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Miscellaneous - 229 APPLETON STREET 4/30/2018
/ C 229 APPLETON STREET 2101065 0-0170 0000.0 i i Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Richard & Beverly Rogato Property Address: 229 Appleton Street Policy Number: HP3088445 Date/Cause of Loss: 6/28/2015, Windstorm/Tree on Fence File or Claim Number: 32276-M Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Mike Peterson On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Signature and ate ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Location __� ��1 �✓� SZ No. Date !� MORTq TOWN Of NORTH ANDOVER Certificate of Occupancy $ k . MUs t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ;• 3 I 22U ; 4 Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: IJ Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION ' pL e./^71 PROPERTY OWNER t G t-llw-6 Print/G G H ti Print MAP NO: L 5--PARCEL:_ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial L/Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: t chap-d (20 q@7% Phone: 6 I M3 F j 7 Address: 22y A-p/9Lr r'ii ST2-Lt_r' 41(U--H �N�d � MA GI � ` i CONTRACTOR Name: C �i o 1 � lr Phone: ? Address: ZD 0 11 7 7?}rU n�tiT S/-/Z 2 26 /36AJ-7"I AJb(JUT-" h/d elfYJ' Supervisor's Construction license: �ly �� Exp. Date: /aZ - / b Home Improvement License: /d S"to Exp. Date: "r`�' U ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ h�(D �(� ! FEE: $ ('0 Check No.: �3-;5Receipt No.: NOTE: Persons co tracting with unregistered contractors do not have acc-u4o theparant und Signature of Agent/Owner Signature of contractor Building Department r The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C.And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks d Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified.Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract . ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance- Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup- Date Doc:.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HE�LTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/Sianature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signaturefdate COMMENTS NORTH Town of 4Andover 0 V" No. �8 _ dover, Mass.,' �� a LA COCMICMEWICK 7�AORATED `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System f O c BUILDING INSPECTOR THIS CERTIFIES THAT ,` \. .. . ..............R-I.Ae.4 ........... ......................................... ....................................... Foundation 4 has permission to erect........................................ buildings on.......2Z. ...... pp. ......49t....:........ Rough to be occupied as 't. .,PLO.". .Q.. �Q — 01111 Chimney provided that the erson�cce fin this permit shall in a respect conform to the terms of the a lication on file in P P g P N P PP 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 Final r y PERMIT EXPIRES IN 6 MONTHS X00 ELECTRICAL INSPECTOR UNLESS CONSTRU STARTS Rough ....... ...................................................................................................... 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. i cry`•.'=:��._.�1_:+ _� = ig ( l{ Mi R r 9 2ii1G DAVID CASTRICONE BY,..................... CASTRICONE ROOFING& SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In HaverhtU 978-374-7314 Uwe the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the following specifications,terms and conditions,on premises below escribed: Owner's Name........... . s :..... ...,L7.C,r.L "..............................................Te one#..I�E.6••..: Ir .:-.d.> .�f� Job Address.v .� � .... 1.E ...G�rS/.... ......................city.../Val...�t ..t�..tl:rt./.............State.....NA..... Specifications: ..................................... ............ . ......................................................................................................................................................... .Strip existing shingles;C� Apply new drip edge to all edges. A&e" .............. .............................................. g t etpp.ly. ......_feet ice and water shield membrane to bottom edges of house. 3 feet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. ............................................................................................................I/......................... ..................................................................... -itliply felt paper un rI Tient. Ynstall ridge vent tAda'ao .�......... ................................ . .......'.................................................... 5...... ..... —Reroof using�I t p�� - 1�� shingles with a,1-t�year warranty. ............................................................................................................................................................................................................ Counterflash chimney. •Alew vent pipe flashing. --LEgal disposal of all debris. - r. Area(s)to be worked on: .... .i ..... . ....... ..................... ........//. . ..... ............ ............................................ .................... ...............0... ..... ... ........... ... . ......... .............................................. ..... ...... /.....l ; 4 ..... ......../. x�.,o............................................1A....... ..0....................................................................................... ................................................:...................... ................................................................................................................................................ Roof board replacement if necessary @ (U /sheet or /fes ............................................................................................................................................................ .................. Two Year Workmanship Warranty(Not Transferable) N anufacturer's Warranty as sp tied by mapufacturer The c actor agrees to erform the work r - ish the materials specified above for the S M of$....�. .c.g'C?••••• ••••••• j ayable........ Q...........I...on....�....c 1 .............. Ie.......:.7=7:7............on.................................6>_alance payable on co 'on ilab Owner or Owners are not responsible for Property Damage or Liability while jo ism operation. Contractor is not responsible for any damage to the interior of property,including pre-existing conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resulting from application of materials specified above(i.e.objects coming loose from walls,crumbling plaster,exposed nails,dust in attic or other living spaces).Items in attic may need to be covered by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above work,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid,immediately due and payable. It is agreed that,if permitted by law,contractor shall be paid by the owner(s)all reasonable costs,attorney fees and expenses,in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the parties.The undersigned warrant(s)that he is(they are) the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their)names(s).There are no representations,guaranties of warranties,except such as may be herein incorporated,if any,nor any agreements collateral hereto,nor is the contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only.if in writing and signed by all parties. All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director,Home Improvement Contractor Registration, One Ashburton Place, Room 1301,Boston,MA 02108 Tel:617-727-8598 Any and all necessary construction-related permits shall be obtained by the Contractor. Any Owner who secures his own construction- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL e.142A. Approximate starting date of work................................................ Completion date......................................................... Receipt of a copy of this contact is hereby acknowledged,and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Owner has three business days to cancel this contract and incur no penalty (see notice ofcancellation). IN WITNESS WHEREOF,the parties have hereunto signed their names th' ` F...........day o ......, .f. ,20.t/...... Accepted: Signed.. ... ..... . ... .. ............................ Owner Signed..'. ................` ................. Owner ......... . ..... David Castricone,President i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations r 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly DAV 1CM-raICONQU EMNCS INan2(Busuiess/Organization/Individual): S ID 1 N(r N L Address: 20 o Su-V-rnt3 S,-v(?- So V-r-e_ Z2t� City/State/Zip: h-AkNbO VE K. h-fA 0 1 K 4S Phone#: 9-)t (p 6 3 3`4 20 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. F-1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y p tY� 9. E] Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.'2] Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing worker_'compensation insurance for my employees. Below is the policy and job site information. n + Insurance Company Name: S"e_ M�•s�Lf �e t..o MD&11 y Gf: 3 ft Policy #or Self-ins. Lic. #:_�N C 9 q,;x,'"14 G Expiration Date: 9-a,3 Job Site Address: dA� APPL,� /Z&,L/ SZ City/State/Zip: ya 1-77/ Ajoad'' Nq 6W of- Attach rAttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: ZZ//0 Phone#: 3 1.0 Official use only. Do not write in this area, to be completed by.city or,town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: j I Town of North And �w over �o►�r�Y . .-- F .a, Building Dep,irtmeni i' - Fp 27 C.hrules Street ►° ,a, ,:, 1`;�i+�l'` �;�. .. r North Andover, Massachusetts 0184 'r (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s Sal, and a condition of. Building permit ,# the debris re�:.!iLing from the work slL:ill be disposed Of in a properly licensed solid waste disposal facilit.-, as defined by MGL c.11, s150a. The debris will be disposed of in/at: Facility to Galion Signarure of Applicant q1 Date NOTE: A demolition permit from the Town of North Andover must be, obtained. for this project thIonghthe Uflice ofthe Building Inspector, N J lta: V.'aiiotrrrtitauce7CCle o// /(rAiJf[c,�ia9ed r Board of ltuil(lin Kl"�ul;ttinnti ;u1tl titunll;u'tls hoad otBuilding RegulatioiSs and St:uulartis -� Construction Supervisor Specialty License i HOME IMPROVEMENT CONTRACTOR License: CS SL 99358 Restricted to: RF,WS ;r'l °`?