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HomeMy WebLinkAboutMiscellaneous - 253 HICKORY HILL ROAD 4/30/2018A —'a ( Z Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING .... This certifies that ... .................... .................. has permission to perform ...... ...................................... wiring in the building of ........................................... ------------------------------ -�' ........ ,North Andover, Mass. .......... ........ ....... .......... Fee Lic. No� ........ ....... ... .... ..... ELECTRICAL INSPECTO Check At 8383 �* Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. 93 X?3 Occupancy and Fee �,� Checked - BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank)��y APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR -12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: % City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or hethe electrical work described below. Location (Street & Number) a 3 Owner or Tenant jtgTI-tL, &e6\J C,�) L Co e Cry Telephone No. Owner's Address g et Is this permit in conjunction with a buil g ermit? Yes No ❑ (Check Appropriate Boz f) Purpose of Building ,2%u✓� Utility Authorization No. Existing Service 2 y Amps 1,9evlLSo Volts Overhead ❑ Undgrd 0-- No. of Meters . 4— New Service Amps / Volts Overhead ❑ Und rd g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: l Completion of the fnllnu inv table mnv h, .-i-4 by fho L.o..e..r- -r A/;,- No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators K VA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of .Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number. Tons KW of Self -Contained FDetection/AlertingDevices No.of Dishwashers Space/Area Heating KW al ❑ Municipal ED Other Connection No. of Dryers No. of Water ICS Heaters Heating Appliances ICS' No. of BalNo. of Ballasts Signs Security Systems:* i No. of Devices or Equivalent 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 tf desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: F' y,C ?- Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, t at the information on this application is true and complete. FIRM NAME: ori% %ems �!-t/c/S%"i G �`'� LIC. NO.: o��Dz— Licensees �, cgye, -,c,, e Signature LIC. (If applicable, enter "exem t" in the license number line.) Bus. Tel. No. }� 7� L C �- 7.f o Address: / r X� GTS ✓ s�° — ���C>i, �/ /-��/� i 7 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent ��` Signature Telephone No. PERMIT FEE: $cW ✓ A �' ���gam- �G,�©� �� i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): F �C%el& j;/f� _r��,,� e- � �, Address: City/State/Zip: W o /74,�hone Are you an employer? Check the appropriate Vox: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 3. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] I am a homeowner doing all work myself. [No workers' comp. insurance required.] t listed on the attached sheet. $ These sub -contractors have wor comp. insurance. e area corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑.New co ction 7. emodeling 8. ❑ Demolition 9' - Ing addition 10..EElect ical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other —..y ay}...ca.0 u.at u..uuxs vox fr, must also nu out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy. and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Job Site Address: Expiration Date: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ito hereby certider th pains and penalties of penury Formation provided above is true and correct r Phone #: Official use only. Do not write in this area, to be completed by city or town official, City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: t w Date TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SSACMUSiS p This certifies that has permission to perform . '.. s'� . tryj!�` `�.�?... '....... . plumbing in the buildings of ...:.; . , . L.. .1 .:.. . .............. . at . . f+v for .. " ,1 .......... North Andover, Mass. Fee . . . Lic. No... � ! ...:............ . U ` PLUMBING INSPECTOR Check # 783 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO'PLUM]3RgG (Type or print) NORTH ANDOVER, MASSACHUSETTS 6.3 4' � N w� � 1 ermit Building Location l�h Ie r1 Owners Name P Amount Type of Occupancy New Renovation ED Replacement .D Plans Submitted Yes � No (Printor type)` _ Check one: Certifiate L,_ Installing Company Name �^ �1� ii =T 6y t Porp. Address p` 1 �' �- Partner. Business Te ep 'one Fimo/Co. Name of Licensed.Plumber: unry-, Insurance Coverage: Indicate the t of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond D 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 ignature Owner I hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and in ] compliance with all pertinent provisions of the Massa use y: D (OFFICE USE ONLY DAgent .ted or entered) in above application are true and accurate to the perf4med unf er Permit Issued for this application will be in �lu bing C e and Chapter 142 of the General Laws. 44p � �mbing License iceneum er Master FI-----Ioumeyman Q si—— 30 Location' "�6"Iro ffiL6 600fl--) No.. - U 47 Date oT c' 577 T" TOWN.OF NORTH ANDOVW p Certificate of Occupancy $ Building/Frame Permit Fee $—Z Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ ` TOTAL $ T Building Inspector I,'2 :10686 Div. Public Works PER11IT NO. 047 APPLICATION FOR PERMIT TO BUILD -NORTH ANDOVER, MASS. PAGE 1 MAP i4O. ® 6 /� LOT NO. -(D � I� 2 RECORD OF OWNERSHIP ATE BOOK :PAGE ZONE SUB DIV. LOT NO. LOCATION y C' `O TZA PURPOSE OF BUILDING ` 1� P' Iw"� OWNER'S NAME • H OWNER'S ADDRESS LI Z _ 1 1 W4 I �_ _ , ` �; �'ll.• 1 O,TW NO. OF STORIES SIZE BASEMENT OR SLAB sem- ARCHITECT'S NAME —_ SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME `C ,' /» (K�;B a SPAN -- .DIMENSIONS OF SILLS POSTS DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET 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 RAM IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS 6F 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 SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 - 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 Z -,.S- PERMIT .S PERMIT GRANTED v Tt�✓. 19 4 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPECTOR OWNER TEL.# CONTR. TEL. # CONTR. LIC. #. H.I.C. 11 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION CONCRETE —I 8 INTERIOR FINISH PINE 3 1 2 13 — CONCRETE BL K. BRICK OR STONE HARDW D— PIERS PLASTER DRY VJALL UNFIN. 