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Miscellaneous - 333 FOREST STREET 4/30/2018 (2)
i 7-7 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: Q— (T,26t-f,, SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: -1 I�-QUANTITY PUMPED ��—GALLONS CESSPOOL: NO Y SEPTIC TANK: NO NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: YES FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENT `� C— , ig S TRANSFERRED TO: Date. ...c..�. `�.l"� ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION A This certifies that .. .�.....`.� :.. '' . :': .. . . has permission for gas installation in the buildings of � .. ............................. . A at ..., North Andover, Mass. FeeZ` .. Lic. No..—. GAS INSPECTOR ` s Check # r MASSACHUSETTS UNIFORM APPLICATION FOR PER i O DO GASFITTING (Print or Type) } , Mass. Date `0/ 20 Permit # Building Location J?� �L ' Owner's Name �j�t� -*%l ri Telephone i %c 9 Type of Occupancy 1 �/Y\, G• New Er Renovation[—] Replacement F] Plans Submitted: Yes E] No❑ G Installing Company Name EnergyUSA Check one: Certificate Address 500 Myles Standish Blvd. X❑ Corporation 115C Tauton, MA 02780 Partnership Business Telephone (800) 822-1300 x8051 Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson INSURANCE COVERAGE: EnergyUSA has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes X❑ No El If you have checked rtes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Xl Other type of indemnity M Bond El 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: Owner Agent Signature of Owner or Owners Agent 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By f-1 Plumber Title XX Gasfitter City/Town X❑ Master APPROVED (OFFICE USE ONLY) Miourneyman L•• u Signature of Licensed Plumber or Gasfitter License Number 3707 J z 0 w w U U. 0 w O LL. 0 J W m z 0 F- CLU W z N CO) W U 0 w a V) w x U F LU Y N z O t= U w CL CO) z J Q z M TF 'rn T1 O z 0 z r LL N a C) 0 0 0 F t- w CL w 0 w z O a U J a CL Q c) z 0 J m LL O W a otf W a z O z D J D m W 0 z 0 Q U O J r LU F 0 w O F U W Location -3,33 No. cc:�1711?1_ Date' TOWN OF NORTH ANDOVER . 11"� ~ o n Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee t�oo� $ TOTAL $��` Check # � <. v /YI Building nspector f (r SECTION I -.SITE MYOKMATION 1.1 _ Pr�apAddress: � 1.2 Assessors Map and Parcel Number: �o*d ` I-02.1 , M � .09457. /� Map Number Parcell umber oa(1.3 Zoning information: (!( j�� 1.4 Property Dimensions: Zonin District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. ) 1.5. Flood Zone Information: 1.8 Sewerage Disposal Syst Public ❑ Private Zone Outside Flood Zone ❑ Municipal ❑ to Disposal Syst SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Re rd `( 'RIc1�a�r� Tocwg!�q '\ Name Addreesss—for Service : Lcre Signature Telephone 2.2 Owner of Record Name Print Address for Service: TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO PAIR, RENOVATE, OR DEMOLISH ONE OR TWO FAMILY DWELLING �6(A�. Y. BUILDING PERMIT NUMBER: DATE ISSUED: 2 �( SIGNATURE: Ad s Building Commissioner/InTedor of Buildings Date SECTION I -.SITE MYOKMATION 1.1 _ Pr�apAddress: � 1.2 Assessors Map and Parcel Number: �o*d ` I-02.1 , M � .09457. /� Map Number Parcell umber oa(1.3 Zoning information: (!( j�� 1.4 Property Dimensions: Zonin District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. ) 1.5. Flood Zone Information: 1.8 Sewerage Disposal Syst Public ❑ Private Zone Outside Flood Zone ❑ Municipal ❑ to Disposal Syst SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Re rd `( 'RIc1�a�r� Tocwg!�q '\ Name Addreesss—for Service : Lcre Signature Telephone 2.2 Owner of Record Name Print Address for Service: 3.2 Registered Home Improvement Contractor &kA6P, Co. lnC. Company Name � WC A9. /lD, Dry Not Applicable ❑ Registration Number �Xi-1/ Expiration Date SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction vow Not Applicable ❑ (23. � Licensed�ruPtion Su isor: 00mi,0� 7 License Number Ad s Expiration Date 3.2 Registered Home Improvement Contractor &kA6P, Co. lnC. Company Name � WC A9. /lD, Dry Not Applicable ❑ Registration Number �Xi-1/ Expiration Date M SECTION 4 - WORKERS COMPENSATION (nG.L C 152 § 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 .......0 No....... Ge % •1 SECTION 5 Description of Proposed Work (check annlicabte ) New Construction 0 1 Existing Building ❑ 1 Repair(s) 0 1 Alterations(s) ❑ 1 Addition 0 Accessory Bldg. ❑ 1 Demolition ❑ 1 Other )X, Specify I""I NJ Brief Description of Proposed Work: I SECTION 6 - F.STYMATFn CONSTRUCTION CnCTC l — Item 1. Building Estimated Cost (Dollar) to be Completed by permit ,3 �, a a CIAi,ITI (ix.�iiy (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 2 3 Plumbing Building Permit fee (e) X (b) -- 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number N 1;11UIN is UWINEK AU 1nUK1LAHU1N lU BE UUMNLELED WMEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �ql , < uthorized Agent of subject property Ix Hereby authorize O, to act on My beha , ' a la 've to work authorized by this building permit application. n Signa of Owner Date `-/ SECTION 7b OWNER/ACLT11ORT7TD _A_GENNT DECLARATION I, �AR �� � � � F�Q�.! ,as Owner/A th_ orized Agent o object property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DE\, ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE MqR 20 2001 4:35 P�; FR K 1 TTREDGe_ I N,SURA"NCE 393 4618 TG • 91 978E 710 165 F1.01" 01 ' DA'1'f itAMrODIYYI `` QCO A CERTIFICATE OF LIABI>_ITY INSUI�ANC Io ms`s 03/20 01 nn --- rIF.ATEA Is ISSUED ASA MATTEROR INFORMATICS Kittredge Insurance A940 =a r. 276 w.xaiu St., p.0. Bax%3129 Northboro XL 01.532 ( „ - phoue1508-393-7744 _ Aa ewe ()Imitt Co. F I=- 6AndRY�auNb6�iRea1RQ d rust North 33. or -lea Ma 01962 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SUN ISSUED TO THE IkSURED NAMED ASOVB FOR THE POUCY PER100 INDICATI ANY pMUIRFM NT, TERM OR CONDITION O>: ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TMs CERTIFICATE M MAY PERTAIN, TME INSURANCE AFFORDED OY THE POLICIE3 DESCRIBED Hi-A6N IS $ULM=To ALL THE TERMS. EXC LSONS AND I POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDU= BY PAID'1AIMS. RETYPE OF INSURANCE POLICY HUMBER I OATUE GENERA{ LLOOLM pI 1 X EwmutCULCENERALLUBem 204a661231 1 03/01/01 03/01/02 CLAIMS MADE (. XJ OCCUR ANO cdNFM AHO RIOKTS UPON THE CERTIFICATE R. THIS CERTIFICATE DOCS NOTAMENDF EXTEND OR THE COVERAGE AFFORDED BY THE POLICIES SELOV INSURERS AFFORDING COVERAGE ' IN3URERA AiS✓fAA.%;AN Vi►ivwa+s i ..vi INSURER m TRAWSPORTATI0IT INS CC INSURER C: VAUSY FORGS Itis . 