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HomeMy WebLinkAboutMiscellaneous - 151 RALEIGH TAVERN LANE 4/30/2018 151 RALEIGH TAVERN LANE I 210/107.A-0111-0000.0 Location No. Date ",O oT ol ,ti , TOWN OF NORTH ANDOVER ya 9 Certificate of Occupancy $ C14U � Building/Frame Permit Fee $ �U• Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # S--:T L 1, 8830 Building 1�s'pector v� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �q t ME, Lin A"Womp"k BUILDING PERMIT NUMBER. DATE ISSUED: M / t3 /as� a SIGNATURE: /VL Building Commissioner/InEpedtor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map-and Parcel Number: ? C LMS Map Number Parcel Number r- , 1.3 Zoning Information: 1.4 Property Dimensions: \ Zoning District Proposed Use Lot Areas Frontage fl 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required Provided Re red 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 ❑ Munic.7al ❑ On Site Disposal-System ❑ i �. SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT it • 2.1 Owner of Record _ Name(Print Address for Service �= ✓ -7 (P Signature Telephone 2.2-Owner of Record: Name Print Address for Service: z M Signature Tel hone SECTION 3-CONSTRUCTION SERVICES Ay 90 3.1 Licensed Construction Supervisor: Not Applicable j Licensed Construction Supervisor: License Number Mn Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ r� Company Name Registration Number Address l Expiration Date / A Signature Tel hone !!) s 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.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ „ Other ❑ Specify Brief Description of Proposed Work: Noon - l2 x Zo &04- P vP SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be f3FFICIAI USER®NLY �r Completed by Erniit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 p® ro A, Check Number SECTION 7a OWNER AUTH09AATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf.in all p1tters relative to 3kork authorized by this building pennit application. bl3f off" Si ature of O er Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent of subject property Hereby declare that the statements d information onthe 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 2 ° \, 3RD SPAN Da ENSIONS OF SILLS DRAENSIONS OF POSTS DE\4ENSIONS 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 LINA 18 TOG, B:EDRO.CK SAND O i \ NOTE i cc LATE PIPE BENCHMARK: SI IKE IN •P• #1 \ 18f1 WHITE PINE. 30, T.#1 ELEV. = 100.00 (asLmed) ^ T.P. #3 T.P. #2 O P R OETAIL- CD I EXISTIN 95 T 1 SYS E o f � .T. 2 . ,BIRO K, T.P. T.P. 00T 1 oc PUI ROCK y f \ \ \ UTCROf cod O \ \„ N 1 oa t i o co G. 1500 GALLON �y- FAST TANK r r O � 0 ((^^ 1 0 � L �o rr^ s---i O ' co ' --- 151 RALEIGH TAVERN LANE ASSESSORS MAP #107A LOT #111 1 45,997 SQ.FT. l � N'74°50' 00" E 103: 00, RALEIGH TLANE e K Y� "�lS., *,:� E i �* �� �. `R �: .Y 4,: � { ��4:5; a. �, A _ � , V ��`i a � d, x �e � i • �. e riper o La 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** /APPLICANT ��Iv� /�L 1 /!"J y`Q 1 PHONEq1 10 LOCATION: Assessor's Map Number 1074PARCEL l 1 SUBDIVISION LOT (S) STREET I s I R�' I �j b'� P�2� v ST. NUMBER USE OF TO N GENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTSn VU LOD! TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEVTH DATE APPROVED ATE REJECTED f _ 1,�'Stff-IC-INSPECTOR(HEAL,YH DATE APPROVED.L L,— DATE REJECTED C; COMMENTS - - ��n i PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm f NaRT� TOWN OF NORTH ANDOVER OFFICE OF p BUILDING DEPARTMENT i 400 Osgood Street ► o e ., ,�r +,T.o:►�'` North Andover, Massachusetts 01845 1S$ACHUStt D. Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: c, JOB LOCATION: Number Street Addre Map/Lot HOMEOWNER Alk Ay :6 fV 1 d)' �I 1 b P Z$3 3 Nam6 Home Phone Work Phone PRESENT MAILING ADDRESS S � Am/ 0 d V6412 o I RqS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended a on r f to be, e o two anvil structures. A person who constructs more that one home in a two-year eriod shall not .Y pP be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL BOARD OF APPEALS 698-9541 CONSERVATION 698-9530 HEAL;rH 689-9540 PLANNING 688-9535 � �tel; • � M-�,.,�$ 3 e�;.,+:� N..y �$�f ��y,��,yaa �"'e� �, �+`a 5,e<f �".�. (• .�t +i.y`."T:,� a �✓/ Ob x w44 dsA vv 19 It mss , �� ,� • • a w s r ms's ap j�( "h r TOO K 7 11 rfA J a a tjp� z jp r Co Cz Is S p i ' t r 9VZ ill, , m N S'1 �•i .*� moi•°. `.......... ..�9. � �..�. �� �� Fri R I i •s Mtn y,� I C..:n C tr!•4�'^p ` NORTH Town of t over No. �Y. 3�" r �O LAE dover, Mass., fT(I� COCMICMEWICK Ids RATED pP�\ �5 7 BOARD OF HEALTH Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT........ V AA041...�I. ^.�•......••............................ .................................................................. Foundation has permission to erect....�.4�.�. � buildings on �s� A L ��� TA w r!! Rough to be occupied as.. M....^C a ^ y� Chimney f'g. Q...............J.. ........ provided that the person accep t 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 relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 07#4 1, * PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough 1111L� ........... ....... .......................i/.�....................................... 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 Street No. SEE REVERSE SIDE smoke Det. N° 2141 Date..�.....�.. D AORTol 0�<;�``.°.;°�tioot TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ''�"' � /..� ............................ ..... ............................ ......... has permission to perform Z �J ..............:-�:y`� ......................... wiring in the building of.................... . --�`......................`........ JNorth.Andover,Mass. Fee. ................ Lic.No.............. y -LELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Official Use only Permit No. ' Department of Fire Services Occupancy and Fee Checked kWf BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] 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: ?6 City or Town of: r � ,�/� ,� 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) /S/ /el Q A 44, 7av22-2 1-12 Owner or Tenant /2J��/,� /� ,C 2�-,;,,��.�` Telephone No. g7y- Owner's Address S147-177-4-1, awl 7B1-15 9=`f6 76 Is this permit in conjunction with a building permit? Yes ❑ No a (Check Appropriate Boz) Purpose of Building �Sf�Jg/P /- a��`�� Utility Authorization No. Existing Service Amps / 2yVolts 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: /i//nom Completion of the ollowin table may be waived by the Insctor of Wires. No.of Recessed Fixtures No.of Cel-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tabs Generators 1KVA No.of Lighting Fixtures Swimming Pool Above E:1 - ❑ o.o Emergency d. d. Batte Uma Lighting No.of Receptacle Outlets No.of OR Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.oo7 De ec on and vices r No.of Ranges No.of Air Cond. Total No.of Alerting Devices ' No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ MConnectunip icaronEll Other No.of Dryers Heating Appliances KW Security ems: No.of ccs or Equivalent NO.of Water KW No.of o._0T_Data Wiring: Heaters Signs Ballasts Na of Devices or Eauivalent � iring:No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Equivalent OTHER: . Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability-insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: 3�, ° (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NEC Rule 10,and upon completion_ I certify,under thepains and penalties ofperjury,that the information on this application is true and completes FIRM NAME: .iso �u11'yGi LIC.NO.: ///37 Licensee: -7&;"a,,_s A-,p�'�l�Z! Signature � LIC.NO.: �/ (If applicable,enter "exempt"in the ficense number line.) Bus.TeL No.•;�7 Address: �D �.r1Ss 141111 sp,4:6.0�w A&TeL No.: > 0266 -9¢7© 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 agent. . Owner/Agent Signature Telephone No. FPERWT FEE.- +�v f ANO 2 J J 6 Date... /4/ NOR71, °f' °:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUS� This certifies has permission to perform ......:.... ?. -�....... . . u ... .?....................... wiring in the building of-110"I. ....r /... ...... .................... .................................... at.........1...� ......:��..................................... .North Andover,Mass. ,,� ` .� Fee .................... Lic.N ... ............................................................... a ELEcmicAL INSPECTOR 09/15/98 12:01 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only �\ Permit No__E�9 Occupant/8 Fee C`eckef/3 � Dre w—•c 4;v-d&4 544 I BOARD OF FIRE PREVENTION REGUI.ATIO 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wont to be performed in accordance with the Massachusetts E:ec:hcal Code 527 CMR 12:00 (Please Print in ink or type all information) Date To the Inspe r' of fres: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. 12 Location(Street&Number s >` Owner or Tenant W f l (� V`� — V� I A Owner's Address S G Is this permit in conjunction with a building permit Yes No O (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service jVU Amps 2,c) Yv Volts Overhead C Undgmd C No.of Meters New Service Amps Volts Overhead C1 Undgmd ❑ No.of Meters Numtxr of Feeders and Ampaciiy Ic=cn and Nature of Proposed E'.ectricai Work W l�_ vL ,r-1rJ VA,,2 �l'G7�i/Ll Total No.of Light8ng Outlets No.of Hot fuse No.of Transformers KVA Above C3 In C No.of Ugnbng Fixtures Swrmmtno Pool gma C qmd C Generators KVA No.of Emergency Ugnang No.of Receamc!es Outlets No.of Oil Burners Battery Units 'No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Tata) No.of Oetecaon and No.of Ranges No of Air Cond Tons Initiating Devices 1i Heat Total Total No.of Ciao" No. Pumas Tons KW No.of Sounding Devices Nod of Self Contained No.of.Qisrtwashers I SoaceiArea Heatina KW OetemorvSounding Devices C Municipal C Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases I Winn No.HWro Massaae Tuds I No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen8ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial egwvalentcytS_ 10 = have submitted valid proof of same to the OfflNO = If you have checked YES please indicate Mee o I rage by checking the appropriate box INSURANCE = BONO = OTHER = (Please Specify) (Expiration Date) Estimated Value of ectnea WorkS / Work to Start ry� . Inspection Date Resquested Rough Final / �J �) FIRM NAME Signed under n ess`,✓'C f Peflu J Y—��S{'� LIC.NO. ,� (5 Ucansee SlgnatureLIC.NO. c� us:T o / Addrr�a `5 Wit 1�OfiJCY�f � Df'• /����/��/li �//�"T AI el.No. OWNER'S INSURANCE WAIVER: I am awarethat the Llcenses does not have the insurance coverage or its substantial equivalent as required by Massacnuserts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) ` Telephone No. PERMIT FEES r�--- (Signature of Owner or Agent) _ 1 Location f �cA �l y 74 ZV. J No. _ f Date ZZ GI TOWN OF NORTH ANDOVER a F n Certificate of Occupancy �$ =' }- Building/Frame Permit Fee`$ }'�s''^°•'�� Foundation Permit Fee $ JACMUgE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $cl ' a/ Building Inspector f 13 57 Div. Public Works J e MRMIT NO. APPLICATION FOR PERMIT TO BUILD********NORTI-I ANDOVER, NI \L\PNO. LOT NO. 2. RECORDOFOWNl:RSIIIP DATE- IMOK PACE ZONE SIIB DIV. LOT NO. LOCA IION c PURPOSE:Of BUILDING /D �/ / �A p IA.) OWN ER'SNANIE VA Ail � NO.OSTORI / to l�J �l n�j,j� P ES�j SIZE O\VNER'S ADDRFSSf s� /��/) 11 / BASEMEN'OR SLAB ! M- 4, 'V ARCIIITECT''SNANIE SIZE OFFLOORTIMRERS j I 2ND 3RD IIUD.DER'S NANIE SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM LOTLINES-SIDES 3a REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE IIEIGII"r OF FOUNDATION FIIICI(NLSS IS BUILDING NEW SIZE OF FOOTING h IS BUILDING ADDITION MATERIAL OF CDININEY IS RIIILDIN ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN NATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTEDTO TOWN SE11'ER IS BUILDING CONNECTED TO NATURAL GAS LINE 1NS1'UCTIONS 3. PROPERTYINFORMATION LAND COST Ap EST. BLDG. COST PAGE I FILLOUTSECTIONS 1-3 EST.BLDG. COST hil SQ. FT. EST. BLDG. COST PER ROONI ELECTRIC Ni ETERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. AWACIM)GARAGES MUSTCONFORNI'MSTATE FIRE RECUL.ATIONS 4. APPROVED BY: PLANS MUST RE FILED AND APPROVED BV IIUILDING INSPECTOR BUILDING INSPECTOR D:\'fEFII.F,Dl / OWNERS TFLN 7 �l CONTR.TEL# i SIGNATURE OF Oi1'NFI1OR AUTHORIZED AGFN'1' //w�/� FEF t PE:RMITGRANTI- koog /7 /(5--19U\- Revised i/S/99 .1�1 -- - � _-,.,.-.,,_._�� -:,��'1 t•}�6 ` 4 tf f 1 t i ry�'t • � I I i FORAM U - LOT RELEASE FORM ,. 4� 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 or requirements.. *****`**************APPLICANT FILLS OUT THIS SECTION******************** APPLICANT L I A N�l 4) 4 r / PHONE LOCATION: Assessor's Map Number /o /2 PARCEL SUBDIVISION / J� "7�- LOT (S) STREET L -e C '` 1 (°vi LA up— ST. NUMBER USE 00 RECOMMENDATIONS OF TOWN AGENTS: 't.✓J ae- CONSERVATION ADMINISTRATOR DATE APPROVED ' DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED 3 DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS [y, DRIVEWAY PERMIT FIRE DEPARTMENT — /Qty RECEIVED BY BUILDING INSPECTOR 4 Revised 9197jm TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, 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 exception, along with other requirements. Type of Work: VIM p e4D Est. Cost tzo 0o Al Address of Work RA,lei� A M A) *` Owner Name: ` .A IV 0 kf_ Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date 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 FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name NORTH T0VM of ` D. L ®ver WS, o�A�oc�,EQ dover, Mass., ORATED P' -`� S cG 74 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System a BUILDING INSPECTOR THIS CERTIFIES THAT........ ...0_60./......... .O.r.)...................................................................LA) .. Foundation has permission to erect....�o..x..l..b............. buildings on .....� I........�E'a1 ��h T �tr�'�u .............................. Rough to be occupied as..... .. .......` r p Y.��. Chimney 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 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final !]JNMA / 497 P LESS CONSTRUCTIONS ARTS ELECTRICAL INSPECTOR Rough PARCEL e ...... . .. .... .•... ... .................. !:::: ........................... Service ��G' • '3A 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 Street No. SEE REVERSE SIDE Smoke Det. l N74050' 00" E 168. 0 \ 18 . TO, BEDROCK SAND PER NOTE # 9 LATERAL j f \ PIPE BENCHMARK: 4KE IN 18" WHIT PINE. 0, .T.#1 ed , um 3 — as� P. 0. 00 ) T. ELEV. 10 � I . .5 ruBE�- T.P. #2 O OBSERVHTtoN .—._.r_ . O to l2 tJETAtt- I \ 0 I EXISTIN \ 95-1 o 1. SYSTE — o T.#2 1 P. #4 I I ; Ou I I / CRO36' T.P. # W I l o 00 1000 GALLON 00 ` , PUMP CHAMBER i ta3 GHTE_ VALVE l'W' !!� UTCROF� � CJ \ BEAR g&c) co C 1500 GALLON �\ FAST TANK OUB GLOP � O I ROCS O 1 o � SCJ 151 RALEIGH TAVERN LANE ASSESSORS MAP #107A LOT #111 45,997 SQ.FT. N74 5o oo E 193-- 100' Loaation 111 / No: `7 Date 61, �oRTM o:± TOWN OF NORTH ANDOVER o? ...o , ,tic� A Certificate of Occupancy $ 41 e i : ; Building/Frame Permit Fee $ 'rv �' b•+r•o•A,�� CHU Foundation Permit Fee $ r Other Permit Fee $ f Sewer Connection Fee $ Water Connection Fee $ G JUN �' - �`��'� Buildi�rf�g Inspector 16 4 1 ,()RTH ANL ER,CCI-I-ECTCF f Div. Public Works Location No. Date NORTh TOWN OF NORTH ANDOVER ojo�a`•° ,•,hoo ,, w 0 Certificate of Occupancy $ 41t s : ; Building/Frame Permit Fee .$ s Foundation Permit Fee $ sACNusE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL - - $ Building Inspector k' 'n9T4 ANDOVER GU I Frit Div. Public Works I'E-IZMIT NO. AI'1'LICA'I'ION FOR PERMITTO 13UIL1)********�NUIt"1'll ANDOVER, MA hi%I,N(1. LOr.No. '(( 2. RIA-011B(1FOWNTRS1111' V DATE BOOK PAGE 7/(h k. SUB DIV. 1.01 No . I.O( A I ION PI)HP(ISF OI HM DING OWNER'S NAME O ,(^ NO.OF SIORIES SIZE O\VNIiR'S ADDRESS \ \ i a BASEMENT OR SLAB ND AR(I 11 1 ELI'S NANIE SIZE OF k[.()OR'][Nil IF RS I 2 3 BI III DER'S N.4IE \ SPAN DISI ANCF TO NEAREST BUILDING DIMENSIONS OF SII.I.S DIS I'ANCE FROM SrREE I DIPIENSI(NdS Of 11OS I S DISI ANCE FROKI LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FR(Nl7AGE 11EICIfr OF F(A)NDA1ION T111CKNESS IS BUILDING NEW SIZEOF F(l(YLING X IS BI IILDING ADDITI(NJ MATERIAL OF CIIININEY IS BILI LDING ALTERATION IS BUILDING(NJ SOLID OR FILLED LAND Will.BUILDING CONFORM TO REQUIREMENT S OF CODE IS BUILDING C(NJNECI ED 1'0 TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO 1OWN SI:WER IS BUILDING CONNECT ED 10 NATURAL.GAS LINE INS IUCTIONS 3. PROPERTY INFORNIATION LAND COST Est.81.1)i.COST PAGE,I FILL CIIrrSECrIONS 1-3 ES F.BIDG.COSI PLR SQ. FT. Est*. BI DG. COSI PER RO N.I ELECrRIC METERS MUST BE ON OUTSIDE of BUILDING SEPTIC PERMI r N0. A Fl ACIIED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS I, .APPROVED BY• PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR B III.DI :INSPECTOR DA I E FILED OWNERS'I lil-a C(WIR.IEt# ( IF WER( CONI-R.I.ICH A LGN IlIRFOG�A PERMIT GRANrED 19 i � NoRrH �rTown of Andover m No. Z -- * _ : dower, Mass., �o /�� LAKF i^, 'S CO-HICN-WICK qAT E D `G BOARD OF HEALTH Food/Kitchen PERM T T Septic System BUILDING I �u D INSPECTOR . . ............. . THIS CERTIFIES THAT....................... .............................................. .......................A......... Foundation ..... buildings on ....�.1......../ ..................... ................................ Rough has permission to erect g to be occupied as .... ...................................................................................................................... Chimney provided that the person accepti this p shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the C , s 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 UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR Rough Service BUILDIN SPECTOR 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 Street No. Smoke Det. :f Vocation ! .S / fir. i..