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HomeMy WebLinkAboutMiscellaneous - 235 PLEASANT STREET 4/30/2018 235 PLEASANT STREET 210/085.0-0043-0000.0 I ® MAPFRE The Commerce Insurance Company"' Citation Insurance Companysm Commerce " Gore Road,Webster,Massachusetts 01570 INSURANCE- 508.949.15001 www.commerceinsurance.com May 15, 2015 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall NORTH ANDOVER MA 01845 RE: Our Insured: WILLIAM DUBOIS Property Address: 235 PLEASANT STREET Policyk BCHHPM Date of Loss: 05/13/2015 Filek KJJK74-HWVMX2 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, 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 my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. LISA LEAHY Telephone: (508)949-1500 Ext: 15846 Sr Claim Representative, Property Toll Free: 1-800-221-1605,Ext: 15846 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. May 15, 2015 TREE FELL DUE TO WIND/DAMAGED HOME &GARAGE CIC 254 (Rev.4/95) MAIL 788 Th e Co .:m rormi, c` 14fCS 0Cr uses J Cf Public as SCARD CF Firm pRFv-',MI ON rZ!_'jLTLA-4,,CNS Sr Cm;l 1✓C0 �,RPLICA�i0N FOR PERiVtIT 10 PER=ORM ELE�RICAL VAD:) : Ail WarSc ti?be paiorme2 hs xflrdaMc ,rit4 a Mme-�csec E•ec ,Zzl Codes S:: ('��- o` '�' r'"'-�, �Y9 t'V`, /�C�:�7• � c=e �yet:.:= c: __ Cm �a L.Ce_� ad acoL'es _`a. a ?ems= c_a= or 2 = L- L�� pe�`_ Sts crr.�La^as er'_'_` h�_Cz'n ?=--- a' d' c ' 1 �✓V1 1' 11 U-_�`=r 1t=.��`_�.-'�^. 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LI-W-4* BayStateGas A NiSource Company May 9,2006 John Skeadas Account Number: 8934520076 235 Pleasant St North Andover MA 01845-2822 Dear Mr. Skeadas: This follow-up letter is to inform you that your gas house heater located at 235 Pleasant St., North Andover, MA has been tagged due to a violation of state safety regulations. It is unsafe to use until the following condition has been corrected. Bad control valve on house heater. Shut off and is safe for now. The Masachusetts code pertaining to the installation of gas appliances and gas piping, established under Chapter 737 Acts of 1960,requires that the condition be remedied. If you have questions or would like to discuss this issue, please call 978-687-1105 and ask for the Service supervisor. Please disregard this notice if the condition has been corrected. Sincerely, Service or Meter Department Bay State Gas Company CRR: 0215 Q\Cisupdatedletters\236 o5/os0s 55 Marston Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1875 Location �� Date No. i HORo TOWN OF NORTH ANDOVER Obi^. . 1ti 3? . oL F p Certificate of Occupancy $ �'�s'••' E<� Building/Frame Permit Fee $ y �►CMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ / Check # / 17310 i�i �-7 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. ` / DATE ISSUED. �_a l]� (G SIGNATURE: �Cs2 Buildin Commissi ner/I for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: c� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Provided v • 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: t- ❑ Private 1.7�Water S�ptyivate C.40.❑ 54) Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ PIIb11C SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record r L S � s s , Name(Print) Address for Service: 1 Signature Telephone C 2.2 Owner of Record: Name Print Address for Service: O Z�qq M Signature Telephone M SECTION 3-CONSTRUCTION SERVICES R� 3.1"Licensed Construction Supervisor: Not Applicable ❑ ::a-k Fr— 5 i ti S r Licensed Construction Supervisor: (O �j Z O _72 9 13 G?C_rJ n n �,�; License NumberMn Address 264 icExpiration Date Sig tur Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 ( wI 4 6y S d3LiC-0/A, .y T� f- 07C-/A.)G— c Company Name ) ) 5-9 —7. m Registration Number r 2 Address _ z."r` Expiration Date ^ Si nor re Telephone V SECTION 4-WORKERS COMPENSATION(XG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all 6cable New Construction 0.- Existing Building Repair(s) ❑ Alterations(s) ❑ Addition 0L-' Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: .9-k A.,14 b111- Z- Il-Ae7i7�oX, SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of �— Construction 3 Plumbin Building Permit fee tel X tbl a 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 CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 'LX 2ND 3RD SPAN i f DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING 3 W,0,1 S z-F 19 X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE l,.e a J FORM U - LOT RELEASE FORM e 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 SFr- S t `'�^ d PHONE C1 Z- /71�' LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET Iy?� � ' ST. NUMBER a`3� USE REC 14IIMENDATIONS O OWN AGENTS: r J� CONSERVATION ADMIN137ftATOR DATE APPROVED �5- / 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 -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm 'Visl) f0speccl orl Q' i a 8) Les ie 7 skeadaT or werty 77 hdoYC/ tein�'rtdev vi�,Lof 2�1 IGYJ Aarbi�ki or"" Z& ,2.9 2 Sto g . dtuecc�r� 20%t garage ioo/ Lot� 1 i t�l OF�{d_ hl Ce tf1aC ffirsplatl FLAB �)F21t �n+At��,f�f' �02�e GII1G� iso �� MAUI ycN �ssce'ia 6 acrd T2V anei rd 60-69e� ye }� ,�� T. (��vett2ng 9f{1p1UlT Ort tfOpS t20t' iI2 Q 5MGR R H fUYtL B1?Lf�L1X11, t�R�C ofG'�5'� RrtC� C Wat'Lov arm eon nn to try local tmubg by-laws in w com= wi#fi t to FforiiontRl dLirtnsionat ¢ teas nuid¢�cordi Yxuyos¢s orr-use inpat-irig decd cCnoms- r 20 i�et-�ica.�ort o,�buttdr�g toru�a'o��ro tine �tor� or tot' _ ��•5� tut tticay��1 att aceutut¢ ' �n� t�ra; 177889 I mast r di�ert iY u onm` on wftctt i�st'ialnn HQtYory 113 y- 37,5 colontAiL 269 IiAnovep. SCS, i X01 {2,C1�SS. 02339 • pboty ron-a26.7t86 px 6t I-826- 523 a P . 01 ------------------------------------------------------------------------------------------------------- a The Commonwealth of Massachusetts dDepartment of Industrial Accidents Office of Investigations Boston, Mass. 02111 o��M Syey' Workers'Compensation Insurance Affidavit Name Please Print Name: J��T�/= ( I/VI L11it 0 A ) S Location '�7 (244-ad(% S Ci1y Phone # ocv— I am a homeowner pe orming all work myself./ I am a sole proprietor and have no one working in any capacity 71 1 am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone#: Insurance Co. Policy# Company name: Address City Phone#: Insurance Co Policy# 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$1,500.00 and/or one years'imprisonment-as_well as.civil.penatties in-the farm iof a_STOP.W.ORK_ORDER..and_a.fine_of.�.$100.00)_a lday against_me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct QY4Signature ) Date 4 Z f Print name 3-Fr �( "t'I t't'1 D�S Phone# !7� --6?Z "/7J¢ Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required 0 Licensing Board E] Selectman's Office Contact person: Phone#: ❑ Health Department F-1 Other Y y 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: 2 S- C LI L STS (Location of Facility) R , (JSignVure of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NORTH Town of O 0 No. ` �+ J �� Z LAKE ' 'dower, Mass. •�� 7 -d T � COCMICMEWICK oRATED � V V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ..........................L� � S� ..a.. d.. .................................................................. Foundation ................. has permission to erect... �.X .. ........ . .... buildings on ...a.3. .......Opk S.....APV. . ...........�'.......... Rough ... .. ... .. W d 4o be occupied as e � .r/..� A.��.......� ...e/i� Chimne . ... ........................................................................ y provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the In pection, Alteration and Construction of Buildings in the Town of North Andover. Q 5�y3 J%S 0 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTJ 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. Page No. of Pages SIMMONS REMODELING CO. 729 Boxford Street NORTH ANDOVER, MASSACHUSETTS 01845 Phone 682-1784 PROPOSAL SUBMITTED TO PHONE DATE STREET JOB NAME 1-35- A-6 4 •A PT 5T , `x*16 ` l ,f CITY, STATE AND ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE 1 4- We hereby submit specifications and estimates for: �419,+�1716 ru -?G �f f- D -4 5ivy'�® tom(7-1-1 �YA4�, ......_.. ......_ _ ....... .. ..__.... ... T ...j L.11.1fhf.S.f4 /Z i vr!t............ .�.....Jz .l:ij of/'gip..... . ...... ...... rf / a& , ......... ......... ........... _.... ............ ......... _ ......... ._.._.... .__. .......................... ...... ...... _ __...__. ........ .. ........... ..... I A.J T1,1vG ( �d4��rae .... ........ ..... ..... .. .... .. ....... Ile Fra;J1115e hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: C>0 1 f2,T F"16. -T-140 GI S k.r4p 6 dollars($ • ,(D G} c3�1 ). Payment to be made as follows: r/ ' A & All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifica- Authorized tions involving extra costs will be executed only upon written orders,and will become an Signature extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Araptttnr�e jot Haat sal—The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature w to do the work as specified.Paymen will be/made as outlined above. p Z.,c9 /�t� Signature— Date of Acce tante: ���rrr / i Location 3S �L A`�4 T < No 60 (D Date **"I- %01tTft TOWN OF NORTH ANDOVER i „ Certificate of Occupancy $ Building/Frame Permit Fee $ cHuSEt Foundation Permit Fee $ Other Permit Feeji $ 2J Sewer Connection Fee Vv $ Water Connection Fee $ TOTAL 1 $ �-- Building Inspector 11/30195 14:18 25.04 PAID 9425 Div. Public Works PERliff NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K40. I LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. i OCATION ?J �J�S�tnT g _ POSE OF BUILDING I/ / Sid/ n� t OWNER'S NAME .r 1 S NO. OF STORIES 4 SIZE OWNER'S ADDRESS S BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD ILDER'S NAME a�^' fI�/1) ./,/I SPAN -- DISTANCE TO NEAREST/BUILDING C'7 DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR " ' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDEST /�L� . BLDG. COST o-5' PAGE 1 FILL OUT SECTIONS i - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COiT PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DAT FI D ( �T ` ? iU1LDIN0 INiP[CTOR SI URE OF WNER OR AUTHORIZED AGENT ' F E E12<11�10 OWNER TEL.# PERMIT GRANTED CONTR.TEL.# �19 CONTR.LIC.# qq H.I.C.# N 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 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. --II PINE _ BRICK OR STONE HARDw D — PIERS PLASTER _ DRY WAIL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'T' AREA 1_ '/ 1/1 '/ 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 COMMON _ VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. d FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. (2 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 I 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 OIL B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING I NORTFI Town Of 0 dove N 0 . ...: \O F r ,, • 616 00 rt ." dower, Mass., 46IM"Ia �'t 19'i S COCHICHEWICK %ADRATED i 5 BOARD OF HEALTH Food/Kitchen i i Septic System PERMIT T D BUILDING INSPECTOR I THIS CERTIFIES THAT. ..... .'.... E�1o/d .....,S........................................................................................ ••"'•••' Foundation has permission to-e►eet AL)�-................ buildings on ..2,3�......�l.,�iE1SA.kfv.......5T .................... Rough to be occupied .�1 as.. ... <<....�taJ� .....S.1!p414*.....93Ve-R.,.... k .�4~'..QeOAN...a4.W.W. Chimney provided that the person accepting this perrilit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXP 6 MONTHS Final UNLESS CON U TI S ELECTRICAL INSPECTOR Rough Service BUILDI G 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. a Smoke Det. PER311T NO. 60 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ' ZONE I SUB DIV. LOT NO. OCATION s (//l14j7(kocj jl-ewPOSE OF BUILDING .r OWNER'S NAME -""'ti 1..1 ✓. `C NO. OF STORIES l/ L• SIZE V J _ OWNER'S ADDRESS14 7 "r BASEMENT OR SLAB 3 S t s �. S �T _ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 2ND 3RD ILDER'S NAME `jit/7 I �' SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER 18 BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST BEE BOTH SIDES T. BLDG. COST '�) ��" rX"' PAG[ 1 FILL OUT SECTIONS 1 - ! EST. BLDG. COST PER SQ. FT. EST. BLDG. COOT PER ROOM PAG[it FILL OUT SECTIONS 1 - IZ SEPTIC PERMIT NO. ELECTRIC MET[PS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR • 1 BUILDING INSPECTOQ 81 URE OF WNER OR AUTHORIZED AGENT FEE : OWNER TEL.a PERMIT GRANTEDCONTR.TEL.# -I>i CONTR.LIC.X H.LC.1/ r TOWN of NORTH ANDOVER AFFIDAVIT Hone bpmvement Gx1 actcr law aRlemat too Pemi t Applirntirn M3.c. 142 A re4.ures that the "teoatstnr altendal, r nmatia4 repair, , , iaprvvena-t, remml, d mhtim, or caisbart of az adrhtun to aiy per- existing brild- irg cmta kfirg at least axe but mt al thanfo r dwPllkg udts...or tto stortzes w4vdz are adjaoant to su3i residare or huldiW'be done by registered cmtza bas, vuh owtain ecTticros, slag nth other M,ri,mer,ts. `Type of Work: 0f" k/Z .J i d l ng Est. Costa 00 `Address of Work 2-3 ����ii,n -� �� `owner Name: :JCS �f12J E) �c� )q CTs Date of Permit Application: L/ a 7-- 2 S� I hereby certify that: Registration is not required for the following reason(s): Fir office Use Only Work excluded by law Ramit No. Job under $1,000 Date Building not owner-occupied pullingY�a permit Other Notice is hereby given that: OWNERS PUUJNG THEIR OWN PERMIT OR DEAL IM WITH UNREGISTERED CONTRACIORS_- FOR APPLICABLE HOME IM1WMIEZU WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER MGL. c. 142A. Sited u:r'ar pa-alties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: 7- Date s Owner Name Location No. `' Date � NORTN TOWN OF NORTif<ANDOVER Ot ,�•o , 1'1.0 O? •• • 0 p Certificate of Occupancy i : ; Building/Frame®ermitVV $ Foundation Perm�ee !� T s'4cMuse . T Other Permit Fee �G�o , r Sewer Connection Fej $ Water Connection Fee 0010-$ TOTAL r , Building Inspector Div. Public Works PER3fIT44P. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 MAP 4-40. I LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE — ONE SUB DIV. LOT NO. a_ of, ILOCATION PURPOSE OF BUILDING '1GyJ,A4r � OWNER'S NAME � ,(✓.,d•"/7GG —I NO. OF STORIES SIZE OWNER'S ADDRESS f3eY/V �A rw�� s"� BASEMENT OR SLAB ARCHITECT'S NAME •7� SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION - THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST eD PAGE t FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS t - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATEF E BOARD OF HEALTH SI AV§FrWbWN ORkdRZEDAGEN 1 OWNER TEL.#A697-71M.- FEE v CONTR.LIC.# PLANNING BOARD PERMIT GRA TED 7 ' BOARD OF SELECTMEN BUILDINGPECTOR i T BUILDING RECORD 1 OCCUPANCY 12 _ G SINGLE FAMILY SiORIEs 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 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNPIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/2 1/ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD\!J'D ASBESTOS SIDING COMMON , VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I-I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH )3 FIX.) GAMBRELMANSARD TOILET RM. )2 FIX.) _ FLAT I 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 I 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 OIL B'M'T 2nd _ ELECTRIC '' 1st 13rd I NO HEATING ,HOA rN OFFICES OF: o Town of 120 Main Street,_ APPEALS' u a North Andover, � =: NORTH ANDOVER BUILDING MNSSM1111sclts U 1845 CONSIa tVA"1•tUN `^�"�"` DIVISION OF (61 7)685-4775 HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIREM'011 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number Z. $ is that the debris resulting from this work shall be disposed of in a properly licensed- solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: a 6-11 (Location of Facility) Signature Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. SEINE RIWAT f=1 NA L ---- TAO R TH 9 own of 6 ndover 0 r �:7 RIVEWAY ENTRY PERMIT * 9FL - � � E ,n er, Mass.; 1 OR pa Ssq E BOARD OF HEALTH PERM. Ij T / 0 ` THIS CERTIFIES THAT.... .. •••••••••••••••••••••••••••••••••••• BUILDING INSPECTOR Als sor has permission to erect !�"'.'.�°�"... .... buildings on ;4. .. .....r••••• Rough Chimney to be occupied as.......) ..... ........... � 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 Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Pe PERMIT EXPIRES IN M NTHS ELECTRICAL INSPECTOR Rough UNLESS CONST CTI T Service Af, Final UILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough p Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector 5�6� Location No. �n �' Date NORTIy TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # J� , 6450 4� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .a BUILDING PERMIT NUMBER / ® p DATE ISSUED: _ X SIGNATURE: Jam( Building Commissioner/I or ofbuildings Date Z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 236 P San 51`7 S? W3 M JL Y_ J O V jt K— v /4 0/*36- MV Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: (� MA 750 )S- Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infonmtion: 1.8 Sewerage Disposal System: Public .8' Private ❑ Zone Outside Flood Zone pi Municipal a On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record -1oh n S Name rint) Address for Service: AAAL 5�r�azlllq'V Signa Telephone 2.2 Owner of Record: Name Print ' Address for Service: 7-7/ M Si na a Telephone M SECTION 3-CONSTRUCTION SERVICES l� 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O A License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v 1 Company Name (/0a/ - ll} -�45�� m nRegistration Number r AddressRnr� Y 1 r Expiration Date /1 Signature Telephone \II 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.......Q:_ SECTION 5 Description of Proposed Work check au a lIcabie New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: (C,I ) r SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) ' Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERSAGENTOR CONTRACTOR,,APPLIES FOR BUILDING PERMIT I,T L'es tie 4 SK.�t �•<c.� as Owner/Authorized Agent of subject property Hereby au orize ` -to act on My beh in al matters el to work authorized by this building permit application. Si nater of Owner Date r SECTION 7b/OWNER/AAUTH(O{R'IZED�/AGENT DECLARATION 11 1®es(�/ z` `-'7('��2G��� 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 Z_-eSG4,t SK d'q Print Name Signature of Owner ent Date NO.OF STORIES / SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TINMER 1 2 3 SPAN (d e DDAENSIONS OF SILLS DIMENSIONS OF POSTS A DDAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHM4NEY IS BUILDING ON SOLID OR FILLED LAND 1S BUILDING CONNECTED TO NATURAL GAS LINE 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. /I **************************II***APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT ZZ311�6 S`.e"4_s PHONED k7��/ LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREET f�(.Scc rl ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** REC ENDATION OFT WN AGENTS: CONSERVATION ADMINIST ATOR DATE APPROVED 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 FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 Jim ' �� . Com' �,� T . � �, . �, . � �� ��� s � � � . . Sn— (`� . r � . . . . rte- � -�- �.� . . . . . .;, i i T ♦ - 1 � � � � Ch�3�� ��� `. -ham; 'N ���f S �w���lt� �� dao s���a��. ����� ,(llopz4Aqe Inspecclorl PL&II., J a Lesie 7. Skle ndoxer ''tp�rlCu'rtdev c�,Lot 2'� Ix Arbon or'' 1&,,-94 dcveu(Qg ----2 ,-t---- garage i Lot.2-6 Ix OF A(� r ce, „Vi/at blis�planha/�s�be/2tymyam�}or' k'o'&8 oI d l QAUL� Q'rU � LU/1CD� (�v-Vp 1 �es od 1 �j��� GRIti sftOttm YAn c eS riot' to a 5 felt. . l w aria. satat - date o.f G•15.53 arta Hm Ixation Ifie d dh' s Con nn to die Loralni»g by-laws in � COm���t�d witfi i to fior votra dine ionat 71 5-plania�s ma lownli ptayoses I rC ' ts¢in_rn}iat-ing deed deser t-5 sC�g; r" 20' t�et�-ca�ion o,�biu�ldtrtg IC��v line �totas, or tot' b�: 7.5.82 Ca trtcay be�tredot an accutut¢ ' s�un�y FILE : 1-17889 �rd�e�tt' tn�onrrxzt7or� wFt�xt is spawn FE¢YOtL. �; �t37- 3�� ' a ColontAL Lxr)b s"pveyi na com Ann, i Jam. 269 I-VW)OWP} SCS,IAMI0%Vjl a)ASS. 02339 - phOt* rolTOZ6.7188 FAX 817-82646 5 -------------------------------------------------------------------------------------------------------- a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Com an name: f ✓t Address ( (NA!21L AJ?, 1A�t� Ill hC CiPhone* air • (0ya( �- Kealy Insurance.Co. Company name: Address City: 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$1,500.00 andfor one years'imprisonment_as_well_as_civil.pienaltiesJn-tbelmn4-aBTOP WORK ORDER and..aline-of_($1AO.OD)-aliay.agaiostme, I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. y . /do hereby certify under the pains and penalties of pe6fury that the information provided above is true and correct. Signature Date Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required 0 Licensing Board E] Selectman's Office Contact person: Phone#: F-1 Health Department Other 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: TP�. (Loc n of Facility) Alel Signat6r9 of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector NpRT►-{ E Town of over 602/a -aoo 3 o � dover, Mass., ADRATED Pl'?k C S H E -- BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT.... kkb.....�..w..........S.A.P .&! ..5............:........................................................... Foundation I i IV'�" a'�' has permission to erect.....�!'�..�....0�.............. buildin s on ..... IT......P.1. .......b�A...................................... Rough to be occupied as. �isK � � �t/`I�► �� ......................................... Chimney ......... ................. ............. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. asi 43 �O i PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR C� Rough 44J �•8... f; A............... .......... Service V BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. s £� 2731 NORTI� "� TOWN OF NORTH ANDOVER OL p PERMIT FOR WIRING ,SSACMUSE� r This certifies that ? f �()& .....� has permission to perform .. .. .. . . . .... . . ... ..... wiring in the build! of......... . ......... .. �1 . ..4-�......................... i Ir at.....�. S^. ...,�(�. �1......�f:.............. .North Andover,Mass. Fee-4-.Z..r...... Lic.No.?.S d.2.4/.4........................................................... ELECTRICAL INSPECTOR Z��o� 14: ID WHITE: Applicant t 3NARY: Bui98900ept." PINK:Treasurer GOLD: File Office Use Only n 3 01 4c (bmmvnw rttlt4 If MassF>Ii�IIutts hermit No. c( aI:partailent Of Public *afztu Occupancy&Fee Checked�` 3190 peave blank) i BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 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 ��-- t& or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) / G`'' `s 7- Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes/N No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service IL Amps J Volts Overhead Undgrnd ❑ No. of Meters � New Seriice Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity n Location and Nature of Proposed Electrical Work 1cem.ove- � �1 C�4�� ►'���( Sc—. r Aa-,- se /A 12 o f S iCzP i Hot V No. of Transformers Total No. of Lighting Outlets I No. of Hot Tubs KVA Above-- In- No. of Lighting Fixtures I Swimming Pool grnd. - gmd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets ! No. of Oil Burners I Battery Units No. of Switch Outlets ( No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. lotai No. of Detection and No. of Ranges tons Initiating Devices Heat Total Total No.of No. of Disposals Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices Municipal No. of Dryers i Heating Devices KW Local LI Connection El Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the reauirements of Massacnusetts general Laws _ I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to the Office. YES = NO = If you have checked YES. please indicate the type of coverage by checking the appy riate box. Z-0.&L., T'_ ���`L �C> —1— a INSURANCE Y BOND 7 OTHER = (Please Specify) ��L Estimated Value of Electrical Work S 7s � (Expiration Date) Work to Start _ QS Inspection Date Requested: Rough l F nal Signed under the Penalties of periury: LIC. NO. FIRM NAME Licensee �v1�'-� �C K -�1 Signature LIC. NO. a J a 7 wV V Bus. Tel. No. �b -274 �.3 Address r Alt. Tel. No. OWNER'S INSURANCE WAI R: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x-6565 Location No. Date /. 12•-/7 z v Q, Of AORTN, TOWN OF NORTH ANDOVER O? •` �ao a i�O� Certificate of Occupancy $ 41 Building/Frame Permit Fee $ Eta' Foundation Permit Fee $ 3ACMU5 V QP�� 'Other Permit Fee Z- Sewer Connection Fee $ vN 25 Water Connection Fee $ Building Inspector Div. Public Works PERMIT NOr 1-24- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. /PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP jDATE BOOK '.PAGE ZONE SUB DIV. LOT NO. LOCATION /,3�" c( - �T'� PURPOSE OF BUILDING > .21 OWNER'S NAME © _.\ �V ! �\ .� NO. OF STORIES SIZE OWNER'S ADDRESS1 Q ~�-C-C�,`�J T` C� BASEMENT OR SLAB _ ARCHITECT'S NAME •J'� �C� J J SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEUl ,, L CQ. SPAN -- DISTANCE TO NEAREST BUILDING 1- DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES 1 O REAR 10 1 GIRDERS AREA OF LOT i o0I K -1S" FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION TC- MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST j 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 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED bI Z� I l 2- 1 BOARD OF HEALTH N .OR F OWN O A T RIZED AGENT �y� p �J '79 F E E T s CONTR.TEL.# L- CONTR.LIC.# PLANNING BOARD PERMIT GRANTED S 19 �?f BOARD OF SELECTMEN /S BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYSTORIES 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 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE __ _ BRICK OR STONE HARDW D __ __ �f_lks PIERS PLASTER __ �,�—•_ _ _ ___ DRY 11—A L L — .— — `f•`"c><xk 5/U4'j�(J H"L AC �C(�>C�(•CSC.c�.�C�l�/,.< UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T AREA I '/ '/, '/ FIN. ATTIC AREA y) N_O B T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH ASPHALT SIDING HARD1!✓'D jl ASBESTOS SIDING COMfdCN J VERT. SIDING ASPH.TILE _ H-u v,- STUCCO STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. f STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORPOOR 1--AD-ATEEQUI� NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. )2 FIX.) FLAT SHED WATER CLOSET _ !� ASPHALT SHINGLES LAVATORY _ J WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER i ROLL ROOFING MODERN FIXTURES D •� �g� �a i TILE FLOOR fi V TILE DADO 6 FRAMING I 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 I C + UNIT HEATERS 7 NO. OF ROOMS GAS�12 I L ^- B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING ram , sAPPROVAL BY y �+ •s c. r .acmes•+ �.. _ RUSTmOLEUM • r. e ' �•, � t w•�� }�d � i {' ap .� �'f �' e'� t � 1• i� '� r r �'� c y` .7� I j r �,.�� A � E i f � r �� ��rl� �� �. '`'i Fp „�, S� i1,1 {+", 1 1 � �:; .� � I p{ ' ri 1 I,' i•. , r �: ka' r e,t ��,raq' t�' -d i, V• N I,� �;�� �.:Yd', It "� y�: � � t��.;1 ,� It `� � 5,), ��+• � � ^' &'� .� �+� ! , �' 3r "}• '.: } �' �' �5e '. - �il. 1 � '; �•'" '' hh � ak,,. t j ,�. •t :.i'- { f •'�,S � : Cit } � r I _ 'I r 1 � ".r`.'[ a• ,��*. r.., � ¢_, ' 4-- Z ���':: �y �•! � ��:.� r �- c. 7i� S,.r� t � :°�. }. �''t,�� }t:.. 1 1 �}- i I 5� �,;. `i!l � j �,:�r i ry h ik ,� Si '� '��•6 �' �, � pa�� � � 1 r jR. 1..�. �' N� �._V�.' i r .� i �'.. ,i �' 1 �• �`� ` .�t � f Yh �•' 6Y 7� t,,� � j 1. T. tF_J t I •r 1 �� � 4 r �, i ,t+t "rf�' ��' '�.r <+`� xi`,• ��:.. a,rg}' g ' } i:r !' h .tif�.� �i:`� .S '} ' "•� r �k �� ,!}N:' :i'�:" �.e�� r �, � 3 r R4� �rr(r t, �i ��t� }°�11 �{j. �,1 � j�1 f _ ; �!1� i1 _, �;. � "r j,' i-���aj'�F" j. �.�1x '�w •� �� � i�' ;"t I ��� i�"t lp •�" ..•. �t� ( �, t V ,. �� A 4 :�• s a ;'rt S 1 ` �!( .„a-' ,} �c.lCl' �'7 ar 777 14 � �.,7+s� �.� r S r•>.�t tib. t,:t ' K• / �e _ I A universal sub structure featuring top and bottom rails and inter- OW. nter- _. locking top and bottom plates are the solid foundation of Swim'n a Play engineered above ground pools. A E,u D FEATURES � —Steel Core Full Contoured Structural '�d a7 Copper Bearing Alloy Stainless Steel Foam Ledge Cover with LEDGE 7-in ribbed for additional strength Top arrdware Medallion designed for proper water runoff complete Alkaline Cleaned with accent strip. G115-Armored Bond V17, Tin.Ribbed Hot Dipped Galvanized 1-in.Universal — -- Top Ledge VERTICAL 6-in box — solid one piece Aluminum - construction complete with accent strip. Alkaline-CleanedCopper Bearing Alloy Top/Bottom_ Universal RAILS Aluminum rectangular 1" universal Bonderized Coating Alkaline-Cleaned Sub Frame Top/Bottom top&bottom rails.We provide aluminum for Chromic Seal G115-Armored Bond 1-in.Extruded >, Plate the best metal resistance to corrosion. Hol Dipped Galvanized Vinyl #I 1 PLATES Universal top and bottom plates. OBaked-On High Gloss Outdoor Enamel Paint Alkaline CleanedEdging 4 Color ': ,t , Printed Wall COVERS Full contoured design—structural Bonderized Coating with a Poly- foam for greater strength — complete with Ply Exterior Chromic Seal `, Sealer anchor medallion stainless steel top cover hardware. Primer Coat ,+ ASSEMBLY Universal sub structure com- Baked-On High Gloss ' t ; bined with modular ledges and verticals pro- Outdoor Enamel Paint vides a posi-lock frame construction for easy Four Color Printed Coat 1-in.Universal Aluminum �O O Massive 6-in."Box" assembly. Poly-Ply Exterior Sealer Top/Bottom Sub Frame Universal Vertical Side Support METAL PROTECTION Armored Bond Top/Bottom Plate -G115 Azinc rich coating of hot dipped galva- DECOR nization that reduces the potential corrosion Inside of nicks and scrapes via cathodic effect. Rich Quad 4 color-printed wall enhanced by almond frame and accented Baked outdoorenamel,weather bonded paint with contoured top ledge covers and feature strips. on frame and wall.(See illustrated diagram of metal protection.) Outside LINER PROTECTOR Extruded vinyl POOL SIZES AND CAPACITIES edging. (approximate) WALL Patented four-bar wall closure ROUND POOL OVAL POOL system insures proper assembly and maxi- G115 SIZE CAPACITY SIZE CAPACITY mum strength(US Patent#4223498).Corru- 12-ft. x 48-in. 4,300 gal. 18-ft. x 12-ft. x 48-in. 5,525 gal. gation of walls provide vertical strength.Walls HOT DIPPEDGALVANIZED 15-ft. x 48-in. 5,525 gal. 24-ft. x 12-ft. x 48-in. 7,688 gal. are scored for installation of thru-wall- STEEL 18-ft. x 48-in. 7,700 gal. 24-ft. x 15-ft. x 48-in. 10,000 gal. skimmers and return fittings. 21-ft. x 48-in.- 10,400 gal. 30-ft. x 15-ft. x 48-in. 12,000 gal. WALL DECOR Wood grain plank pattern. 24-ft. x 48-in. 13,500 gal. 33-ft. x 18-ft. x 48-in. 16,000 gal. Dimensional quad color—distinctively high- 27-ft. x 48-in. 17,100 gal. lighted with four colors. Poly ply exterior sealer. SPECIFICATIONS AND FEATURES FOR OVAL POOLS STRUCTURALS Patented hold down pressure sheets.Heavy gauge steel buttress and braces.High strength tension bolts interlocking buttress post and rail assembly.Universal strap assembly. WARNING: swim9nplgy �11,C• NO.JUMPING M E M B E R �1(Il\LrS Ol `�Irte 'Abt)z,,' [�rO11/1(1 rq_9IVI�aG POOLS ARE Twenty year limited warranty tliki I OW WATER 110f OESIGHEO 313 Regina Avenue n; first two seasons, ` 9 no charge for (°�r / FOR DIVING Ott '� Rahway, NJ 07065-4891 parts. `_ _' „' �/ J1IINIPING NATIONAL Phone: (908) 574-1500 SPA 8 POOL INS T I T U T E Fax: (908) 574-1551 a Manufacturer reserves the right to alter specifications without notice.All pool sizes are approximate. " SEWER/WA`�ER_.®..��.�..���: ; ,,,` '" A w�.�i�r�d�� �,�INAL GUNSE��VATIC�b�_ I�IV�Ak '� MORTfi 1 , own of FAndover "111 ILI, '*191,IVEWAY ENTRY PERMIT Karl o er, Mass., 19?L �A C C�NE WICK � PERMIT T �R� PSG ! BOARD OF HEALTH I L 0 THIS CERTIFIES THAT............... ...... ..... .... ......................,...... tol$ :• . . � �. .•,••�• BUILDING INSPECTOR .. has permission to erect ........ gs on .... . . Rough � ... � ... .... .�. .. Chimney to be occupied as. .. 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 Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNI—LSS CONSTRUCTION S ART _ Service ou Th) O� � ��� Final �..........i . 4..... ........�. ..... ... .. BUILDING INSPECTOR GAS INSPECTOR Rough I1ri Occupancy Permit Required to Occupy Building Final Display in a Conspicuous Place on the Premises FIRE DEPT. C Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by E Smoke Det. Building Inspector SEWER/WATER------- IrLANIANU _ FINIAL CONSERVATION_ ®.�e..JINAI% F NORTH 1 own of 6 0 ndover o. IV'EIAY ENTRY PERMIT = T t} Argo er Mass. 199:. C C- -NEWICK 2 oqf, pa` E W I PERMIT T Of LD BOARD OF HEALTH THIS CERTIFIES THAT............... � � ............ 1.............................. BUILDING INSPECTOR has permission to erect ........... gs on ....AIL.%S .... .. ...4*I� ...."..# Rough to be occupied as.. .1.. y. � ��.... .*,,�iA,,, Chimney 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 Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNI_ SS OONSTRUCTI6Sj_A4RTt Service h1�lf SiM�'rj Olr y�lw�l� Final ��......... .. .. BUILDING INSPECTOR GAS INSPECTOR 11r ' Rough i Occupancy Permit Required to Occupy .building Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector 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 b-2 '7 LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street �LF- R-s4uJ't St. Number Z 3 5 ************************Official Use Only************************ RECOMEENDATIO S OF TOWN AGENTS: AR'Date Approved Ol2 Conservation Administrator Date Refected Comments Date Approved Town Planner Date Rejected Comments Date Approved Health Agent Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Date.. . . 3' HOR T+, Of 14' o= TOWN OF NORTH ANDOVER ti F PERMIT FOR GAS INSTALLATION SACNU5Et This certifies that . . .7!Q!�. . . . . .A has permission for gas installation . . . . . . . . . R.�� L-. . . . . . . in the buildings of . . .5. `P�. �. S . . . . . . . . . . . . . . . . . . . . . . . . . As at . c}. . .moi . . . . &,-i . . . . . . . ., North Andover, Mass. Fee. .3.� . . Lic. No ??f . . .J ;. . . . ..11. WA GAS INSPECT;R Check# 31-79 4785 MASSACHLTSET"1S UNIFORMAPPLICATONFOR PERMTI' TO DO GAS FTrnNG (Type or print) Date -mtf_ot4 NORTH ANDOVER,MASSACHUSETTS Building Locations n& C ,eA, Gln" �� Permit# , Amount$ ?� Owner s Name New❑ Renovation Replacement ❑ Plans Submitted � w W W W p OU F x x C7 F a H �, z z 0.01 F C g O O O O W F C7 w z E' p x D W WW v� .z. U C4 W W E"' EEW. U N iWWY. z WW�c W ¢ rx a O O w O W F x O U 9 D A SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . F L O O R 4TH . FLOOR 5TH . FLOOR 6 T H . FLOOR 7TH . FLOOR STH . FLOOR (Print or type) Check one: Certificate Installing Company Name o i Corp. Address _73 `��t1 ^ '`• ` ^• 'P� Partner. Business Telephone S'. Firm/Co. Name of Licensed Plumber or Gas Fitter tx/1' F�JNNSURANCE COVERAGE Check one: t liability Insurance policy or it's substantial equivalent. Yes 13 No[3 ecked yes,please indicate the type coverage by checking the appropriate box. ance policy Other type of indemnity Bond Owner's surance Waiv am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the M s. Aneral aws, t ly Signa e on this permit application waives this requirement. ! Check one: Signature of Owner or Owner's Agent Owner Or Agent 13 i hereby certify that all of the details and information I have submitted(or ntered)in above application are true and accurate to the best of my knowledge and that all plumbing work and ins tions perfo ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massacha is toWs de and Chapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter Title Plumber � Tit City/Town Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) Journeyman r7iy-oY Date. . . . NORTH TOWN OF NORTH ANDOVER Ali PERMIT FOR PLUMBING : . ,SSACMUS" This certifies that . .DA A) �dW has permission to perform . . . �{'). . .(�,Q!ti' .(. . . . . . . . . . . . . . . . plumbing in the buildings of . . JF`?.?.`'��.�. . . . . . . . . . . . . . . . . . . at . . . . . .`3S. . . . . . ASS �- . . . . . . . . . . . . . . . .\.,. . , North Andover, Mass. Fees -Lic. No.�`. (3 0 /�, PLUMBIN INSPECTOR Check # 6Li SO, 4 MASSACHUSETTS UNIFORM APPLICATION�FOR PERMIT TO DO PL UMBIN (Type or print) NORTH ANDOVER,MASSAC SETTS Date _ 7- Building Location 357 $q Owners Name JI Permit# Amount Type of Occupancy New RenovationEf Replacement / Plans Submitted Yes E No ❑ 1 FIXTURES F � W SLB>E1SV� R4SEM VP MH-0M 2MHI= �I�IDC[Z 4M H.00R SII3)HIOCi2 6IIi)NIDCit 7M- HJOCR S1H H-0m (Print or type) Check one: Installing Company NameA CCertificate El Corp. Address Partner. Business Telephone _ D Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage y checking the appropriate box.- Liability ox:Liability insurance policy Other type of indemnity 0 Bond r Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three,Asuran signature Owner Agent I hereby certify that all of the details and informa o I have submi ed(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing wor and 'ns llati ns rformed under Permit Issued for this application will be in compliance with all pertinent provisions of the M ac u tts S umbing Code and Chapter 142 of the General Laws. By: y: ig re c icEnse um er <� Type of Plumbing License T City/Town cense um er Master El Journeyman .APPROVED(OFFICE USE ONLY t Date.....�`J...�.t. o.` ...... � NORTI{ TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACMUSE� This certifies that J A I �• �`�t ............................................................................................. has permission to perform ....... . ... ...L i. �...}............................... wiring in the building of...... ! .......... K cX S .... .................................... at................... 5?.... {+e S Ani S :..... ,North Andover,Mass. ..... .......... T ' K..... Lic.No.. Vit Fee............. .���.��............l.........°.A...�.M Mf..�:�`:--- ill CAL y Check # _ fL 5340 ------------- The Cc M,mora.:Jealth e` Massaci-,Lse~..s �....� K- e Dcpc w=t of P•.rbGc Scje y 3;4o n.--•�+•�� SCAPI OF Ft:� PSEIT% iON REMIX-MCNS = CMA t�x APPL1CnTM FOR FERMI i 00 PERFORM ELEC71 L VNOFiRK AJ work m be pmiormeG In ae=rdancr vit4 tte S -{CAI Code- S CSn I�JQ CM C:_r c. Delaw. �c��_a CS-ee_ a `h•=�e=) ��J �l e����1 �- �T C.e. or ice^ e n r_ as u-1-mh a bu=_t`zd ?'===� ��= Ha ❑ (Deck Aporap::scs 3c-t) No_ _Arpc� .� / f�T0 ca::.. Q�+e=keaC U tdZ-t.❑ Nc. er seta—�_ SC-4 Se--r c- A=ds __ / Ca1:s Q++e==axG ❑ Lades❑ bio_ o: !Se_cc -dr--z sed A=7== I.*estaa aad Naso at ?-.agesed _eeeicsl :erk �i� �(I{-ft.,Pn n1 I Z Ko_ a t• «yrs._-+s=s "'3 ' C=1a^- 4 I to o_` act S:cIIs �tA v — I�Dave Pool fid.❑ ltd. ❑ Gene_-at�-rs Z:A No. a 1 Z Ricape=14 cwla_s I Ka. a_ cul &_--e:= � • No. of Sw-t=est Cu=Less Isla. of QS _7_1 AZAMS $2. 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SL�s:s-a LTC_ NC. l O 3JA a_ Buz. =e-. me. _ - aee-sss IT) i3A(:)A u)rA i�tatclPP.l:ail, l�-IA �_-. :s1. so.'97q-5A 1- 2, 'S y;l AtIC CJL-'lit: Z j= awra Sat cta L.esaSes doe= naC bsve e:ss t'•°-:944 cava_2%0 or ::s Sua- s:srte:sl •vslaat as raQesi-ad by rsssac to atw Gaa--al .+a, sa r:st r s tsps afl e�:s pr_-�' a;p L'acs -res Gis req's`-_w=. mar da==rt (?'-rise ehset ode) Za:eCttana Na. PC-ju S o= Oretar ar Agsseel