20 CEN'LAGGITEGATE UMIT APPLIES PER. AUTOA LEL"o'"Y C ANY AUTO ALLOWNED AUTOS tKxEDw2DAUTO$ HIRED AUTOS NON -OWNED AUTOS GARAGE LIAMLITf I ANY AUTO 1061929964 03/01/01; 03/01/02 >7tCECe LIABE.t C 8 X {O 66 03/01/01 03/01/0: CCUR CLAIM3MADE 2048660 1 OEDUCTII.E r RETENTION S 10 0 0 0 1 WOp im cOMPENSATI0NAM0 B I EAIPLOYWRB' UABIUTY 2048661276 03/01/01 03/01/0: D, NoTWITHSTANOING kY BE ISSUED OR ANDITCNv� Of SUCH UMITs EACHOCCURRENCE I S 1000000 FRH DAMAGE (MYCII6flr0I i s 50000 MZM AXP (Ay ampff -) 1 S 5000 PERSONAL&ACV INJURY S1000000 G011ERALAGGREG•ATE 132000000 FROOLI=-COMMOPAGO s 1000000 I COMBINED SINGLE LIWT L 1000000 (Ea appidv,lj EQOILYson URY 13 BODILY INJURY S PROPRATY DAMAGE S (PpracsstlamY AUTO ONLY - EA ACCIOENT S OTHER THAN Fa ACC s AUTO ONLY: AGG S EACH 1$2000000 AGGREt3ATE 182000000 3 � a TORY LI I I EJ..EACHACCIDENT $1000000 E.L. DOME -EAEMPLO 51000000 EL olsEAse-POUCYLIMIT I 31000000 CERTIFICATE HOLDER N I ACOM04ALINSUREDI INSURER LIi M' CANCELLATION A Sq. SHOULD ANY OP 11HE ABOVE DESOOK POUCIES SS CANCELLED BEFORE THE EXPIRATIO OA-MTWREOP, YNB MUNG INSUIIAR WILL ENOEAVOR TO MAIL 30 w3 WRITrm i NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BLIT FAILURE TO 00 60 SMALL IMPOSE NO OBUGATION OR UABLr Y Of ANY WNO UPON THE INSURER ITS AOSM OR ** TOTAL PAGE.01 ** r -- 1 ,r Board of Buiidm emulations One Asbburto n Pace, Rm 130 Boston, Ma 02108-1618 Birthdate: 0311411934, License: CONSTRUCTION SUPERMSOR UCE NSc Number.. CS Q27tQ9 Expires:0311412002 4.. RODNEY P ANDREWS 16 7 LOWELL RD CONCORD, MA 01742 Restricted TM 00 Tr. no: 1792$_ Keep top for receipt and u�ange of address notification. '�"�`.' •� �fZ6 lJ0!11t/%1LO�LUIPQ�I/�O� V&QGW HOME IMPROVEMENT CONTRACTORS REGISTRATION • Board of Building Regulations and Standards .r One Ashburton Place - Room 1301 ; Boston, Massachusetts 02108 HOME., TfIPROVE-MENT CONTRACTOR Registration 113772 Expiration 07_/15/01 TyQe - PRIVATE CORPORATION HOME IMPROVEME,41` CONTRACT Registration 11377219 . . Type - PRIVATE CORPORATL ANDREWS GUNITE CO . , INC - Expiration 07/15/01 RODNEY P. ANDREWS 6 REPUBLIC RD ANOREAS GUNITE CO.,..INC _ N BILLERICA MA 01862 � PDNEy P': ANDREA b REPUBLIC. RD H RIU.ERICA MA 01862. y 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 or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT �1 C-V\f)7� C, PHONE ��� �Cl� 3 i LOCATION: Assessors Map Number 10&R PARCEL 3L SUBDIVISION ` LOT (S) STREET �0�5`7- S�. ST. NUMBER 3 3 3 OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED C DATE REJECTED 15"" t t Ofd COMMENTS ' " t,�c�S` TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED FOOD INSPE R -HEALTH DATE APPROVED DATE REJECTED xSRATI INS CTOR-HEALTH DATE APPROVED Z v v DATE REJECTED COMMENTS 7, PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm je r "-Kill U- L V 1 1\L' LL' Cx0JU, I. V1x1Y1 I'vi Ct i ` e i INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This. does not relieve the applicant and or landowner from compliance with any applicable requirements. �. s..... ■.■■ ■ommons■■■■■■r■.■■■■o•■■•■■■.■■�■. ■...■s.....■. ■.. ■.... owns as i APPLICANT ���� PHONE( 3q GO�Z "9'-r-� ASSESSORS MAP NUMBER LOT NUMBER STREET ` STREET NUMBER ■ ■ .. ■ • • ... • 004 ■ ■ m ■ ■ • ■....... • • • • ■ . • ■ . ■ ■ t . ■ ■ ■ ■ ■ . ■ ■ . ■ . ■ . ■ • ■ • ■ ■ .. ■ • ■ was ■ ■ ■ .... OFFICIAL USE ONLY . ■ ■ ■ ■ ■ . ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ..■ . ■ ■ ■ • ■ . ■ .'■ ■ .■ ■ ■ ■ ■ . ■ ■ ■ ■ . ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■ ■ ■ . ■ ■ ■'■ ■ ■ ■ ■ ■ ■ ■ . ■ ■ ■ ■ ■ �RECO�MNIENDATTONS OF TOWN AGENTS .................... .. ........... DATE APPROVED ONSER V ON ADMINIS TOR .DATE REJECTED ,! r C+ia�illl �„�xLe �(Pl.A� TOWN PLANNER COM2v1ENTS DATE APPROVED DATE REJECTED DATE APPROVED OOD INSPECTOR - TH DATE REJECTED 11 DATE APPROVED. SEPTTC W8P OR - BEALTH DATE REJECTED PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COQ S RECEIVED BY BUILDING INSPECTOR DATE APPROVED DATE REJECTED. TE 9/�� 10(ab I c� u� 0 U° U CL Cf) O A c "17 v co x a O U W 'app cn w � O W w ►-� W m �2 u cn ca w O �D cv W a w G z +•' J) v Q O J) c o Cl) I -- cm c p ` C N �"• p V V CL C cv � • c O = • L:4tm� o n y � co •m3 t 23 i CA FA Of �p /�- O e y t+ CL) m a°ic Of C O Q C O gd t p O pC m C3yz o. C MCL Q o .�'`ma •o N COD W G �...�_ .� ~ U)EL= C Z E C=J "0�y O v oom�C g COD CL O� O5 S R 'a H •� O Fes• _ $ �.._.. m 7e i O co L O O v Z °o C. O y � C co o, I o-0 CD — yco co �_ CL 03 3� CD a� L Cc O d CL C Q C ev Cc v J .fl COP) C Z CD 0 CL V CO) � C — C C 0. CO2 D 0 U) U) Ir w .cc w U) ANDREWS GUNITE CO., INC. 6 REPUBLIC ROAD •NORTH BILLERICA, MASSACHUSETTS 01862 (800) 272-7946 MA CONTRACTOR REGISTRATION #113772 SWIMMING POOL CONSTRUCTION AGREEMENT THE GENERAL TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS AGREEMENT This AGREEMENT made as of the date of written acceptanpg of ANPREWS GUNITE CO., INC. herein termed "Contractor" andK I 1 Main Address City WITNESSETH: (Owner/Prime Contractor) he ein to ed "Owner," Home Phont Business Phone Contractor agrees to construct for Owner, in substantial conformance with the specifications set forth hereinafter, the following described swimming pool, herein called "the work"; to be located at 5A" city Gp_,"e POOL SIZE: i X Depth t Surface Area 62� � L�� _10 � -Q Perimeter (� %- Shape C 1 OM CONSTRUCTION SPECIFICATIONS: 1. Contractor's engineered structural plans and specifications for pool................................................................................................................... Included 2. Contractor's plans showing layout of pool............................................................................................................................................................ Included 3. Excavation of pool and removal of soil................................................................................................................................................................. Included 4. Contractor to hand form and shape pool................................................................................................................................................................ Included 5. Engineered steel reinforcing throughout pool structure........................................................................................................................................ Included 6. Engineered concrete-gunite structure to meet or exceed city or county codes..................................................................................................... Included Owner to water cure concrete-gunite shell and fill pool after plaster 7. One six inch band waterline tile (,' Sizein'2O1/4 Color........................................................................................................................ Included 8. Deluxe Coping Type....................................................................................................................... 9. One set of shallow end steps ...... :................................... . Included . . . . .. .. . . ................................................................................. 10. Interior finish to be waterproof •oarb •.I,ir iris°. ............................ .............. Included ....... ..... ............................................... . 11. Supervision of construction................................................................................................................................................................................... Included FILTER EQUIPMENT SPECI C A�T.IONSt � 12. Approved Deluxe Filter Type PP�r ��cc11�7.......................................................................................................................... Included 13. Weatherproof pump and motor with hair and lint "mer .................................................................................................................................... Included 14. Waterproof time clock ❑ 110V 220V....................................................................................................................... 15. Complete hook-up of all water lines from filter to pool including hose bib at pump ......................... :................................................................ Included PLUMBING SPECIFICATIONS: y 16. Plumbing, non-cotmsive type, including face piping........................................................................................................................................... Included } 17. Skimmer with self adjusting weir .................................... ......................... Included 18. Pressure return lines.........:...............:..................................................................................................................................................................... Included 19. Concrete pad for pool equipment..::.:.:...........................................................................................................:...................................................... Included 20. Main drain receptacle with grate........................................................................................................................................................................... Included 21. Leaf basket in skimmer chamber ......................................................................................................................................................................... Included Waste Water Disposal _ _ Fitting on Filer, ❑ Irrigation, ❑ Drywell, ❑ Sewer, ❑ Separation Tank ❑ By Others j BOILERS AND HEATERS• / +1 22. Approved Heater Type Model No. Nat. LP ✓ • y L L.F., Venting of heater ' 24. Heater and as permit Gas Line �--,.••.-...•..,....,.,••,.......•.••. 23. Water lines connected to boilt r or heater b Contractor............................................................................................... t" g pe �' g ................ AUTOMATIC CIRCULATION. / 25. Automatic Pool Cleaner. includm* Pum Tyyppe� � ��............................................................... a 26. in -floor Circulation Type ��,L 4i% I> Heads . O l f�fC (� r; DISINFECTION SYSTEMS: ( ti 27. Approved Disinfection pe /I.q :-.QNL. t+E 28. Magnets Type _ Sets...............................................I.......... I Ni MISCELLANEOUS SPECIFICA LONS: 29. Approved Diving Board Type.................................................................................. 30. Approved Ladder Type �un Ou -............................................................ L' C.L -- 31. Approved Marine Lite, 00 watt, _ volt, heavy uty constructionA_& ............................................................. 32. Approved deck box or lite conduit........................................................................................................................................................................ I IC � pu.) 33. Electrical Energy to motor(s), clock(s), switch panel and marine lite.................................................................................................................0 ;. 34. Electrical bonding of pool, as required by city or county codes......................................................................................................................... r�l_(:nim I�N 1:�4L +� 35. Trees and shrubs to be removed...........................................................................................................................................................................f�C'� I� �lOv�lnlEjZ_ r. 36. Deluxe Cleaning Tools, includes 18" curved Nylon Brush, Hand and Leaf Skimmer, 16' Pole, and Test Kit .................................................... Included s! 37. Instruction on pool equipment and maintenance procedure ................................................................................................................................. Included + 38. Initial start up and water treatment instructions.................................................................................................................................................... Included 39. State sales and Federal taxes.................................................................................................................................................................................. Included 40. Public liability and workmen's compensation insurance...................................................................................................................................... Included 41. Property damage negligence insurance to pool during construction.................................................................................................................... Included ritten Lifetime Structural Warranty................................................................................................................................................................... Included (�l-t�� i n � � / 1�,. I �`� r �'l� /t= 't�'� (� 1-4 ��� �r-z�; _ ► t.l(' 1 THE LIFETI E WARRANTY, GENERAL TERMS AND CONDITIONS ON THE REVERSFiXIDE ARE PART OF THIS AGREEMENT T Owner agrees to pay to contractor the sum of $ �� Dollars. ,�Cory NOTICE Down Payment $ `P1 �J` the receipt of which is hereby acknowledged. ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUB- Balance: 40% day of excavation, 55% day of concrete-gunite installation, 5% day of plaster. JECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR � I� ,� Z- - COULD ASSERT AGAINST THE SELLER OF GOODS OR SER- Accepted this t day of VICES OBTAINED WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS B By PAID BY THE DEBTOR HEREUNDER. 16 C.F.R. §433.2(b). °`v"ECO � CO v'°R cro Pxr nve OWNER . DO NOT SIGN THIS CONT CT E THERE ARE ANY BLANK SPACES. YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN CONSUMMATED BY A PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER, WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF, PROVIDED YOU NOTIFY THE SELLER IN WRITING AT HIS MAIN OFFICE OR BRANCH BY ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE SIGNING OF THIS AGREEMENT. N/ tj-- G v A, •-r is X�W �N 41Y ADDMM4, V �7 DWa11�. r (zo SIR. ABANOoAvo) Ex\sltN& 'TMK �.XtS'TIN6 `® Vr FAT �• GHAmggR o �n wn._...: .... _ RMAe EMENT T. _kNK(z,oeo 6AL. SHIRK coNc. or E, 40-7-3 .4=3.0/ Arc, I hereby certify that I have inspected the construction Of this disposal system and that the construction and final grading has been in accordance with the designer's intent and that the - materials ' he•materials. used conform to the . plan specifications and 310 CMR 15.00. i • �1USC INb TANK 7� �E. �� s�oPE 2�avi2_ �tir�Nr QU�Q�o E �RuS��o ANo � � BAcK��u,EO w/ SAtyO. (150) 3 = 150 — _ ............ .............. . ALL WAS sTR z�uR T roP of - STowE) ,06,516N EL E dTION .4 ........ ( EXISTING 62-ol now AT ......... REQUIRED F/LL = ............................ . elft/. rlolyll oEs1�rN Qs C3U�CT REVISED 40111L T INV PIPE OUT of 11005E / 3 8, 0 13g. Z- 0 /NV PIPE INTOT,4NK 137,, 6 /37 f•/ _ 360 � �� �CE 9 aOA V_/—` L �- N �✓vr,A r . INV P/PE OUT OF TANK 137-2-6 / 3 7, 23 / 37 / q �CTLCM INV PIPE INTO D. BOX TOWN OF NORTH A� NDOVE BOARD OF HEALTH i 'AUG 2 7 1996 //VV PrPE OUT OF D. BOX 14+041;q ADDMM4, V �7 DWa11�. r (zo SIR. ABANOoAvo) Ex\sltN& 'TMK �.XtS'TIN6 `® Vr FAT �• GHAmggR o �n wn._...: .... _ RMAe EMENT T. _kNK(z,oeo 6AL. SHIRK coNc. or E, 40-7-3 .4=3.0/ Arc, I hereby certify that I have inspected the construction Of this disposal system and that the construction and final grading has been in accordance with the designer's intent and that the - materials ' he•materials. used conform to the . plan specifications and 310 CMR 15.00. i • �1USC INb TANK 7� �E. �� s�oPE 2�avi2_ �tir�Nr QU�Q�o E �RuS��o ANo � � BAcK��u,EO w/ SAtyO. (150) 3 = 150 — _ ............ .............. . ALL WAS sTR z�uR T roP of - STowE) ,06,516N EL E dTION .4 ........ ( EXISTING 62-ol now AT ......... REQUIRED F/LL = ............................ . elft/. rlolyll oEs1�rN Qs C3U�CT REVISED 40111L T INV PIPE OUT of 11005E / 3 8, 0 13g. Z- 0 /NV PIPE INTOT,4NK 137,, 6 /37 f•/ _ 360 � �� �CE 9 aOA V_/—` L �- N �✓vr,A r . INV P/PE OUT OF TANK 137-2-6 / 3 7, 23 / 37 / q �CTLCM INV PIPE INTO D. BOX /41,2 / 4} 13 FOR �'�C' ► ��0 //VV PrPE OUT OF D. BOX 14+041;q 3.9 INV END OF PIPE /44.0 /g-3• C7 / TNV. P \QF- zN"76 RFP`.ac. T K. 137.6 Not 26 N Pkerr QuT RSP, &r TKP5 �1l/E2�JCE STONE 5C,4LE . a'.S•Or D,47 .'/1/0v', /7I9i2 DEPTH 47 P 030 ReYiseD ; `3`�,\y 11� 1996 NOTE. r,�1rs PL,4N rs NOT ,4 w�lk'�P.4NTY CSRl5TIANSEN SERG/, INC. ��o su�MFR srEEr HAVERN/LL , tiAss.T1E 5Y57 -EM BAFC4TOF 111/ON OF THE I-OC,4TION OF 711E EX1571NU E PROPOSED ST,eUCTU2ES. � TtlomAs A,�uF���-LO, � E. REv\516N 6Y �.0. Box lay , � NN m D F "! I 15/8" I z V1 0 2i �w nw 0 m sDm yy c.Imm 1 x r, MDs Dz� O2�O > Clm AA it �U70 D r 10 c -4I ( ' I `• 1 VIP r IL Cc 'z In �A' I N n p� CD o4�o z A z z m � O m� V� A N y D y m = Q D N O C C C Fr G G F C y�y << I A ,� n n 1 m r l 7 314' qi in a� 3 O 9 a o g g o g o 0 0 2i L-15. � 1fw. I �w nw L J sDm yy c.Imm 1 x r, MDs Dz� O2�O D m -c Clm AA it �U70 D 10 c -4I ( ' I `• 1 VIP r IL Cc n Qo In �A' � N n p� CD o4�o z A z z m � O m� V� A N y _ y m = Q D N O C C C Fr G G F C y�y << A ,� n n 1 11 1 II n q fl m a� 3 O 9 a o g g o g o 0 Z L-15. � 1fw. I cl9 m m i )• . ..•tca� : 5'•i _. � I-�e•I�i`safdiilira� � a• ��$+�•:� m m r, MDs Dz� O2�O D m -c Clm AA �o�m tN� �U70 D 10 11>4 VIP r Cc n Qo In �A' � N n p� o4�o z = z z m M-4> O m� V� A N y 0 jA y m = Q D N O f n Fr m TO �Tlip a� 3 Imo >� �_S o� z O N y �O ZZ� Ulx O T N7< mN cl9 m m i )• . ..•tca� : 5'•i _. � I-�e•I�i`safdiilira� � a• ��$+�•:� §alb �e v O PPyym O> � 4 -4 D A7O p IA�mN A A= � m PDX�D� ML clCl mO� _kA OA AO nn o= z -, n on O z g p -4 10 t1) o Z jli m rID D- O m O C) > r4 moa m� � g AsZrn ir m n O In r� �0 0� A a mip10, b `� i -4 L 70 5�o omkA c 6 y > m n 70 Z tr m m r, MDs Dz� I' 1 6 D m -c o r � N n p� z §alb �e v O PPyym O> � 4 -4 D A7O p IA�mN A A= � m PDX�D� ML clCl mO� _kA OA AO nn o= z -, n on O z g p -4 10 t1) o Z jli m rID D- O m O C) > r4 moa m� � g AsZrn ir m n O In r� �0 0� A a mip10, b `� i -4 L 70 5�o omkA c 6 y > m n 70 Z tr 1244 NoR7M °��•`" :°�"° TOWN 3? .. °t o: p PE ,,r;o�%•"max cmus This certifies that ..... .............................. ,e Date. .l.fJ .—'P -1a.. OF NORTH ANDOVER RMIT FOR WIRING 2�57' .......................................................... has permission to perform ...... ce-�r...� . ,mac .c,Awl!........................ wiring in the buildin o ............................................................ at ..... � ,2-3.........� .................... . North Andover, Mass. � n Fee . _!�.. r'. Lic. Nola: A/;7- - 6 ............................................................ -�: _/ ELECTRICAL INSPECTOR 10/22/97 10:2754'00 I'NK:"T WHITE: Applicant CANARY: Building Depl. P reasurer 014t (lumm unapt of s Permit Eepm1mrat of Public $afeig Occupam A Fie CltWW BOARD OF FIRE PREVENTION REGULATIONS 527 CNIR 12:00 1 3190 Peale' blank) APPLICATION performed tn accordance with PERMIT TO PERFORM ELECTRICAL WORK All work to be e Massacnusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) pate .60 --C-C- -9`7 OGXr or Town of NORTH NDOV R To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) _ 7 �7 Owner or Tenant - 5A CX .5 Owner's Address Is this permit in conjunction with a building permit: Yes v No C (Check Appropriate Box) Purpose of Building c,z T �i1 y Utility Authorization No. i Existing Service ZOO Amps ,moi 'z Volts Overhead _! Undgrnd [D`_' No. of Motors �� •1N New Service Amps _J Volts Overnead Undgrnc C No. of Meters a Number of Feeders ano Ampacity Location and Nature of Proposed Electrical Worn�Ai� RDJJ j /app/� /"� '�'�b��� c��� r' No. of Lignting Outlets I No. of 'lot ':-sI No. of Transformers Total KVA i Acve— - p,SNo. of Lighting Fixtures Sna. _ 5rno. IGenerators KVA p Swimming r INo. of Receotacie outlets �j 0No. of Oil corners No. of Emergency LightingBattery Units No. of Switch Outlets — I No. or Gas Scrr.ers No. of Ranges I No. Cf An Czr..c. 01a :cns Z - No. 01 OisOOsals I No.of Heat To:ai -oiai Purrs :ons KW No. Of Oishwasners I SoacerArea Heatmo KW No. of Dryers I Heating Cev ces KW No. of 31 No. of Water Heaters KW I Signs ?a ias;s No. Hydro Massage iucs ' I No. of Motors .otai HP OTHER. FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Sett Contained OetectioniSouncing Devices Local _ Municipal f7Other Connection Low voltage ; Wiring INSURANCE COVERAGE. Pursuant to the reouiremenis of r.tassac-Lsers ;eneral Laws 1 have a currant Liability Insurance Policy inctuaing C-m^:e c Ccerations Coverage or its substantial equivalent. YES Z --'NO I have suominso valid proof of same to the Office. YES Y .v0 = It you nave CnecKad YES. p(>.ua indicate the type of Cover 0 py checking the aapi3p nate cox. INSURANCE ' SONO = OTHER = (Please Scec:!,.w) Estimated Value of E!ectncal Work S 3LO. (Exoirauon Osteo Work to Stan If - ZZ-- 9'7 Insoecaon Date Aacues:ec: Rougn Y✓• C - Final Signed under :he Penalties of perjury: FIRM NAME 1CC/X16 LIC. NO. •� (f Licensee T! 6_/_1 v .I`%t', S;gr.a:ore LIC. 1140,ff2Ya E',y _ ��� �. 5� l"%/��iJ �, XYO/t� au3,. Tit. No. 20 i- Y3 _, /oT— Addfeea �L Alt. Tel. Nd. - OWNER'S INSURANCE WAIVER: I am aware inat Ine Licensee ^_oes nor nave ine insurance coverage or its substantial equivalent as re• ouirso by Massacnusetts General Laws. and that my signature on :his permit aaprrcatron waives this requirement. Owner Agent (Please cneck ones. eieonone No. PERMIT FEE S (Signature of Owner or Agenti INSTRUCTIONS HOW TO OBTAIN PERMIT FOR POOL 1. Fill out Building Permit application completely, and sign 2. Provide a copy of the plot plan with the pool location 3. Provide a copy of the contractors Home Improvement Contractors Registration number (HIC) 4. Attached a Form - U Verification form must be singed by Conservation and Board of Health (if on septic system) 5. Assessors map and parcel must be on permit application and Form - U form 6. Pool Regulation attached TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR. RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING -.:,'T'�i4 Sectioi�:for Utiiciat-Use"Oat BUELDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/12EEtor of Buildings Date T M Z O SECTION i- SITE INFORMATION 1.1 Property Address: ss3 -Fo �-t s + 1.2 Assessors Map and Parcel Number: i od f� x 153 Map Number Parcel Number 0 f n— 1 A � V `- 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage (tt) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Re red Provide Required Provided Re 'red Provided 1.7 Water Supply M.G.1-C.40. § 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zona Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 Oa Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 9" �.� M Sic Name (Print) Address for Service -a 3 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company -Name Registration Number Address Expiration Date Signature Telephone T M Z O FORM U - LOT REIEA8E 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 or requirements. APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT �-1 "V\wz-b PHONE LOCATION: Assessor's Map Number I d(Q 1?t PARCEL 3 - X I--- - — .......... OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS �CQJ.s { S� 1 INS CTOR-HEALTH / -(;�- TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED ? l tt DATE APPROVED DATE REJECTED FOOD INSPE R -HEALTH DATE APPROVED e DATE REJECTED COMMENTS DATE APPROVED S/Z DATE REJECTED i— PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT x_74 RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm SUBDIVISION LOT (S) STREET �Oc ��1 ST. NUMBER 3 3 X I--- - — .......... OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS �CQJ.s { S� 1 INS CTOR-HEALTH / -(;�- TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED ? l tt DATE APPROVED DATE REJECTED FOOD INSPE R -HEALTH DATE APPROVED e DATE REJECTED COMMENTS DATE APPROVED S/Z DATE REJECTED i— PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT x_74 RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Town of North Andover t HORTy OFFICE OF'° ' • �ti°o .-COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 WII JAM J. SCOTT i c �cNus�� Director (978) 683-9531 Fax (973) 688-9542 SWIMMING POOL REGULATIONS NOTE: PERMIT -CARD SHA -LL iN A ViSIELE AND ACC£SSIBL.E -LOCATION -FOR OBTAINING THE VARIOUS INSPECTORS' SIGNATURES. ALL SWIMMING POOLS IN EXCESS OF 2 FEET IN DEPTH ARE REQUIRED TO HAVE A BUILDING PERMIT AND CONFORM TO THE FOLLOWING REGULATIONS: 1. ELECTRICAL: An electrical permit- must be obtained prior to an application for a Building Permit to install a pool. 2. ZONING: Pools shall be located to the rear of the front building line of the house and no closer than 10 feet to the side of rear lot lime. 3. HEALTH: a. Location from subsurface disposal system must be approved by the Board ofj,Health. b. Semi-public and public pools must have plans approved by the Board of Health prior to construction and must also have an annual operating permit from the Board of Health. 4. SAFETY: Pools must be enclosed by a suitable wall and fence, at least 4 feet in height with self-closing and latching gate that meets the approval of the Building Inspector.* No water allowed in pool until fence is erected. Pool cannot be used 4ntil +nspected and aWr-0ved by the Electracad lnspectcr and -Building Inspector. _. "Fencing on comer lots must be erected,20ft. inside lot line. FEES: ELECTRICAL PERMIT - $35.00 BUILDING PERMIT - 6.50 per thousand on estimated cast: $35-00 minimum permitfee D. Robert Nicetta, Building Commissioner BOARD OF .4_??E =* LS 633-9541 3=1 LNG 638-9545 CONSLR` A710N 633-9530 H_rAL7:! 638-9540 PL .A,NE lG 633-9535 I :-_ 16'- 0, 5 L >aCG r C Z r r > Or.nr �-�tC m m G=n �Z> 1 y 0 j >> G C -m > t'- N �m>> N� m3-� tnON� °-,> >z - rC r umi > 1 N I hereby inspected of this d the const has been designer' materials plan spec 15.00. SLOR� (150) x DES/CSN EX/STING ELEI/.4T/ON 4T ......... 2EQU/SPED F/LL = T,e .4 7/—/ E W.4TE2 EL EV,4 TION ,4VEZ46E STONE DEPTH 4T P,eOBE Il/OTE.- 7-11I6 PL -4N /5 A107-,4 GV,41C1?4NTY OF THE SYSTEM BUT ,4 !/E�2/F/C,4T/ON OF Tf1E L OC.4 TION OF T1IE EXISTING ST2UCTUZES. FOR 1 CNRISTIA/VSEN s 5E19Gl , INC, 16,0 SUMMER STREET — HAVERAIILL , MA55. DE54�N ,4S 30/LT 45 UUIL T /NV P/PE OUT OF //OUSE % --53A 139, Zg- INV P/PE INTO T,4NK / 3 -7,s / 3.7 �} / A c p �UU -SU/G. F.4�G ��.5/ /NV P/PE OUT OF T�JNK 1 3 -7-1-` / 3 7, 2 3 13 7 SYSTEM INV P/PE INTO D. BOX //VV PIPE OUT OF D. BOX i 4 r ; 3 - .�� /Nol W.4TE2 EL EV,4 TION ,4VEZ46E STONE DEPTH 4T P,eOBE Il/OTE.- 7-11I6 PL -4N /5 A107-,4 GV,41C1?4NTY OF THE SYSTEM BUT ,4 !/E�2/F/C,4T/ON OF Tf1E L OC.4 TION OF T1IE EXISTING ST2UCTUZES. FOR 1 CNRISTIA/VSEN s 5E19Gl , INC, 16,0 SUMMER STREET — HAVERAIILL , MA55. 100L00Z6 CU N n. ►� o .0 = z zCIO z o F to to O m z o owe zm0 Wn.N�� Lei Q Q v a 7 < F W cn CX ck: Q ��11 z 0 Tn U m Q SETTS bpi Q n O 0 Z W w OJ 0 Q C-) V) J 2 m Q OLLJ O Z Z S ZQ m Z 0 C9 Z Q 0 0 W- U Z W W Z Z W to wU' jZ 00 N Q`� i a ,j2 O Q Q U w O D hAi - ZO O N L+- Q O �wWO� P��`hs w "v Q = ar o rr m o F Q p 0 cn { U) 0 w p 0 w 0 0 Q z N (Y F5 m W O O Q Y Z iiOC) U w W w O N � = o � � Z � Q o o Z � � Q a � � � o NQ z II (� U F w f- 2 3= � w w 9 o cin 0� .. w � Q V _ Q .� _ -- U w g (nn i s= w w M v Zo Z `� f -- ° 1, l r X 00 0 m p 0 m OJ �_ c J W m W U m Z� w O Z Q U 11J N¢ W ry Z >' aLLJ �' 0 N W J W U Z w 4. J O W Z 7 Z NO O O a 0 � N Q 0 ON U S� F� N ,-10 CU .sr� Q �t r•- O 0 II o Q n j -.: o. � o X (� h w z F %D Z 0 9� Location No. _ Date N°RT" TOWN OF NORTH ANDOVER p Certificate of Occupancy $ s • Building/Frame Permit Fee $ ki Foundation Permit Fee $ tH ANDOVER COLLECTOR Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ DEC _ 2 1992 TOTAL $ Building Inspector Div. Public Works Location No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee ``4klV they Permit Fee 17Oct SA tion Fee t onnection Fee © gndol erTTOTAL Collector — Building Inspector 67'13 J- Div. Public Works Location No. ate TOWN OF NORTH ANDOVER p Certificate of Occupancy $ - # • > = ' Building/Frame Permit Fee $ ,SSACMUSEt A Foundation Permit Fee $ Permit Fee n 3Am Al— Connection Fee ciFp��ater ction Fee To*, �v Building Inspector Div. Public Works -APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. fj_ �{�%� d � � PAG)v 1 P,P 440. LOT NO. 2 RECORD OF OWNERSHIP:;., iDATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. �- LOCATION PURPOSE OF BUILDING -0- 0 ?dc�� OWNER'S NAMEiIi _/r L• Yl g./•.,Ka l, _..1� NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB 1a Q © C t_ ARCHITECT'S NAME S, . 1<aj j�� SIZE OF FLOOR TIMBERS IST x D' 2ND Q 3RD BUILDER'S NAME 7 I �%,,. �j1 L! CL• SPAN L/ DISTANCE TO NEAREST BUILDING ,t`� �p (J DIMENSIONS OF SILLS t( L�xC7 - --- `� DISTANCE FROM STREET I POSTS �`I~-11��� / 1 DISTANCE FROM LOT LINES – SIDES(j �1 REAR �'\ r. pje7o "" "" GIRDERS AREA OF LOT 1 �' ©O - FRONTAGE I `l�,l%r� / HEIGHT OF FOUNDATION OI THICKNESS 1,641 l� IS BUILDING NEWT i~F SIZE OF FOOTING 611 x II X IS BUILDING ADDITION �� ( O V MATER:AL OF CHIMNEY &_I C IS BUILDING ALTERATION - �\ IS BUILDING ON SOLID OR FILLED LAND o P WILL BUILDING CONFORM TO REQUIREMENTS OF CODE t¢Li IS BUILDING CONNECTED TO TOWN WATER N'o Y/� BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING PERMIT FSE It /m /_ I.:� �. WS FM FEE iiiiiao, 00 8K FRAME PERMIT $ D ATTACHED GAR GES MUST CONFORM TO STATE FIRE REGULATIONS ' PLANS MUST BE ! ILED AND APPROVED BY BUILDING INSPECTOR DATE FILED i SIGNATURE O,,OWNPR OR/ IO ,0'F1ZED AGENT F E E >s PERMIT GRANTED 19 4 � " SEP 2 t 1992 OWNER TEL. CONTR. LIC. # t7 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST t , b EST. BLDG. COST PER SQ. FT. F EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ,t 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN UILDINa NBPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY 11 X STORIES 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. 1st ( � Timm T 1 T# 40*8 CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B I 2 3 CONCRETE BL'K. _ PINE BRICK OR STONE HARDW D _ _I _ PIERS PLASTER - DRY WALL _ _ UNFIN. 3 BASEMENT AREA FULL '/. 1/2 '/, FIN. B'M'TAREA _ FIN. ATTIC AREA NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I g •; FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B 1 2 �_ 3 _ _ CONCRETE EARTH HARD\!✓'D COMMCN ASPH. TILE ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY` BRICK ON FRAME `ATTIC STIRS. 8 FLOOR _ - CONC. OR CINDER BLK. - WIRING STONE ON MASONRY STONE ON FRAME SUPERIORPOOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE I HIP GAMBRELMANSARD FLAT I SHED ASPHALT SHINGLES BATH 13 FIX.) TOILET RM. (2 FIX.) WATER CLOSET 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 t'NO. OF ROOMS , GAS OIL B'M'T -, 4 -' -2nd .3rd I ` ELECTRIC` NO HEATING 1st ( � Timm T 1 T# 40*8 S,3 dyj SD'X���� i,oa1-c oZ, U N 2 Z w cn Q z O 0 F N (n Z O M V- Z o Z W g z Q zo W g N — LLJ w CO n Q O U> U m Q tij SEiTS bp ( Lam/ J Z cn O o W W O O ¢ Q !- � o- I� J Cl 0 U Z W W Z Z W uj m O N V i a Q w m o D W o W i �` Z o ��"0wwoa°�`S W_ AMY W p O m o Q o w Q p 0 Q z N � N LL OO ¢ Y Z W O J w W W Q Q - W J W p } V Q O d = .-- W = zoz Fz ¢00- ���wNQ Z it 3 0 4. � WW LL � Q N e- CY U U ¢ Z n m Z .LLJ m p N W Z Z G — m F w I N =¢� Q O ry m ZO 0 Z F- w m F- J W Z U Q F w v ¢ W W a F- _ D U U W N W W Z w Lei.. -1 O W Z N M Z I U o o o o a o o �, a � N U S� �p S� N Z OJ Q O M II o ___1 a o X � W Go W /w zm �• cn ZU w s ti; i r s r, FORM U - LOT RELEASE FORM r 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. ************,*�**r*Applicant fills out this section***************** APPLI CANT : 4 �l^r' r� i) c:zL 52 '1 Phone 9.1 3l LOCATION: Assessor's Map Number Parcel Q Subdivision khh Lot(s) Street �'0,,.�-� St. Number 33 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: l-LS�� Date Appro `ed G "( Conservation Administrator Date Rejected Comments Town Planner Comments `�3 &bu4J— Date Approved f4lO Date Rejected Z " IL, Date Approved Health Agent Date Rejected Comments { LO✓ Public Works -�` connectionslgkc- - driveway permit;9 .�iApCGaylkiz'ir Ceg /v /ya Fire Departmentt� Received by Building Inspector W! J�;' Date + SEP 2 11992 11 �ommonisealll� r�'� ya�.iactiaxlG :_ DRIVER'S LICENSE Emmal 31509159 12-22 y6 12-22-59 5 mEM JILD 7RMAN 8 III S ENDICOTT CIRCLE ETHUEN MA 1644-4607 § z LLJ U - � LL � § _ ■ « U- \ � 6 n , ": [ ` {\ /P: _ . LL\ \ I- . \ cr zi CL LL Q« R ƒ 2 $ § ƒ W L .§ cr z� / 2 \ v § &L �oi 3 u— a S � k - »A R u � �. — g 'OLD 110- LNE C, !q �* C/� °/0 ° § z LLJ U - � LL � ■ « _ � k ) o 6 n _ [ ` {\ _ L P-4» \ I- zi o 00 Q« uj■ V--_ V)LLS _ o §-`� z� &L �/ u— a o£ °zB - »A » R � �. — U, (w �� zE3 ■�- � e— «»> C, !q �* C/� °/0 ° § z LLJ U - � LL � k ) o LU ¥ o z {\ u 2�« \ ��z f � r$ R ;\7§ , .. m !! - 0 2 G� § . ) �o— 0 ~ \. . �'§ a -\ — »LL� �n W z ° § � _Iz C/) �� \ S 2 } ©9 a \ - EL- %. Go � c . ± 3 . . C) 0 \ ) pi m :1 MM tI to 7,11 FA M a- i .Q w 6 LLJ oG er LJ LLJ co m� Z O p O c N m L d s w O Z me W ICR _G E■ t= p� > a S a. C' � O h W W U.z z Z z p O uh z e o z ? Q o m � e • m m L CE J L L U L Y CL Q U LL Q lL Q co lL Q LL m ca i .Q w 6 LLJ oG c LJ LLJ co m� Z O c N m L d s w O Z W ICR _G E■ t= p� > a ON c C m A ,% i~ R .a 71 z LLI �I 1 v o W & U.- ui H c E La F � UO C q lee R O h g �' v O �c N v m Eeg �a s � H — C O C z O � ° Ccc o m _O ° > m Q W .0 J� O W Z � �� 9 1-: z `�j Z z ^ H W ?09 O Z Z V H L6 u m m t C '� L LUT L U L m Y �� o c o m o c 3 E ¢ U ii OC ii a: to ii CC ii to to �I 1 v o W & U.- ui H c E La F � i A C W O L CL UO C w w R O -o g C v O �c N v m Eeg �a s � H — C O C z O � o m _O > m Q i A C W O L CL 'Q R -o a� v O v Eeg � � H — C O C Z � o m m .0 J� Z � �� Towil of r NORTH ANDONru. It PLANNING'& I :AHWNI 11.1'. NI:I.S( V. I )11 tI: i:'I ()It CHIAINEY APPLICA1*1014 ANO 1114111' )ATE. z I .- 91 ""- OCATION cil N( It 11 Ilii H-1 5 71 i!s -17 17!; PERNIT. #_ ?jj—�f a0e WW'S NAME: -0 -JILDERIS NAME: kSONIS NAME: -P two e .ASONIS ADDRESS: I-,--'Zz X42 z C ,4SON'S TELEPHONE: ATERIAL OF CHIMNEY: i4FERIOR CHIMNEY: BIERIOR C11HINLY: IM BER AND SIZE OF FLUES: (5-' x /C 2- HICKNESS OF HEARTH: cU Chi"WeY 0& 6iAep.Cace con( un tO VIC. Uo VIC code Mid ll(IVC AUCCA (Illd zgutatiojo been aeceZved: kTE: iIGNATURE OF MASON:--'- ERMIT GRANTED: 1'1;1; )BERT*NICETTA I L D I IN G INSPECTOR 4SPECTEL): MARKS: -'Q U I It E 1) SOLID BLOCK H E THIS PERMIT MCISF GE Vl'SPLAYEV 014 ME PIMAI SES V Z Q CL M V V 0 ad W M LL 0 W Q V W V 0 0 wt e C�n C6 z Iv Cd 2 2 m C iv A V ev w 01 ad uiW 66 0 —116 Zj/ < 96 ma '1 , Lu L cc = a cr LU L C P J L m -i m 6w = >0 0C 0 cc 0 W" C cc to U. 0 cc U. 0 C:) E co 2 m C iv A V ev w Location No. Date TOWN OF NORTH ANDOVER Sewer Connection Fee fy Water Connection Fee 410,/IPL aQ` Arco/o "qor — Building Inspector Div. Public Works Certificate of Occupancy $ _ Building/Frame Permit Fee $ _ s^CHUS Foundation Permit Fee $ _ Other Permit Fee $ ._ Sewer Connection Fee fy Water Connection Fee 410,/IPL aQ` Arco/o "qor — Building Inspector Div. Public Works PERAMIT NO. / v APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP dJO. LOT NO. I 2 RECORD OF OWNERSHIP iDATE BOOK PAGE I ?ZONE ' SUB DIV. LOT NO. � LOCATION l PURPOSE OF-Ba+tpU4G -54,.-j�ec�` rz x Z ' ,j OW'NER'S NAME �7r'' NO. OF STORIES SIZE "OWNER'S ADDRESS ¢ �7. _ BASEMENT OR SLAB ARCHITECT'S NAME UILDER'S NAME C 7 c- SIZE OF FLOOR TIMBERS IST 2ND 3RD SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS / f ) C- 6 t�j .0 . ! n 0 � /(D �`"S 7^ S DISTANCE FROM LOT LINES - SIDES 2S!" REAR �� "" GIRDERS .4 AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X 3 BUILDING ADDITION /2 )c /Z r�...��� MATERIAL OF CHIMNEY IS BUILDING ALTERATION' IS BUILDING ON SOLID OR FILLED LAND L L --BUILDING CONFORM TO REQUIREMENTS OF CODE yEs IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY J IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS J. PLANS MU BE FILED AND APPROVED BY BUILDING INSPECTOR ✓ DA FI !o /Z Z SIGNATURE OF OWNER�OR AUTHORIZED AGENT OWNER TEL. # 4� $� 3 " 03-57(- o 4- 3-5 F E E / -s� 4't� CONTR. TEL, CONTR. LIC. PERMITG S 19 rl y JUN f � b¢ it6`s2- L/ 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 BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN 111,4 /z, *v rv�w� 7 •nom "6 K%pR It BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY STORIES 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. ... 1st � I( CONSTRUCTION 2 FOUNDATION 6 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE Bl. K. PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA '/. 1/1 '/. FIN. ATTIC AREA _ N_O BM'T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 �_ 3 _ _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH HARD\!✓'D COMMCN ASPH. TILE ASPHALT SIDING ASBESTOS SIDING 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�POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD I I HIP BATH (3 FIX.) 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 O IL B'M'T 2nd _ 3 d ELECTRIC NO HEATING 1st � I( B�. Q0 CN C5 z H IL z LU LU rA I W o � a X w G� m L.1.J v CL O ao G �C O N a s w 0 0 M �� of Ou O W) Hi O .E a Q L a �++ O ow C u p a ONO Z V Z Z C z u6 LU O IA o o u LLA o z .� z C u < O T u u o m m � m L C � L J L V L � Y m E c a: c W '` c c° c c C N a: U ii Q ii Q V) ii Q ii m rA I W o � a X w G� m L.1.J v CL O ao G �C O N a s w 0 0 M W) Hi O .E a Q L ow C u p a ONO V Z = C O .� C A ti Q N V Q LL o O'Z W �cuO i 0 Qocom 9K 00 0 b 0 N p 00 N 00 �- 9 ujw J NO NW ATO. OTc w=) 00 4j6-03—L COP M w J• a q- N =K a a o zcx 1� w W OC W ' N f U W O a �f- ii w G N1`N 'OLD a,O+G UK - Location 4 �� No. --- i'` Date EE TOWN OF NORTH ANDOVE5 LD Building Inspector 10191U Div. Public Works Certificate of Occupancy $ ` Building/Frame Permit Fee $ Foundation Permit Fee $ �wCNUs Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL I Building Inspector 10191U Div. Public Works PERMIT NO. e. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40.LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE ZONE ----�' I SUB DIV. LOT NO. - LOCATION '? .O J PURPOSE OF BUILDING G/V/Alt:�l,�00/sie�"-IT/O4--- OWNER'S NAME Jam, ,A^j�����y r`{r�^Inr-�- NO. OF STORIES � SIZE OWNER'S ADDRESS +'�dM� A� ��2 ASEM R SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS ��1Z //���/ 2L1D A�tr J�3RD BUILDER'S NAME b .Tr IL-bixj< C0�P, SPAN=7- DISTANCE TO NEAREST BUILDING V 't" DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES 5-0� 'i-' REAR GIRDERS AREA OF LOT 3. � i Rte., FRONTAGE � �- HEIGHT OF FOUNDATION / THICKNESS Y - 6� � IS BUILDING NEW SIZE OF FOOTING 2,1 X IS BUILDING ADDITIONMATERIAL OF CHIMNEY yy� _ IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 1,7/ �/' WILL BUILDING CONFORM TO REQUIREMENTS OF CODE L �` J^� IS BUILDING CONNECTED TO TOWN WATER 4/0 BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER lclO IS BUILDING CONNECTED TO NATURAL GAS LINE 1416--1 INSTRUCTIONS s7ee 3` z- RDp-k,G' SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FI SIGNATMWE OF OWNER OR AUTHORIZED AGENT F E E PERMIT GRANTED �, 9 ` -3 19 ` 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST G -�® EST. BLDG. COST PER SQ. FT. 73 6� EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY zoo uILDING INSP[CTOR OWNER TEL. #��� CONTR. TEL. CO — �' ! 32 CONTR. LIC. k �` 3 H.I.C. k & BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S"ORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION CONCRETE CONCRETE BL K. BRICK OR STONE PIERS _ 8 INTERIOR 3 PINE HARDW D PLASTER DRY WALL UNFIN FINISH 11 12 13 _ _ 3 BASEMENT EA FULL FIN. B M AREA _ 11 '/ FIN. ATTIC AREA NZ5_ B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B 1 CONCRETE EARTH HARDW D COMMON ASPH. TILE 2 3 _ _ _ _ ASPHALT SIDING ASBESTOS SIDING VERT. SIDING 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(� POOR ADEQUATE NONE 5 OF 10 PLUMBING GABLE I HIP BATH )3 FIX.) GAMBREL MANSARD OILET 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 -r- 11-e FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM _ STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS Al CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd_ 10 "%— 13rd I ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. r S`. IFA x a f� v �G o O w T cn a w cn O z z Q o cz a O w to O rz T E .a U m C w O v rL z z p a: m C ii O w U a W p C2 u v cn � C ii p H G u p c� C w w x Q W C cn o v cn v Q a o Un TSO � uj CLz C O CO C C V O i cc, y � C O cj V .Q C O O CD C t O Cc O m CO) — :�a � co V N ' o m CD M 00 co, CD cot y ••+ C 1 m J N C m O N C C C R O V : N R nm t'4Eo .a�� m �._ •C O Q1 o, c m :mor C.' y O I �Z O C=, o o c F -o. m y mCD CC = m Q»O N F— N m ,O �•- m t!� to m W G .0 � • fl t . , c •- LL •y m R f0 C O y d t Z cr- V •p U N 0 U p m C Q W d m' O J Z CNV i h O 0 ►- t a On CIO O CIO w Cf� IN co O CD O O C I y CO2 .CD L CD s t+ C O CD V _m CL CO) O O u .Q CA) C O V L O V co CL y C FORM U - VERIFICATIO,N FORM INSTRUCTIONS: This form is used to verify that all nece nary approvals/permits from Boards and Departments having jur sdiction have been obtained. This does not relieve the applicant d/or landowner from compliance with any applicable local or st to law, regulations or requirements. ****************Applicant fills out this section*********** ***** APPLICANT: l P���d 1� Cn-F Phone S' 7 LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street j -ba St. Number �? ************************Official Use Only************************ RECO r DATIONS TOWN AGENTS: / Date Approved o (� �d Con rvation dministrator Date Rejected Comments Town Planner Comments Date Approved Date Rejected Date Approved Food Inspector -Health Date Rejected i Z /�!/ Date Approved Sep is Inspector -Health Date Rejected Comments a,c c Y- 0 . - Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date n (D ::r rr pi rr (D CL 0) rt ln F- 03 (D 0) :71 ::j fh 01 CD (D (D 0 H 0 (D :2 ri) (D l< eE II fl? a t -L H. ca H- " H 0 " r_ = a r0 cr m / .. F4 W P, 0 d ::r " I 0rt) 0 m C -r . 1 0) CL rt 0 mHS-,- * rr m=3 0 0 CD 0 �-h 0 :3 l< 0 0 0 rr " =3 ca. 0 rn ra rt ca D) w :2 l< rr --r 0 z :3 CL ca CL 0 rt r_ rr (D M (D 0 rr H rr 1,141 0 03 P* Q) 0 rr rt Z) z C) rt :r CL .4 rr 00 (D n (D ::r rr pi rr (D CL 0) rt --z � I � (4-7 27 5z- 0/" eE 5z- 0/" G u A.'rlS '� N V, PROPOSE D%'r\a W (To St ABANOc11g9� IF_-x\ST\NG F.X%51IN6 !� �• CHP,mB$R o DW'_1. Ya .t � Jv R%Pk.At WENT %P_k CONI. 1' I -hereby certify that I >that inspected the constructi df this disposal system the construction and finhas been in accordance wdesigner's intent and tha materials. used conform to the . plan specifications and 310 CMR 15.00. Op ' � rC1C15C IN6 TANK �0 8E.V�� 5LOP�r(/50) X = /50 - _ ......:....... Rll. T ANksTRu, i�u�°DES/GN ECEI/QT/ON AT.........(rOP OFSTONE)..... EX15TI1v4:F ELEpGriolv .4r ......... REQUiieEo FILL elEVOdr/O/I/5 o�s��N Qs Buicr REVISED .45 BE✓/L T /NV PIPE OUT OF I-10U,5C 13316 ItAqg. Zf INV P/PE INTO TANK /37.6 13-7.1-/ _ SU�—SU�FQC&C �✓vr,A �� t /NV P/PE OUT OF T,4NK % 37.,2.6 / 3.7, 2S / 3 -7, //VV PIPE INTO D. BOX / 4, 13 /NV P/PE OUT OF D. BOX / g+0 .4. 99 ©N77/ /NV ENO OF RIPE 144.0 / f -3. C7 / '� TNV. P1Q TNTC %gLNc. TK. 137.5 FDR N Pked NUT RPI.PLAc � 131 P5 N/F ,eOA �77 —A' N T1 t DU.FFlFi1 SAN)1�RY:, .m�09�.G`ISSSP� � P /N 11 ,4VE2,4 E STONE 6C,4LE : zSO" D47E: 1VOPe, /7/9'2 DEPTH ,47- PROBE / , NOTE. 7'A'15 PLt1N /S NOT,4 Gt/,Q,e�',4NTY CIR/5TIQ NSEN SER Gl , INC. OF THE SYSTEM BUT A VE�CIF/C,4T/ON l �� SUMMER STREET -- HAVERNILL ,MASS. Of TqE LOC,4T/ON OF T,,/E Ey/.ST//VU E PROPOSED U7LELD, RE ST,eUCTU2ES. REV`S g \6N YQ.O. Box Iz H, horh'�°i, NN Location No. --�? Date 7rk=9G „OATH TOWN OF NORTH ANDOVER O•t`•D '•,y0 G Certificate of Occupancy $ • • Building/Frame Permit Fee $ Foundation Permit Fee $ m Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ —e S'99iBuilding Inspector 10049 Div. Public Works PERADT N,95r2- APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4.40/ I pt� LOT NO. l l 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE - ZONE SUB DIV. LOT NO. LOCATION �33 �O �i PURPOSE OF BUILDING TfP--6� QLr 1 'tel l 41 "`"a' i1( ".' c rt drl OWNER'S NAME /� �Gj/�n A c �. �_/� _ J v* ✓�(,�� NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAMEM� SIZE OF FLOOR TIMBERS. IST 2ND 3RD A ! �` BUILDER'S NAME � ((Ul✓Ji A16. CAR.�,ID SPAN DISTANCE TO NEAREST BUILDING -- DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT 3,(>( AC FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION 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 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 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 SIGNATURE OF OWNB:AOWAUTHORIZED AdEA+ t FE E PERMIT GRANTED 7,__,F�__ 19 OT� 3 PROPERTY INFORMATION LAND COST EST. BLDG. CO %J_' EST. BLDG. COST PER 96Q. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INiPECTOR OWNER TEL. N sU-�~ ��� f j CONTR. TEL. k Ci (/ -)-L6--/37Z_ CONTR. LIC. if (-) I g V42 3 H.I.C. 11 10 E S'o -1- BUILDING RECORD i OCCUPANCY 12 SINGLE FAMILY ISTORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ PINE d 1 2 13 CONCRETE BL K. BRICK OR STONE HAR PIERS TER PLASTER DRY WALL _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/. '/t '/ FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 3 _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ CONCRETE EARTH HARD"V'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIO! ADEQUATE I-� ONE 5 ROOF 10 PLUMBING GABLE I HIP BATH )3 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 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 GAS 7 NO. OF ROOMS IL ELECTRIC B'M'T 2nd _ 13 d I NO HEATING 1 sr 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. iZ. %'Nb6�✓� L C7 F I� [ STS J l WTf rZA 02 rLr W r.1 x F-� z o A O 0 Z p w ap U m C w O U w z p a' w O WU z ¢ U �u.m p0 1:4 > y V) O ap u w pCw p C4 w w x w Q v w n pp V) C� i O c L O o � Z co CL O CO) CO 0 C cm CDC CO2 CD y O �O -FE m m co cm co LL ~=..+ CD O i � cl cc O Q = �a CO2Cc C v J � C) C Z CD O Q C CQ 'C C y c O :cp W c » O O y �+ C : v� O R R F•a �v, `1: �C rJ• Com• N : E Q � � O F.�om Z U o O: 'vF /n� hh vCD cm �, O .iV. .CDc E Q m a U c C m J 'NO 'Q C C (y I m _ c = N C y C O • "'' R O C �' :mo m C� CLUL I ^ ctm : y O U cc.-,' •� Z o O f-co Q i m C O Q = m : m :E C N CD m C4 N m R D Ci W CO' .O r.+ .. •W .r c E �� c W U m CCD & C2 g� C Q y a m . .O J = R -0 i N O 0 H- L $ C_ . m C� i O c L O o � Z co CL O CO) CO 0 C cm CDC CO2 CD y O �O -FE m m co cm co LL ~=..+ CD O i � cl cc O Q = �a CO2Cc C v J � C) C Z CD O Q C CQ 'C C y Restricted To: N DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - gone Nuiber: Expires: Birthdate: 1A - Masonry only CS 024843 08116/1997 08/16/1953 IG - I & 2 Fatily Hoies Restricted To: N Failure to possess a current edition of the Massachusetts State Buiildinq Code DAVID X SMALL is cause for revocation of this license. 25 BIRCMIADOW RD MERRIMAC, Kk 01860 HOME IMPROVEMENT CONTRACTOR RegiStratiOfl 105502 PRIVATE CORPORATION Type - Expiration 07/17/98 I 9 352. Date �'<:�•° .��o TOWN OF NORTH ANDOVER 49 PERMIT FOR PLUMBING ,SSACHUS� 8 This certifies that ?. V .. �!��°�!..� . �4.� ............. has permission to perform ................... plumbing in the buildings of..� C.�t 5.0.'.^- ................. 2 3 3.3 .��!� �'.s. �...i �.... g at. . ,North Andover, Mass. � Fee., .. Lic. No. !�.3 ! n, PLUMB�KG INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0 W Ib^ — MASSACHUStTTS UNIFORM AP LICATION...Fon.PEnM[T;-TO.00"PLUt4B!(�Ca, '. (Type or Print) r NORTH ANDOVER ,Mass �: Date: Building Location 22--bl �5S� Permit Owners Name '[Ztc:kar ��Sc�►°�.. �� New 0 Renovation j] ' Replacement [] Plans Sybmitted ��Ai C►� FIXTURES t • x _ Z an ac F- N dl O O z ty z 4n a a O J �• W ~ W W 1- a Q W 07 Y z 4' O 4 O v z cc o Cl a °� Q ?. ac h . a N w vi " 9C z a O. .93 ..t W z awq O z X. SG a O I --z z w 14 W J.'.' a H> r O z d O N H z 0 0 01 cc w t' O t) x • . '� >< j J m o) � A J � � H N ga. O � � <� Z m Q s uE—%B S MT. ' 14 BASEIstENT IST FLOOR r 2ND FLOOR ' 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR i EH (Print or Type) Check one: Certificate Installing Company Name Corp. Address /d A U`e- Partner. A 0-,-1-7(,— - Cj Firm/Co. Business Telephone 060 0. o©q/ Name of Licensed Plumber: ka A 0`"^'% Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ' Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been made aware -that the licensee of l this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agene� •1 I hueby certify giant all of Uac details and infornialion t leave submit lcd (Of enicscd) in aMove application site flue ata4 trlate to alto best of sty —• - knowledge and that all plumbing work and installations licefnrnscd under rcrsssit (ssucd for this application will be in cmtaptiattoe with all pegliatettt pgo-4, visions of the ldassadtusetls Slate Numbing Code and Claplcs 142 of the Genual Laws. By Title• City/Town: Signature of Licensed Plumber T•_vpe of Plumbing License 9�305 License Number 0 Master 0 Journeyman TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION A 'a M > This certifies that . .................... ... ......... �' has permission for gas installation ................. 4 in the buildings of .� ? .l' 4 :`........................ at North Andover, Mass. Fee.. ... Lic. No..:. `.. .... :�.... .:= �� ��..... . I GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERIT TO GASFtTTING (Print or Type) FOR r LlJO AnLi�DUP .Mass. Date—5 "f1 19 9 % Per R Y Y n ` Building Location �S33 I-oR r,es+ 5 I Owner's Name ,%C.�,A k 4 SW Telephone • I " S i - t¢ `� a " 3� _ _Type of occupancy eSr d,e11(-c New _ ❑ Renovation ❑ Replacement Q,-' Plans Submitted: Yes❑ No ❑ Installing Company Name EnergyUSA, Inc. Address 2000 West Park Drive, Suite 300 Westborough, MA 01581 Check one: - Certificate Cil Corporation 115C ❑ Partnership Business Telephone 17800-822-1300 ext. 8051 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter William. Kent Corson INSURANCE COVERAGE: EnergyUSA has AXOM a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes V No ❑ If you havfi checked yes. please Indicate the type coverage by checking the appropriate box. A liability insurance policy Br 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: Owner❑ Agent ❑ Signature of Owner or Owners Agent 1 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws �j� By TyDe of license: Plumber Signature of licensed Plumber or Gas Fitter Title NfGasfitter 'Master License Number 3 7 0 7 City/Town J Journeyman APPROVED (OFFICE US . —O—NL-Y-1— , II NONE ME INIONSEENNINE son �NE■NMEMENEEME■E■dEME■E 111 Installing Company Name EnergyUSA, Inc. Address 2000 West Park Drive, Suite 300 Westborough, MA 01581 Check one: - Certificate Cil Corporation 115C ❑ Partnership Business Telephone 17800-822-1300 ext. 8051 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter William. Kent Corson INSURANCE COVERAGE: EnergyUSA has AXOM a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes V No ❑ If you havfi checked yes. please Indicate the type coverage by checking the appropriate box. A liability insurance policy Br 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: Owner❑ Agent ❑ Signature of Owner or Owners Agent 1 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws �j� By TyDe of license: Plumber Signature of licensed Plumber or Gas Fitter Title NfGasfitter 'Master License Number 3 7 0 7 City/Town J Journeyman APPROVED (OFFICE US . —O—NL-Y-1— Y J Z O W N Z W U LL LL O ¢ O LL 3 G J W co 0 W 2 U F- W Y N ur W LL d ccO Z_ r O w W J Z O f- N � _Z ~ N a Q m O J LL � W r N s LL Q O W ¢ m 0 f o W LL r c a O ¢ N O f- a ¢ O Wto .e O uj i of a J ccO r W IL O N _Z N Q O O � W r s a W ¢ f o a r c a W a