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Home My WebLink AboutMiscellaneous - 160 CARLTON LANE 4/30/2018 / 160 CARLTON LANE -` 210/107.A-0192-0000.0 r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING nw rn BUILDING PERMIT NUMBER. r DATE ISSUED: Z Y z-/0 SIGNATURE: G Building Commission&/IRtEtor of Buildings Date Z SECTION i-SITE INFORMATION I0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Ct Map umber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: U1 V Zoning Dist c—t Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 0 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT I 110LU1 i Lr'c, . reS ITo rn 1 Owner of Record Na 71rini Address for Service: N ture Telephone i 2.2 Owner of Record: Name Print Address for Service: rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number mn Address 10 Expiration Date Signature Telephone r i 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name rn Registration Number r Address r Z Expiration Date n Si nature Telephone Y, SECTION 4-WORKERS COMPENSATION(AG.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: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL,USE ONLY Com 1 ted b permit applicant 1. Building 4 (a) Building Permit Fee J Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC D� 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERSAGENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT Ad11 d'L/z�' as Owner/Authorized Agent of subject property Here thorize to act on ehalf in all matters la ve t work authorized by this building permit application. r ---� b i Date X&TION 7b OWNER/AUTHORIZED AGENT DECLARATION 1> ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 RD _ SPAN DMIENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING- X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE .s+ "fi Location No. `� Date NONTol TOWN OF NORTH ANDOVER �?.• a L9 + ' Certificate of Occupancy $ Building/Frame Permit Fee $ sACHUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� Check # �...� `� I J Building Inspector FORM U - LOT RELEASE FORM Vat 0�r 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 PHONE_2,Z4L-y,8��yZS LOCATION: Assessors Map Number PARCEL i Cf � SUBDIVISION LOT (S) STREET l� (_ /�/�/ iJ �5/. �ST. NUMBER v **********OFFICIAL USE ONLY ** E IONS O WN AGENTS: C NSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS m'' P ALrm— TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-H ALTH DATE APPROVED l / " C DATE REJECTED �EVTIC INSPECTO LTH DATE APPROVED d O DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm 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: s�pv^�,�-e G�,�p�� Est. Cost Address of Work Owner Name: 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 hereb ly for a permi as the owner of the above property: Dae Owner Name 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 160 Carlton Ln.No.Andover,Ma.01845 Owner: Robert Krueger Date of Inspection: August 5, 1997 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent references, landmarks or benchmarks. Locate all wells within 100': (Locate where public water supply comes into house). L a T / 7- A 46, 3 3 S9 l vv c'S. ` 1 C�� Qui/rlvtlCf� ,- dd � I I 10' Page 16 of 18 (revised 04/25/97) G 'BZ �:7 2sN - -- NORTH Town of 0 T C, _- L A E - dover, Mass., //,/.z 2 /Opp COCMICMEWICK ADRA7ED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT 2)A '*Jr !IV w / N N it BUILDING INSPECTOR ................................................... ............................. tr .�..........�............................... Foundation has permission to erect...�D....�..��. bwldmgs on / /�/ L/� I{�� ................................ Rough to be occupied as p o ra �c........5......M.............�. .... ......... I� .. Chimney provided that the person accepting this permit shall in every respect conform to the to ms of the application on file in this office, and to the provisions of the Codes and By-Laws rel ting to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. 10 1 A 1 I It OR PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR � C 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 Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. PERMIT NO. APPLICATION FOR PERMIT TO BUILD********NORTH ANDOVER, MA OIAPNO. LOT NO. 2. RECORD OFONVNERSIHP DATE BOOK PAGE ZONE SUB DIV. LOTNO. J.00ATION f _) ,..j L PURPOSE OF BUILDING +-eM o3-a 7�lL� ONVNER'SNAME , WC NO.OF STORIES i O/ SIZE OWNER'S ADDRESS`/ BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 15r 2ND 3RD BUILDER'SNAM1: Qere',-53rJ SPAN DISTANCE:TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATERIAL OF CHUNINEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIRENIENTS OF CODE Yes IS BUILDING CONNECTED TO TOWN NVATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONN ECTED'r0 TONVN SENVER IS BUILDING CONNECTED TO NATURAL GAS LINE IN57'UC"PIONS 3. PROPERTY INGORNIA"PION LAND COST EST. BLDG. COST �j v� PAGE I PILI.Orr SECTIONS 1-3 EST.BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM ELECTRIC DIETERS NIIIST BF.ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ATI'ACHFD GARAGI•S MUSTCONFORNI TO STATE FIRE REGULATIONS 4. APPROVED BY: Zia PLANS MAST BE 11'11.210 AND APPROVED BY BUILDING INSPECTOR �� BI16,DING INSPE("FOR DATE FILED /J) OWNERS TEL# `w I U1 ` I 1J CONTR.TEL4 w `})LCt LlooD e CONTR.LIC# C 5 oc 0 19 SIGNATURE OF-O\N'NER OR AUTHORIZED AGENT FEE PERMIT GRANTED co / Revised 5/5/99 JIII �/ Location l 6 0 � �kA') /" e-- No. f Date �,o?-J()6/ MORTIy TOWN OF NORTH ANDOVER F V A + Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s�cMust 9 Foundation Permit Fee $ Other Permit Fee i ?' $ S TOTAL $ �S Check # I Building Inspector r BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 060219 Birthdate: 04/27/1954 {, Expires:04/272003 Tr.no: 9111 Restricted To: 00 MARK TRAINA _ 33 HANFORD RD STONEHAM, MA 02180 Administrator V 1. o ��rj��0 : IfDj � IMPORTANT DOCUMENT � ��rffl3PL PLPLnLPd�� o i 5 5 55 s Certifirate, of irtame 111111vot"5ta ntle 5 5 REGISTERED ISSUED BY 5 S APPLICATIONa iF i� HORS Date of Manufacture NUMBER s OCR TRIES INC. 03/29/00 C S �5�r EVANSVILLE, INDIANA 47711 Order Number S F 121.4 7 r v 312748 MANUFACTURERS OF THE FINISHED 5 TENT PRODUCTS DESCRIBED HEREIN 5 SThis is to certify that the materials described have been flame-retardant treated 5 S (or are inherently noninflammable) and were supplied to:657150 5 `s 5 PETERSON PARTY CENTER INC 5 R; 139 SWANSON ST � 5 5 5 WINCHESTER MA 01890 SCertification is hereby made that: 5 5 The articles described on this Certificate have_been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done in conformance with California`iFire 5 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. S ' 5 The method of the FR chemical application is: � 55 SSerial #: 8001500(2) 5 SDescription of item certified: µ F 5 5 FI TOP 20W X 20 VL W W i 5 _ Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And '.IsEffective .For:The Life Of The Fabric 5 S Signed: �� 5 JOHN BOYLE STATESVILLE NC Name of Applicator of Flame Resistant Finish 4TENTEDEPARTMENT—ANCHOR INDUSTRIES INC.pal S OcPcPcl�c PrJ�rJ��PrJ��PrJ��r P�Pc Pr PrJ�rJ�cPcPcPrJ�cPcJ�cPc PcncicPr 161,6lrJ�cPcPrJ01 EE LIE! 2111]E-] 5J111 rJ��PcJ�cPrJ��PrJ�rJ�cPcPcPcPr PcPcicPcPrJ�rJ�rJ�rPc PcPcPrJ�cJ�rJ�cPr�rJ�rJ�rJ�cPrJ�rlcPr�cP �5 � y - _ - r--�._--•--__- --- The Commonwealth-of Massachusetts - - _ Department of Industrial Accidents l ;r Office 0110yesfiff 'Iflafts - - - _ y` 600 Washington Street - aa `;-" Boston,Mass. 02111 - — Workers' Com ensation Insurance Affidavit - _ -name: location: city - -- -- - hone# _ =� I am homeowner performing all work myself. - _-- -•-- _ ❑ I ain a sole proprietor and have no one working in anv ca aeli - %///%//1////%%//y//� �%///i�i��/l//%// tl!%%%%%�%%%%��%%%%%%%%%%%/%%/%%%%%%%% -- - I am an em lover providing workers' compensation.for my_employees uor ng�on-this job. -�-�. -- _-com any name: -_address. �.3q 5�2r � Sr x T eity ), �,� QS t?f insurance co: tJT4ivc . _ f. `'/J - 01icV, �1 '7-/ ftmMki— =- - I-am a sole proprietor,-general contractor or.homeowne_r-,(cnrrle£onh)7AAd ve=iii d ihe-contractors listed below who have the following workers' compensation polices X..=:. :.:. aiddress. - - - v::; ::::::.............::.:....: v' :i.'.:.:: i::: _- ............................. .._-.. _..... ..... _._ .................:.�: .....,....a............. ...... .............. ......... ................. ........ ......-. .-.... , Xx company'name. _.k - - _ Gi _ ............ _ - ttr` --� - ..................... •. _ ,ti--��e3oaeettre coverage-as required under Section 25A of MGL352:.can-lead to-the impositrm-of-erkmMal-penWtiei o'7Me aprto S 1,So0.00 and/or - -. ncyes�ca_b"risorun ent aswell is civil penalties in-the to n n o E*$T-GPMO RK ORIXER-_and4Vine o 3100 0it tdayaig a-gist-me:-I-tmderstand-a at a - - copy of thb statement may be forwarded to the Office of Investigations of the DIA for coveiilgVerifffttion. - - �:.-..�1 do hereby.eenify.under the pains and penalties of pedury-that4he informatio 7p v dKf ore is truZant-carer[ signature - Date - 1 n _ Print name S Phone N - -o(Hciakrrst ohty -do-not write in this area to be completed by city or town official — - — - -- _� - -- - _ _ci .or town:->. __ _ ermit/Iiceme# __, 4-,. - - - - p. - --n - -0Building Departnreut. - _- -e check if Lnntediate_rtlpsme is required (]Licensing Board __ -OSelectmen's Office Health Department contact persow --� z- phone#; (rcv�sed 4/4S PTA) i Infer_mation and Instructions Massachusetts General-Laws chapter 1-52 section 25 requires all employers to provide workers' compensation for-their employees. As_quoted.from.the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied,oral or written. - - - --- An employer is defined as an individual, partnership, association,corporation or other legal entity,or any two or more-off' -- - the foreg_oing.engaged in a_joint.enterprise, and including the legal representatives of a deceased employer, or the receiver or' .-trustee of an individual, partnership„association n.or-other-legal entity,employingemployees. However the owner of a- _ dwelling house having not_morethan three apartments and who resides-therein,or the occupant of the dwelling hmKt oT--. another who employs persons-todamauitei�ance,construction or repair work on such dwelling house or-on the�3dunds or .z 1 - building appurtenant thereto shall-not-because._of such employment be deemed to be an employer. — - -"MOL chapter 152 section.25ralso. tates�tat exestate or local licensing agency shall withhold the issuanc` fre --- _ of.a-license-or permit for enate a.business= constvuct buildings in the commonwealth for any apphc2 t-vwtio' -pqo prgduced acceptable ividerrce-of�om Iia-q with the insurance coverage-required. Additional _.•;� - _p g q ly;neithc`rt�ie -- commonwealth nor any;of its political subdh isions-shall enter into any contract for the performance of pudic work until ` -- *ceptablE evidence -compl a�c�e- iththe imuraiice•reguirentents of this chapter have-been presented to the=co _ -authority. - Applicants Pleasefill in the wprkers-'.compensation affidavi completely, by checking the box that-applies�to=your situation and �� '- ers . -.suin companynames,,*ress and phone.numbers-along with a certificate of insurance-as-all--affidavits'maybe submittedto the�:peparpmeatFoj�Industrial Acciifennts;.for confirmation of insurance coverage soTbe sure=to date the affidavit., The a.ffidavtishould be rehunedta the city or town that the application for the=permit or license is”= ' being requeswd notithe Departmento€lndusttial=Accidents. Should you have any questions=regarding the Iaw-'=oi ifyot - are required4o:obtain>aw6rkers=compensationpoiicy,please call the Department at the number-listecl=below = ^" " City_ur Towns - - 'lease be sure that-the afida t.is=coYnplete"andT-ri d-legibly The Department has provided a space attu Fbottom%Ph�==-= ` affidavit for you to fill out in_th_ ent the-Offimof Investigations has to contact you regarding the appflu=.-Pfe - _ be sure to fill-in the permit/licensezumber which-m4Il be used as a reference nuinber. The affidavits may--b6—returned—tow _� thO Department-by mail or.FAX unless other arrangements.} Xe igen made. - t `The Office of-Investigations-would like tojhankyow in advance-for you cooperation and should you have xny-questions;_� r _ . _ _ :.. -Y--. - please do not hesitate to give us a call-. r--- -�- - _�The Department's`addi-ers,teleghorie aiidl'ax number;- _ --The_ Commonwealth Of-Massachusetts Iepa.rtment of-Industrial Accidents Office of Inyestigadons 600 Washington Street - Boston, Ma. 02111 fax#: (617) 727-7749 - - - phone#. (617) 727=490b--ext:=406, 409 6-r375--- - ED TO" ® d6ver O ,err-..W.w• v1 'No. LJ - -7 C N • o�A�oC;J Q\ %, dower, Mass., `7 ORATED FPa,`�5 S H E BOARD OF HEALTH PERMIT . T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT................../4.. ........................ .��.................................................................. Foundation has permission to erect..o�D....�a. ...... buildings on ...4 6.0......('/..4.R.1��......� .'�......... Rough �-e f/rl O !�'/�/^ T�tJIJ Chimney to be occupied as....................... ...................... .... . . . . .. . . .. .. . . . . . . . . . . . .. . .. .. . . . . . . . .. . .. . . . ................ provided that the person accept Ing this pornfit 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. /to I? All gra &<.r,a _ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. T Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ...........V........../.""'...... c................................................ 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. VDI• � _7�_ /y�3 �IIo 49amawado of JUMASOUatto U flPabilk c.,*y Office Use Only 7 Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Ott"Pa cy 6 ere Checiad u Ucavr blank► APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perWMW in accadartce wNA tfte Mstsactmwes filiancal Code. S17 CMR 11:ou (PLEASE PRINT IN INK OR TYPE All INFOrlA1AT1 NII Dare City a Town of To the In The undersigned applies kx a permit to poriortn dn7rinl work described Wa7or of Wino Ir)- Location (Street i Numbiarl IM Orvrser or-Tenant / Owner's Address Is Ibis permit in conjunction with abuib ' pertttie Yes No' (Check Appropriate Box) Purpose of Building Utility Authorization.NU- n Existing Service QLDAmps Lvolts Overhead ❑ Undgrd B No. of Meter New Service �rttpe / Volls Overhead ❑ Undgrd ❑ No. of Meter Number of Feeder and Ampacity, location and Nature of Proposed Elecu" 110101mi ,(-�� No. of ighfing Outlets NO.of TOTAL Hol Tubs No. of Trans(urmers KVA Aboveo- No. of Lighting fixtures SwimmingPool end. xtnd. ❑ Grrterators KVA No of Emergency-Lighting No. of Receptacle Outlets No.of Oil Burners Ballery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones.�,�, Toul No. of Ranges No. of Air Conditioners Tons No. of Detection and Initiating Devices atlow TotalNo. of Sounding Devices No. n(Dis ssals No. of Pumps Tons KW No. of Self Conuined No. of Dishwasher dArea healing KW DewartlSoundmg Devices Municipal No. of Dryers Heat' Devices KW Local❑ Connection []other No. of Low Voltage No. of Water Heater KW Signs Ballasts Wiring No. Hydra,Massae Tubs No.of Motor Total HP OTHER: INSURANCE COVERAGE: Pursuant to de aqui erneft of Massadsusties General laws I have a current liability Insurance Policy inckrding Co npiesed Operations Coverage or its substantial equivalent.YES n NO 0 1 have submitted valid proof of same to this office. YES U NO lJ If you have checked S,,pl m Indk M the type d oon wqp by decking the appropriaM bots. 1 5 '397 INSURANCE L'J BOND ❑ OTHER❑ UMien iprdW lExpiralion OaMI Estimated Vahte of EbNical Wtrtit: Work to Stan YMpeclion Date Row""&. Rough Final Signed under dw penaltNs of perjury: . ATTa y' fIRM NAM e^ LIC. NO. Llcensee Siigrsatu►t LIC. NO. lddress Bus. Tel. No.L Alt. Tel. No. JWNER'S INSURANCE WAIVER:I am aware doral de licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts general Laws,and that my signature on osis permit applitcation waives this requirement. Owner Agent IPiease check one) Telephone No. fSigrWure��or�� ._ PERMIT FEE t Date......7/. /. .. 052 'to 0 TOWN OF NORTH ANDOVER 0 p PERMIT FOR WIRING SACHUS This certifies that (.t..0.A . ........................................ has permission to perform ........................................ wiring in the building of......19!:... 7— P.................................................. at....IL.-i..... f', LN.f...................................... North Andover Maas Fee. ........ Lic.No.0?.0.............. ,.r41...... ELECTRICAL INSPECTOR Cq, WHITE: Applicant CANARY: Building Dept. PINK:Treasurer PERMIT NO. APPLICATION FOR PERMIT TO ANDOVER, NIA -�F- , MAI,No. ° � LOTNO_ 2. RECORDOFON'NERSIR' DATE BOOK PACE [ODI: SUR DIY. LO'rNO. 1(W.k IION J PURPOSE OF BUILDING t N'NI:R'SNAiMI,: � NO.OF STORIES SIZE ON'NEIt'S:IDDRESS BASEAIENTORSLAB :IR('l1IFEC'r'SNAME SIZE OF FLOOR 1,01BERS I I 2ND 3RD MULDER'SNAMI: �1.�� ,. .. SPAN - DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISLINCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM 1.0'I'LINES-SIDES REAR DIMENSIONS OF GIRDERS kit EA OF LOT FRONTAGE IIEIGIITOF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS Hllll_DING ADDITION MATERIAL OF CHIMNEY IS RHILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER 110:11t0 OF.AI'I'EALS ACIION, IF ANY IS BUILDING CONNECTED TO mwN SEWER IS RIIILDING CONNECTED TO NATURAL GAS LINE INSFIICTIONS 3. PROI'EItTY INFORMATION LAND COST EST. BLDG. COST ,7p7, VkGE I I'll LOUTSECrIONS 1-3 EST.BLDG. COST PER SQ. FT. EST. BLDG. COST PER Room FCTRIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERINIITNO. I`l"wilED CAR.I(,.F:S NIIISTCONFORN1 TO STA'T'E FIRE REGULATIONS 4. APPIMVVI) I'LANS MUST BE FILED AND APPROVED BV IMILDING INSPECTOR IIIIILDINC INSPECTOR t / D'l'E FILED OWNERS TEL11 CONTR.TEL11 7fP SICNA AF.IROF OWNER OR AIITIIORIZF:D AGENT coNTR.I.lr11 ^� PCltalrrGR:+NEED � �� Location ft.A X 11,a A-) /4 � No. . 3942 Date 814 91 40RTN TOWN OF NORTH ANDOVER 2EMAN"sift 09 Certificate of Occupancy $ y y i BuildinglFrame Permit Fee $ "ArgoFoundation Permit Fee $ u+ s+cHust Other Permit Fee $ Sewer Connection Fee $ u Water Connection Fee $ TOTAL $ / Building Inspector J � J Div. Public Works NORTH 0VM of dover No. o�A CoCH� Q \y dover, Mass., 30 S S� - BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT.,.... BUILDING INSPECTOR..... N W1 WN �' `�' ................................. ......................................................................... ......................... Foundation has permission to erect.... o� ..�! ��rbuildings on ....� ...Q......04 �� Rough L4 to be occupied as / Chimney �r .. .................................................................................................................................... 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 a UNLESS CONSTRUCTION T TS ELECTRICAL INSPECTOR � � Rough rA............................................................................................. 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. 7 . . ;�� :`��ie �a�r�noruuea� a�✓�/ �uae�Gs ��i ,. DEPARTMENT OF PUBLIC SAFETY TION�.SUPE 1 �<< } CONSTRUC _ ISOR LICENSE Mua►6e� RV +; Expires: N Birthdate: f.. ,. �. res , S� n834�69�a:69/39/1999�� estr89/381945 'R �ated�To BB 1 r >°' "` s Cb.,•+w�S �� NORMAN�" � �s F 79 JEFFERSON ST ' M ANDOVER, MA 91845 • 08/29/1999 21:22 9786856471 ALL UNDER ONE ROOF PAGE 01 5 i 67 (PoltcyProvislons: WC 00 00 c (NM ONLY) , wC 00 00 00 A) 29 vx INFORMATION PAGE-WCIP wz WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY NIURER; WTFORD UNDERWRITERS INSURANCE COMPANY HARTFORD PLAZA, HARTFORD, CONNECTICUT 06115 NCCI Cam Number. THE Compwq Code: 6 HARTFORD X77' *1/ef // -" tw,ak L.ARS 00"At, POLICY NUiR:u. wz 3A 2 aowetom..: i. N"W W"red wW MOMS Address: NORMAN GAY DBA ALL UNDER ONE (No., Street,Town, State,Zip Code) ROOF/PEST IN PEACE N 70 STREET o FERSON FFJN Number: 028349269 NORTHFANDOVER, MA 01845 � >s1tlr iMarttlNpt�lsn Ntapbrr(s): i a� tt� The Named kwurrd Iia: INDIVIDUAL UWMINa o1 NsmW M144 ; ROOFING 0vw War4*W"rat rhOWh abOW. 70 JEF'F'ERSON ST. , NORTH ANDOVER, MA 01845 i 2- POOLYPsrbd: Fmm 11/09/98 To 11/09/99 12:01 a.m.,9tandsrO time at the Insured's Melling address. ProdYoara Neuf: MASS WORK COMP A R DIRECT LEMOX INSURANCE AGENCY s PO Box 462 r LYfWIELD, NA 01940 AQ*JWa Cads: 063477 Of&*! THE RMTtrORD 4801 NORTH WEST LOOP 410, SUITE 200 i SAN ANTONIO TX 78229 f S00 f 152-7991 s » s sne poucy is not ointeng uric cc..��t4rb:0rle3 by u-&r autnortZed representative. I_♦ I�' 7 / ./ Au Wartzd PA ptaas Mdvv Form MIC 00 00 01 A Printed in U.S.A. Poor 1 (Continued on next page) Procww Ds/e: 10/09/98 PoNq►E>OfkalfOh gate; lI/09/9 9 PERAIP6 NO. tom- APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.. 11ZPA GE 1 MAP 4,40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE — ZONE I SUB DIV. LOt NO. � I LOCATION / 14 ;// / PURPOSE OF BUILDING G OWNER'S NAME !'� (�- NO. OF STORIES ilzif o1w j OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME ✓ SIZE OF FLOOR TIMBERS 1 T 3RD BUILDER'S NAME /� SPAN -- DISTANCE TO NEAREST BUILDING Cr d Of lid' 7 DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES29r- REAR GIRDERS AREA OF LOT (" ' O FRONTAGE HEIGHT OF FOUNDATION /)!? E88 T I JJJ�/ , vJ I' IS BUILDING NEW / SIZE OF FOOTING ij 41 X N IS BUILDING ADDITION MATERIAL OF CHIMNEY rQ� IS BUILDING ALTERATION 77 JJ IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yey, IS BUILDING CONNECTED TO TOWN WATERT BOARD OF APPEALS ACTION. IF ANY L� �� IS BUILDING CONNECTED TO TOWN SEWER �Y IS BUILDING CONNECTED TO NATURAL GAS LINE lIII INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. C08T Z PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER Q. FT. iB PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM 0 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 APP OVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIG ATURE OF OWNER THORIZED AGdkT FEE � yiy PERMIT GRANTo OWNER TEL.#� PLANNING BOARD CONTR. TEL. # Z` 1? IB _ CONTR. LIC. # 4n may. /,1 GG A /��L�/�/�4/� /G'D BOARD OF fELECTMEN � V' If 60? � � BUILDING INBlKCTOR BUILDING RECORD 1 OCCUPANCY 12 ' SINGLE FAMILY SiORIE$ 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 I I AGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 123 CONCRETE PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ (1- 72 3 EASEMENT AREA FULL IN. AREA '/ . '/� V. FIN. ATTIC ATTIC AREA NO B M FIRE PLACES HEAD ROOM MODERN KITCHEN Az 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD%,J'D ASBESTOS SIDING 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 ADEQUATE N E I-1 ONE Q 5 500F 10 PLUMBING GABLE HIP BATH (3BATH FIXE GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 1 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. S 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 r Location r � � ,,�u'�'2-�• Ido. C2 Date . NORTH TOWN OF NORTH ANDOVER 3? • s 0 p Certificate of Occupancy $ # Building/Frame Permit Fee $ �ssAcMueEt� Foundation Permit Fee $ Othet Permit Fee Sewer Connection Fee $ Water Connection Fee $ �" RZ AVG _ '/• Building Inspector t. J '� Div. Public Works 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***************** APPLICANT: � 7 � L L—Z/ Phone LOCATION: Assessor's Map Number Parcel Subdivision ✓� Lot(s) Street l/ �/��/ �/� (�/�/� St. Number ************************Official Use Only************************ R,EECCOMMENDATIONS OF TOWN AGENTS: (1 • c Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments v Date Approved Food Inspect�oor-Health Date Rejected Date Approved /23h�l Septic Inspector-Health Date Rejected p p � d Comments Public Works - sewer/water connections - driveway permit Fire Department I/ ✓ "�` 6 4z Received by Building Inspector Date r b 1 i 4h 1 7 4 S f: I t' 1 Z ,. 4 ti / d 12 3 4 / 9 2 3 4 / .i 14 5 fi ] d 1 2 3 4 S b / tl 1 2 3 4 S 6 / 8 1 7 3 4 .5 fi 7 tl o . r E hrera SS Ron-F 4 \ a e� R u L 6 it me Y,,'n rQAe_ Sub 2�a-E';nS_._ __ �x vtI, I to q 5 e � - 'LX 12 R'k 4*,fS V�OD�S�t f fM�' rt d F U 10. a►3� -"top PLs$c , �" So-Ef�♦ Vav`'{ (,IvXf% , RL �$ 1drs �Z) v g,.F, Sky 1;5t�+s• s�.;d�y h TI 6 z Low Pre g,'h t=1as�+;ns 5 M `I Q� „ l;drr ,1 0 ��2 COX '`f?Iytooca' S�,eati.;v\5 '1ZX6 L'�cPar C�a�boa�d wl t'Y pqr go For Qndr , ' s-/o X /o C4semc�"f - - Q_X P,T, --- , Zl �E 3000lb w� (IYfl wtae ---- -- - � i S� r•g o(� f fi F�oaR Plate S�a1c J�y '= l , 0�, ] o b � E GorL o ' 4 L h O s CRoss See{oh $Cglg /L1� : I�-O l.on-IT�.cToQ: obt� JOB «� C.Qf- ' +OP� h4VNi� Nb t'1hG�0U�� MA ,. I V . d eve r. _ . XY14 -- _ SHEET NO. 0 T OF O ✓)e. W CALCULATED BY DATE Q CHECKED BY DATE L I $ I ? y "- SCALE I '-o ,. PRODUCT 20-1 Gr•,r Miss 1147'Ta O•c,,PHC9E TOLL FREE I-E..-225-Efl_° I �f fir. • Finish Work a Specialty $ B alley Quality Workmanship .emodelin g Free Estimates f ,vlA 01845 Builder's License #025620 ~. 682-7087 , TO JOB LOCATION Mr . & Mrs . Robert Krueger 160 Carlton Lane Borth Andover , Mass . 01845 same DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE NO. 3 /g 3 x x x OF PAGES i JOB DESCRIPTION: Sun Room Addition matcbhthat of the main house. �> Tile contractor shall provide four dupt1 x receptacles for the room, 3-way twitching of the present exterior spotlights from two locations a within the room , and installation of two single pole switches to control ! c a fan/ light ( eiling ) combination . The fan/light unit shall be furnished by the owner and installed by the contractor . All circuits to the sun room shall make use of the preeeeb electrical panel by simply installing necessary additional breaker . Allkconstruction debris shall be removed from the site by the contractor . Tyvek or Typar hossewrap shall be installed on ext>brior walls of the sun rood by the oontractor . Exterior roofing shingle color shall match that of the main house. All construction practices shall meet applicable state and local code requirements . Any variances shall be the responsibility of the owner. The contractor shall backfill around the foundation area to approximate present grading . All finished landscaping , sodding , sfshubbery : etc . shall be the responsibility of the owner. I Hereby Propose to furnish labor and materials complete in accordance with the above specifications for the sum of s 14inoteen Thonsario Two Hundre(t eighty-four and --------32/ 100 ( 89 , 284.32 ) i Nith payment to be made as follows: $4500 upon coifiipletion of excavation & foundation OCK � t $8700 upon rou(i framing completion , installaT.ion of Boor & wlnaow units , rooring installaiton ; $2000 upon cofnpietion of clapboarding &exterior trim , r} A411 material is guaranteed to be as specified.All work is to be completed in a workmanlike manner according to standard practices. An alteration or deviation from above Authorized 9 P Y specifications involving extra costs will be executed only upon written orders and will Signature Become an extra charge over and above the estimate.All agreements contingent upon Note: This proposal ma be withdrawn b us if not Strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other P P Y Y 'iecessary insurance. accepted within `' 'days. Acceptance of Proposal-The above prices, specifications and conditions are satisfactory and are hereby accepted. You are Si nature authorized to do the work as specified. Payment will be made g as outlined above. � Signatures�� _ - Date Accepted , , OFFICES OF: TOWn, O1 120 Main Street APPEALS NORTH ANDOVER North Andove. Massachusetts BUILDING `�::,:y CONSERVATION � 4 DIVISION OF (6 1 7)685-4775 HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: } (Location of.Facility) Signature of Permit <pplicant Date /^ NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. S 2?3oG •n a Gs�Z�. 7 e,7' i we � 5�IV 1 i33 a Gal' NORTH Town of over 0 No.2 7 5 o� o��,� dower, Mass., Syt 19 0RArE0 P'Pt,`�� 1 H f4 BOARD.OF HEALTH Food/Kitchen PERMIT T Septic System BUILD INSPECTOR THIS CERTIFIES THAT.....R.10.41irmar � ..xxv.1111r.IN..........•...................• Foundation BUILDING has permission to erectASIA0.44"Af... buildings on .1 A...10.9.#1 AL.. .�� ••••• Rough to be Occupied as...#J&oft## AR �� d /. ., I... � ........ C e himn y 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 UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR Rough ................ Service BUILDING IN ECTOR 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL ( �� CONSERVATION FINAL Street No. Smoke Det. CEMED MIATCD FiniAi a DRIVFWAY FNTRY PERMIT._ CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 275 Date SEPTEMBER 22, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 160 CAR= LANE MAY BE OCCUPIED AS 13' x 15' SUNROOM IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. NORTIy CERTIFICATE ISSUED TO Robert & Carol Krueger 160 Carlton Lane ADDRESS North Andover. MA 'Js„"Us` Buil ing Inspector v Town of N'orth , over , No.2 7 5 • T ` Nortt f Andover, Mass., X&A J 19& BUILD BOARD OF HEALTH Food/Kitchen PERMIT To Septic System THIS CERTIFIES THAT..... A• MAT AVANO .. .. .IS ............................... BUILDING J DING IN�ECT . l has permission to erect.4440.!"Of... buildings on - �.o... ..0.4k.n., .�� .... 76-penc tL �� 3 /3X/r' �W to be occupied as... � 6 ...� � ' I.......��1..m.��........ 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 II1 , I � i Final y ' I 111 ( , i I' i t s' I ELECTRICAL INSPECTOR i � 1 ' i t It j � 1 ' � Rough ... ... ., ...... ' .. ................ Service � \ BUILDING INS ECTOR A � �— Final GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. ' Burner PLANNING FINALCONSERVATION FINAL Street No. `� �' + Smoke Det. C'MAIEn /%AmTCD PIKI01 �'� nRl\/F\A/AY FKITRY PERMIT __ _ __ n . I _4 A/e � �. 000�2 3' a T�•8?' 9 y Ga �3 p JL►L 3 r r cr �