° tf� Registration; 104569 Expiration • 7/14/2010 TO 270265 CASTRICONEDAVID Type: Private Corporation 31 COURT STREET 1 DAVID CASTRICONE ROOFING,SIDING& NORTH ANDOVER, MA 01845 -- '�ir: David Castricone 5�.. 200 SUTTON ST SUITE 226 ��- Expiration: 12/16/2011 NORTH ANDOVER, MA 01845 Adutinislratot Tr:: 99358 Y ' A+' A-CORP CERTIFICATE OF LIABILITY INSURANCE 09/28/20 9 TM1f PRODUCER (508)652-7700 FAX 508-653-5089 .THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER,TH15 CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Natick, MA 01760 Select Ext.53389 INSURERS AFFORDING COVERAGE NAIL# INSURED David Castricone Roo Ing & $Tding Inc IN5URERA: The In5urence CO of State PA 200 Sutton Jt INSURER B: Suite 226 1NSURFR C; North Andover, MA 0184$ INSURER D: INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY RgOUIRGMENT,T0M OR CONDITION 05 ANY CONTRACT OIC OTHER DOCUM5N r WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF:>UCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCIIRRFN(,Q $ COMMERCIAL GENERAL LIABILITY DAAMAj r TF.SO R^HELI $ CLAIMS MADE 1I OCCUR MCD CXP(Any one Parson) I PERSONAL 6 ADV INJURY $ 3L:W-0A1 A0QRGQAY1 $ GLN'L AGGREGATE LIMIT APPLIES PER, PRODUC I5-COMr101'A00 E POLICY f7 PROJEGT 7 LOC AUTOMOBILE UABILIYY COAe91NED SINGLE LIMIT $ ANY AUTO (1-n pcndent) ALL OWNED AIJTOS BODILY INJURY $ SCHEOULED AUTOS (Pei oermi HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Por accident) `$ PROPFR'IV DAMACP $ (Pee eceldent) GARAGE LIABILITY AUTO ONLY,EA ACCIDENT $ ANY AUTO PAACC� $ 07HERTHAN AUTO ONLY: ACG E EXCESSAJMBRELLA LIABILITY CACI I OCCURRENCE I OCCUR FICLAIMS MADE AGGNL'GATE $ $ 17kVVC 1'll3lk ,— T S — RETENTION S WORKERS COMPENSATION AND WC9752746 09/23/2009 09/23/2010 X I WCSTATU- OTM EMPLOYERS'LIABILITY �T" A ANY PRQPRIF,TORIPARTNERIEXECLPfIVE E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER l xCwmo? E.L.DISEASE•EA EMPLOYEE I 100,000 II ry�oS,dascnbc undo &PECIAl-PROVISIONS below E.I.,DI$FASF-POI ICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIrICATE t4OLDER CANCELLATION SHOULD ANY Oe YHE A9GVE DESCRIBED POLICIES 9E CANCELLED BEFORE YHE David Castricone Roofing & Siding EXPIRATION DATE THEREOF,THE I"UINGINSURER WILL ENDEAVORTOMAIL 200 SUttOn Street 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Suite 226 BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY North Andover , MA 01845 OF ANY KIND UPON YME INSURSR,IYS AGENTS OR REPRESENYATIYES. AUTHORIZED REPRESENTATIVE Stacey Brice PKG ILIl/�LK_ ACORD 26(2001108) CKACORD CORPORATION 1988 ... -� -.�::.-..ter--�.ar�.�.�+.tr-..'+,_•.-�4.-.' -�--a'.'r"""...- ,..,...._..r... ._-..� ..-w �Tn 2543 Date....�f NORTH °t' :•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SgACNUSE� This certifies that ..... . . ..... .... .. ..�— ...... ... .... ....... has permission to perform ..... .. .. .. ..��,.�.. . ....... .. wiring in the buil ' g of............ . ..... .. .. .. ..................................... at. .. .... ..... ... ,North Andover—Mass. Fee.. No--7Gi(/a� ,,....... ..................... ........................ C ELECTRICALINSPECTOR 09 111951 12:95 35.00 PAID WRITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Office Use Only - 04e LIIIIIII unuiralt4 of fflassa0ustff5 Permit No. �- SZ/3 . iBepartment Of Public —%feta Occupancy&Fee Checked t BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 390 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 / (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date I'a"? f S Q* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit tope th I trical r described below. Location (Street & Nu er Owner or Tenant Owner's Address El this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps _J Volts Overhead Undgrnd ❑ No. of Meters New Service p r; Am s Volts Overhead r^ rn �' Undgd u No. of Meters —� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Hot No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA No. of Lighting Fixtures I Swimming Pcot above— In - No. 9 grnd. - grnd. ' Generators KVA No. of Emergency Lighting No. of Receotac!e Outlets No. of Oil Burners Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Conc. tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Seif Contained No. of Dishwashers I Space/Area Heating KW Detec;ion/Sounding Devices Municipal No. of Dryers Heating Devices KW Local _ Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hycro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the reawrements of `,tassacnuserts general Laws I have a current Liability insurance Policy including Como a Operations Coverage or its substantial equivalent. YES O = I have suomitted valid proof of same to the Office. YES — NO = If you have checked YES, please indicate the type of overage by checking the appro�late box. INSURANCE v BOND — OTHER = (Please Scec:ty) Qd G (Expiration Date) C/ G Estimated Value of E!ectricai Work S Work to Start insoecuon Date Recuested: Rough Final Signed under the Penalties of perjury: LIC. NO. � -�{� FIRM NAME LICNO Licensee •G-�• �' t 0 C Signat• e . .2ZZ)r ' � � �^ 40' O /�O x ^9� Bus. Tel No. Address do - Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware th the Licensee does not have the insurance coverage or its substantial equivalent as re- cuired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (P!ease check One) Teleonone No. PERMIT FEE S (Signature of Owner or Agent) x-5565 I f d Location Ay A o n'e—nom) �Jr c e f No. Date q - 13 -0c� K.oRTN TOWN OF NORTH ANDOVER E opt,..