date ���7
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Building Location ? W \C � (� nName A rr, (� Permit 2 L 4'
Amount
Type of Occupancy
New Renovation Replacement 1:1 Plans Submitted Yes No
FIXTURES
(Print type) C � �A�` / Check one: Certificate
Installing Company Name a G �� ! S � Corp.
Address o /cam 1! /,n "/ <A%C A,1 Partner.
Business Telephone 2
Ea-firm/Co.
Name of Licensed Plumber. % cA C
Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity El Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and install's p onmed un er Permit Issued for this application will be in
compliance with all pertinent provisions of the Mass bin e Chap 142 of the General Laws.
Y
By: TIM= o ice um er
Type of Plumbing License
Title 3
City/Town Number Master ❑ Journeyman
APPROVED (OFFICE USE ONLY
Date ... i . `. ?/� ........
NORTH
Of ,ro ,ti0
o�OL TOWN OF NORTH ANDOVER
• PERMIT FOR GAS INSTALLATION
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SAC HU`'E '
This certifies that ......1. ..........
has permission for gas installation .... 0.1:� ................
in the buildings of ............................
at ... ....... North Andover, Mass.
Fee..?.)..... Lic. . ..... ,:.. , .. .
GAS INSPECTOR
Check # 2 ICI
5939
t
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MASSACHUSETTS UNUORMAPPUCATONFOR PERM TO DO GAS FITTING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations
Date ? — 9 �-- —0 7
P1 ' /y Permit # 59
Owner's Name
New W` Renovation Replacement
Amount $ L�
CA sC��
Plans Submitted
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(Print or type)ArGll
Name
Address
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ISS I elephone Z: -) 1
Name of Licensed Plumber or Gas Fitter A-1
Che k one: Certificate Installing Company
Corp.
Partner.
Finn/Co.
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes 13 NoO
If you have checked des, please indicate the type coverage by checking the appropriate box.
Liability insurance policy ®' Other type of indemnity ED Bond 13
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner Agent
I hereby certify that all of the details and information I have submitted (or entered) in a13
application are true and accurate to the
13
best of my knowledge and that all plumbing work and installations��erformed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu�Stdtydas Cpje ar�Ch4pter 142 of the General Laws.
By:
Title
City/Town
(APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber 4�)Li u/
OGas Fitter Licebse Number
0 Master
0--�rneyman
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Name of Licensed Plumber or Gas Fitter A-1
Che k one: Certificate Installing Company
Corp.
Partner.
Finn/Co.
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes 13 NoO
If you have checked des, please indicate the type coverage by checking the appropriate box.
Liability insurance policy ®' Other type of indemnity ED Bond 13
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner Agent
I hereby certify that all of the details and information I have submitted (or entered) in a13
application are true and accurate to the
13
best of my knowledge and that all plumbing work and installations��erformed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu�Stdtydas Cpje ar�Ch4pter 142 of the General Laws.
By:
Title
City/Town
(APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber 4�)Li u/
OGas Fitter Licebse Number
0 Master
0--�rneyman
Date ... ZI
.. n. . I 'c-/- 7
.. 9 ....................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... t4._�
7
has permission to perform ... C v .. ...... .............
wiring in the building of ......... .............................................
at ......... f 33...
........ I .. ..... . ? ................... .North Andover, Mass.
4A
Fee ..!r!"' ......... ............. .....
/ Lic. No. *Z*& ..........
**
ELECTRICAL INSPECTOR
Check # 7 V12- 744/
7335
l,ommonwealth o f Vajjachujetb
Apartment of Sire Seruicee
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only _
Permit No. '? 313 5
Occupancy and Fee Checked
[Rev. 1/071 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: f L ` 40 7 -
City
.City or Town of. UDrc--rl A4t-z) O c1 Cr To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) t'�7 WE�d t�o 1X -f Ot 2
Owner or Tenant Ct SUS j-�l��jP [.- Telephone No. ,76r V
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building 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:
Comnletion of the following table mov he waived by the to cnnrtnr of WirPv
No. of Recessed Luminaires
No. of Ceil: Susp. (Paddle) Fans
r o ota
Transformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool ove ❑ n- ❑
rnd. grnd.
o. o mergency ighting
BatteEl Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
o. of Detection an
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
g
No. of Waste Disposers
eatum
Totals
Number.
ons
"' "
o. o e - ontame
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Municipal a—:Other
on
No. of Dryers
Heating Appliances KW
Security S stems:*
uivalent
No. of WaterKms,
Heaters
No. o No. of
Si ns Ballasts
Data Wiring:
No. of Devices or E uivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
a ecommumcationsWiring:
No. of Devices or E uivalent
OTHER: 0 8 a (/-/U _ (
5- o4 Attach additional detail If desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion.
