HomeMy WebLinkAboutMiscellaneous - 240 RALEIGH TAVERN LANE 4/30/201809/07/2000 10:09 FAX 978 688 9556
04/06/19197 15:02 5083736611
TORN OF NORTH ANDOVER 3 CUS R001
STEWART/ANDOVER PAGE 01
Nar ANwver 1246. 1+,.
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11646
L500
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Location 4, -t AUE &,k 7,4yeeAl j �`A4)Fz
No. Date �� S
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ 4-10
Building/Frame Permit Fee $ 'S 240
Foundation Permit Fee $
Other Permit Fee $
i
I' �Mewer Connection Fee $
� Water Connection Fee $
it
TOTAL $ �o
�4 ` �,,
i.' CR l Building Inspector
T To
- 9.0 Div. Public Works
PER111T NO. O3 S APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP 4-40. f o(,C
oq
LOT NO.'Rr(�
i/�
2 RECORD OF OWNERSHIP DATE
-6 •z'
BOOK 'PAGE
ZONE
SUB DIV. LOT NO. jo
-Ih
— � a ��
PAGE 2 FILL OUT SECTIONS 1 - 12
I 3 �—
LOCATION �- �'
PURPOSE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
OWNER'S NAME
NO. OF STORIES SIZEad
xa
OWNER'S ADDRESS y_� T
BASEMENT OR SLAB
PfiCHITECT'S NAME
`
SIZE OF FLOOR TIMBERS tSTc2x/C) 2ND q
o�
x,�O 3RD
BUILDER'S NAME
SPAN �j /
lam! = —
DISTANCE TO NEAREST BUILDING75-!
/ -
DIMENSIONS OF SILLS �J
P �'� " POSTS�y,
DISTANCE FROM STREET
T
DISTANCE FROM LOT LINES - SIDES 31 REAR Z2
/�P^ " GIRDERS
AREA OF LOT 5-.?-
'f ' 03 L1 ,3Q FT-. FRONTAGE 13 l/ I)&
✓ OC�/l v i l�
HEIGHT OF FOUNDATION f THICKNESS
/rZ
IS BUILDING NEW
, V
SIZE OF FOOTING �w /j X
,L
IS BUILDING ADDITION (,%Q ^
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION v/'a _
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO IUQUIREMENTS OF CODE r'�//
Yom/
IS BUILDING CONNECTED TO TOWN WATER
�J/yo
BOARD OF APPEALS ACTION, IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
'
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES jo
-6 •z'
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED rl ) 715:
M1 SIGNA U E OWtdrlUTHOR DAG
F E E SZ(oe 4)0
PERMIT GRANTED
3 PROPERTYV.NFORMATION
LAND COST ( Q
EST. BLDG. COST G�
EST. BLDG. COST PER SQ. FT.S
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
i )
BUILDING INSPECTOR
OWNER TEL.# S2?
CONTR. TEL. # 50'd 5 " 3', 6 -(o0�
CONTR. LIC.# 28 6-5-
i(I OLtot v�su �
H.I.C.# 1�`_ya5
LOCL nL MkCA;AUD -TP,
BUILDING RECORD
1 OCCUPANCY 12
a
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE
CONCRETE BL K.
BRICK OR STONEEE1
PIERS
_
8 INTERIOR
3
PINE
HARDW-D —
PLASTER
DRY WALL
UNFIN.
FINISH
1
1.11
_
2 I3
1 _
—
_
3 BASEMENT
AREA FULL
FIN. B'M'T AREA
1/1 1/1 '/,
FIN. ATTIC AREA
_
NO B M
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS 9 FLOORS
CLAPBOARDSB
CONCRETE
EARTH
HARD" D
COMMCN
ASPH. TILE
11
2
�_
_
3
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
STUCCO ON MASONRY=
_
STUCCO ON FRAME
BRICK ON MASONRY
ATTIC STRS. &FLOOR
BRICK ON FRAME
I_
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIORI� POOR
ADEQUATE NONE
5 R90F
10 PLUMBING
GAB;
GABLE
I
HIP
MANSARD
BATH I3 FI
TOILET RM. 12 FIX.)
FLAT
SHED
WATER CLOSET
—
ASPHALT SHINGLES
LAVATORY
_
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
_
TAR & GRAVEL
STALL SHOWER
_
R!JL OOFI G
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING
11 HEATING
WOOD JOIST
IV
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
O IL
ELECTRIC
B'M'T 12nd I
1st 1O 3rd 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.
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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: � �. '�M % G hO,Ua J tPhone � &
LOCATION: Assessor's Map Number 16'&(f Parcel 4`O
Subdivision Lot(s)
Street Ll 0 ` St. Number O� Lf C?
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Town Planner
Comments
Food Inspeecttoor-Health
Septic Inspector -Health
omments
Public Works - sewer/water connections
- drivewav permit
Fire Department
Received by Building Inspector
Date Approved
Date Rejected
Date Approved
Date Rejected _
Date Approved
Date Rejected _
Date
OFFICES OF: '
APPEALS
BUILDING
CONSERVATION
HEALTH
PLANNING
"OAA" 1
OF
Town of
a
:.;
NORTH ANDOVER
,8@�CMU58S4
DIVISION OF
PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIRECTOR
120 M, in Street
North Andover,
Massachusetts 0 ► 845
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
r-
Signature of Permit Applicant
i Oe—
Date/
..
Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
J, ",� .til->t �.0� .17'�i' �p r'4RA }�� {' ^y 7L 4i'if� f t !`Al �� #.µAi ,y1v� - r.. I• - a - I , ^ � •: ry. �
���,�� iint •,i#!.�\1�ti �v�+� Tek' � w \'�yt Si'�. 5 7 Fr` J'i"J; �,<� �;i h j� a.. • ' --F 1 �.,- _" � SY �,,
t�7t � ltl ^i ��, t t iS i .. t'i t 't '� y t� 1�\ y .yr` ` ,: 1(. ty 1`' 7•�. g Os.1 �•�•
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T4A S 4�vr" GO� r� M eD TO T14 ��1L � o� ��
n��C2121� r,;�- 1:7AI21ljC-7 f4I.$2 Fl A\I-I.
t, s: . -w _ �.•."� r.
-
'A1fG1 'and sub tre or
`1 -,g x(508)'658.5606 `"
'Beeper (617) 945.2996
ted °tit°`:homy-improver nt, contracting; unless
'spelcifir► apt from `registration by Provisions of '
Chapter 142A af'the geiielraf taws; must be regisberid with` `
Submitted -
the .Commonwealtlh of Massachusetts.. inquiries about
rr_.
TO:..—._ ..... ... ._..
registration and -statins should be to the Director,
1........._ ........ . ..... .................. ............... .
Nome Improvement Contract Registration, One Ashburton
Place, Room 1301, Boston, MA 02108. (617) 727-8598.
�........... i//'.��7..._.
U
Owners who secure their own construction related
Permits or deal with unregistered contractors will
be excluded from the Guaranty Fund Provision of
MGL c. 142A.
DATE REGISTRATION NO.
9,5-9 -2
JOB LOCATION
work to be performed and materials to be used: A /, A
/ I r1. -A—V1 /I
• r ' A M/
e LA .
IL
r
- 1/ —Ir . If` 1 1 / C
- U / -
it -
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+........_C�-tY.
..........
.0 c/� .......... .. ............
:tion related Dermits: e n n
WORK SCHEDULE i/ I y
Contractor 'jl not i the work or order the materials before the third day following the signing of this Agreement, unless specified here i tractor will begin the work on or
about (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by din (date). The Owner hereby
acknowled es a d agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement.
WARRANTY
The Contractor warrants that the work fumished hereunder shall be free from defects in materials and workmanship for a period of _C� following completion and shall
comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contra r, his subcontractors, employees or agents, is
discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, or cause to be remedied,
repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work.
We Propose hereby to furnish material and labor - complete in accordance
iCtode as follows:
$2 -1 W, ?n signing Contract;
% ($3��Qon completion of QA G
% ($ / G completion of /'mow► f
($/o Eco, Nall be made forthwith upon
—t ) completion of work under this contract.
Notice: No agreement for home improvement contracting work shall require a
> down payment (advance deposit) of more than one-third of the total contract price
or the total amount of all deposits or payments which the contractor must make, in
advance, to order and/or otherwise obtain delivery of special order materials and
equipment, whichever amount is greater.
above specifications, for the sum .QQ
T A
dollars ($
)f Contractor /
0. 16
/ State
s-& O & po5a /?�;
._......._.........._.................................._......................................... -
Phone Federal ID No.
Nam of e
eA4 (Z --f
Authorized Signature
Note: This proposal may be withdrawn by us if nota pled within days.
• - - -_-a-_- _ - -L n_._.-___1 .f
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02-06-1995 a +�-_••� C? • =-k M �� y ge 1 oT 1
TJBEAMf v4.20 sni214010810 1111
Phone: .
