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HomeMy WebLinkAboutMiscellaneous - 18 STEVENS STREET 4/30/2018Date .12-1 V. IJ.�, TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..In.l. j�,—.. l r',► ? � �_ S� .... . . . . . . . . . .. . has permission for gas installation .." in the buildings of ........................................... at ..... / ..... <1-? ..:. - .......... , North Andover Mass. Fee. .. Lic. No. ./S .SCJ... C7 - . . GASINSPECTOR Check # ' ,� 8514 Qx MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY North Andover MA DATE 12/20/12 PERMIT # JOBSITE ADDRESS 18 Stevens st _ OWNER'S NAMEGlai� ss GOWNER ADDRESS Same TEU FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL [] RESIDENTIAL Ej CLEARLY NEW. RENOVATION: �� REPLACEMENT: PLANS SUBMITTED: YES N0 APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER k _ CONVERSION BURNER COOK STOVE � DIRECT VENT HEATER�M DRYER FIREPLACE FRYOLATOR FURNACE��-�— GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS f g MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST r , UNIT HEATER UNVENTED ROOM HEATER i?(j^w;�j; WATER HEATER OTHER T- � INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES, NO I IF YOU CHECKED YES, PLEASE INDICATI_THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ej OTHER TYPE INDEMNITY L] 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 0 AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issuedifor this application will be in compliance with I Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r PLUMBER-GASFITTER NAME I LICENSE #Lj2L1_j qGNATURE#L1251_ MPD MGF [j JP [j JGF ® LPGI CORPORATION [jj# = PARTNERSHIP#L LLC [J# COMPANY NAME: The Boiler Guy/Mike Ca Bless ADDRESS 160A Pleasant st CITY North Andover STATE MaZIP(-0184TEL 978-382-1017�� FAXi CELL EMAIL .N D ' \/VIYI,IYIVItl YYGHA.,1 il'V I- BYIHJ�iHN11VJ{�A tJ PLUMBERS AND GASE'ITTERS LICENSED AS k MASTER PLUMBER ISSUES THE ABOVE LICENSE TO: MICHAEL N CAPELESS 105 TYLER ST ` METHl1E14 MA 01844-1905 15851 05/01/14 176378 ' Date. .��7...... OFNORTH 'Iti o� TOWN OF NORTH ANDOVER F F PERMIT FOR GAS INSTALLATION This certifies that ...�"��.. !`.�.. i !' ..� .......... has permission for gas installation ................ . in the buildings of ........ ......................... . ................ . North Andover, Mass. Fee --14-12—S .'. Lic. No..l !. .....r! /;, 6045 GAS INSPECTOR Check # c� 17 / 6045 l MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Permit # �% Amount $ Owner's Name !1 Q jis New Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) Name U vl 1) Name of Licensed Plumber or Gas Fitter (-/ 1 ,- v, s /7"i,,,v, Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No 13 If you have checkedrtes, please indicate the type coverage by checking the appropriate box. Liability insurance policy❑- Other type of indemnity 13Bond ❑ Owner's Insurance Waiver: 1 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 Aaent n herehv nprtif- that all n4 tho A-++ :l «A :«4r -- ---- -- -- -- - « - ••Q .. 111 LSV, kvi cnicrcu) In aoove appncatlon are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State*pd�deand Clr 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber ❑ Gas Fitter ricense Numoer Master 0 Journeyman 0 z w W G C j O z W O C7 F w d 7; W CL C w F' x sx dCA z a d x C x ozG � E. 3 A v� m z O z w Oi. x td7 .da oOc > SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR ff 6TH. FLOOR 7TH. FLOOR I 8TH. FLOOR (Print or type) Name U vl 1) Name of Licensed Plumber or Gas Fitter (-/ 1 ,- v, s /7"i,,,v, Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No 13 If you have checkedrtes, please indicate the type coverage by checking the appropriate box. Liability insurance policy❑- Other type of indemnity 13Bond ❑ Owner's Insurance Waiver: 1 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 Aaent n herehv nprtif- that all n4 tho A-++ :l «A :«4r -- ---- -- -- -- - « - ••Q .. 111 LSV, kvi cnicrcu) In aoove appncatlon are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State*pd�deand Clr 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber ❑ Gas Fitter ricense Numoer Master 0 Journeyman Date. TOWN OF NORTH AN PERMIT FOR PLUMBING This certifies that ... ." 0 ........................ has permission to perform .... C�� u �-��� ` `� plumbing in the buildings of .................................. at ... .................1, North Andover, Mass. Fee .`-"�' Lic. No.. . 3 �� `. ........ --�V .... . PLUMBING INSPECTOR Check # J") t 7232 I j I /' 'F - e,7 Date.... .............................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................................... has permission to perform wiring in building of ... ..................... ....................................... at .................. .</� .... .................. . North Andover, Mass. Feec�<3/ .......... Lic. No. &� .'.';/� ................ ii� ................ ..... AL INSPECTOR Check #z 7141 � Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 1% Occupancy and Fee Checked [Rev. 9/051 (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: / ,Pp I City or Town of. NORTH ANDOVER To the spe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) / op S-& V` Av y Owner or Tenant Al A-eJ c. % r4 S s (Fd S c Telephone No. Owner's Address er Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building % a1 ���/ �lC, Utility Authorization No. Existing Service Zoo Amps 12-o / u 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: JLC -r ch =d Wt,y a X e- -4- A-z a/ Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires 3 No. of Ceil: (Paddle) Fans of Total TransSusp. Trsformers KVA No. of Luminaire Outlets /0 No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In -1-1 rnd. rnd. o Emergency Lighting Battery Units No. of Receptacle Outlets -0 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches 3 No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges / No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers p �- Heat Pump Totals: Number Tons KW No. o Self -Contained Detection/Alerting Devices No. of DishwashersSpace/Area <a- Heating KW Local ❑ Municipal El Other Connection No. of Dryers j Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters o. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: s No. of Devices or E uivalent [OTHER, Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: / S e <��. (When required by municipal policy.) Work to Start: / F a 7 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C V RAGE: 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: IWI CE S er`V, r - r-/ AJ e_ LIC. NO.: Licensee: Signa ure %moi =�' LIC. NO.: �� /�>C r// g � (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: Address: yl -7 cJcc,dp-fa J Rd •_ Sa. PazP (e *b -J Alit- c'Jks:� Alt. Tel. No.: (o d 3 i 6064' *Security System Contractor License required for this work; if applicable, enter the license number here: 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. PERMIT FEE. $ q;22 I?P-Y-A of rte" B - ()- q 0-1 P� 14 Iv ESSEX ASSOCIATED — PROJECT"61 Ld.55 �,o-t :. R �i �d--�i"...- _SHEET NO. CONTRACTORS, LTD. 300 Middle Road - -k U�-� �=a� DATE ti Q CHECKED ✓ Haverhill, MA 01830 (978) 373-4550, " TITLE MUM , Q(21 ®TURAI No. 27707 I 14 s +1 L3 FrZC E-5 S;T'ra- V o reV�>q ESSEX ASSOCIATED -___.::._.PROJECT 4jL-k55- CONTRACTORS, LTD. -DA CHECKED 300 Middle Road Haverhill, MA 01830 (978) 373-4550 ...... FTrrLE___5 R -M F;;- OA 0 OF F ez. UM 7�5 _.st" r 2" I URAL 27707 - rq:oj5 AIL —/-( SHEET NO. J01/26/2007 17:20 FAX. 9786643067 William C.. Hale, P.E. 10004 ESSEX ASSOCIATED -NO. CONTRACTORS, LTD. 300 BMW e RiAd 7 92verhU4 MA 01830 (978) 3734550 01 �0"M.N� I I 4'. L o eL, ! ........ .. -1 09 -:a- ar - z. w, ki 4-0-- 6�14 +1 nt­ I > 411 El MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building New Owners Renovation flj Replacement FUTURES Date `o(.", Permit # 3 L Amount 7 y. -t� Plans Submitted Yes 11 No 11 (Print or type)� �� � tJ � � Check one: Certificate Installing Company Name LJ Corp. Address o Partner. fe-9 f 9 rz6117 n ,Orv// D Business Telephone b03 77m L6 3 1 Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policyly, Other type of indemnity E] 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 IOwner 11 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 installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus to Plumbing and Chapter 142 of the General Laws. By: 71vmm o u ens um er Title Type of Plumbing License �� City/Town Ic nse um Master Journeyman El APPROVED (OFFICE USE ONLY 01/05/2007 15:58 FAX 9786643067 William C. Hale, P.E. 0 001 William C. Hale, P. E. Consulting Structural Engineer Three wagon Drive, North Reading, MA 01864 Phone & FAX 9781664-3W7 E-mail• wchale@rcn.com FAX MEMORANDUM DATE: 5 January 2007 SENDING TO: Paul McGrath COMPANY: Essex Associated Contractors, Ltd. FAX NUMBER: (978) 373-4550 FROM: Bill Hale RE: Glass -Ross Residence Alterations d 8 --Stevens -Street _ -North :Andover;= MA Thia facsimile transmission is intended for the use of the individual or entity named above, and may oonWh Confidential infomragon belonging to the sender lfyw are not the intended radpient any disdowm, coppng, distributing or the !eking of any action based on the contents of this infamadon l5 striody prohibited, if you have received this transmission in error, ploaae immediately notify us by telephone or fax to arrange for the relum of the documents. Paul, Just wanted to follow up on our site visit this morning and our discussion concerning the floor framing at the rear section of the existing structure. You had indicated that North Andover building inspector Brian Leathe had expressed concern that supplemental floor joist you had sistered to existing vintage framing was not preservative pressure -treated wood- As I indicated, section 3603.22.4.1 of the state building code requires that floor joist closer than 18" to exposed ground be preservative treated lumber. However, the old joist in this area do not appear to exhibit signs of decay due to past moisture presence. This is an indication that, even though the clearance is less than present code, moisture damage has not been a problem in this area. You also indicated that your intent in sistering new joist was solely to level the floor, not to reinforce deteriorated joist. Keeping these facts in mind, we would suggest as an alternative to the use of treated lumber, the installation of a vapor barrier on the surface of the soil below the framing. Six mil polyethylene sheet should be installed with all laps and penetration taped to prevent the passage of moisture from the soil below. Please call if you have any questions of if we may be of further assistance. Ve trul yours, William C. Hale, P.E. Location!7G/ No. Date /S M TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ � s�s t cMuE Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ -------- Water Connection Fee $ TOTAL $ � �,•,/ ��� Building Inspector x la f n x` 715V 15.00 PAID Div. Public Works / o. G L t� v G L APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. MAP'KJO. LOT NO. 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZONE SUB DIV. LOT NO. �— CATION ` PURPOSE OF BUILDING d)c plc eEc. ��vL.a�� S�nt✓J OWNER'S NAME �.� f�i� csv%n � nep tK I IA1l "—&dy' -I, L M` 4 E OWNER'S ADDRESS ,aF?d S-&�rvl.s sj. NO. OF STORIES SIZE O BASEMENT OR SLAB IZlg1/l� S t�� Sl.��,_ Uvrr ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN - DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET / �'� POSTS 2JISTANCE FROM LOT LINES�pE��/10�/ REAR 41 f .' " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION 4/ / THICKNESS l0 T IS BUILDING NEW SIZE OF FOOTING % IS BUILDING ADDITION MATERIAL OF CHIMNEY ,HBUILDING ALTERATION 4f& c IS BUILDING ON SOLID OR FILLED LAND jMrL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER No BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER Nn IS BUILDING CONNECTED TO NATURAL GAS LINE SEE BOTH. SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 INSTRUCTIONS ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING i ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR b// DATE FILED J4,3CI ( f I !/ SIGNATURE OF OWNERAR AUTHORIZED AGENT FEE GO NER TEL. # �iSy/ f �� PERMIT GRANTED �%/ CONTR. TEL. # 19 —=—f-- CONTR. LIC. #_ -- �a -4:01 � 3 PROPERTY INFORMATION LAND COST EST. BLDG. COS �'(3Ci ' EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ S'ORIES 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 RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I $ INTERIOR FINISH(l4O j 1 �`���` `-,I ; CONCRETE 3 L_13 I1 1} J \! 6 CONCRETE 8L K. PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL- UNfIN. 3 BASEMENT 11 AREA FULL V. 1/2 '/, 10 PLUMBING FIN. B'M'TAREA FIN. ATTIC AREA l DC7 1 n � �Ov�S �% I/!� \ /�-�--c (� `\F\ ��tl 1 V --+'� �V 'L` '�,A •/� I... ^ \\\ {� +`may Y �`EfV �•' \ �% J V � J b I f `-' a �x NO BMT FIRE PLACES _ HEAD ROOM WATER CLOSET MODERN KITCHEN LAVATORY WOOD SHINGES KITCHEN SINK 4 WALLS I 9 FLOORS CLAPBOARDS NO PLUMBING TAR & GRAVEL B _ 1 2 3 _ _ DROP SIDING MODERN FIXTURES CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD�'J D ASBESTOS SIDING _ COMtAC;N VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER ELK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORPOOR 1 11 ADEQUATE I� NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13BATH FIX) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES 6 FRAMING II 11 HEATING WOOD JOIST TIMBER BMS. & COLS. STEEL BMS. & COLS. _ WOOD RAFTERS 7 NO. OF ROOMS B'M'T 2nd Isr 13rd I� rA IV 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: %_ - Phone LOCATION: Assessor's Map Number Parcel Subdivision Lots) Street 1-/7o 2EV0?,,4 � _ St. Number /-/-)C)— ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: n 11i >M Date Approved l W/?� Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date v '`� � '- a NN ON x o Q as o wO V)U nv � a o0 z z C: s a z a a 0 w z U w a O x > C/) w a o u w z z a w w w z C/) o O nO c uj o z o C 0 G N c, C CD ' •a • : CLC • as c .r •y :o H � • L Vi C fl. CO) E c $Cw o Oo o •r cm C C mm a L d lk7lkC N N o L y � 3 C_ � •p 'O C mO O m : t C C H O O -E c02 co CD as L -a o o� O y s t CL o os aCs S, c r m moo cm CL c H y O C 'C 2 m, O N ~ y m o Cl) Lit .. c •- LL 'VJ S O A O N •C.= C Z Ow CD ca O_ V •m v m F•— COD aCD g S R m CD O I-- c � nim 0 zIND F�--t W 0 r4 M y coM coL Q C O CO C.3 _Q y O O O C.3 CA C O u s L O V GC) CL CO2 C co Q O Q Q. Q C !C !C J 'C O CO Z CDQ CO2 C r�mftl J z z 0 Q LU U) z 0 U �` �.:- ,JI. �� rte--., `,/'/�I .'„� r--�p--s-.}\`�. •-�'y�/�(. , SjN3/� 3� S �S1'Loi 3 �t I � O N 1 b 3 d J I nt 40RrN TOWN OF NORTH ANDOVER 00 F- 'A PERMIT FOR PLUMBING This certifies that ............. has permission to perform ... ................. ....... plumbing in the buildings of ... S-., 5 ...................... at. ./................. North Andover, Mass. I/. Fee.. Lic. No.././." J.0. ....... L.... PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT T O PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS c, __`` II Date %� L Building Location Jl �'r� Owners Name V1ot )a G55 Permit #772,7117-111 Amount �� ��- Type of Occupancy _ ,a New ® Renovation F1 Replacement 1:1 Plans Submitted Yes ® No FIXTURES (Print or type)Check one: Certificate Installing Company Name P I ` rv-- b) r S Corp. Address 3 �'� 1� 5+1 Partner. Business Telephone Cj '? F— (f (, Z 7C y q Firm/Co. Name of Licensed Plumber: A n Q oe,,1 I— Q E-SG3 %1 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ❑ 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 I hereby certify that all of the details and information I have submitted (or enti best of my knowledge and that all plumbing work apd—m--sWations performed compliance with all pertinent provisions of the M(sa!kIltsSta Pl binl By: ► Ot LiCenSeaum r Type of Plumbing License Title �S� ' Agent F1 in above application are true and accurate to the r Permit Issued for this application will be in o and Chapter Y42 of the General Laws. City/Town icense Numoer Master EK Journeyman APPROVED (OFFICE USE ONLY .j (Print or type)Check one: Certificate Installing Company Name P I ` rv-- b) r S Corp. Address 3 �'� 1� 5+1 Partner. Business Telephone Cj '? F— (f (, Z 7C y q Firm/Co. Name of Licensed Plumber: A n Q oe,,1 I— Q E-SG3 %1 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ❑ 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 I hereby certify that all of the details and information I have submitted (or enti best of my knowledge and that all plumbing work apd—m--sWations performed compliance with all pertinent provisions of the M(sa!kIltsSta Pl binl By: ► Ot LiCenSeaum r Type of Plumbing License Title �S� ' Agent F1 in above application are true and accurate to the r Permit Issued for this application will be in o and Chapter Y42 of the General Laws. City/Town icense Numoer Master EK Journeyman APPROVED (OFFICE USE ONLY % 1 E N2 2050 Date .....,< !.. „OR7M TOWN OF NORTH ANDOVER PERMIT FOR WIRING cm This certifies that ......./7.!'t .R �...{..I....... L?.��................................. has permission to perform ...... M..Aj..... ............ ............ G, wiring in the building of!^ ! 1. v SS ................. ...................................................... at ......... J..� ...... I ..0 U ............ f :......................... orth Andover, Mas. Fee ... ... Lic. No.....71J... .....................t�...�,l ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer t hi IA W The Commonwealth of Massachusetts FOR OFFICE SE )��\ Permit No. � _ (f Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of / V G R TH A a u' Uy — l,-" To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location (Street and Number) / E-Uc 1V MAP Owner or Tenant Owner's Address 6- PARCH. Is this permit in conjuncts;with a building permit? Yes;0 - No ❑ (Check Appropriate Box Purpose of Building M 00 '411�1 Utility Authorization No. Existing Service New Service Amps / Volts Overhead ❑ Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work m Overhead ❑ Underground ❑ Underground ❑ No. of Meters No. of Meters of my o /Cue_) No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emerg. Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self-Contained Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals No. of Total Total Heat Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of Signs No. of Ballasts Local ❑ Muncipal Connection ❑ Other No. of Hydro Massage Tubs No. of Motors ' Total HP Low Voltage Wiring OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Gt�rr eral Laws 1 have a current Liability Insurance Policy including C mpleted Operations Coverage or its substantial equivalent. YES 151 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 11 BOND C3 OTHER ❑ (Please Specify) l �/ FA X 1 ;VrO (Expiration Dalc). Estimated Value of Electrical Work $ Work to Start — — y Inspection Date Requested: Rough Final Signed under thepenal 'es of perjur FIRM NAME b✓ 0�y I—r— 4 A LIC. NO. Licensee Address 40. L9-317—Rdel Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee DOES NOT HAVE the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives th' quirement. Owner ❑ Agent ❑ (Please check one) �d Telephone No. PERMIT FEE $ � ' Location /r -Za S T i No. Date C4- a �/ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ _ FQ�pq,Qtt�her Permit Fee $ YY5 ✓� 41ponnection Fee $ &0',417010, N 08 Water Connection Fee-� $ �• Anq+o,�r� •�TOTAL / / $ 7 or Building Inspector— Div. Public Works PERMIT NO. -;2W2,13 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. 1"/PAGE 1 MAP +40. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. F LOCATION 16- PURPOSE films' C fin. Y rp- Ce lJt�S+IZE OWNER'S NAME ' j� �•+ ,F tp �� I ex m ia Cg/� NO. OF STORIES OWNER'S ADDRESS k;9 , G` e V e Vt"1� � L�p C/ �C� T LC.. BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD 1 r BUILDER'S NAMF jo(rV C,j a0 tjit --()w ) t, IK�AU� 1 t, J�+1 �4 U SPAN DISTANCE TO NEAREST BUILDING __— DIMENSIONS DIMENSIONS OF SILLS DISTANCE FROM STREET "' POSTS DISTANCE FROM LOT LINES - SIDES REAR " " GIRDERS AREA OF LOT t FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY ,D S BUILDING ALTERATION WILL BUILDING CONFORM TOO REQUIREMENTS OF CODE j/j�� IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO TOWN WATER OARD OF APPEALS ACTION. IF ANY �® IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 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 LANS MUST BEJ�FILED a'AND APPROVED BY GBUILDING INSPECTOR DATE FILED SIGNI&TJJRE OFjPWNER JORI A UTH16RiZftiAGENT- ._ ,r% PERMIT GRANY 19 r o'3 CONTR. TEI(AC.2_Y":(�j^ CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST -So` o0c.) EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH r PLANNING BOARD n BOARD OF SELECTMEN 1 OCCUPANCY SINGLE FAMILY 10 PLUMBING Y 1/2 14 STORIES FIN. ATTIC AREA MULTI. FAMILY N_O BM'T _OFFICES FIRE PLACES _ APARTMENTS TOILET RM. (2 FIX.) MODERN KITCHEN _ _ FORCED HOT AIR FURN. CONSTRUCTION 2 FOUNDATION—I 4 WALLS 9 FLOORS 8 INTERIOR FINISH CONCRETE _ B a 1 2 13 CONCRETE BL'K. CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING PINE HARDW D COMMCN ASPH. TILE VERT. SIDING _ STUCCO ON MASONRY BRICK OR STONE OIL HARDW D _ STUCCO ON FRAME PIERS BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ PLASTER WIRING STONE ON MASONRY i DRYV✓AlL _ UNFIN. 3 BASEMENT AREA FULL ADEQUATE I I NONE 1 FIN. B'M'TAREA 10 PLUMBING Y 1/2 14 I FIN. ATTIC AREA _ N_O BM'T 6 FRAMING WOOD JOIST FIRE PLACES _ HEAD ROOM TOILET RM. (2 FIX.) MODERN KITCHEN _ SHED FORCED HOT AIR FURN. WATER CLOSET TIMBER BMS. & COLS. 4 WALLS 9 FLOORS CLAPBOARDS LAVATORY _ B 1 2 �_ 3 _ DROP SIDING WOOD SHINGLES AIR CONDITIONING CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING RADIANT H'T'G HARDW D COMMCN ASPH. TILE VERT. SIDING _ STUCCO ON MASONRY OIL ELECTRIC NO HEATING STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY I II ADEQUATE I I NONE 1 5 ROOF 10 PLUMBING GABLE I HIP TILE DADO BATH (3BATH FIXE 6 FRAMING WOOD JOIST GAMBREL]- MANSARD I 11 HEATING TOILET RM. (2 FIX.) _ FLAT SHED FORCED HOT AIR FURN. WATER CLOSET TIMBER BMS. & COLS. ASPHALT SHINGLES STEAM LAVATORY _ WOOD SHINGFS HOT W'T'R OR VAPOR KITCHEN SINK WOOD RAFTERS BUILDING RECORD 12 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. Li FLOOR �ITILE TILE DADO 6 FRAMING WOOD JOIST I 11 HEATING PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ 7 NO. OF ROOMS B'M'T 2nd _ 1st I I RADIANT H'T'G UNIT HEATERS GAS OIL ELECTRIC NO HEATING Q W LL. O 0 m 0 W Z ZZ J m L 3' o C E f oLU 96 Z J L �' o S O W H Z Q V LU .IL W c o V ` m O H W d V L a o h„ 96 LU C m E Y c E tL U ii 2 U. tr to ii tL iL to to It: rt Ak T y C_ a, v1 a LUrol F, o 1 ��j'a ai cim N a d = y s 4. s V y Ln O LLJ O - ! X w Y C� m'w O 00 C �C O N (f) w ..I ZD MI O Z 'F.rs. �. c:. .. � �..` .rf...-... s.•sga+: Z`.. .. •.+da�..�:.. �: a.d��a�+a-�=a+EEr.-. _'�n�-r=-.. �s - �. _ , . .. ,_ _ :. _ . a W E i C ow c v O d a E c N. (A c Q _ �C V Z = •Ec .m CL o C � O V � O Z 'F.rs. �. c:. .. � �..` .rf...-... s.•sga+: Z`.. .. •.+da�..�:.. �: a.d��a�+a-�=a+EEr.-. _'�n�-r=-.. �s - �. _ , . .. ,_ _ :. _ . a. (Please print) DATE JOB LOCATION Number Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption l \fevl5 ,,+ feek Street Address "HOMEOWNER" 5V54h 51 [W_0Y\4W 06-g(235� ame PRESENT MAILING ADDRESS -ArZ ome Yhone ection of town Work Phone City Town State Zip code The current exemption for "homeowners" was extended to include owner occupied dwellings of six 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 109.1.1) 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 to be, a one to six family dwell- ing, attached or detached structures accessory to such use acid/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Bulding Official, that he/she shall be responsible for all such work performed udder the ,.building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance 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 m' 'mum inspection procedures and requirements and that he/she wi com ly with said procedures and requirements. HOMEOWNER'S SIGNATURE bw N APPROVAL OF BUILDING OFFICI Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. Location y -e 41 S S4— No. �3 Date ' M�RTM TOWN OF NORTH ANDOVER a # Certificate of Occupancy $ Building/Frame Permit Fee $ Eta' s�CHUS Foundation Permit Fee $ `- Other Permit Fee $ ` Sewer 113onnection Fet lff $ Water Connection Fee $ TOTAL $ N 4� i ►r���o_c_R Af ,'" 'ER rt:L4 lZU I Uduilding � 3418 Inspector \ Div. Public Works t� �©l j Fill v i w0 C Or cn 0F - r GZ: O Z 2 Z! 2 z �- O O O -� S V Z C9 ❑ V A U A � J r a W Fw w J rn r �] W W 1^1 O O O � � N ❑ O O A j Fill v i w0 C Or cn 0F - r GZ: O Z 2 Z! 2 z �- O O O -� S V Z C9 ❑ V A U A J a Fw w J rn r �] W W 1^1 O O O O � O � i U O Q1 � Z a z 7 I A' J N W o U � ❑ y VI tu tit X O U n E•d � � ., r Z C ¢ � a c � O U w U U U O U U U Cd1 � h .. oV) p O Z w „ 14 '(:r a Z 9 ;, o r U U U c O Ca C C o w Wim' r cAa r r o o c a V3_� < W W W a u O `n a C7 Z Z z n O "� -� . F• Z V .� L w j v� w w w O U zO O U O U O U < -a n W n W rn win W a j Fill v i w0 C Or cn 0F - r GZ: O Z 2 Z! 2 z �- O O O -� S V Z C9 ❑ V A U A J a Fw w J rn r �] W W 1^1 O O O O � O � i U O � a z 7 I A' J N W o U � ❑ y VI tit O U n E•d � � ., r Z C ¢ � a c � O U w U U U O U U U j Fill v i n 41Q � ^7 W J a Fw w J rn r W W �N" O O O i I ^7 W W W �N" " q 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. *******************'t*om'*****APPLICANT FILLS OUT THIS SECTION APPLICANT cJr-►� �2Gj� PHONE 6&8 LOCATION: Assessor's Map Number 1?es W&A PARCEL SUBDIVISION LOT (S) STREET .Vel �ST. NUMBER 18 ***********O F F IC IAL USE ONLY*******'* RECOMMENDATIONS OF TOWN AGENTS: 16 e CONSERVATION ADMINISTRATOR DATE APPROVED COMMENTS_ Dri9p,6V TOWN PLANNER COMMENT I DATE (REJECTED_ — tiof I / J0 DATE APPROVED DATE REJECTED I�OOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED_ COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING I Revised 9197 jm ct 129 -7- el'� TE • _.._ it North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision 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 c11,S150A. The debris will be disposed of'in: 3�VD 2611 (Location of Facility) Signature of Permit Applicant i !y �7" gg Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND , 94 High St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL( PO Box 342 COMPANIES AFFORDING COVERAGE Danvers MA 01923- COMPANY � (978) 774-4338 ( ) - A ZURICH GROUP INSURED COMPANY Jeffrey Crean & Kurt Need Dba Corin e 2 Stewart Ave. COMPANY C Beverly MA 01915- COMPANY I 1 , - D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERK INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COI LTR I TYPEOF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY GENERAL AGGREGATE 51 , 000, X COMMERCIAL GENERAL LIABILITY TO BE DETERMINED 05/03/99 05/03/00 PRODUCTS-COMP/OP AGG s1,000, CLAIMS MAGE a OCCUR PERSONAL & ADV INJURY S 500, EACH OCCURRENCE $ 500, OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) S 300,( MED EXP (Any one person) S 10,( AUTOMOBILE LIABILITY ANYAUTO / COMBINED SINGLE LIMIT S BODILY INJURY (Peir pe -n) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY S (Per accident) I HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S _H 1 GARAGE LIABILITY ANY AUTO / / / / / AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: EACH ACCIDENT S EXCESS LIABILITY I I UMBRELLA FORM EACH OCCURRENCE IS S WORKERS COMPENSATION AND 1 .801-1 IMITS I SER -I .-:`:�: EMPLOYERS' LIABILITY EL EACH ACCIDENT S THE PROPRIETOR/INCL EL DISEASE -POLICY LIMIT S PARTNERS/EXECUTIVE Ir` -1' OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE I S DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPEGAL ITEMS CARPENTRY/CONSTRUCTION CORINTHIAN CONSTRUCTION 2 STEWART AVE BEVERLY MA 01915 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 1 1_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LULBI OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATI The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print ,o Name: k U r ' 1 NLM A iJU '3j" Cie�x) 'QbA� A5 Co t.JJ,, -M A.AT \ W^J:!�. Location: ftr 18 - �ctAAa. ytx mak` City Ammo- j9, Phone I am a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address Citv: Phone #: Insurance Co. Policv # Company name: Address Citv: Phone #: - Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to `51,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a rine of (5100.00) a day against me. .1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. / do hereby certify under the pail and penalties of perjury that the infVtato provided above is true and correct. S Date /Cr- 1— 0 Print name gyr,, ' N /— CST, Phone # �i'7� ti� OV Official use only do not write in this area to be.ccmpleted by city or town official City or Town \\ Permit/Licensing Building Dept ❑Check d immediate response is required E licensing Board ❑ Selectman's Office Contact person: Phone : El Health Department F71 Other I . - N aU0 Q �� Op / f/ V FS k I , M. L -57-0 o' Z3.3' 22 5 3. ; 3�a .a 2 STORY N / pIME • `�G 45.5 II A9TCVE'9 G FOR ESTABLISHING LOT LINES FOR 1 HE •�TR�E7" f NOTE: THIS PLAN IS NOT A SURVEY AND SHOULD BE USED FOR MORTGAGE I'UI1P0 SES ONLY. DO NOT USE OFFSETS ERECTION OF FENCES Gon CONSTRUCTION PURPOSES. I HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS. ENCROACHMENTS AND BUILD- INGS ARE LOCATED ON THE GROUND AS SHOWN I FURTHER CONR CERTIFY THAT TO THE ZONING LAWS AND AMENDMENTS OF IV- 11A/.DpVER WHEN STHE BUILDINGS' HOWN CONFORMED TRUCiED,I FURTHER CERTIFY THAT THIS PROPERTY IS NTOLOCATED IN THE ESTABLISHED FLOOD HA`ARD AREA. EDUARDSHENKEFTP.E r3099•I L CAL�rAI�lTiS TO THE .�% �J ✓�iV�REt1/ F�, --____ ?MES t3nRRETT C>''FFh'EJ MORTGAGE PLOT PLAN —fill- LOCATED ''I' LOCATEDNO.; 't,r�l3iSy�sger S_1Q'EN5C C�IIATQA i t P 1 77 �7 i 9 10 BE USFD FOR MORt A c _S G GE PUiI('O.,F —^_------._---_ ,ONLY � a33 ±'m � / - �2~/ On \\®\ 00 2 ƒd 00 0\ c » 2 \ / _ o =o£+ / M0 2o 2 2 � w32 �ow2 2 ® 2CO cf) g 00 \ 0 e E / ( 3 Q a ( \ 0@g Q 3 Ak .5 Boar CAOri -W IN tzo-T W" -A+ A - r E4 "ool -W IN tzo-T W" -A+ A - r E4 ool N. ool ej(►S�i�J6 S�ovt� �oUug>��„Jell o e o c o n e Q o h00 O 9 ® WO +0 p `S,. copy do -(-Cb r O� as 0 m p ®`0 ,�► 40,o t 140A 4 �a�►���v�J w A 34 f 44L4LM R COLA- +Ypjc Q Z •P+ `'f SLAB Vs%�.ie�(�,,eeecneak w��cg, �bv G nw1. �a.Y VApp`4`b�itCi�e-(Z 6Q��1C Ti e. irw waed kn Jf 3�yCornpAcA !t7 31 s�Vv, S1r "(4 0 o VO-vZAQ— +0 MatcYj hc�wkt c, Q'OwOvO} io,%� -'c�qvk bcL.ow Keywoy % Jf 8 #-OVU�Pr�iO�J wku c>tj if, WA wz `roc.}�a6� y` lwww bc�Js cetaoE 4 J +f - 1- Cl s�M--...�._._._—,____________,� ` .� I _ I �, , ':.._�. I I .�� 7 ; j—__---- �... _ r` �,..- _�at.___._.__._ .._ �-��_..;I �, j �a > �,, �� �. w�; —. �.... m �..� % 4p rA V) /, x w O A a! O W C v u u O w cn v cn w C z z cuOD p w O a: U cv w w z z O 04 co G V. O F-4 P z u W C � � m w a O U W to C � cl w z C as cn O cn co O O L O V Z O CL O y D C r.a U O N C :zi+ :z a� W Aon :aa m C/)CA Ed CD Ci) CE [[ MCD Z CD �_ o CL � 1 z O• � E S :� O c ... C.2 O O L3 '� m m V :yam U 0- U) N i : m 3 = +- v/ _ c m�. � IS o �C-i7) Co.) m C W O AmoCLU U o cm m m C = O Of O N a �-•�-1 m D O Q m ea 5 o` y m C c •O = m :m�3 a o N y +' W m S~ W C .0 D �r .UD C CL= .+ m 'N ui Eci Z C o C.2 ��y'� m O F- r $ aim :10' co O O L O V Z O CL O y D C r.a ;4 Location S7EVENS S / / No. % '� Date • 5 -�/ % Z - r ITH ANDOVER cy $ Fee $ $ $ MJWL�r� qgnection Fee $ TOTAL $ �J NO. A17dover Col'ey`Or✓✓ Buildirig Inspector % C Div. 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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: 10,q U / n /�/1%�' (� Phone 1/1 8.. /,313 (.01 LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street 35 &65f/Z/s St. Number % ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Town Planner Comments Health Agent Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date