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:)
I certify, under the pains apd��tiesof perjury, that the information on this application is true and complete. _ _
FIRM NAME j/� 6earrT QrVl S' LIC. NO.: /�
Licensee: C (t-� �e Signator < LIC. NO.: f 6?6C=
(lfapplicable, enter e license number lig // Bus. Tel. No.:0'10 rff-//<<1
Address: C_�L %rl (U� � ��- /1l J,/ S NAlt. Tel. No.:
*Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. �SSC��t'
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 owner,agent..
Owner/Agent
Signature Telephone No. PERMIT FEE: $
z
COMMON 5ALTn
R_�IV�S�E- I
DEPARTIVIE.NT OF PUBLIC SAFETY
-EtEtT S Li -cerise: SEC SYS CERT. CLEARANCE
�AN ELECTRI IA�-
��AS: A*-'k�� JOUR.NEY,
R It -!AN
Nurnber--.SS CC 002421
LICENSE To—'_
Birthdate:'jdjj9jj972
li RD, 388.0
K Dbtt iplr�s:: 10/19/2007 Tr. no:
E�
Ak�
Res
RICHARD K DUBtm
lug
4.'- 2 6�` CLINTOIN OR
03049
HOLLIS. NH Cornmissioner
S8686 E
37 2 6)'
SSACHUSETTS
...... .............
VMUMBER COMMERCIAL DRIVER'S LICENSE .. ..
S06707793
DATE OF BIRTH CLAM REST HEIGHT SEX
10-19-1972 c LN -r" 10 m
EXARES ISSUED ENDORSE
10-19-2008 10-16-2
DUBE
RICHARDK
_LaWELLrMA
01.854-2461
T.,
.... ......
. ..... .....
...... ......
Location C(/2
No. f Date �U i
„ORT"
TOWN OF NORTH ANDrOVER
c �,
;
Certificate of Occupancy $
•
Building/Frame Permit Fee
$
•• �•,b',^°'''tom
LnSsC14USE
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
: ru
Water Connection Fee
$
a�
`
TOTAL
$
Z 7 7!r
Building Inspector
9670
Div. Public Works
Location C/k-
''° Date Y /o -i
NCRTM
TOWN OF NORTH ANDOVER
- y
Certificate of Occupancy $
Building/Frame Permit Fee $
sACMUSE
Foundation Permit Fee $ v
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ /S O
r
Building Inspector
04/12/96 11:40 150.00 RAID
6n
39 Div. Public Works
i
Location. ? Com✓ 4 �� r' l0 �' 25
No. /!_ Date
' � A
t NOR7M H
TOWN OF NORTH ANDOVER
° , % Certificate of Occupancy $ o
> : ' Building/Frame Permit Fee $ $
�. SSACMUSE Foundation Permit Fee $
Other Permit Fee $
Ufa Sewer Connection Fee $?�
f�0 lam Water Connection Fee $ ld77.5p1
TOTAL $
Co
ae Z IF
a./2 12/96 11:40
z _0 .
Building spWApr
77.
Div. Py&6 P6Works
Pva,%fi f Nb,. Q
RMIT TO BUILD - NORTH ANDOVER MASS. V PAGE 1
APPLICATION FOR PE ,
MAP d-40.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
'PAGE
ZONE
I SUB DIV. LOT NO.as
( e
(BOOK
LOCATION 13 ) w eq/A N
C, J,
-
fie-
c,
PURPOSE OF BUILDING 57/
J
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OWNER'S NAME x w D d
_` R�
Q /�` C
NO. OF STORIES a SIZE
OWNER'S ADDRESS 7,3:3
/ 3� U )-W
/C
01 [jam
1
BASEMENT OR SLAB � Lp i ep�
ARCHITECT'S NAME
BUILDER'S NAME
[ IM
e /
SIZE OF FLOOR TIMBERS IST rT y/O 2ND �/!a 3RD
SPAN f`
DISTANCE TO NEAREST BUILDING
(i
DIMENSIONS OF SILLS Y /l V 4
DISTANCE FROM STREET
7
POSTS �I
--
DISTANCE FROM LOT LINES -SIDES
7 EAR /C
[
GIRDERS 10,
AREA OF LOT I) o �)
rteesV
!FRONTAGE / / V
(/
HEIGHT OF FOUNDATION I
R
THICKNESS /Q
IS BUILDING NEW
yes
SIZE OF FOOTING / •f
X/, 4
/9
IS BUILDING ADDITION ' V v
/
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
0
IS BUILDING ON SOLID OR FILLED LAND
S� //
42/
[�5
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Lp S
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANYAMIS
BUILDING CONNECTED TO TOWN SEWER
es
IS BUILDING CONNECTED TO NATURAL GAS LINE Z! S
INSTRUCTIONS /7 Z
SEE BOTH SIDES / /
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
PLANS MUST BE FILED AND APP/ROVED BY BUILDING INSPECTOR
DATE FILED A
SIGNATURE OF OWNER OR AUTHORIZED
FEE /3yo.
PERMIT GRANTED
/39o�r7
- 19-�. PERMIT FEE.... D 7
` LESS FDA FEC...._.
DUE FRAME PERMIT 0
3 PROPERTY INFORMATION
LAND COST
/ UOQ
EST. BLDG. COST
EBT. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INBPtCT011
OWNER TEL. It � � �- 341', 7 y
CONTR. TEL. N
CONTR. LIC. # /(O Cy
H.I.C. #
c
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION
�I
$ INTERIOR
FINISH
CONCRETE
PINE
HARDW D
d
1
l7�
2 13
CONCRETE BL'K.
BRICK OR STONE
PIERS
PLASTER
WALL
_DRY
UNFIN.
3 BASEMENT I
-•
AREA FULL I
X
FIN. B'M'TAREA
1/1 �/� '/,
FIN. ATTIC AREA
NO B M -T
FIRE PLACES
HEAD ROOM
MODERN KITCHEN,'
_
4 WAILS I 9 FLOORS
CLAPBOARDS
AB
1
2 3
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
--
CONCRETE
EARTH
COMMON HARDW'D
ASPH. TILE
STUCCO ON MASONRY_
STUCCO ON FRAME
BRICK ON MASON Y. .
ATTIC STRS. d
FLOOR
BRICK ON FRAME
(-
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON -FRAME
SUPERIOR IX POOR
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH 13 FIX.)
GAMBREL
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
DiC
LAVATORY
_
WOOD SHINGES
KITCHEN SINK
_
SLATE
NO PLUMBING
TAR d GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
TILE FLOOR
_
TILE DADO
6 FRAMING
11 HEATING
WOOD JOIST
A
PIPELESS FURNACE
-
FORCED HOT AIR FURN.
TIMBER BMS. d COLS.
STEAM
STEEL BMS. d COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS ��
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
OIL
ELECTRIC
B'M'T 2nd _
tat 13rd
NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA.
RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. �.
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6 � �-4P.f� ST,PEET
A.t/ODI�E•P, �1ASS,4C,�l/SETTS O/8/D •
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********c�**********
APPLICANT: D 1,71:4D� �P 6r Phone [l d >^ //,)0
LOCATION: Assessor's Map Number Parcel
r"'
Subdivision 4otuood Lot(s) ;�2�
Street l�%P(/`�lol St. Number
************************Official Use Only************************
RECO NDATION TOWN AGENTS:
- < � //� /W Date Approved A �M*
C servatio Administrator Date Rejected
Comments
Mt�� 1 Date Approved Li 3
Town Planner Date Rejected
Comments
Food Inspector -Health
Septic Inspector -Health
Comments
Date Approved
Date Rejected
Date Approved
Date Rejected
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector
M
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Date .... P� ... I.!
I TO
1., 603
00- "U. F
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that
............................
has permission to perform .......... .. . . ..... ....................
wiring in the building; of Z3..-? ............ . . .. . .. ... ....... Ems.... "'
...... 0 .......................... . North Andover, Mal.
Fee ...3..Q.5..V:-'0'Lic. No.1.15f.-2fi . . ........................................................
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Office Use Only
011e �DMJUV11WraItJ1 of �agBaCJ1U,�Ettg Permit No. & G3
Jkpurtuuut of Public enfall Occupancy A Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank)
i 773
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) Date// - 2-C ' c7C1
City or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & NumtWr) Z07 _25. 4/37 If )PI -4 Ak
Owner or Tenant
Owner's Address
Is this permit in conjunction with $ bu)ildirig permit: Yes No ❑ (Check Appro riatee Box)
Purpose of Building Sl lu e ` AJell t n Utility AuthorizatioNo. /
Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters
New Service 206 Amps -2,(l 6 -volts Overhead ❑ Undgrnd � No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
❑ ❑
grnd. grnd.
Generators KVA
No. of Emergency Lighting
No. o1 Receptacle Outlets
No. of Oil Burners c-
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
No. of Ranges
No. of Air Cond. Total
tons
Initiating Devices
No. of Disposals
No.of Heat Total Total
Pumps Tons KW
No. of Sounding Devices
No. of Self Contained
No. of Dishwashers
Space/Area Heating KW
Detection/Sounding Devices
LocalMunicipal ❑Other
❑
No. of Dryers
Heating Devices KW
Connection
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Compl ted Operations Coverage or Its substantial equivalent. YES NO ❑ 1
have submitted valid proof of same to the Office. YESNO ❑ If you have checked YES, please indicate the type o coverage by
rY
checking the ap priate box.
INSURANCE A BOND ❑ OTHER ❑ (Please Specify)
(Expiration Date)
Estimated Value qf Electrical JVork $ _
Work to Start /'
Signed under the Penalties of perjury:
FIRM NAME 16 r..h " rNO C Q
Inspection Date Requested: Rough & a �/A.Final
LIC. NO.
OWNER'S INSURANCE WAIV'ER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts 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)
x-6565
�/y/gid
Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
co
This certifies that ....... �..P..T ......... f.(
:�� .... . ......... �4.1/ ..................................
has permission to perform ..... —A .............................................
wiring in the building of ....
-'�! .............................
at .... ...... �q.v,,d ...
....................... , North Andover, Mass.
Fee..,.,,. ... Lic. No. /I.X ...............................................................
ELECTRICAL INSPECTOR
C G3�
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
K
•The Commonwealth of Massachusetts
Permit No. Office Use Only
Department of Public sQletv 3
Occupancy b Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed In accordance with the Ma"achusetu Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /O — Z.9 — 94
City or Town of /V4e7;V �lNDdVFre To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street 5 Number) /.37 &1eY4AA1,p C.:lzey_E
Owner or Tenant C'1-/Je/STOPA16f It T"EE (r6NW A)1
Owner's Address .Ylq ME (so6 88 - /SOS_
Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization NO.
E:.isting Service Amps / if verhead r Undgrd P, No. of Meters
New Service
Amps /
Volts Overhead ❑
Undgrd ❑ No. of Meters
Number of Feeders
and Ampacity
No. of Receptacle Outlets
No. of Oil Burners
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming; Pool Above In-
grnd. 1:1grnd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No, of Switch Outlets
No, of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Total
No, of Ranges
I?o. of Air Cond, tons
initiating Devices
No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
Local 11 Municipal ❑Other
No. of Disposals
eat
No. of Pumps Total Total Tons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
Connection
No. of Water Heaters KW
No, of No, o
Signs BallastsW
w Voltage
m
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
NOVNSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws N
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial .
equivalent. YES ❑ NO [] I have submitted valid proof of same to this office. YES ❑ NO. ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE ❑ BOND ❑ OTHER F] (Please Specify)
Estimated Value of Electrical Work S a 400
Expiration Date
Work to Start 96 Inspection Date Requested: Rough Final
Signed under the penalties of perjury:
FIRM NAME ADT Security Systems, Inc. LIC. No. 1231C
Licensee Signature A07" ��►�.. LIC. NO.
Address 60 William Street, Wellesley, MA 2181 Bus. Tel. No. 6 1) 431-5800
Alt. Tel. No. ( 617 ) 431-5831
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
00
Telephone No. PERMIT FEE S 3J�
Signature of Owner or Agent