------------------------------------------------------------------------------------------------------------------------
(came: MOYNIHAN LUMBER Project Nage: Page Title:
Based on ALLOWABLE STRESS DESIGN ( ASD ) BOCA building code for TJM products available through Distribution
------------------------------------------------------------------------------------------------------------------------.
Application........ Floor - Res. Deflection Criteria (MR) Member Use .................. Beam
Load Classification....... Floor LL Defl TL Defy Member Top Siope(in/ft).;. 0.000
Load Duration Factor....... "1.00 _ Span I L1360 L1240_, '3` ;Roof•Slopetin/ft},.......; 0.000
Live Load(p5f) .:.;:...:.... 40:0` :; . -A.; - F1 car
Dead Load (psfl 12.4. Repetitive:Member
Partit'ifln Load (ppf).........04 _ Reinfocced�Ovechangs, .`.. N1A'•
Tributary liidth('d-°);... 12- 0.00 ;
acs of 1..: 5” �a 'MJC�`0—I AM «' ES 1_�'L' ?. CtiE
'
24.'- 0.04°
.................... ---- ----=- S`,1 E AN A l Y S I S A S D
IMPORTANT'.:; TW, presented belbw is output from softwiie .developed by Trus Joist MacMillan(TJM)4 TJM 'r ri,bis
tfie siting -of it .pr'oducts by this software°wi1'l be' accoepiished•in accordance with 7JM.product'design'criteria'and rode'
accepted :design values: The specific product application,'input design loads, -and -stated dimensions have been provided '
by the software" user. This output has not been reviewed by a NH Associate.:
The, eaxrmuer`.unbraced_iength(s) shown are based on the controlling compressive fortes on3either the. top or bottom edges
of"the aeot+er:; Lateral bracing needs to be properly attached -and positioned to achieve'stabiiity.
Note: See Residential Products Reference Guide for multiple ply connection.
Maximum; Design Allowable Control .> w
Shear(lb) 7801 6826 t 17488 256% I.T..end Span 1 under Floor -loading
Mazent(ft-lb) 46807 46807 { 65396 140%. MID Span 1 under Floor loading
Liue'Defl.(in) 0.744 f 0.800 L1387 MID Span I under Floor loading-
Total
oadingTotal Defl.(in) 1.008 1.200 L/2B6. MID Span I under Floor loading
Max. Reaction Total(lb),
Live(lb)
Required Brg. Length(in)
Max. Unbraced Length(in)
Span -1
7801 •- 7801
5760 .5760
3.50(Wl 3.50(W)
32
Copyright `c' 1993 by Trus Joist MacMillan, a limited partnership, Boise, Idaho.
MICRO=LAMIR' is a registered trademark of Trus Joist MacMillan,
TJBeamT" is a trademark of Trus Joist MacMillan.
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTINO �
(Print or Type)
NORTH ANDOVER Mass. Date
tuilding Location Permit #
Owners Name Oji viQ mc�cc��e�
•Y
New 1;�--Renovation D Replacement p Plans Submitted I]
FIXTUR-I
(Print or Type)_
Check one: Certificate
Installing Company Name_
— t- f
Q
Corp.
Address y3—
Partner.
, /s®_ �
N
Firm/Co.
1//
Business Telephone: ,6c:2,3
-3 fS� Z✓�� i
Name of Licensed Plumber
or Gas Fitter e j` , .fir
,
G R 'J
lnsuranct' Coverage: Indicate
J
the type of insurance coverage
by checking the
appropriate box:
Liability insurance policy
Other type of indemnity
0 Bond
Insurance Waiver: I, the
undersigned, have been made
aware
that the licensee of
this application does not
have any one of the above three insurance
coverages.
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BASEMERT
IST FLOOR
EL
2ND FLOOR
(
'
3RD FLOOR
(
I
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or Type)_
Check one: Certificate
Installing Company Name_
— t- f
Q
Corp.
Address y3—
Partner.
, /s®_ �
Firm/Co.
1//
Business Telephone: ,6c:2,3
-3 fS� Z✓�� i
Name of Licensed Plumber
or Gas Fitter e j` , .fir
,
G R 'J
lnsuranct' Coverage: Indicate
J
the type of insurance coverage
by checking the
appropriate box:
Liability insurance policy
Other type of indemnity
0 Bond
Insurance Waiver: I, the
undersigned, have been made
aware
that the licensee of
this application does not
have any one of the above three insurance
coverages.
ignature of owner/agent of property Owner 0 Agent Q
1 hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of mY
knowledge and that all plumbing Work and Installations performed undo: Permit issued for this application will be in compliance with all pertinent
provisions of tho Massachusetts State Gas C;ude and C apter 142 of the Ceneral Laws.
By
Ti.tle
City/Town:
APPROVED (oFFiCE USE ONLY)
TYPE LICENSE:
Plumber
Gasfitter Sign Lure of Licensed
4 Master Plumber or Gasfitter
,journeyman 7 2873
License Number
Location h` KP'LetGtt
No. Z"'' Date 3/ 9
TOWN OF NORTH ANDOVER
S vv
Certificate of Occupancy $ --
Building/Frame Permit Fee $
Foundation Permit Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
PAW BYMg
CCon„rection Fee $
'b1r1l 3 ' 1991
Wo. Andodev Collector
Building'Inspector
Div. Public Works
PERMIT NO.`
a
-I
V
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP 4-40.
LOT NO.
2 RECORD OF OWNERSHIP :DATE
BOOK :PAGE
ZONE
SUB DIV. LOT NO.I
LOCATION � � �f�j �
PURPOSE OF BUILDING C� x('3 ),)-act C• ?K'
OWNER'S NAME
NO. OF STORIES SIZE %
fj
OWNER'S ADDRESS /• f v 1 t '�
/✓ /
-yA+L
BASEMENT OR SLAB F"
ARCHITECT'S NAM
SIZE OF FLOOR TIMBERS 1STa �/17 2ND 3RD
SPAN % T
DIMENS O S OF SILLS �{
BUILDER'S NAME
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES – DES REAR
GIRDERS
AREA OF LOT •� �'� FRONTAGE
IS BUILDING NEW
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING /' �/ X
IS BUILDING ADDITION
MATERIAL OF CHIMWElf
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 1iG
JC I
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY —y
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES���
PAGE 1 FILL OUT SECTIONS 1
PAGE 2 FILL OUT SECTIONS 1 - 12
i
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING •�
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PERMIT GRANTED
3 ,9
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
cl A
3 PROPERTY INFORMATION
LANG COST
EST. BLDG. COST rz
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY % 12
SINGLE FAMILY STORIES
MULTI. FAMILY OFFICES
__
APARTMENTS
CONSTRUCTION
2 FOUNDATION
CONCRETE
CONCRETE BL'K.PINE
BRICK OR STONE
PIERS
_
8 INTERIOR
B
HARDW D
PLASTER _
DRY WALL e
UNFIN.
FINISH
1
2 13
_
3 BASEMENT
ARE FULL
'/. 1/7 l/,
FIN. B'M'TAREA
FIN. ATTIC AREA
_
NO SMT
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
_
_
4 WALLS I 9 FLOORS
CLAPBOARDS
B
1
2
�_
3
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
_
HARD",/'D
COMtACN
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STIRS. & FLOOR _
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR POOR
ADEQUATE NONE
ADEQUATE
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
MODERN FIXTURES
_
TILE FLOOR
_
TILE DADO
6 FRAMING
WOOD JOIST IV
11 HEATING
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
_
STEAM
STEEL BMS. & COLS.
_
090T W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
OIL
B'M'T2nd _
10 1 -3rd
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.
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FORM U
TOWN OF NORTH ANDOVER
LOT RELEASE FORM
M
SUBDIVISION
ASSESSORS MAP
.SUBDIVISION LOT(S)
PER NENT ADDRESS ASSIGNED BY D.P.W.
--'STREET
APPLICANT / PHONE b 6
ATE OF APPLICATION
TOWN USE BELOW THIS LINE
PLANNING BOARD
DATE APPROVED
TOWN PLANNER DATE REJECTED
COXON COMMISSION
DATE PROVEDv�'
COION ADMIN, JECTED
BOARD OF HEALTH
DATE APPROVED
H- LTH�SAVfTARIAN DATE REJECTED
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
S ER/WATER CONNECTIONS
FIRE DEPT.F,
M
I R.2.. t-�a��l �`/ 1-- r4 t-eJ 414am S
RECEIVED BY BUILDING INSPECTION.
DATE Ig
/
This form'shall be signed by the agents of the Planning and Health Boards$
the Conservation Commission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
I
.f
LL -
02).#9
V-
01"
o
REAR ADDITION AT 240 RALEIGH TAVERN LANE
HOME OF DR. f, MRS. EDUOARDO HADDAD
co I e,
11 O -r
V, PIPF�-
:J4
S�u a- P -
T c
tie
-it
t5
Location ,A .
No. Date
TOWN OF NORTH ANDOVER
.�.: • •• vQR
Qi
`
Certificate of Occupancy
$
si •
#
Building/Frame Permit Fee
$
s�cHU
Foundation Permit Fee
$
Other Permit Fee
$ \ 1 •:_�•
Sewer Connection Fee
$
Fee
$$
PAID Q Y
M cnection
i
�^ 7
2 31991--
�
ft
Building.lnspector
.,v
00. Andover Collector
Div. Public Works
PERMIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP 4d0.
LOT NO.
2 RECORD OF OWNERSHIP iDATE
BOOK 'PAGE
ZONE
SUB DIV. LOT NO.I
LOCATIONG
/
!v'
PURPOSE OF BUILDING A _�% B y�,
/✓
OWNER'S NAME
NO. OF STORIES SIZE
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME �` D ---T
s�1°"' -
SIZE OF FLOOR TIMBERS IST 7 y /y 2ND 3 Q
SPAN
BUILDER'S NAME
I
DISTANCE TO NEAREST BU16bl&
/-'
DIMENSIONS OF SILLS
DISTANCE FROM STREET
L
"" POSTS
DISTANCE FROM LOT LINES — SIDES
REAR `!
"' "" GIRDERS
AREA OF LOT L
FRONTAGE �i
HEIGHT OF FOUNDATION / `� // THICKNESS
/
IS BUILDING NEW �O
-
SIZE OF FOOTING /''/1!� yY Q /� X
/L
IS BUILDING ADDITION ! /
MATERIAL OF CHIMNEY(/
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
—S
WILL BUILDING CONFORM TO REQUIREMENTS
OF CODE / /�
(!
IS BUILDING CONNECTED TO TOWN WATER
y
BOARD OF APPEALS ACTION. IF ANY
1
s
IS BUILDING CONNECTED TO TOWN SEWER
3
IS BUILDING CONNECTED TO NATURAL GAS LINE Q
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED p� O
SIGNATURE CPVWNER.OR AUTHORIZED AGO?* _ l
FEE
PERMIT GRANTED
'Z-3 19_
m4l
rnNTR TF1, 9/J1�.3i(9[�
3 PROPERTY INFORMATION
LAND COST _3 0 0 U'
ogi
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING RECORD
1 OCCUPANCY 12 ,
SINGLE FAMILY I Si ORIES
—:::A
MULTI. FAMILY OFFICES
4
APARTMENTS
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
PINE
HARDw D
B
1
2 13
CONCRETE BL K.
BRICK OR STONE
PIERS
PLASTER
DRY WALL
_
_
UNFIN.
3 BASEMENT
AREA FULL
1/1 1/1 '/
FIN. B M'TAREA
FIN. ATTIC AREA
_
NO B M T
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
_
4 WALLS
I 9 FLOORS
CLAPBOARDS
B
_
1
2
3
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
HARDIW'D
COMtACN
ASPH. TILE
ASPHALT SIDING
ASBESTOS SIDING
_
VERT. SIDING
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
ATTIC STIRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I--1 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
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 _
It 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.
s -
L.'
014t &Mmonwr# of Massar4ustflo
Bevartment of Public Safetu
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only �./ 6 N
Permit No.
Occupancy & Fee Checked
3/90 (leave blank) lm� 111
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 / -7 1
(X* or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the e
Location (Street & Number)
Owner or Tenant
Owner's Address
work described below.
Is this permit in conjunction with a b (ding per es No ❑ (Check Appropriate Box)
Purpose of Building ��� Utility Authorization No
Existing Service 4U90 Amps 04 - Volts Overhead ❑ Undgrnd
New Service Amps _� Volts Overhead ❑ Undgrnd ❑
Number of Feeders and Ampacity
Location and Nature of Proposed I
No. of Meters
No. of Meters
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
IIIYYY
Swimming Pool Above In-
grnd. ❑ grnd. ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets &7No.
of Gas Burners
FIRE ALARMS No. of Zones 1
No. of Detection and
Total
No. of Ranges
No. of Air Cond. tons
Initiating Devices
No. of Sounding Devices
No. of Self Contained
No. of Disposals
No.of Heat Total Total
Pumps Tons KW
No. of Dishwashers
Space/Area Heating KW
Detection/Sounding Devices
Local CoMunicipal N Other
❑ nnection
No. of Dryers
Heating Devices KW
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring a (%
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER: —2 Fr, c% (3,A_&y46i 66",s r S,,
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 P NO —_ I
have submitted valid proof of same to the Office. YES _ NO J0 If you have checked YES, please indicate the type of coverage by
checking the appropriate box. I
INSURANCE P BOND _ OTH (Please Specify)
IN/
/ V V _ ^ ( pi Date)
Date)
Estimated Value of Electri I Work $ ` � (!�(,J
Work to Start Inspection Date Requested: Rough �- al
Signed under the enal esof erjury: c
FIRM NAME LIC. NO. _
Licensee ignature t LIC. NO. .2? �� 7
` f� zSG? 6
%}% Bus. Tel o.
Address C� Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensgoer does n(/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) tjd,l
Telephone No. PERMIT FEE $ U U
(Signature ofOwner r Agent) Q�
' �r �6 JV � 0ib / 9� x-6565
D
NORTH
"'° TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
°r:o-�"�
,SSACMUSE�
This certifies that .... / ....: P`... .............. ........... ....... ............. ................................
has permission to perform i r... -...................................`
wiring in the building of�f ...`.: I. t
...........................................................................
• y '
at ....... �............................:.. ..:..:.'J..... ,lr. , North Andover, Mass.
Fee.;7 .!'. ti (i...... Lic. No.� .-.. -%..............................................................
ELECTRICAL INSPECTOR
C'
09 7000 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
f Date
74
40RTH TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that .. ..../ ............ ............. .
has permission for gas installation ...' /'..� .../, I f.......... .
in the buildings of.:?.. 1 ........................
at .....-.. ............ .... `..l !:1.., North Andover, Mass.
Fee. r'.021i3%95 ic. No.! .'.:09:0..:. s . .
15.00 PAID GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
4197
Date....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
........... ............ r ..................
This certifies that ....... �J .
C
has permission to perform ........ .................. . ........................... I .............
...
wiring in the building of .........
..............................................................
at .......
L IIJ ........... rth And)
... ...
Fee ... Lic. No.I�J-.( ................... . ............. 7,
ECTRICAL INSPECrOR
Check #
- Commonwealth of Massachusetts Official Use OnI4
Department of Fire Services Permit No.
k�w BOARD OF FIRE PREVENTION REGULATIONS [Rev. OccuP nc and Fee Checked
leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 5 7 C R 12.00
(PLEASE PRINT IN INK ORge4d've4sn�
EIN ORMATION) Date: 1p
City or Town of: To the Inspector o Wires:
By this application the undersi �cerfs or hgLntention to perf rm the electrical work described below.
Location (Street & mber)
Owner or Tenant Telephone No. —
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No V (Check Appropriate Box)
Purpose of Building
Existing Service
New Service
Amps
Amps
Volts
Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Utility Authorization No.
Overhead ❑ Undgrd ❑
Overhead ❑ Undgrd ❑
Installation of Securi
No. of Meters
No. of Meters
stem
Comnletion nfthe fnlh d.. r. Wq —,t .., :.. a 1— - _ c___
No. of Recessed Fixtures
-.. ..
No. of Ceil.-Susp. (Paddle) Fans
.-u— -U — rru.vcu Dy Iric IrM ectur ul rrires.
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Swimming Pool Above ❑ In- ❑
o. o Emergency Lighting
rnd. rnd.
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
o. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
g
No. of Waste Disposers
Heat Pump
Number
Tons
I
KW
No. of Self -Contained
Totals:
Detection/Alerting Devices
No, of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
SecurityNo. ystems Devices Q
No, o Water KW
Heaters
No. o No. o
Signs Ballasts
or E uivalen
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [3 BOND ❑ OTHER F`1 (Specify)
Estimated Value of Electrical Work: - (When required by municipal policy.) (Expiration Date)
Work to Start: / � Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pai s andpenalties ofperjury, that the information on this application is true and complete.
FIRM NAME: nn•r c,....�; 4— c^-4 ,.__ , n n, :/2. A- -, , _ - ..1. LIC NO
Licensee: John S. Bassett Signature
(If applicable, enter "exempt" in the license number line.)
Address:
required by law
Owner/Agent
Signature _
JRANCE WAIVER: I am aware that the Lidghsee does
By my signature below, I hereby waive this requirement.
Telephone No.
.. 1 531;
LIC. NO.: 1533C
Bus. Tel. No.: 603 594 q928
Alt. Tel. No.:
not have the liability insurance coverage normally
I am the (check one) ❑ owner ❑ owner's agent.
PERMIT FEE. $