3 BASEMENT AREA FULL, FIN. B M T AREA Y, 1/7 1/ FIN. ATTIC AREA _ _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 3 �_ _ —{I_ DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD"✓'D ASBESTOS SIDING_ COMI✓,CN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME- RAMEBRICK _ BRICKON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME - AOR SUPERIOR NONE DEQUATE 5 ROOF 10 PLUMBING GABLE GAMBREL I HIP BATH 13 FIX.) MANSARD TOILET RM. 12 FIX.) — FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ _ ROLL ROOFING MODERN FIXTURES _ 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 IL 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. B'M'T 2nd _ E 11 OLECTRIC ' _ 1st 13rd I NO HEATING 9 CD CA �■ b Wim. oo O O C. #sk Ca o oZy� �pCDCD NO 06 �. - C � o o CD coo oCL mHz,R �11 •` r # � � tr'� 1 � 1� "�R^rare-�•mr -�, ..;.;� >.O �_W • `'y- v�..=_• � � k` �s�P i, fi� � ..- 77. j m �.* # k ' Yi S'Y. • cn CACD pop m 1 xP+ ? CD CD CV cc 0 bit CD CD CD ( Tom,Cn le o m CA d �f CD /O� a �' 0 m x h* F ' w+� •�.� � v 3 c r k r. ; �.__■ }a :rY /1 9 - K c�'� th ./1 z ara� Y 1�y�: � a fc`r f ��* s.. 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Lam.#�f ri F r �4t � *' KEEN CONSTRITCT�UN G�. r 1' r w '�' °' � X21' H'EWI AVENUE" �a Y , NORTH AND VER' M ' i4a -� '� , ^ b - ., - ' _ : "^' i ` Q `�� " � W ` N A i��i0 All home improvement contractors and subcontractors �, f_� Tel" r0, ' 69i 5201 I t, �.� `it ,NF's ,.MxE E R ,,� .erigaged } ui. home' tmprgscement'.contracting,- .unless; " Fax 3(66'.4) r682 3231 :# � k� _ r ?,o ' E grE y 4, � s cificall exem t.from re istration.b ,'.Provisions of , f �. t I Yr. p , g Y< �` Y� r*3;r Vit- <-;sus. ��;�a " �� Chapter 142A'af the general.laws;'must be, registered with."i tiY M �£ r C) e �#,'r V' ,�� the Commonwealth of Massachusetts inquiries about'r �ubmltted « °�'k� � Toa y w w�-1 �t 1 �h ;� J> ,r5r y� 9 +xw f t� ,, �<, : � r� , k :. registration and :status should be made to the Director,,: j L a r r Home Improvernent Contract Registratfori; One Ashburton `' "' �' b � i ( -•iii A/1 fi�` , 1,1 � ; `� C '', Place, Room 1301, Boston, MA 02108 'k (6i7) `727-8598.• ' `` �'t fi r �Z "- °Z" `3' 4 Owners wha secure their' own construction •,related r rpt n ; t7 ,- t j^ +aIC ci�'�f*', ( '`� xk� permits Roc;-deal.:with unregistered contractors',wtll ` �F �= t� . k tc} •'s�, tie excluded from the Guaranty and Prow ion ,of 2 w '} t ,r `r 1 s3, t" : MGL'c.'I42A !iq , :`.. S k t PHONE r s I. X� k DATE r l REGISTRATION NO. F 1 q NO. .r ,��; , (J r 2rr�3.b�` ; ' r s "i 1 MA H 1 C 108383 x04 325 8052 , F x Y,�'/ /T j �` t' d 7 �k is _ f: ,3,.. '.i R' m nN,,..-,+ % t.:'�'�Sr6 i f r ,�s r s 4rof 7.ra s• x k mac, r r :.'`fib k <. T:�- 1 ' ""fi`°A s.CYr a'�0 'S F a.. 3 �,� Y"'4 } h yix7.. '�h y .r '}� i .!! H `.n. F '•ay9 �>f N4 ':.'N r, 1 4 #' : x 7rt 'Y Y '' ';,}r F` .'irk '� 7fA. t. f V R4 `SS •�' '�' i - `j q - - t p e., h' ra.,r ii "`l Fi ...a.t ,. <., -.r� _ wi a tS s .'''�' k.f_ - 'rr ..,, €.,.` ,a t We hereby s4tbmd specrficahons and estimates for work to be performed a1 dtmatenaI to,be used: � s , j * 7 rye *; r Ri, , ` Ty , r :. "r ) :;.