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HomeMy WebLinkAboutMiscellaneous - 24 FRANCIS STREET 4/30/2018 (2)N i i r Location No. Date Xi"- e NORTN TOWN OF NORTH ANDOVER Oi t,�•o '� 1h00 • e ; a Certificate of Occupancy $ s�cMust Building/Frame Permit Fee $ n Do Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r'1 / t Building Inspector a TOWN OF NORTH ANDOVER �— BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIJ RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .. X1151fp1' BUILDING PERMIT NUMBER: Q DATE ISSUED: JQ SIGNATURE: Building Commissioner/I for of-Nildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required -provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private 0 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record -Re. E 5 -E - Name (Print) Address for Service: & E -7 SignatureU Telephone 2t12 Owner of Record: t Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone v�. SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) i o 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 an a Iicable New Construction ❑ 1 Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: / NL I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I o� Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building l ;L6 0 . 40 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) ` 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 b 0.00 Check Number SECTION 7a OWNER HORIZATION TO BE LETED OWNERS AGENT OR APPLIES BUILDING PER CONTRACTORMIT 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 It SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,Q I, r oui1 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 P0. C��-r � u Print Name `�� n �� �,�xQ� � /' � � • O Si Sianature of Owne /Anent Dater NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVIBERS 1ST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS IIEIGIIT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIMv NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 7 CA m m C m CA VI m M CA Cl) 'v O CD Z y 06 o �, � � o CL = CO) aCO -v � C7 o p CD CD O 06Q d CD CD O CD C CD y. —� CD d CD O CO) CD a v y O 1 Z CD St O CD C CD R; cn n O VqJ V 0 cn G 0 C ? % O t ti v ti __ d O CL 0 Sl ED m y y C2 y d C 1 "� O '' ?= N -1 � rl O � Cy r C C 91 O n re m ti �O ti O O' 0 = CA m m C m CA VI m M CA Cl) 'v O CD Z y 06 o �, � � o CL = CO) aCO -v � C7 o p CD CD O 06Q d CD CD O CD C CD y. —� CD d CD O CO) CD a v y O 1 Z CD St O CD C CD R; cn n O VqJ V 0 cn G 0 C ? % O O ti :1O ti __ d O CL 0 Sl ED m m y C2 y d C 1 "� O '' ?= N -1 7d O rl O � Cy r C =r c .0 a m 91 O n re m ti �O ti O O' 0 = O N n .O m : =r % : acopCL =� _� mm "" CL C's p� N • U. 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In a z 0 U U) f U O v I ccm O•— � G-0 ._ .CO2 CD O FE m m � O � 3� a� � 0 0 O d �Q o � ev •v Co CCL Z � V CO) c C C . C _c d CO) Office Use oniv e Commonwealth of Massachusetts Penni[ Nc. Department of Public Safety 3/90 pancyi(k.ve blank) 3 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 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 z -1-- 6) City or Town ofa/© 01 A Al D00 M To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Z t4 F IZ•A N C E- < Owner or Tenant D Ays.D C AST"I2-C d N L Owner's Address "7 %l LL S r n e- gj% A• Q 13o xl-o12.D, M A- 012?-) Is this permit in conjunction with a building permit: Yes 1911, No ❑ (Check Appropriate Box) Purpose of Building S �i �,j_ pict m:1 L Y Utility Authorization NO. Existing Service Amps 17-0 / 2-q D Volts Overhead 01 Undgrd ❑ No. of Meters_ New Service Z( Amps Z U / Zq I)Volts Overhead ® Undgrd ❑ No. of Metes / Number of Feeders and Ampacity Location and Nature of Proposed ElectricA-1 Work '' S e li✓ I C e n G c1 rfr O 1 `6 � y - 10 CQ �A J- ' I i Q 1 i vi A . , r -M F� /In P No. of Lighting Outlets - No. of Hot.s• . No. o£ Transformers Total INA No. of Lighting Fixtures Above In - Swimming Pool grnd, ❑ grnd, ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners (No. o£ Emergency Lighting Batte Units No. of Switch Outlets No, of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No, of Sounding Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal ❑ Other Connection No.tof Ranges No. of Air" Cond,• : Total; tons. No. of Disposals No, of pumps Total. -oral, Tons` KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW ;of o, o sBallasts FN,,. Low Voltage WirinNo. Hydro Massage Tubs o£ Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES@ NO 0 I have submitted valid Eproof of same to this office. YS F NO If you have chec ed YES, please indicate the,type of coverage by checking the appropriate box. INSURANCE E] BOND ❑ OTHER ❑ (Please Specify) Expiration,Dare Estimated Value of Electrical Work S r Work to Start 4•- L Inspection Date Requested: Rough 1 J (c Final Signed under the penalties of -perjury - FIRM NAME -71) l?72� (s1, l _ u LIC. N,% 5'3 Licensee 1 bJ A M �A - C (•J Wg,-r4kJ Signature Q LIC. N0. I S Addressl� tip' to t j Dkry [s [11�iZ1 Bus. Tel. No. Alt. Tel. No. rte„ 7p,— �j �jZ �LC ZVO OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) , -Y Telephone_ No., , Signature of Owner or.Agent PERMIT FEE S U iotoodsui .aHOOB8 NoIJL04d i SNJBWaa - saIoN I alea f'C4 01 1-3 NORTH 0 0 ,SSACHUS Date.. -..2 G........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... r— if.4 ........ .................... has permission to perform ...kr.!! ...... ................................. wiring in the building of ..... ..... C.-M.S. /.C*-. ..................... at .... .......5l .............................. . North Andover, Mass. Fee... :7s ... . ...... Lic. No. ............................................................. ELECTRICAL INSPECTOR 04/09/96 13:53 75-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File !/r i Date ... ... ... f:. f ..... J OF NORTH ,41 TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION y •t wruuSEt� This certifies that 1.:.�F't......................... has permission for gas installation.. !? .. .. r............ in the buildings of ........................... at .. . `C ..� .�' a...... + ............... . North Andover, Mass. Fee. Lic. No.. . ..... G,XS INSPECTOR Check #/i t MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) P. /=}N�pU�1I ,Mass.' Dofe `/ _ � Permit # u i" �i sTi2r caiv�' Building Location �- / F �' �1's S7- Owner's Name Type of Occupancy G New ❑ Renovation ❑ Replacement L� Plans Submitted: Yes ❑ No ❑ Installing Company Name CALLA AoyL< 74 Address q1 131FLI'70 — 57— A 4t ----,o o vL IL. /Llit--S S Check one: Corporation ❑ Partnership Business Telephone Cid Sl Q:v �L S4 C9�-3 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter ` —& C/ILLAI/ d l J Certificate # 0�C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 1 Yes B'— No ❑ If you have checked rte, please indicate the type coverage by checking the appropriate box. A liability insurance policy. C7— Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 1:1 Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application'are true and accurate to the best of my knowledge and that all plumbing work and installation performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: El Plumber Title El Plumber Si ature of icensed Plumber or Gas Fitter City/Town Ci-�klaster License Number LIYO O APPROVED (OFFICE USE ONLY) ❑ Journeyman U co Y w vi ~ 2 Q O Q J O U W W ~ 0 c m Z O O _ Z cc W m to H Z O O ¢ > rn W ¢ W Cn U) W cry U Q w 2 = tt u) ft W Q w~ O w H= w Q C3 F- Z J _Z F- Z W w C7 O� rQQh W Z U W J O W 2 � m O 0 2 LL O (7 J 8 ¢ > O a. w F- i- O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name CALLA AoyL< 74 Address q1 131FLI'70 — 57— A 4t ----,o o vL IL. /Llit--S S Check one: Corporation ❑ Partnership Business Telephone Cid Sl Q:v �L S4 C9�-3 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter ` —& C/ILLAI/ d l J Certificate # 0�C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 1 Yes B'— No ❑ If you have checked rte, please indicate the type coverage by checking the appropriate box. A liability insurance policy. C7— Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 1:1 Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application'are true and accurate to the best of my knowledge and that all plumbing work and installation performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: El Plumber Title El Plumber Si ature of icensed Plumber or Gas Fitter City/Town Ci-�klaster License Number LIYO O APPROVED (OFFICE USE ONLY) ❑ Journeyman E: 0 z 0 v D m i r c 3 m m m 0 m 0 D N m x �r 0 0 Z 0 In to c 6 Z v m m z O 0 (Prinl a Typal NORTH ANDOVER, , Mats. Date 1 '0�e/G / _10 91 QQ / Building L Permit # • U 6 6 Location --Y /�S .6 r Owner's`� Name Name OO 5 V1.0 New ❑ Renovation ❑ Replacement 01 Plans Submitted: Yes ❑ No. ❑ FIXTURES Instalilnp Company Name �i3uL Lc/i�t7e f?�� �f TG. Address /3 Nf0A11Af-_R Business Telephone 6a3 36/"',- 4221 Name of Licensed Plumber lthlhl�:_ Check one: Certificate ❑ Corp. ❑ Partnership trm/Co. INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantW equivalent. Yes Ci'- No ❑ It you have checked y", please Indicate the type coverage by checking the appropriate box A IlabiRy Insurance policy l Other type of indemnity ❑ Bond ❑ .. _ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Masa. General Laws, and that my aignature on thta permit application waives this requirement_, Check one: Owner ❑ Agent ❑ Slonatuts of Owner or Owners Acent I hereby certify that an of the details and Inlormallon I have suberAted W entered) in above application at true and ao=ats to the best of my knowledge and that ata plumbing wait and Installations p*dcxn-ed under the pent I for this appNcatlott veli be In compliance with aM pertlnenl provisions of the Matsachusetis State Plumbing Ckode end Chapter 142 of at gna urs W Lkwsedmer Uconse Number // �%3 Type of Plumbing l cense: Master Journeyman 0 st »Z _ 19 Is a /AL1 u= r » i s�» = t• d s a U ✓ at O ON 1- we>~ s at s a� I _ a a� a y N=»`< ;s o» y��J O a H J s t ski O as •» o O j� i M 0 a A < it t 0- - aua—•erMT. I. SAstwtNT IST FLOOR 2NO FLOOR SRO FLOOR 4TH FLOOR sTH FLOOR OTHFLOOit. TTM FLOOR aTH FLOOR — Instalilnp Company Name �i3uL Lc/i�t7e f?�� �f TG. Address /3 Nf0A11Af-_R Business Telephone 6a3 36/"',- 4221 Name of Licensed Plumber lthlhl�:_ Check one: Certificate ❑ Corp. ❑ Partnership trm/Co. INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantW equivalent. Yes Ci'- No ❑ It you have checked y", please Indicate the type coverage by checking the appropriate box A IlabiRy Insurance policy l Other type of indemnity ❑ Bond ❑ .. _ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Masa. General Laws, and that my aignature on thta permit application waives this requirement_, Check one: Owner ❑ Agent ❑ Slonatuts of Owner or Owners Acent I hereby certify that an of the details and Inlormallon I have suberAted W entered) in above application at true and ao=ats to the best of my knowledge and that ata plumbing wait and Installations p*dcxn-ed under the pent I for this appNcatlott veli be In compliance with aM pertlnenl provisions of the Matsachusetis State Plumbing Ckode end Chapter 142 of at gna urs W Lkwsedmer Uconse Number // �%3 Type of Plumbing l cense: Master Journeyman 0 Date. . +..... `. . f NORTH O TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� This certifies that .... r.r..[-..l.!.Itc./.G...,.,,�.../,,,,, has permission to perform ...r' plumbing in the �uildings of ... _: .... fl...r. :'! ......... at. . . . . . . , North Andover, Mass. Fee. -,,,.4. 7.. Lic. NO.. ..'. !. i.`�.............................. PLUMBING INSPECTOR it 04102hys 1 5 59.03 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Location Date��� TOWN OF WORTH ANDOVER Certificate of Occupancy $ _ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee -- Sewer Connection Fee $ _ Water Connection Fee $ TOTAL 031221% 15:59 i Building Inspector 52.00 pAID Div. Public Works PER11IT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. INSTRUCTIONS "'�J'aQ v SEE BOTH SIDES ��m Pjc7�i PAGE 1 FILL OUT SECTIONS 1 - 3 s PAGE 2 FILL OUT SECTIONS 1 - 12 ( ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED - I -'/ v "-I? (- SIE OF OWNER OR AUTHORIZED AGENT FEE v PERMIT GRANTED /1 19 q, 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST jgdro.b S EST. BLDG. COST PER Q. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY SUILDING INSP[CT011 OWNER TEL. CONTR. TEL. k CONTR. LIC. # [ Q H.I.C. # / /? 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. — LOCATION PURPOSE OF BUILDING f OWNER'S NAME111 NO. OF STORIES StZ OWNER'S ADDRESS BASEMENT OR SLAB I ♦ o W ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1S 2ND , D BUILDER'S NAME SO F 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 P, c •l 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 "'�J'aQ v SEE BOTH SIDES ��m Pjc7�i PAGE 1 FILL OUT SECTIONS 1 - 3 s PAGE 2 FILL OUT SECTIONS 1 - 12 ( ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED - I -'/ v "-I? (- SIE OF OWNER OR AUTHORIZED AGENT FEE v PERMIT GRANTED /1 19 q, 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST jgdro.b S EST. BLDG. COST PER Q. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY SUILDING INSP[CT011 OWNER TEL. CONTR. TEL. k CONTR. LIC. # [ Q H.I.C. # / /? BUILDING RECORD a 1 OCCUPANCY 12 SINGLE FAMILY MULTI, FAMILY _SfOR1E5 OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE PINE B 1 2 13 _ CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER ORY WALL _ UNFIN 3 BASEMENT AREA FULL FIN. BM T AREA _ '/, 1/2 '/, FIN. ATTIC AREA NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 3 �_ _ _ _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING CONCRETE EARTH HARD",'D COMMCN VERT. SIDING _ ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME r- BRICK N M N Y ,ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR POOR ADEQUATE I-1 ONE 10 PLUMBING 5 ROOF GABLE 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 MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. 6 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 _ to 13rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. M t �¢ O w v cn 0 C—Z0 "10w O w O x .0 U ie G x 0 p a: G w' GG O w w p w cn w a p a: C ii w A E w� cin o cn W a z co O co � O O CA O H O co CL �O CL CD •B+ O CJ CO2 O Q �. CO) O O O S cc CO) Q L O V O Q CO3 C O CM C 0.— ,= 0 m m 0 co O � co O CL CL Q c _ ccC 0 CO Z CD CL CA C c� 0 :oma ;ac ea m c o co co I `Q CD ci =s v •• as CL om :cam O O ;oma J V h D S c E co � � N • Q O t CO m O t 'fl y r y C C O ca O :mo cm `I y m C� CD 'o CL 0 o m cc >Z � c o c c Q, : N m C C Z m= p C. N S N k Nm om' m t C W o W L m -0= yr LL- AR H C z ui E c3 ca CD O� C f/) Q' aa O _ O a.,..m> co O co � O O CA O H O co CL �O CL CD •B+ O CJ CO2 O Q �. CO) O O O S cc CO) Q L O V O Q CO3 C O CM C 0.— ,= 0 m m 0 co O � co O CL CL Q c _ ccC 0 CO Z CD CL CA C Location 24 No. to 3 6 Date J TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $~ 33 ..- Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector J. i'_I ;1 +� j 1 57 i3_ C", PAT-' Div. Public Works PERMIT NO. (J 34- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZON' E _ L SUB DIV. LOT NO. I LOCATION J, C PURPOSE OF BUILDING OWNER'S NAME f" /7 NO. OF STORIES SIZE i/ Y 3 OWNER'S ADDRESS anJ �qr iJ, T• p� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD o BUILDER'S NAME /1 n /I- 'S .•ua1[a.��- SPAN 1 A ( d -X DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS 4- �x0' DISTANCE FROM STREET q /� I `L(( POSTS t4 Q (•G�-C[( DISTANCE FROM LOT LINES — SIDES (f AR /, /G GIRDERS 1 1 AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION 11 L( THICKNESS I✓1 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 �y IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS i - 3 PAGE 2 FILL OUT SECTIONS i - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED IJ -,e,-- 1'0 1 af,' a - 3 SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 19_ r DEC -6 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST �O EST. BLDG. COST PER dQ. FT. EST. BLDG. COBT PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY Aki*A;�-� BUILDING INBPECTOR OWNER TEL. N CONTR. TEL. N 6 kK - l Y % CONTR. LIC. # V 17 1 f -c-- 3 a3 9 H.I.C. # �Ato I C BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY_ STORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE PINE d 1 2 13 _ CONCRETE BL K. BRICK OR STONER D PIERS PLASTER 1 E DRY WALL _ UNFIN. 3 EASEMENT AREA FULL FIN. B M'TAREA _ '/ 1/2 1/1 FIN. ATTIC AREA _ NO 8 MT HEAD ROOM FIRE PLACES MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B 1 2 �_ 3 _ _ CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDVJ D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK N MA N Y ATTIC STRS. d FLOOR BRICK ON FRAME I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE 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 d GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 8 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEEL BMS. & COLS. OR VAPOR WOOD RAFTERS _ ITIONING _ 'T'G ERS WHEATING 7 NO. OF ROOMS B'M'T 2nd _ 1 t 13rd G s THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. 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