•° :.�"o Certificate of Occupancy $ Building/Frame Permit Fee $ s4CMU5 f Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 100, CID Check # ,j r 158 ,15 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPA15 RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING .rpt V BUILDING PERMIT NUMBER _•1 DATE ISSUED. a D D r� M CX � SIGNATURE: ivt,4j Building Commissioner for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ,)3o /PPLE yak) so , oZ Map Number Parc&Number 1.3 Zoning Information: 1.4 Property Dimensions: Rs y, 06L7 cjd i Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided R 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 ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Q ' 2 d-SUSS. (4AA 0.2 g r e ms S� Na (Print)) Address for Service: na Telephone 2.2 Owner of Record: Name Print Address for Service: Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 1 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licengid Construction Supervisor: License Number Address / W111 (t16 Expiration Date icic Signa a Telephone r 3.2 Registered mprovement ntractor Not Applicable ❑ It t ly/ 6AW10 / &101(6 SO/ Vd Co any Name rn 6Registration Number Address R I �J Pe, r Expiration Date e nature Telephone 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 au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: is" Deck ALW- EkWJ SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFTCrAVUSE ONLY Completed by permit applicant 1. Building .� (a) Building Permit Fee QQ 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 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTTRACTOR APPLIES FOR BUILDING PERMIT CqM r 'f/ ,as Owner/Authorized Agent of subject property Hereby authorize �U / w O f U i L to act on " My half,in all matters re tiv to work authoriz d y this building permit application.�7 ` Si is e of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, %ty 1 ,/,o (Laa_U�� 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 &W-114 Au4dz ezo Print Na e461ell2- A r Si at er/"en r -g NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 ST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS 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 -ew.asv� (Z- FORM FORM U - LOT RELEASE FORM (l -D, 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 a-�'"�� �u3�+�3 ��c'� 'J�� PHONE r C _tib v� `�t?(-q LOCATION: Assessor's Map Number PARCEL � I v z-2 SUBDIVISION II LOT(S) STREET Q1�`�e. J ST. NUMBERC ************************************OFFICIAL USE ONLY*********************************** )*A-T JA F TOWN AGENTS: TRATOR DATE APPROVED 7 DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT e FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 im Rug 15 02 03: 27p BRILLIE&COMPRNY (781 ) 944-6112 p. 1 MORTGAGE INSPECTION PLAN A . 4.1-256, �� pa;? E, fti 23Q y � .��,•--74.E t i r — I 113,8 "" "`-- -�-_..._ — $6,t� •�1 .a I T.RG Pt}fJ 14 BA'.E:�Qn�.•:rk�=en L'JRVE�';:<•�r:,ra�N6';t;;;u:G;l';;Un.EY;AND ISTO BE USED FOR MORTGAGE PURPOSES OSEa ONLY. I THEREFORE,ORE,THE OFFSETS.AS SHWdN SHOULD NOT BE USED TO ESTABLISH PROPERTY LINES. F 1E�5c�1 COUNTY DEED REFERENCE: PLAN REFERENCE: I PLAN OF LAND j PL No. 9085 SK. 4.3 G 9 PG. l F2— 71rate at IN I CERT t3tJ. �. - - -' SK------- PG I her9by certify that the existing structures are located approximately as shown and I pq Fpa RED FOR: ware nc-.in v',')z- n ca me Cmr- ey ;:os,� tie firrre i,:,anstruction,or are exem t -' ' RED FOR:" from violation enforcement action under,Chapter 40A Section T of the Mass. p .aeflvibi i.nvvs.Ti,a siruciures are locatedin cone_=accoraing to the following ! TAAFE.S u!• 15 V. ,j G,kM F.E.M.A.map.Note;Zone C represents areas of minimal Elocding, If P tie f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 W 'ers'Compensation Insurance Affidavit . Please Print Name: Location: 1936 !t° CitV Phons am homeowner performing all work myself. II�_llI am a.sole proprietor and have no one working in any capacity T71-1 am an employer providing workers' compensation for my employees working on this job. Company name: a- ALL-0001,f t /OQ/16 f `ICY Address C A- - -cw V Ph I oev1UA4-- £ - GJ e a 3S b�o. P �. UNWAWX Address Cit,: Phone#- insucanoe&o Polak.* t=aiCara Eor sra covdfag. nso unenas"tdred under t�.s+meltas dva penalties on 25A root a STOP WOF2K oRM d a fines:d a fine vP to$1:so0.00 and/or one m' understand that a Copy is ement may be forwarded to the Office of ($100 ri fi a day against nte. _ Investigations of the:DLA for coverage verification: /do herby certify u tr, i and pens ties of perjury that the information provided above is brie and correct Signature Date Print name P�l[� �f�U" Phone# x -totem Official use only do not write in this area to be completed by city or town official' Building[Check if immediate response is required Buil din Det n9 Dept 9 P p Licensing Board Q Splectr,»an's trace Contact person: Phone# Q Health Department Other t-LUVUHA[AROCOMMUNITYNO 4PE"'20 BOUNDARY MAP NO, 0,:2'c)'7C-EFFECTIUEJyO?3 SCALE I KN 4p FEET THOMAS BAILLIE & COMPANY ` 1 �•� BAIILLIE LAN® SURVEYING & RESEARCH too.ats0aa 33 HOWARD STREET REGISTE ED LAND SURVEYOR �ox� ��`' READING,MA,01867 a 9_ r� �nz• PHONE: (781) 944-2767 p� _:._.. ._, R ,Q JCC° FAX:(761){) 944-(3 1,1 121 1 Vo s v as '02i Gi I tod , h� x?