>, , r 1"� tip`, S . iz s .y La •"ria $' : , :i "s rt "x - t a' .ti 4. t '` t z - :>, r' n -° 4r ' € Tt - r r !s ea wT+�:. a * d ,� �, .. , a '' y, 5 rt,, fa"y„34:...:x i$�5-''` 'x` k „* n7 f 'a 4°5,$. ^ r s. x�..8..x.a'x"Ya�.�x.''7". 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( / C I 4 :},fir �'i..; f .. �Y *'Ly ` (.� �ctLirr Z Ips � f :/ GJ +s z:e`rr 'tis x x i, d� _ a, �'" NtIy y} +, �, 4n rn� tp_, < ,, r r ;;x r -C + t £•_ a 4Re-0 r� r.' t. -:a a M a v.,'s '-v.2 s i f c'�7 �+- ^� ",:. ,7 '. < { - , J" ! gat• a �••:l r' i * 6, R n% *"�' i iB Y .,� nJ :- Sas }. 1l� : t t a-... ' .......'q l % b ; ,3- 'r r� S Es i r R+. 3 r , p; km2" {'Se 15- sx .�+. - '.�,, 1:" 1 t rri ,.e r "�; �! s $ 1- 7,r % 1 .,.} s ;' 4 w. :...t fi .: a r r _ S- F s r r? 1_ }: r w .4� i �j nrwr� 1 s , Fes` Y.y! ,fir`'' a uo t - J, `1r1LG4`V'"IGa�Fr t�,tl)/J>t\ :14fV1lx n C"? �3'"f` fa, f rr" ;, Construction related' rmtts � i T r r `t tt . "' ° t', t � �. 4 t n Pe P i YT ? t r r ak 1 fii :i s s w a" nn Y" - w .0 � �r y " a i ;a �. t * t ,+ c r . a , -r k P,.� ,1x41 �t e , �'... i,y; (1 ys ;`a 1w,1m w w' � 3` #`f., -t k:. r ais;, yg , ,,�.......••-. ` ..Q 1 __ � (•J ..�•,•...., 1 C'.. r'L,i Y ° -. i p'�, �" vt w} ."*.n,., *r i' i, p a rtt x, 1 J'r 'q 9 'z. r r" n 2 '} F.' X4 L t .!. t Y 1 1 + H 5''4., 'I s� ,n t i } b . VVCIi3ft SCHEDULE .." y? t rj; ,.'. _. `-.1 contra or wilt t i the work or order the materials befo a tf a third day tct0ow�tn�ttte yt;, rgof this Agreement unless specified he n:w it g. tractor will begin the work on or ihout I (date) Barring delay caused by;circumstanr�gs,pp ContractoPs confrol,dhe work will be;completed by date sThe:Owner, h_ ereb si :kncwledges and agrees hat the sehed- - , dates are approximate anG thatasuCh delays that are not avptdable by.the, Contractor hall not be,constdered: aolatlorts.of this A y RRANTY _'. r t� R '. r a r .as greement. . V k t Sr, a; ' ^ 0" ,,� 4 { untragor warrants that the work fumshed hereunde sf ft ! .f.ee, frc ' _' 1. 1. materials and.workrranshlp for a period of `y' ' `following COmpletion.and Shall. i w✓ I ne r uirements'of.thts A reement fn the event;any defect ifi workmansni or materials,'or damage caused by th@ Contractor his"subcontractOrs'etri `lo` ees,or / e9 - , 9 P p Y . , agents, is +7 ed within one year.}after completto, any job ut 1... ng cleanup t. 71 Contracior'shali at his own expense, Jonhwith remedy, repay, correct, replace,-orcause;to be'.remedied ed, or replaced;'such damage or such defect m matenal5 or orkmanshro The ore otn warranties shall su.. an the �{ y ill {; ; S 9 9 ;r ,r y: pection performed in connection with the agreed-upon worka a r _• r , , PYO ;- *. .. hereby . furnish rnat .n. and'labor com lets Ip accordance: with above sped#Icatlons for the sum ". . _ p � .G s t� 410 �S>f?1N � t("� j�- �1P;44 " r Y.?ill - 1 a� 4 SIC �� '� �yl g ,.�• gment tube made'as follows 's * �-- --dollars / r� ` {. e. k v Nte .a. -- �'_ . t' .t .,µ ` a KENNETH B KEEN ($` ) upon signing Contract '41 - � . , r i r ak 4 W i ,x LL7 a t , r #, . , b f ' Name of Contractor /Designated Registrant t j:� 9j < r� n` pt^ L % ($ )upon completion of $ 21 iiEWITT AVE: �� b r - r y„ x 4 a .4t t r z, Sheet Address is as a. e" . I - .. �, .. °i° (` ' ) p cps `x� NO AI�DO,VER t�lA 018~45 F `� $ . on I tion of r, , 'x"' q i4t."