�/ Date' ' -� ,.aR,►, TOWN OF NORTH ANDOVER . Certificate of Occupancy $ s ii• ' ' �a ' ding/Frame Permit Fee $ bktion Permit Fee $ q� Othrmit Fee $ �^ Sewer Connection Fee $ ,70g ater Connection Fee $ YOTAL $ `� d Illy rt •,, J�--��;_ � Building Inspector 4 Div. Public Works P * JIITITO. 9 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. (� PAGE 1 MAP K-4O. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK iPAGE ZONE I SUB DIV. LOT NO. 7I LOCATION PURPOSE OF BUILDING !/ /3LJ L -U & OWNER'S NAME S � aA-' iWm NO. OF STORIES SIZE OWNER'S ADDRESS �✓�1!/J,fs.2C/,n�Y�'„` 0 BASEMENT OR SLAB -- ARCHITECT'S NAME L L Yf SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �I`1 /3D �,n , G�I i.o_ 7 SPAN DISTANCE TO NEAREST BUILDING (••• •W T `V 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 13,9 o-�` �, �m 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST J r_5Z lJC/ % ) PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER CQ!Fr, 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 FILED 3 �� v BOARD OF HEALTH SIG T E OF OWN OR YyqRqIWD AGENT FEE /Q�_ PLANNING BOARD PERMIT GRANTED OWNER TEL #Ca COJ pp c CONTR.TEL. # 19 L CONTR.LIC.#S�_�� BOARD OF GELECTMEN n a'� BUILDING INOPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I Si ORIES 1 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _- LOT LINES AND EXACT DIMENSIONS%OFJBUILDINGS: WITH'PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW-D PIERS PLASTER �I DRY WALL UNFIN. _ 1 3 BASEMENT I!{( AREA FULL 11I FIN. B'M'TAREA '/ 1/2 '/, FIN. ATTIC AREA _ HOPLACES D ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �/1 WOOD SHINGLES EARTH � w 'Yl ASPHALT SIDING HARDW D ASBESTOS SIDING COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY _ Z 1 f STUCCO ON FRAME — i t� 1 /I `O S�� 4 BRICK N MASONRY - ATTIC STRS. I FLOOR \ g (., 1 BRICK ON FRAME I o O CONC. OR CINDER BILK. 4 / STONE ON MASONRY WIRING �– STONE ON FRAME SUPERIORPOOR ADEQUATE I� NONE 1 !I G 5 ROOF 10 PLUMBING GABLE MIP BATH (3 FIX.) II N GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET a, 1 ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK L SLATE NO PLUMBING TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR S IJ t`! f�eM l �LIQuGt! TILE DADO 6 FRAMING 11 HEATING 1 / WOOD JOIST PIPELESS FURNACE j FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. — HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING If RADIANT H'T'G UNIT HEATERS 7 NO. GAS OF ROOMS GL T2ELECT 1 1st d L,I dJ0 t G i . !I •r� w !s COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF 9 1010 COMMONWEALTH AVE. MASSACHUSETTS BOSTON,MA 02215 L I CENI:=_:E PE'. ... _. CAUTION EXPIRATION DATE 0 l/:/:31/19%` ( hl hl'=:'1'1 i. 1_1R�I.::;-I_IR s ? EFFECTIVE DATE LIC—NO. FOR PROTECTION AGAINST I RESTRICTIONS THEFT, PUT RIGHT THUMB >'- -2 -" PRINT IN APPROPRIATE 6 BOX ON LICENSE. g F:F:NKIr::1 F i B K:F�--tJ € BLASTING OPERATORS ._ =: it 014—:=;2-2•781. m :'a. 1-1 E,W I I l" FIVE MUST INCLUDE PHOTO. PHOTO ,G10PR ONLY) FEE: I�.I ()NI._II„IVF.*R MA 01'c:45 � Yy 'NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY ' • �' t'~ STAMPED-OR-SIGNATURE OF THE COMMISSIONER HEIGHT: DOB: � its /2'A./1.'=�a:; l � THIS DOCUMENT MUST B; + 1 .! CARRIEDONTHE PERSON OF OF I 710ENbfE SIGN NAME IN FULL ABOVE SIGNATURE LINE I M THE HOLDER WHEN EN- 0 NIC! ' OTH \�` MB PRINT GAGED IN THIS OCCUPATION. YiS1Y�'1� APRRt iV. AI_►TH. �I II HOME IMPROVEM NT CONTRACTOR Registration 108383 Type - INDIVIDUAL ” •i �-!M Expiration 08/18/94 �:. Kenneth B. Keen 21 Hewitt Ave t CROW } (, No. Andover MA 01845 I :`° •""" �z,"� ?" pONOR ADMINISTRATOR ° {,yt- AMERICA Is REMODELING A with NATIONALASSOCIATION of th KEEN CONSTRUCTION CO. �c5W e REMODELING INDUSTRY i`" 21 HEWITT AVE. c/tea NORTH ANDOVER, MA 01845 TEL. (508) 691-5201 RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. Notice: All home improvement contractors and subcontractors engaged in home Improvement contracting,unless specifically exempt from registration by provisions of Chapter 142a of the general laws,must be registered wltlkthe Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Nome Improvement Contract Registration,One Ashburton Place,Room 1301,Boston,MA 02108. Designated Registrant's Name: Kenneth B. Keen Registration Number: Mass. Reg. 108383 Salesperson's Name: This agreement is made on T> t"' between �t (DATE) (CON-TRACTOR) - of (ADDRESS) rums 3t) l he:einaftcr called"Contractor"and , s ;:t !'' °i p=} '� ` •l i � J J (Ow VrR) of i (ADDRESS) (FIto.NT_n-U Calx) hereinafter called"Owner". DETAILED DESCRIPTION OF NVORK TO BE PERFORMED Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following: 1 DETAILED DESCRIPTION OF MATERIALS TO 13E USED Materials to be used in performing the above described work consist of the following: U. CONSTRUCTION-RELATED PERMITS The following construction-related permits will be necessary in order to complete the scope of work included in this Agreement: The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all cortstruction-related permits. The Contractor s zL not be deemed responsible fol delays in the work described in this Agreement caused by regulatory, permit granting or inspecuonal agencies, authorities or individuals or strikes, accidents, weather conditions, material availability, or delays beyond our control. Notice: If the homeowner obtains his own construction-related permits for the work described under this agreement, the homeowner is hereby advised that in the event of a dispute, Judgment and nonpayment of the contractor, the homeowner will not be entitled to make a claim to or collect from the guaranty fund established be Chapter 142A, M.G.L. III. PRICE )r Contractor agrees to do all work described in Section I for the total price of S Removal of all debris generated from above work is the responsibility of the customer, unless specified in this contract. IV. PAYMENT Payment will be made as follows: 17 upon signing Contract; —)upon completion of ! i %(S )upon completion of , and the remaining, >+? - %(S `;i ,?C- )upon verification of the work by Owner and Contractor as having been satisfactorily completed,which verification shall take place promptly after completion. Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever amount is rel' HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Owner's Signature Date Signed j' (Over for additional information) Contractor's Signature' Date Signed NORT # ToVM of ) Andover o �. VIA _- _ L AO ° dover, Mass., JMi f-A&M t 19 t3 2�ACOCMICMEWICH DRATED '9S H BOARD OF HEALTH Food/Kitchen Septic System . .PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT...s4 .. ...... 1.. .. are. OW.......................................... Foundation has permission to erectAww".40a . buildings on .AV—04�t 4040.04....AwarjeoLkoe Rough to be occupied as..... 0004.*..00r.A....ACN0•0�.C.*.. ...................... Chimney 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 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of.the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ....................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL �,S�d� CONSERVATION FINAL Street No. Smoke Det. .qFWFR /WATFR FINAL d DRIVEWAY ENTRY PERMIT