( vt six LI -i -i rr NC'QQ )72- -,/Otto) t „OlXz q W r TH Zxz" �r 3V X(d T tt U �TO 1ST NORTH Town of And so _ A o dover, Mass., R �Q�v CC MIC HEWI K ADRATED p`?�� C9 S BOARD OF HEALTH Rol 11 7 U Food/Kitchen Septic System TT BUILDING INSPECTOR THIS CERTIFIES THAT.....%7om..�S..aloo S.4. ......(' .. P 'e`.�............................. . Foundation has permission to erect'.. �.. .s.3.. .1... buildings on s3.0....,PO/.— '........N....... S .................. . Rough APO/.- to be occupied as... PR N...... l� D N /�r 8r..... .......PW* //141 Chimney ... .... .. . . ... . ..... .... provided that the person accepting this permit shall in everyrespect conform to the terms of the application rnfile 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. `y/ ) 3a 4 OD r.s PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTH4 ELECTRICAL INSPECTOR UNLESS CONSTRUCT N AR Rough ...... . . . A ��. ................... 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. !Location -72 '`No. Date ,,'RT" TOWN OF NORTH ANDOVER 3?0�,�``D •,MOIL Aiii� A Certificate of Occupancy $ * Building/Frame Permit Fee $ ,SSACMUSEt Foundation ,Permit Fee $ Other Pefmit'Fee�J $ oQzo Sewer Connection Fee $ Water Connection Fee $ 1� \s TOTAL $ ? r Building Inspector Div. Public Works Location No. Date V'pRTM TOWN OF NORTH ANDOVER pf,,,to ",'S'O 3? 0 S Certificate of Occupancy $ # Building/Frame Permit Fee $ S�cM11Foundation Permit Fee $ 1 F/V Other Permit Fep $ 4�(�p Connection Fee $ OCf?0 atVConnection Fee $ � No.A�o'QvTOTAL s, $ ergo// � ct ol Building Inspector �y 5�51� Div. Public Works f C !Location a Cr.''. �A-i�,�c- %7 IN o. �r�1 Date TOWN OF NORTH ANDOVER pt � o O _ � pL F . pCertificate of Occupancy $ Building/Frame Permit Fee $ °„sE Foundation Permit Fee $ rU, -b='Fes'- Other Permit Fee "" $ Sewer Connection Fee $ '97JIFater Connection Fee -9�/V $ aG`p�, ', a � ,TAL $ O D Building Inspector Div. Public Works Location No. Date TOWN OF NORTH ANDOVER ° p Certificate of Occupancy $ Building/Frame Permit Fee $ --�-� ,ssACMUSEK Foundation Permit Fee $ .s e •O.t.,�2Iermit Fee $ ~` ©ert `ewer Connection Fee $ Water.Connection Fee TOTAL $ �y _ Building Inspector r Div. Public Works Location Z� 4 rJ Ste` No. V V Date 16 2-- "ORT" "ORT" TOWN OF NORTH ANDOVER Of t�ae ,a'�.yO Certificate of Occupancy $ 4 a 4Li Build'&b/Frame Permit Fee $ ,SaAGMUSE� Foundation Permit Fee $ p ®(�( lbt r "�7 ermit Fee $ #5-24Sewer Connection Fee $ >r, • ' � Water Connection Fee $ rLy i+ TOTAL $ C` f� 3 3 jD-:5 Building I ector - / Div. Public Works PEWMIT N-b. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. 1 AGE 1 o MAP KdO. �s LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE — ZONE ly7 I SUB DIV. LOT NO. —I LOCATION PURPOSE OF BUILDING I7 OWNER'S NAMEV. `CJA r-� O NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB -RJ ARCHITECT'S NAME <' / SIZE OF FLOOR TIMBERS ISS/TNtiww��211�)� S 3RD BUILDER'S NAME CJ f SPAN DISTANCE TO NEAREST BUILDING ji DIMENSIONS OF SILLS DISTANCE FROM STREET cam!1! POSTS DISTANCE FROM LOT LINES-SIDES/ O �O i REAR �1 t 1 GIRDERS AREA OF LOT ,J Q18 3 CO FRONTAGE [!s`S/ HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW LVe_ SIZE OF FOOTING X IS BUILDING ADDITION Mo MATERIAL OF CHIMNEY M IS BUILDING ALTERATION O IS BUILDING ON SOLID OR FILLED LAND SO i r` WILL BUILDING CONFORM TO REQUIREMENTS OF CODE YeS IS BUILDING CONNECTED TO TOWN WATER GS ! 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 , F Q� f EST. BLDG. COST � '�� )�+a;(,�Q SEP z /^" 1992 EST. BLDG. COST PER SQ. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 - i V EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 - T.. DEPAi i IHi- T 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 BUILDI G INSPECT R DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTH ED AGENT OWNER TEL.# 1 FEE CONTR.TEL.# ce r5i ®(am ,6p cj®,40 CONTR.LIC.# PLANNING BOARD PERMIT GRANTED 0 /0 851) BOARD OF SELECTMEN 6!s�YiS.J N DUE FRAME PERMIT$ 417�.ac � 538� INBPECTOR I S L � `• BUILDING RECORD " 1 OCCUPANCY 12 SINGLE FAMILY ld STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM s MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION B INTERIOR FINISH CONCRETE 3 1 CONCRETE 81.K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY--WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/1 '/ FIN. ATTIC AREA _ N_O 8 M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS u CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD\rJ'D _ ASBESTOS SIDING COMMON VERT. SIDING ASPH.TILE. STUCCO ON MASONRY �— - STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) — GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER .� ROLL ROOFING I MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM op STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING rnrl RADIANT H'T'G C...