�?"R ':..isi tt ;t. 2 t' r rt t Ir +} ,- 1 f City/Stela a, r.. y.., r „}4 i t Ln r#:; 1I °o r i ., shall, ads' fo Itl1 td�n//yn 4 r a, �, . 1yj . +/ t ;, 4 U R 1%, (�i 1 f F{ _ )�' T - i'y e.' ✓ 2 '4 �i ti. f`S�: iti�Y 'it�L•y 'r/Rif R� ��Si�,n hJ -_Y.nf u Tpt, f.#"'i:,+"t'4 t i:^ k a??x� =y ompletton Of �rork under this cgnjiract s xr'` M a �iCSa?�31� i r F r ' Iyz :ky_. r:.s $ 6, tik# j'S.. i C , _ p -* rr+ri .,. .rf y Yt ,.�,.. ,.:" '-,, ,t ::. .I�tIOnB :r , 'F 'r r.. 1. z i 1=ax� ;a, — - 7;,i• y �� p s�; 4 t 37 Y }2`t ..e C �+ ^„ '"{..+.;.V"'" 11 i , ; . t. `e nr i . y. �. Y p i 3 k k +•"_ ' ..i . . 1 pk , T t 1- + s .. .• .Y if f. 'k a 3 S ,x ;opce : iNo `agreement ,for home tmprovern contract ng,-- - ii ., shall rogolre a _, " .,wn payment (advance.:deposit)°'of more than one-third oft the Notal contract price ' ° Name 's man fi` t ,.: o total amount of all deposds or payments whish the contra or must make In encs,: to order'';and/or:otherwise obtain delivery"of special cer'matenals and �; Ao n ,gnaure �uipment whichever amount Is greater rn�'�'" r `; x e -. �' ;?' Note This proposal may be wdhdrawn by us d not accepted wrthln - daya.. i��i�l�� ��� _ ..„ 3 i ,:'.f y 1 as:'••M ; Y>."I , r, ,:�' .r:L ny -,. Ceptance of Proposal I have read both sides of tntsdocument and all attached doctaments and accept the prices; specfieations and conditions stated. unc(erstand th uporrsigni.. th oposal Becomes a binding contrax ._You are authorized to do the' work a5 specified. _Payment will, be ,made as outlined above f'ou, ,the .0 er .., n el is transaction at a��y aime phor to midnight rof the third business day after the d.,ate of'. this tragi a i Can II ti must one in`wrl�ting � , t -- k . A €t SO S StCONTR tL 'itr THERE ARE ANY BLANK SPACES �a ; t k X � � " x r -.- Signeture' `S f a� _ s 1 x h * i :. 'YS ca ` ; n°' 4 M Y .r t 4,, x y y t. Dale `Signature '* � _ �.: t, y Date '� f X t' 3 fr ,,a a4 ' , ' -''� ' a" � '6 L tr �� .s, ` � -ia '° . e ': - ^.k ��' �r ,, h r r':, � F �,r 4i gi.'. IMPORTANT INFORMATION. ON BACK .,L;� : ,.3 �:: +�' } y,' '' 9"�' 4cewa �'k *'�' a Yw t7 `kY.x r a '; ,a '' ' w"N''f` ,_ 'yg .s z- r- - -x3 ' ^ _ ,t t 2 9 �i �,J'r ;fi,..- - i L'st'S�d''Y a+ 9'.:' g4 ,f.x, xa-^. _a nY; - X•.a .a.=.f as. �'t .4 . .. it . • . . 's. ... - ' ... 4. ; ..... =_i !{ -,- 3 i ._ .. _. .... ..,-..__. �� .. _ .' .. I _. i... .. _�_ ... _f. ..._ I it Water Connection Fee $ ,L Building Inspector z r�c� a`tQ I G�8 Div. Public Works Location- ' No. ii �1l> - ' Date ' ` �pRTh TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ "—" ArS < Foundation P mit Fee $ ` Otf�er Per ee i $ J �* Sewer Connection Fee $ Water Connection Fee $ ,L Building Inspector z r�c� a`tQ I G�8 Div. Public Works 3 " LVdation No. Date'/off MaRTM TOWN OF NORTH ANDOVER _••�.�ofl� 10 „ Certificate of Occupancy $ Building/Frame Permit Fee $ 0 A"D<� Foundation Permit Fee $ //' s�cNust Other Permit Fee $ Sewer Connection Fee Water Connection Fee $ 141-1 4 r TOTAL $.1 Building lnsspector 5 /94 49:45 875.40 PAID <. kr 72y� Div. Public Works Z/- /AV'. 'Location e No /i O _ Date ,.