HomeMy WebLinkAboutMiscellaneous - 261 HICKORY HILL ROAD 4/30/2018Box 55098
Boston, MA 02205-5098
617-951-0600
J�K
Form of Notice of Casuafty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To- Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER, MA 0 1845 NORTH ANDOVER, MA 0 1845
RE: Irisured: ERIC MAGENNIS and -TAMMY MAGENNIS
Property Address: 261 HICKORY HILL RD, NORTH ANDOVER, MA
Policy Number: HMA 0350246
Claim Number: BOS00050391
Date of Loss: 2/19/2015
Company: Safety Indemnity Insurance Company
Claim has been made involving loss, damage or destruction of the above -captioned property,
which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chqpter 143, Section 6 to be
applicable. If any notice under Mass. Gen. Laws, Chqpter 139, Section 3B is appropriate, please
direct it to the attention of the writer and include a reference to the captioned insured, location,
polic num er� date of loss and claim number.
b
Eric Keenan Claim Examiner 2/23/2015
Safety Insurance Company
Homeowners Claims Unit
P. 0. Box 55098,
Boston, MA 02205-5098
A/1- 45��
N22222 Date ..................................
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that .... ...... ;�7 ............................................................
1; 1. 1 --�- 1111�7-1
has permission to perform ..... i!n .............................. .......
wiring in the building of .............................
at ....... . .................... & --- .......... .. -9 North Andover, Mass.
6
Fee—Q Lic. No�'14
......... ..... ..... .......
ELEcTR icAL INSP ECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
THE09W0AWE4L7H0FMAYSXHUSE77S Office Use only
DEPARTMENTOFPUBLICS4FM Permit No,
BOAMOFMEPREVEMONRWULAHOM-WCMIZ�09
Occupancy & Fees Checked
APPUCATION FOR MART TO PIMORM ELECMCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 cMR 12:00 3 / (0 — C) c,
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat&_
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) c� � / gLk�j A. (f
Owner or Tenant C 1
Owner's Address s q
Is this permit in conjunction with a building permit: Yes r"'—T No (Check Appropriate Box)
L—.J
Purpose of Building Utility Authorization No.
Existing Service 5P -V Amps (Z�-) 7c(d Volts Overhead Underground No. of Meters
New Service Amps Volts Overhead underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work I
No. of Lighting Outlets
No. ofHot Tubs
No. ofTransformers
Total
KV4--
No. ofLighting Fixtures
Swimming Pool Above
M
Below/
M
Generators
ground
ground
//KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
41
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
I'll
Tons
No. of Detection and
No. of Disposals
No. of Heat Total T�tal
Pumps
Tons
KJW
lititiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating W
No. of Self Contained
Detect ion/Sound ing Devices
Local —1 Municipal
E]
—1 Oth�7t—
No. of Dryers
Heating Devices W
t
Connections
No. of Water Heaters KW 0
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
0
No. of Motors
Total HP
OTTiER -
hua=CuAr,V-
I ha%e acumit Labilly hum= HLY MCb&9CMT1deOPWAM Comworits mbftltd e*ivakn YES NO M
Ifimea hnJWdvalidptcdc(§wriotheOffix- YES M NO ff�m hmedwdwd YES, pkm vdKzkthet)WofwmW bydockrigthe
I I bcpL
lNSURANCE BOND OTHER ftmSpa*)
Exph6m Ddr
E4nakdVahrdMmfimlWczk $
WcikloSut hpe=D*RapesWd Ra#13/ V F.,W ff 6t
SigrWuidaSPwahies 40illy. I it, � E Ic 7-?
FIRM NAME
Lk=m
U Bau*xssTdNd /((5-(
dim AkTdNh �7-5- W77 C-11
OWNER'S MJRANCEWAIVER;- I amaw=t1xttheL=xedm not dvmn-&=o7mmWa-zabutWa*uvaiatasm#WbyNiazahEczCaxdLmvs
(Please check one) Owner. F-1 Agent M Telephone No. PERMIT FEE $
4482
Date..
TOWN OF NORTH ANDOVER
'A PERMIT FOR PLUMBING
This certifies that ...... ......................
I t 5��54 .......
as permission to ....................
,Jlu mbing in the buildings 6T
4* ...........
North Andover, Mass.
.... . ...... ..
443
... ..........
Fene6- .. ..... Lic. No ... ..... IN, 6TOR
LUMBRON PEi
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
M��
MASSACHUSETTS UNIFORMAPPLICATION FOR � PERMIT TO DO PLUMBING
(Print or Type)
D mass. Date I 9� Permit #
Building Location -1(o f Lc-,�) /41 1 ( 1'6� Owner's
N 0 tl�' �-j a L/ vo 14 (D (M—Type of
New 0 Renovation 0 Replacement 2-11,
FIXT . URE� . I
I"
1)6 1—
LGX rM'VG'A/V/e flo
Submitted: Yes El No 0
Installing Company Name ""AoaEe-r a - �s-,4(r ^4 T Aen
Address L'04(HMt4f'j '4' pi
E T�-t o
Check one:
0 Corporation
0 Partnership
**Business Telephone cl 7 1 915i" -/Co.
�,Iame of Licensed Plumber
Certificate
INSURANCE COVERAGE:
I have a current gability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes a' No 0 .4
If you have checked Yes. please indicate the type coverage by checking the appropriate box
A liability Insurance policy Other type of Indemnity 0 Bond 0
OT!R'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
Pvo er 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner Agent 0
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 in nerformed under the permft issu for this application will be in compliance with all
pertinent provisions of the Massachusetts Sta=n� Ig e and of the eral Laws.:
t4
BY.
TdJ e SLqbaMre of Licensed P—lum-ber'
City/Town Type of License: Master Joumeymah E]
APPRUVED (OFFICE USE -O—NL-YT— License Number �33 I
Judea
Installing Company Name ""AoaEe-r a - �s-,4(r ^4 T Aen
Address L'04(HMt4f'j '4' pi
E T�-t o
Check one:
0 Corporation
0 Partnership
**Business Telephone cl 7 1 915i" -/Co.
�,Iame of Licensed Plumber
Certificate
INSURANCE COVERAGE:
I have a current gability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes a' No 0 .4
If you have checked Yes. please indicate the type coverage by checking the appropriate box
A liability Insurance policy Other type of Indemnity 0 Bond 0
OT!R'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
Pvo er 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner Agent 0
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 in nerformed under the permft issu for this application will be in compliance with all
pertinent provisions of the Massachusetts Sta=n� Ig e and of the eral Laws.:
t4
BY.
TdJ e SLqbaMre of Licensed P—lum-ber'
City/Town Type of License: Master Joumeymah E]
APPRUVED (OFFICE USE -O—NL-YT— License Number �33 I
v
m
30
4
30
m
f-
0
0
z
0
z
m
m
0
c
z
a
z
m
z
0
)w
In
V
m
V
in
0
z
0
0
a
0
c
z
0
V
C)
z
m
0
z
w
m
0
z
0
m
0
z
P
-vc
LocatIon
No. Date
jORTN
TOWN OF NORTH ANDOVER
I A
Certificate of Occupancy
$
CINU
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check #
13672
Building Inspecto—r
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Oil'
BUILDING PERM[IT NUMBER: 40
DATE ISSUED: 43,43/00
SIGNATURE: 'JOW 0.009� 00000C&10�� I
BUM ding Commissionerflq�REtor of Buildings Date
I - V 7
SECTION I -SITE INFORMATION I
1. 1 Property Address: 1.2 Assessors Map and Parcel Number:
2,6-1 4Z /?6L
zol
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning Distri�i__ Proposed Use Lot Area (sf) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard Rear Yard
Required Provide �Mired Provided _Reqwred Provided
1.7 Water Supply M.G.LC.40 54) 1.5. Flood Zone Information: 1.8 Sewerage DiVosal System:
Public 0 Private 0 Zone - Outside Flood Zone 0 Municipal 197 On Site Disposal Systern 0
SECTIbN 2 - PROPERTY OWNERSHM/AUTHORMD AGENT
2.1 Owner of Record
Ce- le f
/0 261 11,,4-,�z /,?C/
Name (Print) Address for Service:
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable 0
W E _j,:. tj
Licensed Construction Supervisor: S'? 6LIY
License Number
211 Yew; IT Au,�r AJ. 4,4601^1
Address
A_bQ '?72-,(S?/-S:2,0j Expiration Date
Telephone
3.2 Registered Home Improvement Contractor Not Applicable 0
k e -IF tj ce-, P0 5f I C_ + a Pj
Company Name z 5 ? 13
u.) N. 14JUA n ol"_ Registration Number
Addr 12 2
Expiration Date
Si Telephone
MU
M
X
z
0
9
ptu
0
z
M
0
"n
ic
QVrT11nN,1 - wnRK'F.R-,g rnmPENSATION (M.G.L C 152 6 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 ....... 9' No ....... 0
SECTION 5 Description o Proposed Work (igheck appUcable)
New Construction 0
Existing Building
Repair(s) 0
Alterations(s)
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Description of Proposed Work:
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICLAL.USE ONLY
I Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical (If VAC)
5 Fire Protection
6 Total (1+2+3+4+5)
a-0
Check Num
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 REtjp E-A RSFXJ — 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
propertV
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
Sip -nature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS IST 2ND 3RD
SPAN
DMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING x
MATERIAL OF CHRvINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
4�
3
The Commonwealth of Massachusetts
Department of Industrial Accidents
1.2 L_�
G_,
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
1TW- Z
1&!R �.41*90m:
name*--
loc tion: 77—/ Yellu t. 1—r AtI6-
city A/b )qtwd6u.�_,-L nhgne#
f -I I am � liomeowner performing all work myself
R_l am a sole proprietor and have no one working, in any capacity
7,12.-M, 5=07MMMM 7r, 17BURREM,
M I am an employer providing workers' compensation for my employee' w
s orking on this job.
company narrm.
address:
X.:
city:
phone
insurance co.
I'M
2 M
C] am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractor's listed below' who have
el
the followina workers' compensation polices:
c9m any name:
official use only do not write in this area to be completed by city or town official
city or town: permittlicense #
Building Department
C] check if immediate response is required [JLiceasing'Board'
-]Selectmen's Office
[]Health Department
contact person: phone#; —Other
-C cog-= — =r -4
C -to w
=CA z cr CA 2E
CO3
CD C12
CCD3. C-) 1
0 m
C3 (a CCD) � c a =
1; 5=� a a 00 =
-2. CA
CD m
CK CL 0 rn
Ct cm =r
D i a x
S CD co, 440
CA Cl) Q LA. C2:
10 0 i4ftow
CD cs -9 ix
CA
C)
CO)
CL 44b AN
CD
F C/) .0c CD
cl)
C/) A
0 CD
nCD
CD 5 COD 0
m C& C-,
M C2 C43 =r
C, Cc,
M ff Ao
S. 'IF 5 4,
m CD CL
CO3 r.7 CD
< dc c
m CD C/) CD
CD:
cn s7o 'a") C-40
m CD
CD . . .
C/)
CD Q CD
m CD CD:
cc w
CD COFF
CD
CD
CD C/)
CD
CO3
ca
CD
co
0 C=2 C=D
CLs
CD
COD:
c CD
CD
C-3
CD:
0:
cn
0
cn
w
171
cp
x
"X
It
0
:71
cn
m
n
::I
pa
0
:r
al
CL
0'
cp
cp
;p
0
z
9
2)
W
W
0=3
0
'---A
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .1 ........ ..............................
_4
,�,.bas permission to perform .......
e,,, plumbing in the buildings of ...... ..........................
aj_
_7
............ ......... ... North Andover, Mass.
H� ........ Lie. No ........ . .... _Y
Check # "<<�UMBIZ,> &PECT(OR*
6219.
MA.SSACHUSETTS UNIFORM APPLIC�TION FOR PERMIT TO DO PLUMBPqG
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location HicLaa�f 0"I
'I
New 1:1 Renovation M
Date /0/;?0jo
)wners Name 1� Aj I C L Permit #
f Amount :?e) 'P
Of OCIPan Doj'e I I i.,i "�'
cemenj rlyn Plans . Submitted Yes No
.Check one: Certificate
al�int. or type) 7; L L c, Corp.
ins
Mling Company Name
Address 57,1, Partner.
rz --i C e M V4 018k4
Business Telephone 9 -7 X & 25 5�2 5'0 V Firm/Co.
Name of Licensed Plumber: -7-1-10,,105 1-14 /A) /Z
Iiisuran�Le�� Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond
Insurance Waiver. 1, the under . signed, have been made aware that the licensee of this application does not have any one of the above
three insurance
...Signature Owner El Agent El
I hereby certify that all of the details and information I have submitted (or en . tered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Pjp bi Code and Chapter 142 of the General Laws.
p ing
`7
Title
City/Town
APPROVED (OFFICE USE ONLY
Signature ol Licensed Plumber
Type of Plumbing license
7cense 1-4773577 Master Journeyman
Date. e ...............
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that .7. .......
"I'has permission for gas installation ......
in the buildings of
at ... ............ North Andover, Mass.
Fee�.�,. Lic. Nw:;� -1.2'�.JU . . . . . . . . . . . . .
T6
tNZ �T6
Check # 41�1 /
AkRSACHUSETrS UNIFORM
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
'U1 #/?/;r,1AC191
Building Locations I -
t�, . s Name
New Renovation [] Replacement [D
PERM TO DO GAS FrrTING
Date /a A) L-/
Plans Submitted
1 1:1
Permit #
Amount $
C eck one* Certificate Installing Company
(Print or type) L
Name—T' .4114 L t 0 A-4 U Corp.
Address 0 - 13 e X 5- 7,�, Partner.
e-4kj4e,rvce /;I -; e7
Business Telephone 9-71 6 S(5-- 2 15-0 Finn/Co.
Name of Licensed Plumber or Gas Fitter 7�/',,,-j os W,4 /kfq t -J
INSURANCECOVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. YesEl Noo
Ifyou have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy EM I 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 El Agent 0
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 installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Codeand, Chapter 142 of the General Laws.
jCity/Town
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber ;( Y � 33
0 Gas Fitter License Number
Master
Joumeyman
�IST. FLOOR
,7TH. FLOOR
C eck one* Certificate Installing Company
(Print or type) L
Name—T' .4114 L t 0 A-4 U Corp.
Address 0 - 13 e X 5- 7,�, Partner.
e-4kj4e,rvce /;I -; e7
Business Telephone 9-71 6 S(5-- 2 15-0 Finn/Co.
Name of Licensed Plumber or Gas Fitter 7�/',,,-j os W,4 /kfq t -J
INSURANCECOVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. YesEl Noo
Ifyou have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy EM I 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 El Agent 0
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 installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Codeand, Chapter 142 of the General Laws.
jCity/Town
VED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber ;( Y � 33
0 Gas Fitter License Number
Master
Joumeyman
LocAtion(�?&/- ITT
11 No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
SZ)
Building/Frame Permit Fee 4;
Foundation Permit Fee
Other Permit Fee
4& Sewer Connection. Fee. $
-4-6 Water Connection Fee $
TOTAL $
0 6
f -7
P-4 7594
VZ-�P,'Building Inspector
Div. Public Works
Locatlo�,. 1-, 30 -2-61 did
No. Date
i
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
.Foundation Permit Fee $ /0-0
Other Permit Fee $
Sewer Connection- Fee $
Water Connection Fee
TOTAL $
08/2 Building Inspector
9/94 PAID
Div. Public Works
Location 02
-lj
N '370 Date
6 57
6 9 23 5
A
TOWN OF NORTH ANDOVER
Certificate of Occupahcy
$
Permit Fee
$
Foundation Permit Fee
$
Other PenniHFee
$
ew
Sewer Connection Fee
$
Water Connection Fee
$ IL"A'
TOTAL
Div. flublib Works
1 .4 -
PERMIT NO.- 37p
MAP 4-40. 7
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
1 $�AGE I
INSTRUCTIONS PERMIT FOR FOUNDATION ONLY 3 PROPERTY INFORMATION
REGULAIM BY PAR 114.8-S. B.C. LAND COST � ?, er,�o� -
SEE BOTH SIDES EST. BLDG. COST LA . ger--� AF&Qg
.0 ' ' - - i I It)
y PAGE I FILL OUT SECTIONS I - 3 0q. EST. BLDG. COST PER SQ. FT.
DATE 91.441flic- 'FEE PAIDhp/fw — EST. BLDG. COST PER ROOM
PAGE�2 FILL OUT SECTIONS I - 12 ffi.
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
PERMIT FOR FRAME/BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSFDATfr-: — FEE PAIDL----i—
I I -
DATE FILED
F E E
RE OF OWNER
ZED AGENT
PERMIT GRANTED
AM 19tW
L.C3O rt)h rrr -f-
iF FRAME PERMIT S ff!ilwlgb' ON*
el 1 &7- 6-0
OWNER TEL. #
CONTR. TEL. # "e-2- E63J—
CONTR. LIC: /�?
BOARD OF HEALTH
MANNING BOARD
BOARD OF SELECTMEN
ILMING INGPECTOR
;V,
IQ
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE
ZON E
SUB DIV. LOT NO.
Ter A i2cAl, Cr -g9. 21-� o/
LOCATION
PURPOSE diF BUILDING
OWNER'S NAME :F?Z c�v -
NO. OF STORIES
OWNER'S ADDRESS
BASEMENT OR SLAB
74-A
ARCJHITECT-S NAME Lz 14
SIZE OF FLOOR TIMBERS IST 2ND 3RD
SPAN
BUILDER'S NAME
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
POSTS La //-V
DISTANC.E,FROM STREET
DISTANCE FROM LOT LINES - SIDES REAR
GIRDERS,��)2,
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x 16,
IS BUILDING ADDITION A,)6
MATER:AL OF CHIMNEY 4? �,c�4
I.S 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 PERMIT FOR FOUNDATION ONLY 3 PROPERTY INFORMATION
REGULAIM BY PAR 114.8-S. B.C. LAND COST � ?, er,�o� -
SEE BOTH SIDES EST. BLDG. COST LA . ger--� AF&Qg
.0 ' ' - - i I It)
y PAGE I FILL OUT SECTIONS I - 3 0q. EST. BLDG. COST PER SQ. FT.
DATE 91.441flic- 'FEE PAIDhp/fw — EST. BLDG. COST PER ROOM
PAGE�2 FILL OUT SECTIONS I - 12 ffi.
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
PERMIT FOR FRAME/BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSFDATfr-: — FEE PAIDL----i—
I I -
DATE FILED
F E E
RE OF OWNER
ZED AGENT
PERMIT GRANTED
AM 19tW
L.C3O rt)h rrr -f-
iF FRAME PERMIT S ff!ilwlgb' ON*
el 1 &7- 6-0
OWNER TEL. #
CONTR. TEL. # "e-2- E63J—
CONTR. LIC: /�?
BOARD OF HEALTH
MANNING BOARD
BOARD OF SELECTMEN
ILMING INGPECTOR
;V,
IQ
B14ILDING RECOAD
OCCUPANCY 12-
�.INGLE FAMILY I S-OPIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF�LOT AND,DISTANCE FROM
MULTI.—FAMI LLL__� MICES LOT LINES AND EXACT DIMENSIONS OF , BUILDINGS�', -WITH PORCHES. GA -
APARTMENTS ...RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT,PLAN-.
CONSTRUCTION
2
8 INTERIOR FINISH
CONCRETE
3-- 1 2 13
CONCRETE BL K. PINE
BRICK OR STONE HARDW D
PIERS PLASTER
DRY WALL
UNFIN. X
3 BASEMENT
AREA FULL FIN. 8 M T AREA
V, V2 '/4 FIN. ATTIC AREA
NO 8 M T FIRE PLACES
HEAD R OM MODERN KITCHEN
4 WALL$ 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE
WOOD SHINGLES EARTH
ASPHALT SIDING HARD\lv D
ASBESTOS SIDING COMMON Y-11�'�O 001TANIU01 9031 T IMM
VERT. SIDING ASPH. TILE
STUCCO ON MASONRY .3.8 ZE.411 figAil YS Offt-A332
STUCCO ON- FRAME
BRICK ON MASONRY 'ATTIC STIRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK. 331 1 -
WIRING . 'T --
STONE ON MASONRY RAU
STONE ON FRAME
11
SUPERIO _P�00 �R
NONE
ADEQUATE NONE
'.
� 1 97
IV j 14
5 R OF
10 PLUMBING
L
G BLE
HIP
BATH (3 FIl,l
A M B I JEL
I
MANSARD
JOILET RM. (2 FIX.)
T.A
�T
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL_
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
j,.,ggj
�3q
TILE DADC)
H
6 FRAMING
'All AN
11 HEATING
WOOD JOIST
Pl"
PIPELESS FURNACE
t T If I'A 3
FORCED HOT AIR FURN.
TIMBEICBMIA COLS.
7j;;l
STEAM
STEEL BMS. 6-COLV
_4
HOT W T -R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T G
UNIT HEATERS
7 NO. OF ROO!AS I
AS
IL
8 4,111
ro tjA
ELECT
�C
�AT
B'M'T
I 3rd
E I NG
Cf) -V w Pl"= 10, =r --4
C E -4 C2
m CD Ce 0 = I, RE
dc W
cD. =
m CD 0 CD C13
CO C') M.
cm C's CL C.)
CD
CA w w ca
_0 — -n
c) 0
CL rn
CD
�. =r w CO3
CD -40 CD rA
CD
m co a
rn IA
m
0 2E C.)
CO)
0 LO2. C2
CD
CD 7R
rA
> Cl)
-n CL
CD
0. o CD
- �:" =0 CD
> CD C -j
c79
CD
CA
cgo, cr
Im
CD CL
E7 CD
CO
CD CD
CL CD
CO) � Q =
CD
r -r
CD
=-9 z
CD :Z4
go
=r
C) C-) CD 0 CD C.2
:0 CD
m Cf) co col)
m
CD CO) ft
<
CD
> .0.
C=D
M CO
CD 000�7�,
rm
=CO3
CM
=
CD C�
m
74 CO A
CD
CD
c*
=
m
> CD
am a*
cn
0
cn
0
C)
00
cp
:5.
r)
0
"ZI
8
0
GOD
pc��
0
C:
X
2
:v
Z
n
,,j
ro
Tl
0
CL
00
0'
C
COD
U)
"a
cp
Irl
0
C)
9 V.
pi,m
74
0
omq
CD ca 0 cr CO.,
N." Eco -0
= =tCD 0. CD Cl)
to 0-1 cl) -W
Mo M=
CD C, p �. c
z =r's. co --I
G') CO) co w CA
= -* CD — :;i
=r CL -0 CL C=:, M
CD =W CO)
=r CD CA
-M CD
ICD
rn �mp C) St
rn CD
0 c")
co' �A cl4l
03 zo o
03
.C.J:
LA.
CO) C—)
C) CD
m CD
ca
> CO)
CD Mr�
;;;�o co 0 7
CL 0 r .' c co
= CD
CD -T
C
CDLS�
CD
a co Q3 f
CO) P:
C
W CL cr
CD 0)
70
OF
CD E
0 CM I— cc,
C)
:E CD
CO2
CD ca -4
0
CD
co
r -r CD
-4
'-C CD
CD
z4
CD CD CD
CD
w w IND, io
cn
rn CD
CD C42
< CL C7 Cori
C-)
=CD
cm
C=
C) D cy —
P CD
ca C)
f
CD
C)
79 CD
m
C2
0 C="
m
CD
M:
bo
C3
wl-
z -
0
ON
0
9
roll! -N
�L
0
I
fn
rU
0 "qN
moo;
171
0
404
CD
OMI
(D
0
(D
Piz
0
r:
C)
P--4
z
m
n
I'D
10:1
r-
0
�3
r"
C�
z
C/)
rD
D
0
rD
o
>
I
fn
rU
0 "qN
moo;
171
0
404
CD
OMI
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*****************
APP LICANT: lu (Aos -D 7d" 1-�Iv r4 1-40 Phone 0/
LOCATION: Assessor's Map Number _ (�ez- Parcel
Subdivision - wCAY16-W A'Ilt Lot(s) 'So
Street /m a, St. Number 7-61
61
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved -ZA
CoZnserva�t����� Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Heal:th Agent Date Rejected
Comments
Public Works sewer/water connections
- driveway permit
'or
Fire Department Lu-&�—�ftayetla
AP4-;��
Received by Building Inspector
-A)Ate
lilt''
W4
ILW rl,,H�
PROPoSED SITE PLA�J
tor 30 � tC KOZY HLL- KPAD
I Ljo/
H 14 1 O� Ll
e -
15740
L OT 30
23,093 S. F
L s Af
06W-27 E-
q
J6
Jopf
i-3 zq/fo
0.
E IS
L E
L
ip 17
TIFIED FOUNDA TION PL A /V
!LOCATED IN NOANDOVER, MA.
F --T
LE: 40' DATE: -/0/ 20194
Scott L. GlIes R L. S,
50 Deer Meadow Road
North Andover, Mass.
-\A
HICKOR Y HILL
ROAD
I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE
0
THE OFFSETS OF 7 -HE SUIL DING INSPEC TOR ONL Y
SHOWN COMPLY AND SUCH USE IS FOR THE
WITH THE ZONING DE TERMINA 77 ON OF ZONING 0.
BY LAWS OF CONFORMITY OR NON -CONFORMITY
NO, AND 0 VER, MA. WHEN CONSTRUCTED.
WHEN BUIL T 94
-M
rn 210
rn
C/)
n
0
cn
cn
0 a S—D
CL
Car m
co 0 CD 0
ir
2>4
.00 ccol
C,3
0 C2
:&a CO
=r -W Ak
=..MCO
CL.
0 =r -
C CD
.,CD
CD
0
GO
0 03 co,
IN CL. =Cr
Cr
U CD
:E CD co
C2
coo
CD
CA
CaD
0
C*
a:
CD
F a
C-2
�CD
uco,
--i a:
03
-M CMD
COD ca "o
'S
c C,7
:Fz
2t 02
CD 5 m
bo CD
CD
w
Li
C/) C/) M
0,
A
CD
C/)
C:*4
uloo
0
A
CO)
Cl)
*n,
CD
n
co)
CD
CL
C')
21
00
0
cn
Ot
CO)
lo
0
CD
CD
CL
cr
=r
CD
C')
=r
CD CD
lot
CD
C)
2�
cn
M t"
CD
a
co)
m
CD
co)
cm
CD
cz
CD
CD
-n
CD
-M
rn 210
rn
C/)
n
0
cn
cn
0 a S—D
CL
Car m
co 0 CD 0
ir
2>4
.00 ccol
C,3
0 C2
:&a CO
=r -W Ak
=..MCO
CL.
0 =r -
C CD
.,CD
CD
0
GO
0 03 co,
IN CL. =Cr
Cr
U CD
:E CD co
C2
coo
CD
CA
CaD
0
C*
a:
CD
F a
C-2
�CD
uco,
--i a:
03
-M CMD
COD ca "o
'S
c C,7
:Fz
2t 02
CD 5 m
bo CD
CD
w
Li
C/) C/) M
0,
A
CD
C/)
C:*4
uloo
0
A
*n,
CD ::rl
R rD
:3
21
cn
Ot
lo
0
M
M
0
10
fn
rkj!
0
41�
CD
lbo.
Oro
Z Oil
All;
CAO
p
3
w
C
CL
57
co
M
0
z
C
I z
lbo.
Oro
Z Oil
All;
CAO
p
3
w
C
CL
57
co
M
0
z
C
0
m
mn
0
>
m
0
-71
Cf)
m
go
0
0
0
z
0
OD
�D
0
m
mn
0
>
m
0
-71
Cf)
m
go
0
0
0
z
0