�...} UNIT HEATERS 7 NO. OF ROOMS GASOIL {� B'M'T 2nd ELECTRIC �++¢ • "a" 11'I 1st 13rd I NO HEATING s � y 13 tlj 17 171-5 0, 3002- 65- 1951300 002•65•195130• T 196- 6-5 96•6.5 x 1274• 912-( (Cie, ����� IAC�A D c�+►� n• A -P'P L.r�-r-o►�t c r'����' _ l 61.58 cam° 3(.74 I 38 4, 20 l�oT S 0 R.au 1 1,34 3 l.J•E,.�.a Q � m N 1 V y �L 1.11M0 e '\ i } .} � e• �.�.+ti SY �: '7 r FORM U - LOT RELEASE FORM K 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 Deo LOCATION: Assessor's Map Number Parcel - /7Z) Subdivision Lot(s) Street St. Number ?-2 cl 1 OF ************************Official Use Only************************ RECOVMNDATIONS OF TOWN AGENTS: eDT� Date Approved 2 Conservation Administrator Date Rejected Comments Date Approved - Town Tanner Date Rejected Comments Date Approved ealth Agen Date Rejected Comments I&A 114 Public Works - sewer/water connections 2 U - driveway permit / Fire Department Receivedjb BuildingInspector Date I� I;Y� P i OCT - 2 I9T 4 i �O�U31S�g.) ,.' X51.1!.•Ir?J o�rvo t-tio �o S l"�b"1 �g �f'r1 rlC=b -moo olyb f-41%,-4?1�.i'�Q =Jf11T`la2�Hs_ tt-� (�1 w S t n '�!Q•� S 1 '�J S!l H'X�5 a rr b ,L�T`t O �'-1dlivo^J T-`�/'••'�01-1 S On N��� '�rt.L '��� �a d r�cy.4►+S s i`as o .iti r1 .�� i z--m s A � _ 0 � No,�� �H •is,x� 6� ro i .a 1 bL't5 ='1 85'1 gl ._ " •dam ..ter--, r-.t c�a.�d�-� � �j���� ��) UI Y"`�%zo n Clpo t C:ra 1---4 1_�a�� AT SINAL AN N FI9A 44ONSERVATION FINAL SEINER/W _ _ own o ,. 6. n over No..11.-0. 0 S P DRIVEWAY ENTRY PERMIT E6Ar� over, Mass., 19 P ' A0/F PL E I BOARD OF HEALTH LD PERM11. . !TT ISCERTI IES THAT#Wt� . •..• BUILDING INSPECTOR has permission to erect11.6#60f uildings on e .... � .�. Rough to be occupied asJ A.At. ' . ,,�!. ....�. .��..�Oft Chimney u Iv/A,cJt Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough PERMIT FOR FOUNDATION ONLY Buildings in the Town of North Andover. REGULATED BY PARA. 114.8-S. B.C. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 M 0 N 1 ..SEE PAID'6 ELECTRICAL INSPECTOR gh UNLESS CONSTRUCTION STARTS � Service PERMIT FOR FRAME/BUILDING , Final DATE* FEE PAID •00/ BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner �N,9,, .athing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector lil 111.1)IN(; ._�/>�. hl:is;; i►1Fiir.►•II ►iltS.tT; (.'()NSF:HVATION \'" 1►I\'1 ►N ►I° II I i 1►itl!�•I i i Illi\1:111 I'I.i\NN1N(� P1,ANNINt; & (AAMIAWNITY I)I;V131,( PMI' N'I' KAI 1-Ft", I I.I '. NI: I..ti( V. I )ll tl:(: l t )I t • CIIIAINEY APPLICA110I1 ANO IT13111' PERHIT. # L- OCATION WNER'S NAME:_ i JILDER'S NAME: 4SON'S NAME: ASON'S ADDRESS: v , SON'S TELEPHONE: �O' i�T� d� 2 - ATERIAL OF CHIM B : 4FERIOR CHIMNEY: • EXI ERIOIZ CHIMNEY: 1_�— .IlWER AND SIZE OF FLUES: NICKNESS OF HEARTH: -t,?.R? Chimney o/l. (i)Lepcace con4oul to .tile he.qu,ute+ne+I.t:S u() -tile cure and have :(ucc'.6 (111(1 egutati.alvs been aeceLved: __—.- kTE: c IIGNATUREOF MASON: --- PERMIT GRANTED: P'EE BERT NICETTA IILDING INSPECTOR JSPECT-EU: -MARKS: J SOLID (CLUCK RLQUlltLl) r�7 THIS PERMIT MUST- BE UISPLAYEU 014 TILE PREMISES i I CERTIFICATE OF USE & OCCUPANCY I Town Of North Andover Building Permit Number 450 (1992) Date January 28 , 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON LOT 5 APPLETON STREET (229) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR IN ACCORDANCE GARAGE UNDER WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. e' CERTIFICATE ISSUED TO Mr. & Mrs . Richard R o g a t o Appleton Street o ADDRESS North Andover. MA s' ""S� Bui ding Inspector i i i i fz�, ► ILS' ► vt �� 'ONSERVATION '`'! + FINAL SEWER! WAT FINAL LAN N ��INA � � �.� wn of 6 �� ndover IRIVEWAY ENTRY P t .. IM 19 *• Er'�a} ever, ass., ?� Y oRF p� BOARD OF HEALTH PERMIT I., el 11 All I Xojiuov IV 11 W V L .I./.f'.. . . ..I'. ..../.. t� o .r' . THIS CERTIFIES THAT ... .... ..•• Wo BU�DING I SPECTOR 9c� has permission to erect so.fiff g e .. � •�• � uildin son .... ... .. .. ............ Rou r✓e lv. I f tobe occupied as. . . . .. .. .. .... ... ............ ... ... . . .................... ... Final �/� / v� W#W/gAr#t r _ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUN48INq IfySPEC OR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of PERMIT�R FOUNDATION ONLY Buildings in the Town of North Andover. REGULATED BY PARA. 114.8•$. B.C. e4g,6 /g VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONli2:� ..FEEPAID '. ELEC�ICA SEER tfJ �fi4"0 ;7 r'rl- Rough UNLESS CONSTRUCTION STARTS service (J PERMIT FOR FRAME/BUILDING , Final f BUILDING INSPECTOR DATE ' I �'-'' FEE PATO , cAs/iN59ECTOR p gh, Occupbncy Peril .equired to Occupy Building �G � CV r IA4 - Display in a.,�-onspicuo�us Place on the Premises IRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. �� 0 (rSVy, q ,� Building Inspector Location 2 RPlr ; 1't J 1 k,�No. Date (- 01 NpRTIy TOWN OF .NORTH ANDOVER G A Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Pit Fee $ s�cMus Other Permit F � $ Q Sewer Connection Fee $ Water Connection Fee $ _ TOTAL tM ' Inspector �• _ ^^�yy gl�Z/g5 15e23j8. 