� NORTM. TOWN OF NORTH ANDOVER a OL t p Certificate of Occupancy $ c r �0 ; "Building/Frame Permit Fee $ ,: s„C,,,,, t� Foundation Permit Fee $ -11 U U fi Other Permit Fee $ n Sewer Connection Fee $ -- Water Connection Fee $ TOTAL yf�1a a b Building`Inspector s ����.. c� Div. Public Works Location3i�' /.", � 3% No. � Date TOWN OF', NORTH ANDOVER Certificate of_ Occupancy $ Building/Ff.ame Permit Fee $ :¢ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ /faGY?`. 331 , Water Connection Fee , $ �f/.I✓� lift 6926 TOTAL- $ It o0 v Buildi g Inspector 4 OW- tla Divublic Works ` PEbi.1flT 11T0.� �/ r APPLICATION FOR PERMIT TO BUILD = //PAGE1 NORTH ANDOVER, MASS. �Z 7 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE R=ZI SUB DIV. LOT NO. -Z i D � ki LOCATION l - . Ci - l f f� l PURPOSE OF BUILDING AT OWNER'S AME r y NO. OF STORIES OWNER'S ADDRESS C �] / BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 2�a' 2ND y T 3RDdor '•.�` C3 BUILDER'S NAME /�, DISTANCE TO NEAREST BUILDING•1J Q p n V/9 /L �l T' SPAN a DIMENSIONS `OrF SILLS oi - DISTANCE FROM STREET "' POSTS r/"\ DISTANCE FROM LOT LINES -SIDES ^/* REAR Gl GIRDERS ��1r % /1C� AREA OF LOT �7 I / G C7 FRONTAGE % HEIGHT OF FOUNDATION p. THICKNESS IS BUILDING NEW SIZE OF FOOTING ./ X D-�-,CJ IS BUILDING ADDITION 1, i� 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 fV _/1 _ �'i IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE YE_j Cd INSTRUCTIONS Y' � �i SEE BOTH SIDES 18L�DG. PERMIT FEE j� i Z�! PAGE 1 FILL OUT SECTIONS 1 - 3 LESS •SYi1'+'�¢�Y.�f'�'._!�� e)0_ PAGE 2 FILL OUT SECTIONS 1 - 12 WE __ _ _ _E PERMIT =��� ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING IfGip1HA11vN11 ATTACHED GARAGES MUST CONFORM TO STATE FIREIRULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDINGPECTOR DATE -1 t SIGNATURE OF.04VFIER OR AUTHORIZED AGENT FEE PERMIT GRANTEDO • V 19 OWNER TEL. 2� CONTR. TEL. #22- CONTR. LIC. i !!! ol 3 PROPERTY INFORMATION LAND COST / A�,�(� EST. BLDG. COST K� O C1 EST. BLDG. COST PER SQ. FT. 65-Q EST. BLDG. COST PER ROOM � � -7Z SEPTIC PERMIT NO. /( j 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPECTOR I 1 b Y BUILDING RECORD 1 OCCUPANCY 12 SINGLE fAMlly -- _f pr SrORIEs_ ,THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY ��OFFICES - LOT LINES AND EXACT DIMENSIONS:OF BUILDINGS. WITH'- PORCHES. GA- APARTMENTS — !,RAGES. ETC. SUPERIMPOSED. THIS REPLACES., PLOT PLAN. •-', ' CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 1 2 I;_ '`•,',; , CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS '\ PLASTER- _ DRY V✓All UNFIN. 3 BASEMENT .^�•, I - - AREA FULL FIN. B M T AREA _ 1/1 1/2 °/, FIN. ATTIC AREA - - NO B M T FIRE PLACES HEAD ROOM MODERN KCTCHEN 4 WALLS FLOORS''` ' CLAPBOARDS B 1 2 3 - .DROP SIDING CONCRETE �_ - (- WOOD SHINGLES %ARTH _ ASPHALT SIDING HARD") D _ ASBESTOS SIDING _ COM/ACN VERT. SIDING ASPH. TILE STUCCO ON 'MASONRY STUCCO ON FRAME BRICK ON '•MASONRY: ATTIC STRS. 8 FLOOR _ BRICK ON FRAME. •, CONC. OR-' C I NDE R 'BL K. STONE ON)MA'SONRY WIRING Tit 1 434 3MR1 luo STONE-ON FRAME - SUPERIOR I- I POOR ADEQUATE NONE S ROOF 10 PLUMBING GAB LEZj HIP BATH 13 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. TIMBE@rBMS I 5. - EAM STEEL B . BdfCOLS2 ;SOT W'T'R OR VAPOR WOOD RAFTE AIR CONDITIONING h" RADIANT H'T'G N i UNIT HEATERS r 7 NO. OF ROOMS GOAD B'M'T 2nd ELECTRIC " 1st 13rd NO HEATING'_ -1 i ` 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: 7-1115 call �, �6E/1 (141 to Phone 687--203S- LOCATION: Assessor's Map / /Number (� Parcel Subdivision �l ( "I�d� g111 Lot(s) i Street��L!