HomeMy WebLinkAboutMiscellaneous - 28 FOXWOOD DRIVE 4/30/20184 0
- -4v�ww i 0
9800 Fredericksburg Road
San Antonio, TX 78288
USAW
04664.lW3WK.JSS1043067295.01.01.790
CITY OF NORTH ANDOVER
120 MAIN STREET
NORTH ANDOVER,MA 01845-2420
Reference: MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B
Attention Building Commissioner,
I am writing regarding the claim referenced below.
Policyholder:
Raymond M Macedonia
Reference #:
000385933-8
Date of loss:
March 17, 2015
Location of loss:
North Andover, Massachusetts
Address:
28 Foxwood DR, 01845
May 1, 2015
A claim has been made involving loss, damage or destruction of the property referenced above,
which may either exceed $1000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143,
SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139,
SECTION 3B is appropriate, please direct it to my attention and include the reference
You may submit correspondence or questions to me. My contact information is:
Address: P.O. BOX 33490
SAN ANTONIO, TEXAS 78265
Fax: 1-800-531-8669
Phone: 1-210-531-8722 Ext. 44506
Sincerely, -
Jeshua I Wilkerson
Property - TFL Unit 7
United Services Automobile Association
PO Box 659461
San Antonio, TX 78265
Phone: 1-210-531-8722 Ext. 44506
Fax: 1-800-531-8669
CMG/J,WW
000385933 - DM -04664 - 8 - 8048 - 36
54577-0914
Page 1 of 1
A
.�7
Date .... ...... ....
7
toRTH
0 q
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
�4
This certifies that ................. x
has permission to pe -a. 1.4.6
rform ............. .4
wiring in the building of ........ ................................. .
at.........
.......................................... ....... ..... . North Andover, Mass.
0.
.. . ... .. ............
Fee ... ... Lic. N .......... ............... . ...........
ELEcrRicAL INspEcrok'
Check 11
1� RIM -
IR -, - T-Jj� I I
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Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
official Use Only
Pen -nit No.
Occupancy and Fee Checked
�ev. 9/05] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be perforined in accordance with the Massachusetts Electrical Code (MEQ, 527 ZCR 12.00
0'
(PLEASE PPJNT IN INK OR 7TPE FORMA 770,N) Date:
L—r� W
City or Town of.- 14?/-/� welelavel-- To the Inspe tor Wires:
By this application the undersig�ed gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 4//mr
Owner or Tenant
Telephone No.
6wner's Address
Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box)
Purpose of Building
Existing Service Amps Volts
New Service Amps Volts
Number of Feeders andAmpacity
Location and Nature of Proposed Electrical Work:
Utility Authorization No.
OverheadEl I Undgrd n
Overhead Undgrd
No. of Meters
No. of Meters
Comnle�on ofthe fnili5winv tahl.� may h- -gived Ay the
No. of Recessed Luminaires
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Luniinaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Swimming Pool Above Ej In-
grnd. grnd.
No of Emergency Lighting
Bat'tery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS INo.
of Zones
Nll�� . of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. / Total
Tons
No. of Alerting Devices
No. of Waste Dispose . rs.
Heat Pump
Totals:
I Nu
Tons
of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
E] municipal
Local Connection El Other
No. of Dryers
Heating Appliances KW
Security Systems:*
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of No. of
Signs Ballasts
—
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications Wiring-.
No. of Devices or Equivalent
OTHER:
Estimated Value of Electrical Work- Am. Z?&� 4ttach additional detail ifdesired, or as required by the Inspector of Wires.
(When required by municipal policy.)
Work to Start: 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 operation7 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 LE� BOND 0 OTHERE] (Specify :) 61MICt 1-klhl�11/
I certify, under the pains an pena �'esqfperju
that �Ae information on this application is true and complete.
FIRM NAME: LIC. NO.:
V- i
Licensee: Signature
LIC. NO.:
(If applicahle, -14—
�per pt in the li ense.numb�erjine.) Bus'. Tel. No.
�"Iekym-zl ZZ -7,c./ -3� 1 —n 7
Address: � �/11 e /y2" /0�// Alt. Tel. P
*Securit)r'System Contractor License requirecrfor this work; if applicable, enter the license —number here:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage no��a—lly -
required by law. By my signature below, I . hereby waive this requirement. I am the (check one) El owner El owner's agent.
Owner/Agent Z,
Signature - Telephone No. PERMIT FEE. $ 007
The Commonweafth of Alassachuseas
Dep ortment ofindutrial,41rcideer
FAR. Office of Investigations
600 Washington Street
� JV Boston, MA 0.2
VY,arjkers' Compensatiot; Affidpvft: Bufld-_r&/%'_ on' tractors/Electricians/P1 umbers
Information Please Print Legibli
Name i.7.winess/organizafiowl,-idividual)' 412,
Address:-
Ciry/State/Zip: Phone - xO
F,%re -you an employer? Check, the appropriate box:
Type of project (required) -
0 1 am a employ -w with
4. E] I am a generul contractor and 1
6. [) New construction
Omployees (fall and/or part-time).*
'proprietor
have bired the sub-contraciors
listed an the at=hed sheeL
1
7. 0 Remodeling
2.B,"I a. --n a"sole. cr partner-
ship and have no emp'Myees
These sub-contracturs have
8. 0 Demolition
wodring for me in any capacity.
employees and have workers'
.9.' rl Building a&ition
[,No workers' comp. insurance
comp. hisuranceJ
5. Wc are P_ corporadon and its
10. FR �Eleczrical repairs or additions
reWi dI
We I
3. 0 1 am a homeowner doing all work
officers have exercised their
I LO Phunbing i-cpaits or additions
myself [No workers' comp,
fight of exemption. per MOL
12.C] Roof repairs
insuranae requimd.] t
c. 152, § 1 (4), and we have no
13.El Otber
employees. (No workws,
oamp. fimmee required.]
*Anyappiicant that check; box#] must also fill out the szetion below showing thcirworkes'comperisation policy infannation.
I Romeowccrs whowbrait this efflinvit indinting they arc doiDgall work antith= him outsiciccontmctDrs must subat anew affidavit indicating such.
$Contractor. that check this box must attackd an additional sheet showing the name of the sub -contractors and sate wholber or no, those entities have
=ployots. Zftht sub-coatractors have cmpioyees, they me st provide their woikem, camp. policy number.
I Irm an emplojper that isproviding workers' compensadon insurancefor my emplopem BLOloop is the poticy andjob site
htfortnadotL
lasuraum Company Nam;:
Policy # orSelf-ins. Lic. 9: _ Expiration Date:
Job Site Address: cityistate'siv
Attach a copy of the workers, compensation policy declaration page (showing the policy numberand expiration date).
Failure to securc coverogt: as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
floo up to $1,500.00 ardior one-year irwrisonment, ss well as civil penalties in the fcarm of a STOP WORK OMER and a flne
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Officc of,
(nvestistations, of the blA for insumnce covem2e verification.
I do hereky certif), under the pains andpenaltks ofpedury that Me information providgd above Is true and correct
QinnnnwrA- -40e 1 _.. 1
1-9 _4210// __
u.se onfil, Do not wfile in this area, to
or Ion" orldaL
City or Town: PermitfLicense #
Issuing Authority (zircle one):
1. Boak of Health 2. Building Department 3. CityITown Clerk A. Vecfticsd Inspe--tor 5. Plumbing Inspector
6. Other— I
Contact Person: — Phono fl:
Date. .......
T
0 4,
0 TOWN OF NORTH ANDOVER
PERMIT FOR GAS. INSTALLATION
ACHUS
This certifies that ..............
has permission for gas installation A �1.4� .......
in the buildings of 1*.#4q , --C. �
....................
at P. ................. North Andover, Mass.
Fee..��—t .... Lic. No..��7/
INSPECTOR
Check#
6781
1�5
'Ar
WworType)
.,Mass. Date 2P��— Permit #
ELM
Building Location
�Owner S Name__44,��
OwnerTel#- _Type of 0=4)=Yj
New 0 RenDVatiOn 0 Replacement Yes Q No r -
FIXTURES
1119,1rose, I lvlq
Business Telephone#
Name of Ucensed Plumber or Gas
Check one:
,fCorporation
0 Partnership
E3 Firm/Co.
Certificate
INSURANCE COVERAGE.
I tiave, a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes* No 13 WN- 1 1 T!verage by checking the a�paprlate box.
if you have checked yes. please Indicate
A-7
A liability Insurance policy/P 00 a Bond 13
OWNEFrS INSURANCE WAAk- I am aware that the licensee does not haw the Insurartce coverage required by Chapter 142 of the
Mass. General Laws, and Mat my slgrwWre on Oft permit application waives this requirement.
Check one:
Owner E3 Agent 0
Avrw or uwners Agem
that all of the details and information I have submitted (or entered) in above application are tru;and accurate to the best c
that all plumbing work and installations perlbrrned under the permit issued fbr this application will be In compliance with all
Title
City/Town—
APPROVED (OFFICE USE ONLY)
State Gas Code and Chapter 142 of the General Laws.
Type of Ucense: 12
- -Plumber Signature of-I-Icertsed Plumber or Gas Fitter
4/-Gas fter
- -master Ucense Number ko
-Journeyman
Date../ ............
,tORTN
01
TOWN OF /RTH ANDOVER
0
0
PERMIT FOR PLUMBING
SACHUS
es that k)
This certifi' . ......
has. permission to perform ............
plumbing in the buildings ol .................................
a t
............................ North Andover, Mass.
F Lic. No.F. .
Check
7261
_�Lx
MASSACHUSETTS UNIFORM APPLICATION FOR -PERMIT TO -DO PLUMBING
(Pri t or T pe)
VA"ass. Date 20 P mit #
Building 4ocationlv b Owner's am
YPe of Occupancy
New 0 Renovation 0 Replacemente� Plans Submitted:' Yes 0 Noo
um?
!CMAtar) 4.L
FIXTURES
—7
ristalling Company Name _
kddr
lusiness T61ephone 1,069 P ? q /) 6a�
(ame of Licensed Plumber or Gas Fitter x?6 /0
Check Ong: -
0 Corporation
0 Partnership
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ristalling Company Name _
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(ame of Licensed Plumber or Gas Fitter x?6 /0
Check Ong: -
0 Corporation
0 Partnership
Ceitificate
INSURANCE COVERAGE:
I have a current liability insurance Policy or Its substantial equivalent, which meets the requirements
Yes No . 0 Of MGL Ch. 142.
If YOU have checked . Yes, pleas . e indic . ate the type of coverage by checking the appropr iate box.
A liability ins . urance policy Pl"" Other type of indemnity 0 Bond 0
OWNER'S INSURNACE WAIVER: I am aware that the 11'
censee does Lot _have the insurance coverage required by Chapter
142 Of the Mass. General Laws, and that my signature on . this permit application waives this requirement.
signature of Owner or Owner's Agent
Check bne:
Owner 0 Agent 0
ereby certify that all of the details and -information I have submitted entered) In above-appilcation are true and accurate to the best of
knowledge and that all.plu ' orme 9' �r t
mbing work and installations perf �n he Permit [as or t 11 Is applIcation will be in co�piiance �ith,
- , , , - ". ". ' " 4 v
pertinent provisions Of the Massachusetts State Plumbing Code a 14P2 f the e ra I La s.
By JU
m e
Title S, , a- %,' _ 40e d b
fu e of Lic en.
City/Town
APPROVED (OFFICE USE L Type of License: b1fraster OJourneyman
License Number
5
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Ceitificate
INSURANCE COVERAGE:
I have a current liability insurance Policy or Its substantial equivalent, which meets the requirements
Yes No . 0 Of MGL Ch. 142.
If YOU have checked . Yes, pleas . e indic . ate the type of coverage by checking the appropr iate box.
A liability ins . urance policy Pl"" Other type of indemnity 0 Bond 0
OWNER'S INSURNACE WAIVER: I am aware that the 11'
censee does Lot _have the insurance coverage required by Chapter
142 Of the Mass. General Laws, and that my signature on . this permit application waives this requirement.
signature of Owner or Owner's Agent
Check bne:
Owner 0 Agent 0
ereby certify that all of the details and -information I have submitted entered) In above-appilcation are true and accurate to the best of
knowledge and that all.plu ' orme 9' �r t
mbing work and installations perf �n he Permit [as or t 11 Is applIcation will be in co�piiance �ith,
- , , , - ". ". ' " 4 v
pertinent provisions Of the Massachusetts State Plumbing Code a 14P2 f the e ra I La s.
By JU
m e
Title S, , a- %,' _ 40e d b
fu e of Lic en.
City/Town
APPROVED (OFFICE USE L Type of License: b1fraster OJourneyman
License Number
�* N2 3441
Date.. ........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... A
... ! ...................................................................................
has permission to perform ..... ::-:15��'..-f;:�-;--'.'—'—� ......................................
wiring in the building of .......
..............................
........ . North Andover, Mass.
..................... ..... .......................
'-; —CyeV
Fee-:5�5 Lic. No
Check # j -, Z- F'? ECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
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41
I.
6 --7-ov
Date .......... f. .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
...... ....
This certifies that ................
'has permission to perform
............
plumbing in the buildings of . -:t� .........................
at .. .......... North Andover, Mass.
Feel ........ Lic. No.C�V'qj
............
8 ;IN
1,. G SPECTOR
Check # 9
6U52
MASSACHUSETTS UNIFORM APPLICA
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building
New ri
- Owners
of
Renovation rl Replacement IS]
FIXTURES
FOR PERMIT TO DO PLUMBING
I I Date
4vAJq A4C? J0A/;04permj7#
Amount
Plans Submitted Yes No
(Print or type) Check one:
Installing Company Name N-411-01?#Al '&J1411JI",,j� Corp
A . ddress - %X C./ rl
Partner
Certificate
ss I elephone _ 13 ? 3' -6,16- 9 co �' — LJ Firmico.
Name of Licensed Plumber: 7Wff '*#j /,/,f Ik,1,4 A--'
bsurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity
El 11 . Bond
Irance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three ins rn
.0 S
Signature Owner Agent El
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 MassachuWIL,5State
__pde and Chapter 142 of the General Laws.
113y:
JA�PROVED (OFFICE USE ONLY
Type of Plumbing License
3 3
ri—cense Numver Master Journeyman
1:1
Date. . ........
14
'LORTH
0 TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
S CHU
*This certifies that
I -bas permission for gas installation .......... 0-114�
in the buil f ......................
at ....... North Ando
....................... ver, Mass.
MY 01
G
Fee<:9)! ..... Lic. N,-v:A/ .......
ASIN Ej 9R
Check # 26 9
4759
MASSACHUSETrS UNIFORM APPLICATONFOR
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations
R.
(?A!4 Ai PJA M A Ce 130A/1 A Owner's I
New Renovation Replacement
11 LIJ
TO DO GAS FrrMG
Date 6-3-04
Plans Submitted 11
Permit # fl -70
Amount $ %go - 0—
A
(Print or type) "heck one: Certificate Installing Company
Name J114 L 1 o Corp.
Address Partner.
Business Telephone 2-71 515-0 V FimL/Co
A
Name of Licensed Plumber or Gas Fitter 7Vool qs W,4 My
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes JE] No[3
Ifyou have checked ves, please indicate the type coverage by checking the appropriate box
Liability insurance policy ED . Other type of indemnity r] 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 Agent
I hereby certily that all ot the details and intormation 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 Code an
_ d Chapter 142 of the General Laws.
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber 33
0 Gas Fitter License Number
Master
Journeyman
�2ND. FLOOR
A
(Print or type) "heck one: Certificate Installing Company
Name J114 L 1 o Corp.
Address Partner.
Business Telephone 2-71 515-0 V FimL/Co
A
Name of Licensed Plumber or Gas Fitter 7Vool qs W,4 My
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes JE] No[3
Ifyou have checked ves, please indicate the type coverage by checking the appropriate box
Liability insurance policy ED . Other type of indemnity r] 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 Agent
I hereby certily that all ot the details and intormation 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 Code an
_ d Chapter 142 of the General Laws.
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber 33
0 Gas Fitter License Number
Master
Journeyman
I Fcv c,,-),
Location 4
No. Date IFIXI541—
.. .-I / Y I
8:0.73 -
TOWN OF NO RTH ANDOVER
Certificate of. Occupancy
Building/Frame Permit F ee
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
s
LM5
Buildingumpector
Div. Public Works
oemlion kof '+B-, P
Date
I&ORTpq TOWN OF NORTH ANDOVER
0
iidK Certificate of Occupancy.
BuildinglFrame Permit Fee $
Foundation Permit Fee
.,Other Permit Fee
Sewer Connection Fee
-Fee,
...Water Connection
C;I C.>.
/S Z�
TOTAL
Building Ingpector
1170
7544
Div. Public Works
Location
0. Date
Cn
TO
WN, -.OF NORTH ANDOVER
0 A Certificate of Occupancy $
Bull lding/�yrame Permit Fee
0
A .. . Foundation Permit Fee
Other Permit Fee
-�r�ewer Connection Fee
ate'r Connection Fee
TOTAL
�.i,
7
6990
K�
lk J
.PERMosNO. 3/3S APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. "GE I
t
IzzN
MAP 4-40.
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK ;P GE
ZONE
SUB DIV. LOT NO.
LOCATION
yy
PURPOSE OF BUILDING
OWNER'S NAME &
x %,Aj oc. r,<
+
NO. OF STORIES 7-7Z SIZE
OWNER'S ADDRESS
-"k
BASEMENT OR SLAB "-46 Pltl
ARCHITECT'S NAME
BUILDER'S NAME
,96woou)l�oLiK
SIZE OF FLOOR TIM8,ERS IST? 2ND 3RD
wto _V< t
SPAN
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM LOT LINES - SIDES
REAR
GIRDERS
AREA OF LOT '2-z' 6w
FRONTAGE
HEIGHT OF FOUNDATION THICKNESS Ap
IS BUILDING NEW t
SIZE OF FOOTING X 17-1�1
IS BUILDING ADDITION
MATER:AL OF CHIMNEY 4ekl
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND ob T,
WILL BUILDING CONFORM TO REQUIREMENTS O��.:�
IS BUILDING CONNECTED TO TOWN WATER yf-
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
1
IS BUILDING CONNECTED TO NATURAL GAS LINE
NS di Cf /Li
4 PERMIT FOR FAME)tKIDIN
SEE BOTH SIDES
T
'z v
Tl��b EE PA
�AGE I D IN-,
PAGE 2 FILL OUT SECTIONS I - 12 mite
ELECTRIC MET EPS MUST BE ON OUTSIDE OF BUILDING
=FM E
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIOM FRAME PERIC S
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR ck C:q
DATE FILED
SIGNATURE OF OWNER OR AUTHORIZED AGENT
FEE
PERMIT GRANTED
19 2IL
PERMIT FOR FOUNDATION ONLY
REGULATED BY PARA. 114.8-S. B.C.
DATE M-3kFEE PAID kl"
1+
3 PROPERTY INFORMATION
LAND
,?ST
olk
EST. SLDG- COST,-,"'
I I EST. BLDG. COST PER SQ. FT.
4M EST. BLDG. COST PER ROOM
===WAEPTIC PERMIT NO.
clr�
, ft& APPROVED BY
C>c-
OWNER TEL. 12_19
CONTR. TEL, #-6-ju
CONTR. LICv.
1 41994
FOR Fr-,,Al'N!F/-P"l1LDfNG
BOARD. OF HFALT"
MANNING BOARD
BOARD OF WELECTMEN
)L,---/ -2-
wiewn
O-U,ILDING RECORD
Ocqu�ANCY 12
SINGLE FAMILY \ ; \I -P'.
S'ORIES
MULTI. FAMII[Y."
!�FFICES
APARTMENTS
I -
CONST RUC T I O'N
2 - FOUNDATION
CONCRETE
CONCRETE BL K.
BRICK OR STONE
PIERS
;'-8 INTERIOR'FiNiSH'
3
PINE
HARDW D
PLASTER.-
DRY WALL
UNFIN.-
1
v
2 13
3 BASEMENT,
AREA FULL
FIN. B M T AREA
1/1 1/7
*FIN, ATTIC AREA,,
NO 8 M T
FIRE PLACES
HEAD ROOM
MODERN 'KITC-HEN
4 WALLS
FLOORS
CLAPBOARDS
B
2 3
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
�CONCRETE
EARTH
_WARDW D
COMMON
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME ,
BRICK -ON MASONRY
BRICK ON FRAME
CONC. OR CINDER BLK.
ATTIC STRS. & FLOOR
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR
_;�DECUATE NONE 1
10 PLUMBING
5 ROOF
G8111E
6AMB
B.R JEL
Ll
I
BATH (3 FIX.)
2_
MANSARD
TOILET RM. (2 FIX.)
FLAT
T
SHED
WATER CLOSET
ASPHALT
SHINGLES'
L A V A TO R Y ' " ' ' I
WOOD SHINGiES
KITCHEN SINK'
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING
HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER 8MS. & COLS.
_&TEAM
STEEL BMS. & COILS.
HOT W T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T*G
UNIT HEATERS
GAS
7 NO. OF ROOMS
OIL
ELECTRIC
i7M'T 2end
I 3rd
NO HEATING
_.-THIS SECTION MUSTSHOW EXACT DIMENS I IONS OF LoT'A� 6 C�ISTANCE FR I OM
,�ILOT LINES AND EXACT DIMENSIONS OF- B,UI,LDINGS.' WITH PORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.'
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FORM U — LOT REX=E POMI
INSTRUCTIONS: This form is used to verify that all necessary . .
approvals/permits from Boards and Departnents 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 seC4- on*****************
APPLICANT: ro tr_ Phone
LOCATION: AsSessor's Mau Number Parcel
SubdIvIS -Lon /:10 Y -it) 0 0 Lot (s) LJ 19
Street S t.' . Nu*.= e r
Use 0
RECOMHENDATI S OF TOWN'AGENTS:
rr-
%, Date Arm.oved -711414
Date Rejected
C c= ra n -_ S
K6L16e_k�
Tcwn Kanner
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FcCA 7ns=e=:r-Hea1th
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PUt c Wcr� seWer/watar ccnne=_`ons
drivewav pe=44-
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e enar
Recaive,d by Building Ins=ector
Date Approved
Date Re-ieczad
Dame Approved
Date Re-iec-_ad
Date Ap-_r-_,,vred
Data Rej e=::=_�4
I
4., r, , , 1
J -LUT 11-1
7
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CERTIFICATE OF USE & OCCUPANCY
Building Permit Number 333 Date NOVF-mgFg 8, 1 9c)4
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 28 FOXWOOD ROAD - LOT #48 (#4 Bordeaux)
MAY BE OCCUPIED AS SINGLEFAMILY DWELLING W/2 CAR IN ACCORDANCE
GARAGE UNDER
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
CERTIFICATE ISSUED To Foxwood Ralty Trust
733 Turnpike St.
ADDRESS North Andover, MA
Building Inspector
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TOTAL
6- 00 PAID
SJO:
Building'rn'spector
Div. Public Works
Location
X ak:)bb
No.'� 13 Date
VkORT#t
TOWN OF NORTH ANDOVER
0
0
41
-ZV="&i2ML.
Certificate of Occupancy $
IL
Building/Frame Permit Fee $
A CH
Foundation Permit Fee
'.Other Permit Fee6kl,�,Ve�$
Sewer Connection Fee
Water Connection Fee
TOTAL
6- 00 PAID
SJO:
Building'rn'spector
Div. Public Works
KAREN H.P. NELSON Town of
Director
NORTH ANDOVER
BUILDING . ..... .
CONSERVATION DIVISION OF
HEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
f
CHIMNEY APPLICATION AND PERMIT
DATE � �//
LOCATION
OWNER'S NAME
BUILDER'S NAME
MASON'S NAME
MASON'S ADDRESS
MASON'S
MATERIAL OF CHIMNEY
120 Main Street, 01845
(508) 682-6483
PERMIT # S 3 S'L
INTERIOR CHIMNEY EXTERIOR CHIMNEY1�0s*-Zte-?Q11'
NUMBER AND SIZE OF FLUES
THICKNESS OF HEARTH 1/0
will chimney or fireplace conform to requirement f the code and
an r
have rule:sV ulations been received:
DATE
CONTR. LIC. # i,,,
SIGNATURE OF MASO -/4f
EST. CONSTRUCTION COST/CONTRACT PRICE 0
PERMIT GRANTED FEE
ROBERT NICETTA, BUILDING INSPECTOR
INSPECTED
REMARKS
SOLID BRICK REQUIRED
THIS PERMIT MUST BE DISPLAYED ON THE PREMISES
a
- �yv (I —