4 PAID ~� V��n in. Public Works PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 -MA a40. OT NO. �7 Q 2 RECORD OF OWNERSHIP IDATE BOOK PAGE — ZONE SUB DIV. LOT NO. OCATIONaa9 PURPOSE ANG Lo ll&V R'S NAME �Q� �( 06A NO. OF STORIES SIZE OWNER'S ADDRESS as q BASEMENT OR SLAB ARCHITECT'S NAME ! SIZE OF FLOOR TIMBERS IST 2ND 3RD r BUILDER'S NAME�lN�� oy dGL �N � SPAN DISTANCE TO NEAREST EIUILD14G DIMENSIONS OF SILLS DIST CE FROM STREET POSTS ISTANCE FROM LOT LINES-SIDES Q ' REAR ��s " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND ILL BUILDING CONFORM TO REQUIREMENTS OF CODE �� IS BUILDING CONNECTED TO TOWN WATER BdARD 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 _4 . BLDG. COST '2000" PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM (,1 SEPTIC PERMIT NO. ' ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS Py1NS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR TE FILED "j S_� IV/ BUILDING INSPUCTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT-��4 �Q/ ^�_ FEE 16 OWNER TEL.� toR(y-s 1 lz PERMIT GRANTED CONTR.TEL.# 2 0 Ig qk CONTR.LIC.# H.I.C.# 883 t - CAS 14 BUILDING RECORD ' 1 OCCUPANCY 12 SINGLE FAMILY StORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE CONCRETE BL K. PINE BRICK OR STONE HARDW-D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 71 AREA FULL FIN. BM'T' AREA _ 1/1 '/t 1/. FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR ADEQUATE I-1 NONE 5 ROOF 10 PLUMBING GABLE I IP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. 12 FIX.) FLAT 11 SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OI l B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING NORTH Tow, 'i of (o r 6 Andover No. � COC hllC lit IV ort � I. tPT � 9 �AO''ATEE) BOARD OF HEAIXH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR LKia THIS CERTIFIES THAT1 .... 5?.(P�� Ca............. ...... w�ln�ruo��.... """ Foundation PP has permission to erect..�ao.. ........................ buildings on .,Z29......... 4��?.1'�....... .7�T.�'.............................. Rough to be occupied as. SPK.4(p...... . .Da —VoA Chimney 1......... . y l�.rK.t . ............................................. y provided that the person accepting thi permit shall in every respect conformlto 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 CONST 'S_ ELECTRICAL INSPECTOR J' Rough r,� .. .... ........ :... ...... ............................................ ....................... Service BUILDING,INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RouFinagh No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT 83 1 �,+�. t-► �.� :.t cava-T- o u ►..i z a C::►44vc.em— ,t-t a Ste. t'77 Ise, I I 1 ! � I ' 1w• I Ik i E - duo f (3 E C-V- a-1.2�_ . 0 o T L N ` v0+ ft L d -u .-r�o r. `"" "rj rrwl /'-rmorr C=F'""^"'y�;rw'S.»+"�"'ko 444. +� Q `wA{ .... .. 4'+•-,�tsj ..'�..R,A+e P*-- 'rj awt> LL., rrr4. ►rtt+. � #`,,la ,.• +1 : , awe,.a . w. �T MW WIN, 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 / Lot(s) Street 5J7 St. Number ************************Official Use Only************************ COrIlKENDATIO S F ENTS: Date Approved Conservation ;Z�nistrator Date Rejected Comments 7D �P1_4eN r`(� Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Swimming Pool Center Witer Pool Distributors f 670 SOUTH UNION STREET • LAWRENCE, MASSACHUSETTS 01843 / *'-Phones (508)682-6916—685-0711 Name Ri `l U /c! 1�� Date J 19 � . Address �, 5 4�� e_ City - r, Stater Zip Telephone- Home: 1- -5 � — CONTRACT — Work: We propose to furnish and install one 1 ,L� In-Ground Swimming Pool for the sum of$__ � ov This price is for normal swimming pool installation in a workmanlike manner. Access to the construction site and the location of the pool shall be the Buyer's responsibility.The Buyer agrees to obtain and assume the cost of reconstructing existing fence sections and supplying temporary fence for the pool. The Buyer agrees to obtain and assume the cost of any required permits; cost of blasting,jackhammer work,additional equipment and labor charges if ledge or objects too large for our equipment are encountered;stumping and removal of trees;additional gravel or stones if required,for the proper installation of the pool as advised by the job foreman;patio around•the pool;all electrical and grounding cost;cost of water to fill the pool to operating level at the time of construction.The Buyer also agrees to pay additional backhoe charges beyond the 8 hour day allotted for the excavation of the pool. The buyer also agrees to pay all extra equipment charges needed on excavation. Swimming Pool Center will not be liable or responsible for damage done to walkways, driveways, patios, lawns, shrubbery, trees, flowers,sprinkle systems,well lines, underground utilities,sewage and drainage pipes. If the contract cannot be fulfilled by the Swimming Pool Center due to: 1) Buyers cancellation during construction; 2) having improper ground conditions for a proper installation; - 3) backyard stump dump, the Buyer agrees to assume the cost of labor and materials already provided by the Swimming Pool Center. LIMITED WARRANTY: Swimming Pool Center agrees that for a period of one(1)year from the date the pool is completed,it will, without charge, provide the labor to remove and replace any component part of the pool that-.ip subject to an independent manufacturer's warranty, providing that the pool has been certified by the SwimmingPool Center` i 1) At the option of the Swimming Pool Center,this warranty is voided if the swimming pool is used by anyone priorto certification by the Swimming Pool Center and the Buyer has fulfilled all payment obligations including extra charges,if any. 2) This warranty does not include the cost of supplying water to refill the swimming pool in connection with the performance of any warranty service. ' 3) There are no warranties which extend.beyond those described on the face hereof,including the warranty of merchantability. **It is recommended that the pool owner wait a full season before any patio work is begun. All Inground Pools come standard with:Filter System,Skimmer,Main Drain,Hard Bottom,2 Wall Inlets,Polaris Wall Inlet,Print Liner, Receptor Coping,Foamed Walls,Manual Vacuum Cleaner. :.' Extras — Stair with rail(s) $ Base Pool Price Ladder $ G' Total Extras 0 a Swim Out-Jets $ 5%MA Sales Tax :To a Diving Board �o $ j Temp. Fence Deposit Slide $ l Total Price $ o e-,) Light $ ?�'(� ' Deposit Received 00100 Heater $ Balance of Contract $ za. oo Automatic Vacuum $ Maintenance Package $ U Payments Excavation $ o Solar Coyer $ Liner in pool Winter Package $ :a �f°0.,I D.E. Filter /71 i d r C/<c, ✓ $ NZe' Completion $500.00 �- Miscellaneous $ Miscellaneous $ The Buyer acknowledges that they have read and accepW all conditions of contract an agree honor the contract accordingly. i /� t SELLER — ( A BUYER .r � . . \ � 0 � � CENTER"�� ��� � � ��� | ��00 | �� � �r0�� � � � �" 0 ,�� � � �� � � l � �� � n �� � �� �= == �� ~�r�`� ��mr��� 7*7K���� � T?�TlK�-�l�.T ���Q� ` � �� � �� SOUTH�� �� ln� ���ln� �� � N 14' N( Ew MA 01843 508-682-6916 ` �* THE COMPANY ** 37 YEARS IN BUSINESS FAMILY OWNED AND OPERATED FULLY INSURED LICENSED CONTRACTOR EXPERIENCED MANUFACTURERS � EXPERIENCED AND TRAINED INSTALLERS NO SUBCONTRACTING POOL INSTALLATIONS FINANCIAL STABILITY UNSURPASSED REPUTATION CON�INUAL PROFESSIONAL SERVICE AFTER SALE OPEN YEAR ROUND ** STRUCTO-GLASS VINYL LINER POOL ** FIBERGLASS WALL IS CORROSION-RESISTENT MORE STUDDING FOR STRENGTH MORE BRACING FOR STRENGTH THAN STANDARD STEEL WALL 12" THICK CONCRETE BELT ` 5" THICK GUNITE BOTTOM � ' FOAMED WALLS SHALLOW END FLOOR FOAMED 4 DAY INSTALLATION COMPLETE START-UP UPON POOL COMPLETION HIGH GRADE 100 PSI PLUMBING FOR EASY WINTERIZATION DECK EXTENSIONS AVAILABLE LIFETIME WARRANTY * 2' RADIUS CORNERS - STANDARD ' * BENEFITS OF 2 ' RADIUS CORNERS GIVES MORE STRENGTH TO WALLS ELIMINATES GAP BEHIND LINER CORNERS : UNLIKE 90 DEG. CORNERS � LESS STRESS ON LINER AT CORNERS � MAKES LINER MORE PUNCTURE RESISTENT � AUTOMATIC POOL CLEANERS WON ' T GET STUCK IN RADIUS CORNERS IMPROVES WATER CIRCULATION CONTEMPORARY STYLING AND APPEARANCE 1 ® signed f. r strength . . . Efillipeered for durability. Rectarigle Th Swimming Pool Center 11as been a quality manu acturer and 1ns�aller of ingrDund pools ior over 35 years. We offer superior workmanship, dependable service, qual ty product, and so much more. Wel have an unEqualled rep tation fordoing the finest installations along with friendly reliable ervice. Qua ity work has to start with a quality product The Swimming Pool Ce ter as a ma u acturer has developed a structural fiberglass panel I hat is non-corrosive with the str ngth manytimes greate than a steell or polymer type panel. It was 15 x 30 deigned with unique fiber matrix that in cold environments w II not x 32 crack or fractu like some concrete wal s. The resultof this superior x e ign is iong Iisting durability, consist n quality a — maximu ---- str ngth all ba ked by a lifetime warran y. T ue-L. Gr cian ( ! Lazy-L , 6x32x2 4 x20 16'/2 x32'/2 8x36x2 16x40 0016'/2 x35'/2 x4x2 > X All' 201/2 X 41/2 20`x 46 x 24 Swimming Pool Center 670 So. Union Street Lawrence, MA 01843 508-682-6916 W. . 4 ` t IA 1 p�iay' A LL Now r . tA die RVIN WN o NA fl T k r 1 r � « T`ri to 8 aa'S. ° �'`dNk3 *I'i �C� " .ic1 i3 t ,�*rr�•t ti 1*� s�r�il'�i , M1 _ i' f rte { 4 ( V ` 71 f-a" I kO --- JM MORTH Town of And No. 0 �r3 . moo' — odover, Mass., C OCHI C ME WO ADRATED C S BOARD OF HEALTH PERMIT TFood/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.�� �:l .P.+- f.... . Cl , ' a Jc�a�4��ac� ���1 'u .c� +*� ?.............:.......... ... . Foundation has permission to erect... �J........................ buildings on ..Z.: ...... ....... .:...........I.................. Rough to be occupied as..1.Wr;..,� 2.... . . . .. *.Q � .......1. !,�.�.....�". { .yy.�....�.1y!4:�i� ............................................. Chimney provided that the person accepting thi permit shall in every respect conforrn�to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final K_ Buildings in the Town of North Andover. Doll PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ,rte 0 Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRYCTION STARTS ELECTRICAL INSPECTOR Rough , r ..........:.........:.:..:::.:...........<..................................:...........:....................... Service BUILDING INSPECTOR Occupancy Permit Required to Ocaipy Building 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 FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATFR FINAI DRIVFWAY FNTRY PFRMIT