`�. St. Number 2-�3 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: It Date Approved Conservation Administrator Date Rejected Comments +---� Date Approved Town Planner Date Rejected Comments Date Approved Hea th Agent Date Rejected Comments Public Works - sewer/water connections c - driveway permit 3_Z - Fire Department Received by Building Inspector Date CERTIFIED FOUNDA TION PLAIV LOCATED /N NO_dNnaV[E',Fq_ U SCALE: /". 40` DATE Scott L. Gi/es R.L.S. 50 Deer Meadow Road North Andover, Mass. ' • 258.00' 1 LOT 3/ 2/,959 S. F. rr •.� �� LO T 30 EX`/S T. h' FOUN,, 2T M L•OT 32 F 35' �.6Q 0- 55.00,. oa HICKORY HILL. ROAD DEPARI / CERT/FY THAT OFFSETS. SHOWN ARE FOR THE USE THE OFFSETS OF THEBUIL DING /NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE /S FOR THE 13972 WITH THE ZONING DETERMINATION OFZON/NGfc�S."T BYLAWS OF CONFORM/T Y OR NON- CONFORM/TY f 0�'�t LAO NO.ANDOVER„juA WHEN CONSTRUCTED. WHEN BUIL T. 511194 PROpOSED StTE PLAI U07 t C K 0 RY HILL KPA 1) Ho/ 14 I ON m 49(.05'E 740.40" a m D m m z z M 0 � z CO) > r ?? o w �O m Dp "n 0 C p w C � 'C 9 0 o O\ l77 Ty 'v O 2-1 c Z CO) T r CCD O D M c�. d O � CO) n� -v O v CD CD CL O Q CD CD n CD O CD T C) C/)= D m < CD _ O. v y� y m z p cfl. CD CD I < z — y O m x CO') O CD T C z D CCD w+ CIO ?0 O CI= m m O -• Vs O CT N n o R CO .p V4 = m g c) � F CL.m Z N• ® g"C ca T a c CD aim y W -1 o co o 'o m o i ' m a > > N . CD p O .O•► CO S] O ODO N• C7 a' o c° 4a N CD CD a CD O CU N CL ?� C c N CD �p .. E C, N ,► N N d H CD 0 CDO um C7 n • O Er CD D :A •-� ' n = CCD ccuj C=D P • .. c- c CD CD cn ry d cc r: Z o m m 0 0 z M 0 cn =° (D z ° 7n 0 7t 0 r ?? o w n a- Q z 0 G �a "n 0 C p w QJ C cn ( n cn 9 0 o O\ l77 8 E4- H 0 9 O C CD t)1=1�1(aa OI�. lit 111.1)ING C:ON FRVATION I lliAl: l'I I 1-i. NININ( ATE 's 1 b1�� L� )CATION Town of NORTH ANDOVE Nc. 111VISH 1N t 11° 1:'� 1 taail t ' �1►� •i"1 • Ilil iltit(!i•li �!i I'LAN- NING. & (A)(1IAWNITY DIEWIL1,01'AHIEN'1' I:AHEN 1 I.P. NELSON. l 111(.1( m CHIMNEY APDL ICAf ICN ANU VEI;MI 1' UNFR' S NAME:_ S Za1y n4 tb 1ILDER'S NAME: ' ' _ 4ay iSON' S NAME: kSON'S ADDRESS: � � vel �� C�we--.. , AmAelr ISON' S TELEPHONE: J TERIAL OF CHIMNEY: tiERIOR CHIMNEY:r) _ L'XILRlCR C11IbINEY: IM BER AND SIZE OF FLUES: OJ yer (ICKNESS OF HEARTH: :tZ ch-buney on 6iuptace eorc()aAm to .tile kcqu.iAcm(mt5 u() the curie and have ,tulc-6 tutu :gutati.olvs been uce-bed:Al A .GNATURE OF MASON :RMIT GRANTED: 'BERT NICETTA 'ILDING INSPECTOR .SPECTEU: :MARKS: FEE S'• o CD SOLID [CLUCK ItEQUIItED TUIS PERMIT MUSF GL UISPLAYIU 014 111E ITLAISLS 0 m MT1 0 > m 0 WT1 Cl) m 20 0 0 3.0 Z 0 ° Cl C y z > > 0 m MT1 0 > m 0 WT1 Cl) m 20 0 0 3.0 Z 0 z z _ >,OO,f Z O O CL r O d DCC2 'D O CD %oc v CL c rr CD _ CA 10 CD O WJ CO) M3 O O CO2 'v. C O C CO) d C) CD O _ CD CD H� CD DO 0 O CCD 0 CD 0 4rt7 C W rr-a g co rm=r�Zi � O. H C� � H y m n W C7 —Ico m n c- m O H _ -nZ ?�• vi o � col = -I- CD ..o .. CD fl- CL CD o m 'T1 CD O W H o y M ni o m x mo=� o- b4 CD Cab• C O ycm . C� C IoW: �� CD SCI �a o=ff. V1 � CD WCD 0 CD N �� c D.�� J �: CO) CO ocu O CO) CLC ►�"° V o W d �+ CLCO3 r— CD co '� :♦ ^' � CD H y ,c O C y `mCD CD cm CIO� CD (a o � CD Z-1 CD CD aED CD CD rC. 3s "' y Ne '< a* =r T O o ec C to m Za o Q. -o• r .� C CA C7� C17 : Q ✓0.. C O CD �. �c . z O civ m am CI y 0 9 O C (D G G n_ < G �y G � O C 'O O y �wz r�ML \'o ,c,- y 0 9 O C (D �rrria�rr�.•r�a�. • • v v•••. V••••• r�rra.•�.r� • •vas t'Vty r (Type or Print) . NORTH ANDOVER ,Mass. Building Location -S _ Owners Name 141: J. -��V�sP�.���8�,�� •r ` Permlt 12 �Tt.' New l.d" Renovation rj ' Replacement [] Plans Syibmitted FIXTURFS{„ K (Print or Type) Check one: Certificate Installing Company Name T fir -P Corp. Address S 0 �Lj X ( Partner. Business Telephone 17 -6 Name of Licensed Plumber: (3,/J 42 S �4 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type ,of indemnity 0 Bond U 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. . Signature of owner/agent of property Owner Agent \ •; I bembr cutifr Wal all of aiae dclails and infotaalion 1 lu•c suLu.illcd lot calcmd) in Aho- appikadoo ite tsttt aod� Bat to dw bad of Mf Iuwwk/ie and "all plumbing work and inuallations toctfnrmcd undct rctueit issued fat this appikali" will M iia oautplia•wtt �iw �y opts MAIM of"Maaaaelwaeats State rluatbial; Code and Maplct 142 of Ike Gc> 1 LaW W By Title . City/Town: ADDPe)vi=n70FFlrF use ONI_Yi signature of•Licensed Plumber Tvpe of Plumbing License License Number Lh Master ❑ t Journeyot z 4n YJ p p ?- 0 V< 2 , Id y~j N z. N < 4r cc d cc z F to z O 0 z N Q a iC a _ 1- p W �, cc 1.. cc W x i CC m AL z z _ <{� �' .. (� X •C O O 7 a< W Y (- < h W Z O 4 O d 4 Q J'. •• t� ¢ W W x a- f-• W 3 a) O O z x. �t vl tL cc at: t-.11 J= >< p au to It w W < z z O O Q w < W 1- O 11d tJ W = • :.; ; < t -O to N < 4 J J < IC A: W. < O < t� >< J O O O O J 3= r h lV O a p< is o a' SN8-%8SMT. BASEMENT �' t 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 6TH FLOOR t K (Print or Type) Check one: Certificate Installing Company Name T fir -P Corp. Address S 0 �Lj X ( Partner. Business Telephone 17 -6 Name of Licensed Plumber: (3,/J 42 S �4 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type ,of indemnity 0 Bond U 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. . Signature of owner/agent of property Owner Agent \ •; I bembr cutifr Wal all of aiae dclails and infotaalion 1 lu•c suLu.illcd lot calcmd) in Aho- appikadoo ite tsttt aod� Bat to dw bad of Mf Iuwwk/ie and "all plumbing work and inuallations toctfnrmcd undct rctueit issued fat this appikali" will M iia oautplia•wtt �iw �y opts MAIM of"Maaaaelwaeats State rluatbial; Code and Maplct 142 of Ike Gc> 1 LaW W By Title . City/Town: ADDPe)vi=n70FFlrF use ONI_Yi signature of•Licensed Plumber Tvpe of Plumbing License License Number Lh Master ❑ t Journeyot Date rad' 3598 / TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that e4�.�1.s1....�.y..................... has permission to perform ..................... plumbing in the buildings of . c'A �,: < X .0 ................ at. x?.? 3... Y ! c A.4� !''/.. N� ! 4 ........... North Andover, Mass. Fee. k. C,... Lic. No. � ©.3 G .. ............................. . .PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer