HomeMy WebLinkAboutMiscellaneous - 282 BLUE RIDGE ROAD 4/30/2018tl)
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Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
1600 Osgood Street
North Andover, MA 01845
RE: Insured: Mark & Barbara Noyes
Property Address: 282) Blue Ridge Road
Policy Number'. VW8440
Date/Cause of Loss: 8/28/2011, Wind & Water Damage/Roof
File or Claim Number: 25235-B
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 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 the attention of the writer and
include a reference to the captioned insured, location, policy number, date of loss and claim or
file number.
Bobby Keeser
On this date, I caused copies of this Notice to be sent to the persons named above at the
addresses indicated above by First Class Mail.
Signature/and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03053
14
Date. 1,4 -. /-,/- .....
.... ....... .
TOWN OF NORTH /NDOVER
PERMIT FOR GAS INSTALLATION
This certifies that
has permission for gas installation .........
in the buildings. of ... : . ..... f % .....................
,4
Pe�� ....... . .. h d ver, Mass.
at �r
...... Nprt An o
Fee,.. f-�. Lic. No. -2 . ............
GAS INSP 4.1 -R
Check#
69b�
4
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town: 10 A juF-ID -nW
MA. Date: 9�Pennit#
S- po
Owners Name:
Building Location: / ' --.' P0 YE -S
GType of Occupancy: Commercial E] Educational Fj Industrial El Institutional El Residential
New: ET'-' Alteration: E] Renovation: Ir -1 Peplacement: E] Plans Submitted: Yes Ej Non
FIXTURES
----
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SUB BSMT.
BASEMENT
Isr—FLOOR
2NL'FLOOR
—f'Y-F—LOOR
— — — — — —
4111 F �00R
—��
FLO—OR
6"' FLOOR
-
VH FLOOR
81H FLOOR
Installing Company Name: CLAUIV
Check One Only Certificate #J1
Address: 91 CitylTown State:
0-6rporation
Business Tel: Fax:
1:1 Partnership
I
E] Firm/Company
LName of Licensed Plumber/Gas Fitter:
INSUR COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 13'No El
It you have checked Yes, please indicate the type of coverage by checking the appropriate
box below.
A liability insurance policy El""" Other type of indemnity Ej
Bond E]
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this
permit application
waives this
requirement.
Check One Only
Signature of Owner or Owner's Agent
OwnerEl
Agent
Bv rhprkinn thi� h�y F -I. 1 -4-
i— � immul eugammu trus appiwation are true ana
accurate to the best of my Knowledge and that all plumbing work and installations perfor underZ permit issued for this application will be in
------ riumving %,ocie ana una T r 14Z of Me General Laws.
-7 4
I Tim- ^f I t I
BY umber
Title E] Gas Fitter Sigdar,#gt Licensed Plumber/Gas —Fitter
a -Master i I I
Cityrrown E]Joumeyman License Number:
APPROVEDIOFFICE USE ONLY) 11. LP Installer I I
11i �L\
OOF -/;;(g e07M07M19,4Z7,;( 057 X455,4rWUS5'7?5
vo-&--t s4d#
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only
Permit Na.:M��—
Occupancy & Fee Checxea
'PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 � t 1�, �00�
IA / 'A I ,
(Please Print in ink or type all information) Date
To the Insoiectot of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work d bed below.
Location (Street & Number -q -Z 77079/c
Owner or
Owner's
is this permit in conjunction with a budding
Purpose of Building E 6
E)dsting Service Amps
New Service _____,Amps Volts
Number of Feeders and
Yes EJ
)S-42
Location and Nature of Proposed Electrical Work W
No [I (Check Appropriate Box)
Voits Overhead 0
Authorization No.
Undgmd C1 No. of Meters
Overhead 0 Undgmd 0 No. of Meters
OTWPP-
L
INSURANCE COVERAGE. Pursuant to the requiremen6ts, of Massachusetts General Laws
I have a current Liability insurance Policy including Completed Operabons Coverage or its substanbal equivalent YES = NO
have submitted valid proof of same to the Office YES = NO = If you hive olease indLgalle the type coverage by checking the appropriate box
INSURANCE = BOND = OTHER (Please Specify) Ile
I (Expiration Date)
Estimated Value of Elt
I Work$
Work to Start L Inspection Date Resquested Rough Final—
SIgned under the Penbdo" �13
� J U, 9, Jp"-7 -V? (r Lo n <,
FIRM NAME LIC. NO
UhA �-UJ-YU'Slanature AJ/// LIC. NO.-
-C-;� � I Bus. Tel No. / ALE
Address " 3 % C iey? gJ Alt Tel. No.—
OWNER'S INSURANCE WAIVER: I am aware that the.Vcenses does not have the insurance coverage or Its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) 30 -di
Telephone No. PERMIT FEE $— —
(Signature of Owner or Agent)
Total
No. of LigMt8nq Outlets
No. of Hot fuse
No. of Transformers KVA
Above 0
In C)
No. of Lignbng Fixtures
Swimming Pool gmd 0
gmd 0
Generators KVA
No. of Emergency Ughbng
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
_
No. of Sv4tch Outlets
No of Gas Burners
FIREALARMS No.ofZone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Diposal
No. Pumps
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Soace/Area Healing
KW
Detection/Sounding Devices
C3 Municipal 0 Other
No. of Dryers
Heabng Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Bailases
inng
i
No. HWM massage Tuds
No. of Motors
Total HIP
OTWPP-
L
INSURANCE COVERAGE. Pursuant to the requiremen6ts, of Massachusetts General Laws
I have a current Liability insurance Policy including Completed Operabons Coverage or its substanbal equivalent YES = NO
have submitted valid proof of same to the Office YES = NO = If you hive olease indLgalle the type coverage by checking the appropriate box
INSURANCE = BOND = OTHER (Please Specify) Ile
I (Expiration Date)
Estimated Value of Elt
I Work$
Work to Start L Inspection Date Resquested Rough Final—
SIgned under the Penbdo" �13
� J U, 9, Jp"-7 -V? (r Lo n <,
FIRM NAME LIC. NO
UhA �-UJ-YU'Slanature AJ/// LIC. NO.-
-C-;� � I Bus. Tel No. / ALE
Address " 3 % C iey? gJ Alt Tel. No.—
OWNER'S INSURANCE WAIVER: I am aware that the.Vcenses does not have the insurance coverage or Its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) 30 -di
Telephone No. PERMIT FEE $— —
(Signature of Owner or Agent)
0 Date .......
......... /47K
r-- *.' , - '
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
t-k'�j C' C -
Thiscertifies that .............................................................................................
has permission to perform ...... Pod ......... .................................
wiring in the building of 7- /,p V .. .............................................
.. ......... . .... ..
at ... U. .............. . North Andover, Mass.
60
FeJ. 3 ) ............. Lic. No.
..... ..... .......
il�i��iiCAL INSP ECTOR
C
(73 10
06/to/98 08:36
30. 00 PAID
WHITE: Applicant
CANARY: Building Dept.
PINK: Treasurer
NO _-Ww-
Date........ ...... .........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... ........... (
-.6) .. .................
has psrmission to perform ......
4
wirin$ in the building of .........
.........................................................
Id
at ....... P ... 97.0� ... 0. ... . .. .. .............. . North Andover,>fass.
C
U v
Fee... 4�6 ........... Lic. No . .......... 4 .. .......................
LEMICAL INAECrOR
Check # -AO-
5226
Official Use Only
Permit No. S�
'"&C09I,"0WWE'UW0T9W �VCVVSMS
0epartmnt of (Pu6fic Safe Occupancy & Fee Ch
BOARD OF FIRE PREVENTION RE , LATIONS 527 CMR 12:00 Ilk
APPLICATION FOR P�RMI 0 PERFORM ELECTRICAL WORK
AJI work to be performed in accAdance 'th the Massachusetts Electrical Code 527 CM
—IR 12'
(Please Print In ink or type all information) Ekft_ 3 12,1�o Y
To the Inspotor o9wires:
Town of North Andover A . 7'
The undersigned applies for a permit to perform the electrical work'described below.
Location (Street & Number
Owner or Tenant NO
Owner's Address *�Af—
Is this permit in conjunction with a building permit . Yes 9 . No V (Check Appropriate Box)
Purpose of Building Utility Authorization No.
EAsting Service Ainps voits Overhead 0 Undgmd 0 No. of. Meters
New Service
—AmPs--------yoitS
Number of Feeders and Ampacity w I
Location and Nature of Proposed Electrical Work
INSURANCE COVER#6E.. Pursuant to the requiremen6ts of Massachusetts General Laws
I have Lia�,* Insurance Policy including Completed Operations Coverage or its substantial equivalent YES 0 N9 0
have sl= 8 proof of same to the Office YES 0 NO 0 If (ES please indicate the type of by checlung 9* appropriate box
INSURANCE VE�ND C, OTHER 0 (Please Spec", 7 " , _
. 47 Z/ 7
Estimated Value of Electrical Work$_ 0it 4 (!:� Ex1ArAIbWV*f
Work to Start Inspection Date R ues-ted ___Rough —Final
Signed underthe Penalties of perjury Z
LJ
FIRM NAME d e,Fl; . LIC. NO.
.A
NO.
s. Tel No. �93-'EOJ
Address C/4 BAK Tel. No.
OWNEWS INSURANCOWAIVER: I aXavvare that thtAicenses7doeg.Aot have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) 1-1/ 1
Telephone No. -PERMIT FEE $
(Signature of Owner or Agent)
Total
No. of Lighting Outlets
No. of Hot fuse
No. of Transformers KVA
Above 9
In 0
No. of Lighting FlAves
Swimming Pool gmd 0
gmd 0
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initialing Devices
Heat Total Total
No. of IDiposal
No. Pumps
Tons
KW
No. of Sounding Devices
NoJ of Self Contained
4
No. of Dishwashers
SpacelArea Heating
KW
Detection/Sounding Devices
0 Municipal 9. Other
No. of �ryers
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Sipris
Bailases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
INSURANCE COVER#6E.. Pursuant to the requiremen6ts of Massachusetts General Laws
I have Lia�,* Insurance Policy including Completed Operations Coverage or its substantial equivalent YES 0 N9 0
have sl= 8 proof of same to the Office YES 0 NO 0 If (ES please indicate the type of by checlung 9* appropriate box
INSURANCE VE�ND C, OTHER 0 (Please Spec", 7 " , _
. 47 Z/ 7
Estimated Value of Electrical Work$_ 0it 4 (!:� Ex1ArAIbWV*f
Work to Start Inspection Date R ues-ted ___Rough —Final
Signed underthe Penalties of perjury Z
LJ
FIRM NAME d e,Fl; . LIC. NO.
.A
NO.
s. Tel No. �93-'EOJ
Address C/4 BAK Tel. No.
OWNEWS INSURANCOWAIVER: I aXavvare that thtAicenses7doeg.Aot have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) 1-1/ 1
Telephone No. -PERMIT FEE $
(Signature of Owner or Agent)
Name:
Location:
cily Phone #
F -I I am a homeowner performing all work myself
F -I I am a sole proprietor and have no one working in any capacity
F -I I am an employer providing workers' compensation for my employees working on this job.
Company name:
Address
Phnnp 9-
Cily:
insurance Co Policv #
Compgny name: I
Address
Gily: Phnnp A -
insurance Co Poligy #
Section 25A or MGL 152 can lead to the imposition of criminal penalties of, a fine tap to $1,500.0
Failure to secure coverage as required under
and/or one years' imprisonment-as-w.efl-as-civii,penalties in lhefam -da-STOPWORKORDER.and�a fine -of -($1,00M).-a day.a;ainsf m e. I
understand that a copy of this statement may be forwarded to the Office of Investgations; of the DIA for coverage verification.
/ do hereby certify under Me pains and penalties of peilury that the information provided above is true and correct -
Signature.
Print name.
Phone #-
official use only do not write in this area to be completed by city or town afficial�
Pt-rmit/Licensincr
Citv or Town
FICheck if immediate response is required
Contact
El Building Dept
[] Licensing Boaf
E] Selectman's Oi
E] Health Departri
El Other
Location
No.
, - -/ j - I � --, -
Date / --, - ,'
,40RTH
TOWN OF NORTH ANDOVER
0
P.- ., 0
Certificate of Occupancy
$
4'
Building/Frame Permit Fee
$
A "US
Foundation Permit Fee
$
Othef�Pderbit Fee
$
Sewer Connection Fee
OCT 1,3
46W Connection Fee
$
TOTAL
Building inspector
Div. Public Works
Location
NQ- Date
,401tT"
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
S', C" Foundation Permit Fee $
A , 1 1 " . A *, - ,
Other Permit Fee $
w Se ii;,�Qwnectlon Fee $
Water Connection Fee $
_TOTAL----- $
Building Inspector
Div. Public Works
Lo7ation
Not D a t e Ito -d - 9
"ORTPI TOWN OF NORTH ANDOVER
0 Certificate of Occupancy
$
4L Building/Frame Permit Fee
$
roe
CH FoUndatibli,*061rrhit Fee
$
Other Permit Fee
$
.471ewWr &;��ectlon Fee
$
Water Connection Fee
$
TOTAL
$
t) Buildirig Inspectoi
1w I
Div. Public Works
�—Ailfff NO.
I
0
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. // 0121, PAGE I
MAP 4-40.
LOT NO.
2 RECORD OF OWNERSHIP JDATE
BOOK '.PAGE
ZO�NE0
SUB DIV. LOT NO.
0
F
LOC T
OCATION
PURPOSE OF BUILDING
OWNER'S NAME We
e
)z
NO. OF STORIES SIZE
::
OWNER'S ADDRESg
-
-x
BASEMENT OR SLAB
J31-7rz;r
ARCHITECT'S NAME
u
SIZE OF FLOOR TIMBERS IST 2ND
3RD
CIO
BUILDER'S NAME ;�"2: Lv/
SPAN
/ -/ 4, (!.,:;)
DISTANCE TO NEAREST BUILD�ING
:7a
DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANC E FROM LOT LINES - SIDES
REAR
GIRDERS
AREA OF LOT >-7
FRONTAGE of
HEIGHT OF FOUNDATION Sc- THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
IS BUILDING ADDITION
MATER:AL OF CHIMNEY e
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
5
IS BUILDING CONNECTED TO TOWN WATER
>/�C- s
BOARD OF APPEALS ACTION, IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
v000�
IS BUILDING CONNECTED TO NATURAL GAS LINE
yc s
INSTRUCTIONS
SEE BOTH SIDES 0
I
PAGE I FILL OUT SECTIONS 1 3
PAGE 2 FILL OUT SECTIONS 1 12 7 - =7
I I L-3
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 6?/a, -? / .9 -,1--
SIG
OR AUTHOTaTED AGENT
I
F E E F1 7 1,
'o? 10401"5,0 NER TEL 3.?
PERMIT GRANTED ��C'OWNTJL TEL b -6 3
1
VO4TIt. LIC p.QjaS-c-,-'L
30 ig Z�
L
6
/ 15 -old 91
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COS%2�/; lo�go,00
EST. BLDG. COST PER 66. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
10 INSPECTOR
I A
BUILDING RECORD
I OCCUPANCY 12
SINGLE FAMILY RIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY �ICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA -
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
1;
J jai 22'%sa
..........
0 0
9
v
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
3
1
2 13
CONCRETE BL K.
—
PINE
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
X,
F�NFIN
3 BASEMENT
AREA FULL
114 V2 '/4
L40 B MT
HEAD ROOM
FIN B M'T AREA
FIN. ATTIC AREA
FIRE PLACES
MODERN KITCHEN
4 WALLS IL
9 FLOORS
CLAPBOARDS
_8_
1
2
3
DROP SIDING
CRETE
_�ON_
EARTH
WOOD SHINGLE�
ASPHALT SIDING
ASBESTOS SIDING
HARDNU D
COMAACN
_ZPH TILE
VERT, SIDING
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
ATTIC STRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I V11 POOR
ADEQUATE 1
5 ROOF
10 PLUMBING
GABLE
HIP
BATH (3 FIX.)
GAMPE]L
MANSARD
TOILET RM. (2 FIX.)
F LAT
F LAT
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.
7'
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 looms
GA
OIL
B'M'T 2nd
l.t 3rd
ELECTRIC
NO HEATING
1;
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..........
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Cet�- r i r --i c -,c> Fc>u u c>prT-,c;,jj
1-�-MAA
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NAJ V4 r— Q <2
FORM U - LOT RELEASE FORK
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:
Phone
LOCATION: Assessor's Map Number Parcel
subdivision -7 Lot(s)
Street C2 A, St. Number
************************Official use only************************
RECOMMMDATIONS OF TOWN AGENTS:
Z t J� - - I
Date Approved
Conservation Administrator Date Rejected
Comments
4.1
'�(bwn /PlanneF
Comments
Comments
Date Approved 1Z
Date Rejected
,or � I /
Date Approved
Date Rejected
Public Works - sewer/water connections(IA?/
- d�ri�vewaypermi
Fire Department
Received by:Building Inspector Date
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10:27 FAX 6034315109 CUSTOM POOLS INC 0002
Restricted 10; 00 60960
DRUM" or PUME SWIM
WISHUCT109 BUIRVISOR ucsfin fA - Note
Nuber. sqires. Bizthhte. 1A - KaBoAry DDly
r
051231199B 0512311911 10 - I 12 lalily &MES
Restrictad Tot 10 Failure to possess & Current editiGR Df the
Hassachusetts State Wilding C046
EUGENE I SHORT is cause tor revocatiou of this license.
ELM RE
HOME INPROVEMENT CONTRAMR
Registration 123810
Type - PRIVATE CORPORATION
Expiration 04/11/99
Custom Pools, Inc
)Ian D. Short
STRATO M 1?2-3 kiver Rd
ADMINJ
Newington NH 03081
03/17/98 11�: 31 TX/RX NO.8386 P-.002
va/lz/vo 10:44 tAA. 5U6 0689556 NORTH ANDOVER
\ 41
I
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvalstpermits from
Boards and Departments having jurisdicbon have been obtained. This does not relieve
the applicant and/or landowner from compliance vAth any applicable or requirements,
*ww**ww*ww """APPLICANT FILLS OUT THIS
APPLICANT PHONE -79 Ll
LOCATION- Assessors Map Number PARCEL
SUBDIVISION Naocas�& ss�d4e-q' LOT (S)
STREET B/U'-'—'- R(' d4 _lp_ T d' - - — ST. NUMBER
CONSERVAT
COMMENTS
TOWN PLANNER
COMMENTS
FOOD iNSPECTOR-HEALTH
SEPTIC INSPECTOR -HEAL
COMMENTS
LAL U-S'E
14TS:
2 11 ael
DATE APPlid'iij—D 7 f >10-M
DATE REJECTED
DATE APPROVED
DATE REJECTED -
DATE APPROVED 37/",3
DATE REJECTED—,
DATEAPPROVED
DATE REJP-CTED
PUBLIC WORKS - SEWERJWATER C011`11NECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT.,
RECEIVED BY BUILDING INsPECTOR DATE
2002
10
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Location
No. %at P
40RTN TOWN OF NORTH ANDOVER
0-
. 0 Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
P -j
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$
TOTAL
$
Building Inspector
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(D
AGRI CONSTRUCTION
75 Frost Rd.
DERRY, NEW HAMPSHIRE 03038
(603) 434-4902
JOB -
SHEET NO. -
CALCULATED BY
CHECKED BY-
.RrAl F
OF—
DATE
DATE
PRODUCT 2D4-1 (Single Sheers) 2D5-1 (Padded) J�e Inc., Grotm, Mass, 01471. To Order PHONE TOLL FREE 1-800-225-6380
AGRI CONSTRUCTION
75 Frost Rd.
DERRY, NEW HAMPSHIRE 03038
(603) 434-4902
AOR
SHEET NO. OF—
CALCULATED BY DATE
CHECKED BY DATE
SCALE
..................... .............
........... .............. ............. .............. WIN,
.........................
PRODUCT 2D4-1 (SingleShees)M-1 (Padded) J�m Inc., Grotm, Mass. 01471. To Order PHONE TOLL FREE 1-8W225-00
PRODUCT 204-1 (Single Sheds) 205-1 (Padded) ��m inc., Groton, Mass. 01471. To Order NONE TOLL FREE 1-800-225-M
JOB
AGRI CONSTRUCTION
SHEET NO. OF -
75 Frost Rd.
DERRY, NEW HAMPSHIRE 03038
CALCULATED BY DATE
(603) 434-4902
CHECKED BY DATE
SCALE
PRODUCT 204-1 (Single Sheds) 205-1 (Padded) ��m inc., Groton, Mass. 01471. To Order NONE TOLL FREE 1-800-225-M
03/12/08 15:44 FAX 508 6889556 NORTH ANDOVER
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvaJa/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner frorr compliance with any applicable or requirementz,
�WIRWWWI* ""APPLICANT FILLS OUT THIS SECTION'%4"0"'***"*—
APPLICANT PHONE -79 t/ -q �?2
LOCATION: Assessol's Map Number PARCEL
SUBDIVISION Newcas-�� F-S�641?-!z LOT (S)
STREET ST. NUM13ER O� 2,-2-
......... FFICLAL U -S -E
_REC EN/DANS TO AGENTS:
CO 2 -
TIO IST
CONSERfVATIO ADAAINIS TOR DATE APPIR-0 VE' D Jr
DATE REJECTED
COMMENTS
TOWN PLANNER
COMMENTS
FOOD iNSPECTOR-HEALTH
�EPTIC INSPECTOR.-H-EALT
COMMENTS
DATE APPROVED
DATE REJECTED
DATE APPROVED �3 Z9
DATE REJECTEP___,
DATEAPPROVED
DATE REJECTED
PUBLIC WORKS - SEWERIWATER CONNECOTIONS
DRIVEWAY PERMIT
16002
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AFFIDAVIT
Home improvement Contractor Law
Supplement to Permit Application
MGL c, 142 A requ es that the "reconstruction, alteration, renovation, repair, modernization,
conversion, improvi�rrnent, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units ... or to
structures which are adjacent to such residence or building" be done by registered contractors,
with certain exception, along with other requirements. CT,
Type of Work: Al ",0 0 / 906 L Est, Costq
Address of Work �2 ;Z 2, SJLI--c-
Owner Name�__ b 47 All--�
Date of Permit Application: I 2i��6
I hereby certify that:
Registration is not required for the foilowing reason(s):
Work excluded by law
Job under $1,000
Building not owner -occupied
Owner pulling own permit
Other (specify)
Notice is hereby given that:
For office Use Only
Pernit No.
Date
OWNERS PULLING THEIR OWN PERMIT CR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARAN—Y FIND UNER MGL c. 142A.
Signed under penalties of perjury:
CIO
X
C.
I hereby apply for a permit as the agent of the owner:
_r 7 -
5 -ate t Contractor Name Registration No,
as the ner of the above f
Notwithstandirg the above notice, I hereby apply for a permit
property, -
MAY 8 19%
Date Oker Name
B661 8 �V
05/06/98 18:26 %21 603 434 9174 AGRI COSTRUCTION
TOWN OF NORTH ANDOVER
AFFIDAVIT
Home improvement Contractor Law
supplement to Permit Application
MGL c. 142 A requ es that the "reconstruction, alteration, renovation, repair, modernization,
conversion, improv�rrnent, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units ... or to
structures which are adjacent to such residence or building" be done by registered contractors.
with certain exception, along Wth other requirements.
Type of Work: L (-),q 4 Est. COSR 0-0 0
Address of Work L/ --e— ei
Owner Name-.
Date of Permit Application:
I hereby certify that:
Registration is not required for the foIlowing reason(s): For office Use Only
Work excluded by law Pemit No.
Job under $1,000 Date
Building not owner -occupied
Owner pulling own permit
Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARAN—Y FIND UNER MGL C. 142A.
Signed under penalties of perjury:
I hereby ly for a permit as the agent of the owner:
_!!�_ 7 ---
Date � Contractor Name
Registration No,
4001
W-9
1-io I P n
Notwithstanding the above notice, I hereby apply for a permit as� "ewner of the above,
prope
M AY 8 1998
Date oker Name
�15N � W�
Location PLO
No. —7-s"10 Date -Lk
5 VRT 111* �- TOWN OF NORTH ANDOVEW
��7 �-,�Noo M
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
14U
Other Permit Fee�&J $
Sewer Connection Fee $
Water Connection Fee $
TOTAL //-) $ 1 ;�:2
it
aI/ -4k 1 C, I " Building Inspector
t
8312
Div. Public Works
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
r I �07 _- ,
PAGE I
MAP +40.
LOT NO.
2 RECORD OF OWNERSHIP jDATE
BOOK
;PAGE
ZON E
SUB DIV. LOT NO.
I
LOCATION
PURPOSE OF BUILDIN
OWNER'S NAME
NO. OF STORIES -ZlZE
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME r -
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES SIDES
REAR
GIRDERS
AREA OF LOT
FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW Ab
SIZE OF FOOTING x
IS BUILDING ADDIT16N
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
&,5eA
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 /14)
14ye
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS I - 3
PAGE 2 FILL OUT SECTIONS I - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED `,TJ Jk YI?j
OF OWNER OR AUTHORIZED AGENT
F E E c)(3
PERMIT GRANTED
19
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
SUILPING lN6PKCTC
OWNERTEL#
CONTR.TEL.#
CONTR.LIC.# OY0256Y
H.I.C. # - Z0764)9:2t -
0!I-)
0,542- -r�--i&tLq,(,
%--Vq
BUILDING RECORD
OCCUPANCY 12
SINGLE FAMILY
S.-ORIES I
MULTI. FAMIL
OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
PINE
a
1
2 13
CONCRETE BL*K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
[�RY WALL
_�NFIN
3 BASEMENT
AREA FULL
FIN. 8 M'T AREA
V, 1/2 1/.-
FIN. ATTIC AREA
NO BMT
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS
9 FLOORS
CLAPBOARDS
B
1
2
3
DROP SIDING
WOOD SHINGLFS_
_�ONCRETE
�ARTH
ASPHALT SIDING
ASBESTOS SID11Z
VERT. SIDING
_�ARDVV D
COMMGN
_kSPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR R
_�DEQUATE OZ 1
5 ROOF
10 PLUMBING
GABLE
GAMBREL
I
I
HIP
BATH (3 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
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
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RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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OF ONEAMBORTONPLAOF
TV MASSACHUSETTS BOSTON, MA 02100
EXPiRADON DATE
REA018NIS, 9 Ili
16
1 & ? FAMILY HOME
LICF.14"E
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CONSTk, SUPLRVISOR
C-FFEI�TiVF tjAYt Lic-No.
05/31/1994 C!ICS'14
Wl LL.( A I I F.F'S I E R
P C.-hrlico-rT S4T
S5 024-58-5712 LA4RENCE MA 01841
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HOME IMPROVEMENT cor,�IPACTOR,-,., REGISTRA11ON
..�Rc)arcl of Building Requlat.iotis� arid '$,ta�'OardS,
one Ashburton Piace - RoOm 130,
eoston . massac h?.i,:�.cit t s I C')8
�4OMF IMPROVEMENT CONlkAC�10R
Regi St 7- at i ':�rl io7t'02�1 Expi rw. ion
Typ�: - PRIVAIE coRPORATION
CotLle & Foste" Cor1r,
(,n"
20 Aegean Dr-"Qrilt 1�
Mett)L,ull MA 016344
F.— -- - - -- I
Post -it ' Drand fax transmittal memo 7671 of pages 6,
To From
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CONTRACTING
BUILDING v REMODELING
This agreement made the First day of June, year
Nineteen hundred and ninety five by and between Cote and
Foster Contracting, Inc. hereinafter called the Contractor
and Peter and Mary Tyrrell called the Owners, witnesseth that
whereas the Owners intend to build a finish basement with a
half bath and a cedar closet. All work as per specifications
enclosed and drawing supplied by Cote and Foster.
Now, therefore, the Contractor and the owners, for
consideration hereinafter named, agree as follows:
ARTICLE 1
The Contractor agrees to provide all the labor and
materials and to do all things necessary for the proper
construction and completion of the work shown and described
on drawings. The drawings and specifications are the basis
of the contract.
ARTICLE 2
In consideration of the performance of the contract, the
Owners agree to pay the Contractor, in current funds as
compensation for his services hereunder $21,000.00, to be
paid as follows:
Payment I - $7,000.00 at the start of project.
Payment 2 - $7,000.00 at the end of rough plumbing,
electrical work and carpentry.
Payment 3 - $7,000.00 at the completion of project.
4041WAW"
Final payment on contract amount as agreed above to be
paid within ten (10) days of project completion or occupancy.
If final payment has not been made within this time a 10%
charge per month on the balance due will be charged. All
minor punchlist items will be completed as part of the one
year warranty on the finish product. Failure to pay balance
within ninety (90) days may result in legal action.
Initials
, T, 2;- - 7 1 (" - -,
20 Aegean Drive 0 Unit 15 0 Methuen, MA 01844 * Tel: 508-682-6518 0 Fax: 508-682-1221
Page 2
Tyrrell Contract
CONTRACTING
BUILDING v REMODELING
ARTICLE 4
Additional work above and beyond the contract agreement.
All additional work done to be quoted at the time the client
requests the work. The work will be done and billable at its
completion. The client has ten (10) days to pay the
additional cost after he or she has been billed for it.
Initials
In witness whereof they have executed this agreement the
day and year first above written.
Peter Tyrrell, owner
Steven M. Cote, contractor
Mary Tyrrell, Owner
William T. Foster, Contractor
Irk 6�a & 51164V,��t
CONTRACTING
BUILDING v REMODELING
May 15, 1995
Proposal submitted to Peter and Mary Tyrrell for a finish
basement in North Andover.
1) Permit - All permits required to do said job.
2) Debris - Removal of all debris from said job.
3) Framing - Walls to be 2x4 typical frame with pressure
treated shoes.
4) Insulation - To be 3 1/211 Kraft face in walls.
5) Plumbing - Raise existing drains to height of existing
beam. Install a new half bath with toilet
sink/vanity.
6) Heat - Cut two vents into the existing heat duets.
7) Interior - Doors, baseboard and casing to be painted.
Rail will be oak; handrail and balusters for
stairs to be stained. Six panel molded doors,
two piece baseboard louver venting door to
boiler room. Cedar lining inside closet with
shelves.
8) Walls - To be 1/2 blueboard with skim coat plaster.
9) Ceiling to be suspended two by two tiles.
10) Interior Paint - All walls and woodwork to have two (2)
coats of paint. Color to be chosen by owner.
11) Floor Covering - Allowance of $25/yd; estimated 109
yards.
12) All materials to be supplied by Cote and Foster.
13) Tile - Floor in bathroom to be tile.
Total Cost of Project - $21,000.00
20 Aegean Drive * Unit 15 e Methuen, MA 01844 * Tel: 508-682-6518 - Fax: 508-682-1221
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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This certifies thaj� ....... .........................
has permission to perform
plumbing in the buildings o� . .....................
........... ........ �.., North Andover, Mass.
Li
Fee"/?�. . Lic. No.C�15/4 . .. ...............
PLUMBING INSPECTOR
'X/15/98 14:30 40-00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION F/0ERMIT TO DO PLUMBING
rype or print) Date (!I—/,
NORTH ANDOVER, WASSACUU5E
.1,4. 1 +; 1'411JT0"KdQ0)eV1- , Permit 3V6
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New In Renovation n , Replacement 0 Plans Submitted n -
WIFYTITURR
Check one: Certificate
(Print or type) Z- ( 70 C/ Corp.
installing Company Name
I Partner.
Address —Z/, NO Al, El
)01// //(-/] ;q '50 / /V I e 3t 7 Firm/Co.
Business Telephone 1,*.'1�`5`,Wo7_—&_(f17 -
Name of Licensed Plumber: / Irr I I ow /IV -ate box:
insurance Coverage: Indicate the type of insur#ce c&verage by checKing me appropn
Liability insurance policy rM Other type of indemnity [3 Bond
Insurance Waiver: 1, the undersigned, have been mdde aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner 11 Agent 11
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
te Mass
,�c,h� Code and Chapter 142 of the General Laws.
compliance with all pertinent provisions of ti
7own
ROVED (OFFICE USE ONLY
T f Plu bing License
a 2W 7,
u-ce-ftse NUMBer Master Journeyman in Ili
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MASSACHUSE-M-S UMFORM APPUCATION FOR PERMIT T 0 DO GASFITTI M*G
(Print or Type)
NORTH ANDOVER Mass. Date
tuil-ding Location Permit #
Owners Name/--// &12 _e
New 7D -Renovation Reolacement Plans Submitted
(P -int or Type) Check one: Certificate
Installing Comc3ny Name—el Corp. .
Address 3z) It J .5- T— Partner.
_e L —Zz, 4 E�_Firm/Co.
J
Business Telephone: _OF��b
Name of Licensed Plumber or Cas F-itter
Insurancr- Cover3ce: lndica:e :6--a v/pe o" insurance coverage by checking the
accrocriate box:
Liability insurance policy UzIner type of indemnity Sond
Insurance Waiver: 1, the undersianed, have been made aware that.the licensee of
this application does not have any one of the above three. insurance coverages.--- -
Signature of owneriagent of procerzy Owner = Agent_.D
I hachy ccniry th4t ag of the de(AUS and information L 6wre suhmitterd (or entered) in &Love zop6cation are trw aW accutate to the best of rny
knowtedge and tUat &U 9(urnbing wart and WCALUtions -,=fo=Cd undcr, PUTmit iuued ro.- this appilcation Will COMPdance with ad perda=C
provisiorLs Or L,16 WASaC.1jUjC(jZ Sixte Cas G�de snd CLaptc: 4-" CC Uza Ceancrzi LAwi.
Bv
,r4 4-1 e Signature of License -d
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APPROVED (OFFICE USE ONLY] Licen'ge NurnbeZ
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(P -int or Type) Check one: Certificate
Installing Comc3ny Name—el Corp. .
Address 3z) It J .5- T— Partner.
_e L —Zz, 4 E�_Firm/Co.
J
Business Telephone: _OF��b
Name of Licensed Plumber or Cas F-itter
Insurancr- Cover3ce: lndica:e :6--a v/pe o" insurance coverage by checking the
accrocriate box:
Liability insurance policy UzIner type of indemnity Sond
Insurance Waiver: 1, the undersianed, have been made aware that.the licensee of
this application does not have any one of the above three. insurance coverages.--- -
Signature of owneriagent of procerzy Owner = Agent_.D
I hachy ccniry th4t ag of the de(AUS and information L 6wre suhmitterd (or entered) in &Love zop6cation are trw aW accutate to the best of rny
knowtedge and tUat &U 9(urnbing wart and WCALUtions -,=fo=Cd undcr, PUTmit iuued ro.- this appilcation Will COMPdance with ad perda=C
provisiorLs Or L,16 WASaC.1jUjC(jZ Sixte Cas G�de snd CLaptc: 4-" CC Uza Ceancrzi LAwi.
Bv
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7* Ga ti��ar
s Plumb or Gasfitter
C_,; ty/ T C wn -a s e r
journeyrnan E� 3 t -
APPROVED (OFFICE USE ONLY] Licen'ge NurnbeZ
ri - / " 11
4. Date. ........
'1ORTM TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that I I t�'. —�. f I ," .�. I , t .,.. 1. . r .....................
has permission for gas installation L ........
in the buildings of I I'D. 11.
............................
North Andover, Mass.
at .........
Fee. I`V ... Lic. No.. � ... ... .......
AS
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer