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Miscellaneous - 345 CANDLESTICK ROAD 4/30/2018 (2)
Columbia Gas- of Massachusetts A NiSource Company 995 Belmont Street May 14, 2013 Brockton, MA 02301 r Mr. John Millert� I/1/ ^,0 r 345 Candlestick Road1V North Andover, MA 01845 f� Dear Mr. Miller: During a recent visit, our service technician detected a safety problem with your gas heating system at 345 Candlestick Rd., North Andover, MA 01845 — knobs on top all broke. Accordingly, we have issued a Warning Tag because of this situation. Under the circumstances, we strongly urge you to correct the code violation. In addition, the Massachusetts code pertaining to the installation of gas appliances and gas piping, established under Chapter 737, Acts of 1960, requires that the condition be remedied. If you have any questions, please call our Service Department at 1-800-677-5052 and ask to speak with the Service Supervisor. Please disregard this notice if the condition has been corrected. Sincerely, Customer Service Department Columbia Gas of Massachusetts 6 �ZZ � Lo 935s�� l 47,(57 11-4. A g2 � i I �i ti itlorE � b: n�vNDAT.b,•/ Loc.or/6.v .�.ea�., /�'.V �iGiST,�'Y/l7Sat/TS,evE'yI l _ C'.q�c%�c EST/G,� •�0.9D S //EREBy C'E.cT%-)- TO TyE T/TLE AlSU•eOW4VO TD Tf+'E BANK 7w47, 7;v.— /S LaCATEG OA/ ryE GOT qS S/iGA✓N ANO T//,4r/T P4CS eggA/FG eow N'/r// Tf/E Tl1U'A✓ OF,f/O,,gNpG✓cam ZOWIW4 z-oam4.47W,KS ,FL�6•/.QO/.tom SErs,4c rS FROM ST•eEETS �-' I.OT L/HES. 0 S Farrs�ER GE.er/FS�- 7//.47- TiY/S ON'E4L/N6 /S "Id7' 40G97E0 %.tl 7-.1EFEyII.Pf4L FiCOOO ii/i4ZA�0 APE.4. CeF 00/O a T7//S PGAN FO,�+��i �,4GE P!/,��SES - .1/OT FD.P BO!/,vO,Py G�ETE,Pi1f/.t/�JT/OR! BD!/ivOA.eY /�t/FORiyI- Ar/0-4/ TA.rE.S/ F,�iYI EX/STivG .PECo,PpS. e,=L or /N - O.PA/YiV/ FO.P TOMgs L �4v�.9,c!/ i1fE.PP/'11.4Gt' E,�/6•Gt/EE.P/.(/6 SE.Pi�/CEs 66 �.4•PX .ST•rEET A.VOOYE.� �lAS.S.4G5fU/SE77- O/8/O Location S r �l�l JJ/ (' di hd2 lol *2 2� h/� 4'- , No. Ci CtGut Date d a CI �- N°"T" TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ . C E Foundation Permit Fee $ � s�cMus t u -CJ -etfw'Permit Fee $ SCE` E (�� Connection Fee $ \ R �Water Connection Fee $ �g T'CS�AL $ 11ear -- No. pn OV . Building Inspector 50 Div. Public Works Location �� �' ' ' t �C / ✓ t No. �� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ z Building/Frame Permit Fee $ / rc.,rj Pa /O - ?/ Foundation Permit Fee $ ' Other Permit Fee Sewer Connection Fee ��Wt'riConnection Fee TOTAL ov 0 5 1991 NoD k�$i1C�over'0Q1!69(," ? $ f'r/ /) -// �/ Building Inspector Div. Public Works Location No. L13 S Date TOWN OF NORTH ANDOVER certificate of Occupancy $ a Building/Frame Permit Fee $ Foundation Permit Fee $ / d� Other Permit Fee $ Err Connection Fee $ fi ���® � ter Connection Fee $ - TOTAL $ 10� 4. ver Collector9( building Inspector C i'—? Div. Public Works a � aI a. Y T� O v m CIS1 V W F - Q �- W N 0 yj a a � N � Z c o Z a Z o J N _ m W CuU. 0 W W N z o W I a O Ix p N d z Co O F l W ^� � V N •\ 0 Z Z qc �o Q O � Z 0 N � 0 � W i Z a O f0 uy Z U z Q w� N OJ 0 a ilr Is C4 p N :) O 0 4 x o z OD w F- W a. z r 0 a w LL J t Q W uj W Z i C) V NW lid LL G Z 7 m W J f > Z O F z O � o � W 0 m N a FW N K x w W W o N N p F F Q 0 Z m W O O F m a z J J_ i U N W. W i W 0 O W 7 J ¢ ^P F O N F x C :1 m W W U m Z N a a w a a O N 0 m rc rc � d mmdmZW u u • . m u L C C o0 o Q a J m m V j W co W �CD t o C4 p N :) O 0 4 o H: OD w F- W a. z r 0 a w LL -+ � W cr. Q W uj W Z i C) V NW lid L W t Q N :) O 0 4 O O uka W OD w F- Z a J ^ WL O y O u W Z i Z p W l9 z NW J LL G Z 7 m W J f > Z O F z O N m o W W 0 m N a FW N K l+l N :) O 0 4 O Z Z a = !- ^ ^ O u < I i N NW Z Z O Z O m N M o U U� N � < C � W W f N J (� F F Q O 4 v` W O O F m a J J_ i U N W. W W W U O W 7 J ¢ ^P F O N F x 1 W :1 m W W U 0 z W Z N a a w a a O N 00 LL WW } f� U= Z FQ- N Nn o= z - - Ooa z5N OmU r, NLLa �ZOa.g f W oZ� r ' F -0m , • UNI XW~ W W - 0�0 H U E -X0 NWW 0 j ZZN Q 0 j - UWW WZ NJW N N 10< __FI i$ TIT f "JIM I-�►� O f ��� T� - Z TO.229,zz,'_ 2 m LL W , ZO Z LL Z u ~ 0 a >zo ro Q v C LL +�V W Ki '2 N.�: Y,� Q a°` a �_ I. o r, Z W a w_ d X 'i N Z Z y•� o X: 0 C)z W _ z. w W N yu 0 U• 3 w Q y z mawo < o; w V2p p > �. Z< 0 ;z N O Q —� CI ,.�,w� U a 0 �. Z J �JpW N Z � wWo p Q 2 N wp ... N Z :H o z2 Q V Q x O W J Z Q a Z Z Z G' O Z oV K w x N 0V W o d p O x ��a H m O Q% f wd ' FOIUI U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION J—&�c, ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSTNED BY D.P.W.) i= STREET APPLICANT ��' `. ���'iiL-3 PHONE DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNING_ BO TOWN P� CONSERVATION COMMISSION CONSERVATION AD91N. BOARD OF HEALTH L.:�r.cj DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT U/Lt R/WATER CONNECTIONS `. FIRE DEPT. DATE APPROVED• DATE REJECTED DATE APPROVED It Iq Lit DATE REJECTED DA'T'E APPROVED / ��1�✓ DA'Z'E REJEC'T'ED ."t0".. P-, � � ' J RECEIVED BY BUILDING INSPECTION DATE T 4 f 3 o� I This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. r 'w O` 232 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. � 19 Application by the undersigned is hereby made to connect with the town water main ineet, subject to the rules and regulations of the Division of Public Works. , n The premises are known as No. or subdivision lot no. �— c/1 r, Owner �� ); Y44 Contractor Address p 0 MC; S Address Applicant's Signature PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main at C subject to the rules and regulations of the Division of Public Works. Inspected by Date /Boardflic Works B Y See back for rules and regulations RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES 1. No person shall tap or in any way tamper with water mains which are part of the distribution system of the Town of North Andover without a valid permit from the Division of Public Works. 2. All water services shall be installed a minimum of Hive feet below the finish grade. I No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964. 4. Service connections shall be 1" type k copper tubing. 5. All fittings shall be brass flange type Mueller or equal H 15202 Corporations H 15212 Curb stops H 15402 Three part unions H 8185 stop and waste valves 6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 41/2 foot rod and brass plug type cover. NOV - 1 1991 �ZZ L o 3 s BUILDING DEPARTMEN t ¢ 7, g2, N, �M INI � 3 .Hort : b; 1 l az - L=/O6.S¢' le,46�.ZZi. c,q.v�cES7 7c14 E: r /1EREBY CE.cT/FY TO TyE T/TGE IAIS6,MOW ANO TD TINE 404 Ao ' 77V47 T//E O/✓ELG/AW /S LGCATEO OA! rye zor,gs 5hvA-.v.4vo 7,w7 -1r p pcs colllrc+Pnw !YlrA" Tf/E 1010'^/ OF,!/O„gN�O✓ ZON/.vG �E6!/LAT,bc�S ,,fL--S, 4.e0/NG ;rerFEOM STPEETS LOT G/•vES. S A&A -71-1--,C CE.PT/FY T//AT TN/.S OA✓ELG/N6 If SNOT L0447E0 %N T.VEfZVOP ff•4ZWd!O .4,e— . J$Afd & /Al 40A., 7FL vE/ /983 's: /N O.P.giriV FO.P 7va,vx L 4v1;wiv1 7711..f PL.giV ,tea, °yi4aq P�,c�sES - tioT Fo,P Bovvo.Ps� o�'rE.e�sivgriov Bo�.vove3' �.f/Fa.P.rf- 1�4Gt' E.v6.uiEE.P/•v6 .SE.Pi�/lES A7 -10.v Ti4,ee-V .�,Co.H Exisr�,uc .eE-co,�►os. G6 P'4�P� .S'TA!EET A.VDO/�E.� �1AS.SgCy!/SETTS O/8/O L Irt O cc m Ln L -J cr z r- ,m^ V I �•R O H _ � SefyRy�Y_ J +i 7 4 A f' erg; v po CA m D z 911 z C cs� (A o CDC 3 � C _ � SefyRy�Y_ J +i 7 4 A f' erg; v po CA m D z 911 z C cs� (A o CDC T T v rtf 31 n a Z V rr1Un O T fA < 31 rn M ; y '' ^+ 0 T 37 c z �_ r^ 0 T 0 31 c _ n 70 OW v O D = to w --IW - 7! Yn m 2+m 21 0 >o 3 > > m C - c° °-' �• m m c° o m m� T s W v n ^ c O m > T 70 > v m Z In T H m O ^ �o o i 0 O Or W CO) O W Q + v W 0 M W 41 �+ a) a O �+ a 2 4 U U H A� W U Ud' Q U Gti Q F a bc y y v � v W � � W L) w y a Mof Q Q rA d � W c a z o cti o M W 41 �+ a) a O �+ a 2 4 Location No. Date /Y-09- 0/ TOWN OF NORTH ANDOVER s Certificate of Occupancy $ _ Building/Frame /Frame Permit Fee $' 9 Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ s` Check # YSO! 14- 7 building Inspector TOWN OF NORTH ANDOVER • BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILISINGSpERMIT NUMBER: / r DATE ISSUED: Y-cS2 > SIGNATURE: C Building Commissi222E222e2SPor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 0.? Map Number Parcel Number 1.3 Zoning Information: onin District 1.4 Property Dimensions: PZkop,;e_d_U_, Lot Areas Frontage, ft 1.6 BUILDING SETBACKS fit Front Yard Side Yard Rear Yard R Fred Provide RecMired Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5• Flood Zone Information: Public 0 Private ❑ Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record IN Name, int),__ Address for Service Signature Telephone ` < �� t 2.2 Owner of Record: Name Print Address for Service: Signature Tele on SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed 'Construction Supervisor: Licensed .CoAruction Supervisor. Address - (7 / Signature f Telephone Not Applicable ❑ U S-3 V License Number t l Expiration Date I 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name (j } Registration Number /A7d ess < `, G% Expirationton Date Si nature Telephone 1 SECTION 4 - WORKERS COMPENSATION (MG.L. C 152 § 25c(6) 1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result 1 in the denial of the issuance of the building permit. Sinned affidavit Attached Yes .......0 No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ . Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: { ` I CF.rTTON 6 - FCTTMATM r0NCTR1[TCTT0N MSTS i Item Estimated Cost (Dollar) to be Completed by permit applicant Ot ;. 1. Building '\ U 7 v v (a) Building Permit Fee Multiplier •S� 2 Electrical —'"-� (b) Estimated Total Cost of Construction 3 Plumbing -------- Building Permit fee (a) x (b) (10 L!5 4 Mechanical (HVAC)/ 5 Fire Protection 6 Total 1+2+3+4+5 U V Check Number SNC;'1'lUN 7a UWIVLK AU ILHUKIZAllUN 1U Hh UUMYLh l'ED W1Mf4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, •- ,,�� \tea% 1 .� �w �.� LIC as Owner/Authorized Agent of subject property Hereby authorize ,,, . C ,p to act on My be�half. '}n all matters relative to work anthorizec by this building permit applicatio / \ �� rU Signature of Owner Date SECTdON 7b OWNER/AUTHORIZED AGENT DECLARATION I, C as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief r t Print me <- I (� 4; Sia"nature of Owner/Aae \1 I Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRVIBERS 1'-0 1 ST 2 NID 3- ---- SPAN DIlvIENSIONS OF SILLS DIMENSIONS OF POSTS DlIVIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING \ X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND �� Cx' IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM 'FA r►n�et,\ S �d PC. 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. .....r.r...r....r..woo .........■..r.........■■Somme Oman rr.rrrrrrrsrrrrrrrrrr APPLICANT �� "O `� D PHONE `� 4 3 ASSESSORS MAP NUMBER U LOT NUMBER `� 3 SUBDIVISION _ LOT NUMBER STREET CA � <- (C l C CQ STREET NUM BER 3 OFFICIAL USE ONLY .............................. ................■............................r■. RECOMMENDATIONS OF TOWN AGENTS :.........+t.....r............................................. '........Emma.■ 4!�¢ DATE APPROVED Z CWERVATIONADN 41STRATOR t DATE REJECTED i DATE APPROVED TOWN PLANNER COMMENTS DATE REJECTED DATE APPROVED FOOD INSPECTOR -'HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED CONMIEN S ' S% W / 2111AI R31 ,L/AU� PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTN4ENT COMNffNTS RECEIVED BY BUILDING INSPECTOR _ DATE APPROVED DATE REJECTED TE EuEOVE F8 12 2001 BUILDING DEPT. LA W H A idi M 64/21:1994 67:29 FROM Corey 9 Donahue. Inc iu varussO Law urr r. WL�07 Anh Nn_ r. �V44r`s ..�.�vea•...>� .�'�e�-' God 1 This plan was not prepared from an InstrumentMORTGAGE LOAN INSPECTION' survey. Offsets and distances shown should not LOCATION: be used to establish property lines. This plan Is intended for mortgage -purposes SCALE: r Fes. ��,� ie f.:. only. ., 1 certify that the structure shown on this REGISTRY- Plan in conformance with the zoning TITLE REFERENCE:4fA setbacks in efferrt at the time of construction. PLAN REFERENCE: ,,�—tea •;ka .%ir,. 1 certlly that the parcel shown is ter. located within a flood hazard area as depicted COREY & DONfii3UE: INC. ~ on FEMA Flood Insurance Rate Maps for nntlgccra &Sur-;cyevs Community No: M GambeidRs IIAwd, WQbnM bfA 01601 � � i � � � I , I i I r i 1 1 � � + . � r I � i . � i r 1 _ +. i .F .. _ y � } � , + � - � } -. _ f 1 ... T ,._. +. � a ... .. .r - ... _ � � � i r �. _ i 1. _ r t j _.. .� .� _ J .. . - � r � � ' � � � , '1 � �' � + f -i — f� - ♦- - . 1 + � _ t .. y _ .. r - _ _. _ � � I ' ' I ' � r � y i + - r 7 � r ._ + + '� li f � I I . i _ _ _ . + _. 1 + � � t � _ _ — _ ... .. _ t IjI + 1 ' � . __ � + + � � . ' _.� -- -� , _ ,- � - � � -� , + � .. ,. � � t _ � ,. r J _ ' *- � -- � -1 1 - i � - � � J Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 DEBRIS DISPOSAL FORM SORT, O �S4E0 0 4V �T Oq� GOCpI[p WKX �\ � In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: p Facility location Signature of Applicant v Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. :Tr farnrnarzuzrxtl(� �� ,la,�r./rurlCs .Y !?s HOME IMPROVENENT CONTRACTOR 't =- I Registration: 101814 Expiration: 06/29/1002 Ty¢e: Individual KEVIN MURPHY ,KyYin Murphy ADMINISTRATOR X69 Boxford St N. Andover MA 01845 ✓fie Z%'amannnur�rxtl� a ' %1f�rc/%uarll BOARD OF BUILD14 REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 053099 Birthdate: 06/2911967 Expires: 06/29/200, Tr. no: 10126 Restricted To: 00 KEVIN W MURPHY �,.j 169 BOXFORD ST N ANDOVER, MA 01845 Administrator The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit -S- � 3 am a homeowner performing'all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing. workers' compensation for myemployeesworking on this job. rmmnanv name Address City N� & � Phone #: Insurance Co. t �� �� J w - -� - Policy # Company name: Address City: Phone #: Insurance Co. _ _Policy Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby ce j under hd`pains d penalties of perjury that, he informationp vided above is true and correct. Print Official use only do not write in this area to be completed by city or town official' []Check if immediate response is required Building Dept Contact person: Phone #: FORM WORKMAN'S COMPENSATION # LQ -5-�,,5 ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other m m G m C/) 0 m C) N1 .O C � CO) C-) 10 0 CD MZ CA CL _u C CL CO) a co CD CD O CLr CD CCD O CCD w E C CD N)� CD CL O CO) O ' co CD H O -oCD Z o CD 0 CD CC 2:-O d m RoCAy a o o m c� n CD ymwc z =r.0 H° o, o*m c � CL m CD -40 m N O G 3E =rm m = m C co O O C yin ►� c ErCD :S.. :CLO R r m CL U2 o ? Cn m0 CD C d m � N N ? Q O O d :3 06 C3, ECD to o = C N O m . Ob_� _ �. f` o CA b_CD o 0 0 _ Co O H z � CD cp co) CDCD d d z G): nCA om: CD �o o'er �q 0G 7 z 0 rte ro '- 0 r C) M O O r� � y O o 1 i W O y 0 0 c = _. .�= —� �'-�.-,.q _.d.d .�,-.. ,:.�r� d.i,iv ..="' �taaacaa•;..:,:.e �ria�Vurm.a ,.a.,,ar�, y lY�d4Wa&S F��A1'�. �vvs, � MORTGAGE INSPECTION PIAN NORTHERN ASSOCIATES iNC. 401 SOUTH BROADWAY, LAWRENCE MA.01843-3322 TEL --(9785 913'7@.3-335 FAX:(( 8) 837-3336 MOBTGAGOR: ,TOHAT & CDATTE COOX DEED RWJ:.4069 / 288 /S LOCATION 34/�j6 C'�AMLESTICK ROAD PLA I�� M. 11216 Cpry, TAT2.IV'�.fi�Ti� ANDOVER .(�A SCALE-- w=50' DATE: MARCH 12, 2001 JOB #.- 2Cl/P .01671 4&46" CANDLESTICK ROAD CERTI,FUD TO: °CACI' PARTNERS I 4 � � / k APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code. 527 CMR 12-00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3-k ria OFFICE" SEOI T'he Commonwealth o 11?assachusets pe�,uNo, Depct'ft=t of Publk Safety Occupancy do Fee Checked MAW OF FIRE PREVEMION REGULATIONS 527 CMR 120 (trete Rhald `= N o , is n nr Li r To the Inspector of Wires: - -- Cky a'ibwa of � _ Tbs undardawd applies for a permit to perform the electrical work de unbed below. ' toridm Pkre -A k Number) 3 y5 L� n �1 eS-ti l • v OwnerorTenwa, naY. — Cwner'a Addr ass S A 222 1s it is p�.ratit M car jWWAion with a VU -6 peratlt: Yes lad No ❑ (Check Appropriate Box) it:pars of BcdldIrts '��` , , _ Utility Authorization No. SeYvsee Amps / Valls Overhead Q Uridgrd O New Service Amps —1—volts Overhead O Number of Filers an Ampacity location and Natum of Proposed Electrical Work Undgrd O No. of Meters No. of Meters Afo�ofLi�tir�0ut4w U No. of Hot Tuba No ofTransfottxters :otalKVA Swimming Pool Above Grnd O LtrCrnd ❑ Generators KVA ell cf Racepeade Outlets No. a(Swfedi Outlets No. of Oil Burners No. of Gas Burners No of Emergency Lighting Battery Units No. of ones FIRE ALARZones Na of amiss No. of Aft Cored. Total Tons No. of Detection arid Initiating Devices I,lo, o(Diapassy No. of Heat Pumps'. Total Tons Total KW No. of Sounding Devices Na of Dishwashers Space/Area Racing KW No. of Self Contained Detection/Sounding Devices Na of Dqvm Hating Devices Local O Municipal Connection O Other Nm of VAv" Heaters KW . No. of Signs No. of Ballasts Low Voltage Wiring No. HydroMamle Tubs No of Moon Total HP OTHER: REINSPECTION FEE $25.00 INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a etaterut Uability Insurance P cy Including Completed Operations Coverage or its substantial e:quivilent: YES 1" NO O I have subinitted proof of same tothis office. YFSEf NO O U you breve YES, please indicate the" of coverage by cheddng the appropriate box. DWRANCE7 BOND O Oniq O (Please.` Specify) (Expiration Date) FAdmated Value of Electrical WorOT work to Start J� Call Electrical Inspector for Rough and Final Inspections Signed under the penalties of perjury: FIRM NAME j-,� it u41.lE1� QC . C c � L. UC NO_ P 3'7/`• - Licensee. Mtc,�r,��-� oJJ zt+ti Signature�o c.osCi.� UC. NO. 16 Address ;XD P tet_,-�f lA� 5 a �S,M A r_ 7 i�: o t� Bus. TeL No. Alt. Tel. No. C"NF.RS.INSURANCE WAIVER: I am aware that the Licensee d=net have the insurance coverage or -its substantial equivalent as required by Massachusetts Cenral laws, and that my signature on this permit application waives this requirement. Owner O Agent O Please check one) Telephone No. PERMIT FEE 5 (Signature of Owner of Agent) R /. t N2 1 *4 91 J Date,:? ... I�..:.a...... ... 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....................................................... has permission to . . . perform ...................... .. ................................... .. ........ wiring in the building of ................................. L-n� ............................... I -1 ................ ........................................ . N611h Andover, Mass. . ...................... Fee Lic. .......... NOR' WHITE: Applicant CANARY: Building Dept. PINK: Treasurer No.� Date >f NOItTN. TOWN OF NORTH ANDOVER OR 9 Certificate of Occupancy $ f * ; ; Building/Frame Permit Fee $ 5a �+ °''•°''�� Ss�cHU Foundation Permit Fee $ Other Permit Fee $ ¢ Sewer Connection Fee $ .o 4 Water Connection Fee $ TOTAL $ w Building Inspector ° a 45 5 0 Div. Public Works c i a I) po < a Y 0 0 m C( J W W N %Aa X a 9 J m W WZ 3 0 _ u Q Z Z ° 0 J J W oC 0 W 0 0 0 F z W w0m I� gul o: W O N 4 Z 0<0 m O 1� 1� LU Z O cM 6 Z d OJ z o 0 J N k r� rJ y 01 W `iCVI Z <O Z < 0 0 y y a W< W W i N j 0 10" 1/ a r� a Z _0 ~Z OZ ] ILLL W 0 F = W Z 0 LL LL 0W W N W U J < h < O J 0 Z p 7 0J y W F < W Z u u Z O ] m y W F W E Z Z LL Z O 7 0) y W F N W Z Z u Z O ] m y z Z I Z 0 W � W O H p L 1 < o � �` 141 m I 0 H Z 4 W _ Q 1 W O u i m L I W < I 0. O J J JLU Ul � LL 0 /1 v O 1 ? 3 0 0 01 F - Z W F W S O U J] (t ® .J o W Z < Z i 2 Z 0 0 � Z 0� � U) Z 0 o F 0 W 0Z< u y J 0 J W Z 0l7 Z W J0 < l0 Z Z p J 9 O Wm O Z O m m J ci 8 < Y I y J 10 ��y G V 1 m W W L C L U _>< < < J 1 U) Z W W M R C Z I I a 0 0 0 r 0:Ir y ` 0 u U U O a o g o L Z < 3 W 10 J U J m J m J 00 U J Z Z ] O Z 1- F- ►- W F 6 J 0 0< A — J W W - Z _0 ~Z OZ ] ILLL W 0 F = W Z 0 LL LL 0W W N W U J < h < O J 0 Z p 7 0J y W F < W Z u u Z O ] m y W F W E Z Z LL Z O 7 0) y W F N W Z Z u Z O ] m y �. Z I Z 0 W � W O H p L 1 < o � �` 141 m I V D H Z 4 W _ Q 1 W O u i m L I W < I 0. O J J JLU Ul � LL 0 /1 v O 1 ? 3 0 0 01 F - Z W F W S O U J] (t ® .J o W Z < Z i 2 Z 0 0 � Z 0� � U) Z 0 o F 0 W 0Z< u y J 0 J W Z 0l7 Z O < Z J0 < l0 Z Z p J W d < LL O Wm O O 0) O m m J 0 O < p y < y IT I y ; 10 W ~ K 0 t U U W 7 d J e C Z 1 I 1 1 � I � Z O J J_ �. Z I Z 0 W � O 1 J 1 H p L 1 < o � �` m I V D W Z 0 W _ Q 1 < v i m L I W < I 0. O J J JLU Ul � O 1 ? 3 0 0 � 1 O U V S ] 0 Z i 0 1 U) Z 0 y Z O W E0 � F u u W W W W S 1 1 p y 0 J r 0 J i 1 t - F 0 LL W ~ V 1 m W W W l7 ► 1 U W 1 W < < J 1 U) 4 0. W r K 0 t U U W 7 d J e C Z Z O J J_ �. t ] m 1 > > .0 W � E W > i d : I:N o; p L 1 < o � �` O J J �Ij W 0I W Z 0 W _ Q W < v i m L I W < I 0. O J J JLU Ul 3 0 0 O U V S K 0 t U U W 7 d J e C Z Z O J J_ �. t ] m 1 > > .0 W � E W > i d : I:N o; p L 1 < o � �` O J J �Ij W 0I W Z 0 W _ ( ' y O J W < v i m L I W < I 0. O r Z v ! W t W C IL L ) 04/21:1994 07:29 FROM Corey S Donahue. Inc TO Carusso Law Off P.02/04 .inh No. -11),4+<5 M This plan was not prepared from an instrument survey. Offsets and distances shown should riot be used to establish property lines. This plan Is intended for mortgage -purposes only. I certify that the structure shown on this Plan i:-:!'- s . in conformance with the zoning setbacks in effect at the time of construction. 1 certify that the parcel shown is located within a flood hazard area a5 depicted on FEMA. Flood Insurance Rale Maps for Community No:� MORTGAGE LOAN 4NSf'ECTIOR • .: . LOCATION: SCALE: a - DATE- REGISTRY- TITLE REFERENCE: —qe- -,WCe PLAN REFERENCE:�•'"� COREY & DONAHUIE' tNQ, $ntIncers & Spivereva 198 cambridg* nawd. Wgbnn% b1A 0180t Z O LU - LU At Lu LLI it -Salto U ZL 7P 8 LLs 10 N O N x cA Q to x LL Z O LU - LU At Lu LLI it -Salto U ZL 7P 8 LLs 10 � z NQ �O M r LL z Q N ^S— b1 CZ ' O N NQ C1 M1cc X: O X = cA tlJ o voo W �X �o s 0-7 a 0 I �i II II II II II II II O N O IIH Q X 10IIS W I Ili xIq I Illi1 N 7E of II 0 II II A Q I IL .6 -,ti X .;I£ -,L i CV .6-,b X ,z4£ -,L .0-A z U Y lu IS LL 'Coo m }— cl �a? 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An SD) m AmON 00 NDv00 O -NO OA O ? C OTm mZ N x zzAzzOOOS noZZ N 0 3 y y m- mOAZ m in36O 0 N O 9^ n Zm 0r GlZ N O30ma m mO0 Z as N = T p Z Z o Z ~ Z nO N II I I '_IIII_IJ_11�1.�� zmOG�Cnyx�T'o 0' - DZ_DAO Ov _IIII!1111! -.-.3yZ�c .-DODO-DaO-a. ��m _ ac o� D y Dn2 NODDO n l0 3„TT o z Z Cvvx Z A D �_ D Z C O x ti A N O D y n< < A 3 T T v m r (� G x -1 m A y x O Q A _ n A 3 A ? S O A Z x m O A T D pp m Z` < y m o T //�� \JI T m Z' y n T y Z y O a ,o O Z 2 C z A n A W H 0 -N/ ` AZO z _ Y ti 3 D A l N N ,Dyx0A 00T A Om N_'< 3:T T T N "ZD O O A ~ D A S z T X< -1 Z A Z x NO �. X y N r C r x N D A D A A O Z 1. W I I I I An m m �- '° m DD A �0 A AT Z N X a 00 T� I AI - I 0 Z Z IIIIIII� IJ JAIL ! I I III11 fllll" III !il III 0 00 C D z 0 0ON N (mj1rN �m� a0 Nzz C �X1 D n 010 U) o: _ mim mX•• -1zD Imp NO -1 ;az_ mN3 [oZ ymN M 0 NCz F m 600 ANO DgD z_z =o N 0z =n mm N� Lo 915 Crr] cn O z I O z cn C O CO O .a y »_ o eos -M M we'ao m -.. P. , -, = rern m C2. m 4M.- rn �omN C N O ?o3E CD m S -p No Owe O �; m y ca Go C2 :0 =r 0 ate,.: CD c �? - m m N RCD CD m N N � :1• S1 CL Q �m o_ m N N _-j -rte CD CD CD CD p) N m C -3 O CD O :� N .O► co ny mo� �n o m= 06'S- .� r d c CA CDo C2 m O O ., r� vtoz m Z Z w < C Zz y m M p C C C 0 ' r C b O a O Y d � x T = O D nZ C y T r CD O =. z CL r c) CO2 O 0 CD v CD o '� Q CD n CD cm CD C cn m CD y < 0 y m z o z C I v < y O CD CDCD --nao z 4c D r CD Lo 915 Crr] cn O z I O z cn C O CO O .a y »_ o eos -M M we'ao m -.. P. , -, = rern m C2. m 4M.- rn �omN C N O ?o3E CD m S -p No Owe O �; m y ca Go C2 :0 =r 0 ate,.: CD c �? - m m N RCD CD m N N � :1• S1 CL Q �m o_ m N N _-j -rte CD CD CD CD p) N m C -3 O CD O :� N .O► co ny mo� �n o m= 06'S- .� r d c CA CDo C2 m O O ., r� vtoz w Z w < C Zz w G M p C C 0 ' r C b O a O Y d � x 7d '� �j G 0 c FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: c Phone Ls LOCATION: Assessor's Map Number Parcel Subdivision ��,. �C_ S�--i c lC,:� Lot (s) _D-1 Street / C s C_ St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health ,4 Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved r Date Rejected Received by Building Inspector Date The Commonwealth of Afassachusetts - - Department of Industrial Accidents �+ - ..- 5 /ll�'d 11IOICSI(4�tlIOS 600 Washington Street !� Boston, .Mass 02111 i [) I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0I am an employer providing workers compensarion ,or my empiovees working on this joo cmmnanv name \ i _ .... prance co - ooEicv# Failure to secure coverage as required under Section :5.a of NIGL IS: can lead to the imposition of criminal penalties of a fine up to SI.500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP `.YORK ORDER and a rine of SI00.00 a day against me. I understand that a copy of this statement may a forwarded to the Office of Invescigaoons of the DI.a for coverage verification. ! doherebv cern un r the pains and penaldg, pf rj - tlt>a th orJrrari rovided above is true and co el Signature f.� Date I Print name e L-. N ✓ r� ��� Phone 1�� Official use only do not write in this area to be completed by city w town official city or town: permi"cense # rlBuilding Department CLicensing Board C cheek if immediate response is required CSelectmen's Office CHealth Department contact person: pboae #: r7Otber (i v&W 3195 PJA) ,o �vNDATX3.✓ LG�CA7'/GN FiCOy� Z //EPEBY CE.I T/FY TO TyE 77i 7W47 T.✓EOn'ELG/.tK /,S GGC'ATEO aAl rf/E Z07 ./S .S.SC/Y.v.gNO 7W47-17-,04CS LGLt/FC7Ciff , rir/f r//E n7 -A/ ' Of .vO„ V--')d✓e;P- OaV W6 tE6vGorxwS AFKC 6COI,W SE7-A4cA-X Go_— L/.✓ES. ' I F!/.rT/YGC CE.�T/FY �;�;Vf7-7.11Xf O.Y'E!1/.YB /S-ot/OT 4OG47EG 4r,3 '=+7 - FiCGIOO f/'4Z.4.�0 APER. S.yew,�! Oiti ,c'7""�+le:I��•��.v�ry W:, 10?gkt NOV - i teal BUILDING DEPARTME /G or /N To�.os Lgv�.p,V/ Tib//S PC.4it/ Fd`,E►i�j►q� Pv,��,�,s -NOT FO.P BOIiNO.Py �E,P�1!/N•4T/O.�! BO!/.VOA�PY ///FQR�y/- �i1FP.�/�11gGt' E,v6,wEE�P/,(/6 .SE.Pf�/�'ES .rrov r.4.rE.y F,�,H Exisri.�c ,«rows. G6 Pq•P.f� •sT•rEET oorE,c, ,�.vss4cvvsErrs oi8io 04/21:1994 07:29 FROM Corey & Donahue. Inc 70 Carusso Law Off P.02/04 This plan was not prepared from an Instrument survey, Offsets and distances shown should not be used to establish property lines. This plan is intended for mortgage -purposes only. I certify that the structure shown on this Plan . in conformance with the zoning setbacks in effect at the time of construction. 1 earthy that the parcel shown is7- locat(id within a flood hazard area as depicted on FEMA Flood Insurance Rale Maps for Community No: MORTGAGE LOAN INSPECTION:. LOCAT ION: �r',•�-.s� SCALE:---. CO` DATE- �•�� ��'.. REGISTRY•--� TITLE REFERENCE_ efet PLAN REFERENCE:.��,.a COREY & DONAHUE: INC,.. £n0xteers & Survererr IDS camnrldRe n*Rd' wnb"M bf)L 01801 I4 4 t[ + t _f too �, I \vl tl�CA_}� ,�a 4 41, T ( r i r i I � I • +- + + r+ i + I , I I ` I y I I I I 1 J I +- + + + I i I t I + - +- + + ++- y Ij _ Ij + - I i- t- + -+ +- + + +-, -t + + 4 + - ' i + - + I - + +- + + + +- - - +-� + - + + -} - +- -+- - +' + + i- + - I - + t t + t I I � I I II I I I + + + + + + + +-I I 4 + �- {- + + + + - - + - i- + - - �- - + - + + -+--{- - + - I - i - -t - t-- --E • t - + + - + - + r - + + + + - +- - -�-- �- } + I +-t + - r -4- - t + I 1 I + + t � I I I+j I - -+ + I + I I Ij I t t T _ + . 1 _ Y-- 't --i- �.+ _ �' _ . _ _ _ . -F-j-�--T I . +- T- - t t - II - Y- II , 1 II +II-- } I II L II I I I I I I I + } + + + t-+ + } + + + r + } + + + + r } + + + + t + + } + + + + } t + - } t } I I III I II I I I' I +I III I + i + r } + + +- 4-4- I f- +- t I } + + + + �- t t + } + + - t { + + + t + + + + - +- - y + + + I I i I I I I I I + }- + } I +- t -+ + + I { + + + + - t + t + { t + + + - - + t t I + + + + - + - + - + + + + + + i + --} -+ I I +- -I- + -+ I t I -} +--4- +- +--- -I- 2s; 1 ��- j - t + - c�� � j J E � I- t 't + It + t 2s; 1 ��- j - t + - c�� � j J E � I- t 't i + t + ' + + + + 4 + + +-- + + +- I I I 10 I I i + + t + i t + +—+— + - t --t— +- �— + t—+ t -+-- a- + a- + + + - f • t- - I t • �- + I {- + .'-4 '.f -_�_ t ;•' + � -+ -4---4- i•' t -h - + i —t +--+— + + �-- + t 4' t — t - + a � I I + + + + + + + t t- -F-t - t I + + + t + - - + + + � I 1 I I I I 1 1 I I , + + + - + • +-}- I } +-- '"� + +- + -+---� --+ + ' i + -+ - Y �- + -+ -+ i -t - i-----+ - - -F-+^-�- i t I II II I y I I I I I 4 4- l ro MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER Mass. Date ::2 7 building Location-,- �,(,s �-�r//,j r, ,jC �j %� � Permit # /k75 Owners Name_)Coy// New T/116enovation 13 Replacement Plans Submitted FIXTURES C! (Print or Type) Installing Company Name Address %l r /_.4✓��;��"� --r/l_ Business Telephone: i"1 29/) Name of Licensed Plumber or Gas Fitter i Check one: Certificate Q Corp. Partner. irm/Co. m Insurance Coverage: Indicate th type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner F] Agent M 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 knowtcdge and that all plumbing worts and lnstattations performed under' Permit isseed for this application will -be in compliance with all patlnent proymons of the Massachusetts State Cas Code and Chapter 14: of the General haws. _ . By Title City/Town: APPROVED (OFFICE USE ONLY) — � t -TYPE LICENSE: Plumber Gasfitter Signature of Licensed Master Plumber or Gasfitter urneyman �24-5%1 License Ndmber - MEN ME M EMEMENE ME MISSION - FIRM (Print or Type) Installing Company Name Address %l r /_.4✓��;��"� --r/l_ Business Telephone: i"1 29/) Name of Licensed Plumber or Gas Fitter i Check one: Certificate Q Corp. Partner. irm/Co. m Insurance Coverage: Indicate th type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner F] Agent M 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 knowtcdge and that all plumbing worts and lnstattations performed under' Permit isseed for this application will -be in compliance with all patlnent proymons of the Massachusetts State Cas Code and Chapter 14: of the General haws. _ . By Title City/Town: APPROVED (OFFICE USE ONLY) — � t -TYPE LICENSE: Plumber Gasfitter Signature of Licensed Master Plumber or Gasfitter urneyman �24-5%1 License Ndmber - Date..................... NORT" TOWN OF NORTH ANDOVER of e .' OO ;, A .- PERMIT FOR GAS INSTALLATION This certifies that ............... ."............................ has permission for gas installation .................. . in the buildings of........................................lu at ..................................... North Andover, MakFee. X...... Lic. No........... .......................... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .r Location ,-2�-I �DZ No. y.S '� Date i NORTiy TOWN OF NORTH ANDOVER � s 41 Certificate Occupancy $ + i , of swCHus Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # , 15 � Building Inspec53x5 CCJJe ,1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLI&TION TO CONSTRUCT REPAIR, RENOVATE, �OR DEMOLISH A ONE OR TWO FAMILY DWELLING By J11 DING PERMIT NUMBER: �5 �/ DATE ISSUED: SIGNATURE: C Building Commissio eEI ctor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 3qS CA14 JLt 1.2 Assessors Map and Parcel b {� Map Number Number: Parcel Number eb&,,e K -J Name (Print) Address for Service 1.3 Zoning Information: Zoning District Proposed Use Signature Telephone 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Name Print Address for Service: Signature Telephone Front Yard . Side Yard Rear Yard Required Provide R ed Provided Required Provided 00 /v to 3 f� o* V 10 4- 1.7 Water Supply M.G1-C.40. 54) Public ❑ Private 0 1.5. Flood Zone Information: Zone Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSH P/AUTHORIZED AGENT 2.1 Owner of Record eb&,,e K -J Name (Print) Address for Service S **wcimn 7k- '-2 b - c� 6 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Superviso . 3:1 a (� `1 t7 % License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ FA• A,AP� tj 1- j CompanyN m l l no —7,) S �� ����� w��. Registration Number Address Ck� 11 t3 ' C� ���� Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this athdavit'will result in the denial of the issuance of the b ilding permit. Signed affidavit Attached Yes ..... No ....... 0 SECTION 5 Descri tion of Proposed Work check au applicable) New Construction Existing Building ❑ Repair(s) ❑Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑` Specify Brief Description of Proposed Work: —J—vt_ SVM I SRC'TTON F - F.STTMATF.n VnNCTRTT('TTnN !'nCTC 1,-,u61( (, Item Estimated Cost (Dollar) to be Completed b ermit a licant I fvllA>C.tUSEIM—'E _... , `. (a) Building Permit Fee Multiplier ` . E 1. Building Ul7 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) i 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number u��,iiVt� is V�71�1C1C Av1IIViC1lAl1V1`) 1V Ifl; l;V1V1YLL1LU WtJt:1V OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDINGP��ERNIIT 1, 60""�Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to ork authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, a U,,� P ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief � Print PI Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVIBERS 1 sr 2 3Ku SPAN DMIENSIONS OF SILLS DIMENSIONS OF POSTS DMENSIONS 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 I 0 2 FORM - U - LOT RELEASE FORM 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. �■■■■■■r■■■■■■■■■r■■■rr■■■■err■■■r■■r■■■■■■■■■i■■■■■■■■r■■■■■■■■■■■■■■r�■■■■ APPLICANT **b l 6Pe-4' jpkA Nt; tier PHONE 91�-�� ASSESSORS MAP NUMBER © LOT NUMBER 02,3 0 SUBDIVISION Wit A j D LUST Gk. STREET NUMBER 3 'tS STREET 1 OFFICIAL USE ONLY ■■■■■■■■■■■■■■■■■■r■■■■■■r■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■r■■■■■■■■■■■.■■■■■■■. RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED /60—NSERVAT10NADNMIUSTRATOR --1- DATREJECTED i 0 DATE AP -PR VED TOWN PLANNER p2 / DATE REJECTED F D INSPECT9OR TH JSAC INSPECTOR - HEALTH PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVEDImp DATE REJECTED DATE APPROVED DATE REJECTED RECENED BY BUILDING INSPECTOR DATE The Commonwealth of Massachusetts Department of Industrial Accidents Mes 01/nre5#921/uas 600 Washington Street Boston, lViass. 02111 Workers' Compensation Insurance Affidavit name: -/ �brJ�E 9 ���/1 AA 4ee location: Co,-, A STZti— ciry Q . A !J pG✓ phanc I rJ%O - q 9 5/ 0 m C] I aa homeowner performing all work myself. 7 [I I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. — 1� ��r.v r. ::rt a• �t�TVvLt W/ 'l c*Lt 'i— address: —70 6YDGt .. e.JDt-h , �q t city: f f --6�-� l fwvi-¢�C— { Y � fZ.. r.1n h o n c d- (of? " d `T6 ' -5�v i�arance ca �yrrill�ll�C�Q�Vt`-A411"`,4 �y�t'''i� (ea onlicy # G (6`( QqS/ tD a r7 I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: city: phone 47 oolicv # intttrencr CO. gotnuanY name: city phone #• imarnnce cn Failure to secure coverage as required under Section 25A of IVIG L 152 can lead to the imposition of criminal penaltica of a fine up to 51,500.00 and/or one years' imprisonment as well as civil penalties in the form of :t STOP WORK ORDER and a fine ofS100.00 a day against me- I undersand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verificanon. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Print name too1 ne# 9?Gtfk-91347 official use only do not write in this area to be completed by city or town ufficial city or town: permit/license N f78uildiog Department 0 Licensing Board Q check if immediate response is required CScfectmen's Office CHealth Department contact person: phone q: [70ther (r—d 3/95 PJA) 1. 0330 FAMILY Pools & Patio, Inc. � CSL # 01 � ��u � f /�� HlC # 118220404 Sales - Service - Supplies ��� WC # 156942897 70 So. Broadway - Lawrence, Massachusetts 01843 LIAR # CO 164095968 Tel: { ) 688-8307 Fax: ( ) 688-1949 NAME "t V,ik t � I a ( DATE ®� a d+ 20 ADDRESS � STATE �ASl ZIP t �,� TELEPHONE 4 �`� ~�� Res. CITY. —r--- CROSS STREET _ T -- 4 1 a � '`�-A ���`"�d Wk. EST. START DATE f v V r EST. COMPLETION DATE PRffO//POSAL • We propose to furnish and install one �.fJ /z- ➢C $6 lrZ �``�.`ti�,'" swimming pool for the sum of $ 14 ( w The price for normal installation consists of: Nine hours total machine time including two trips for excavation, backfilling, and rough grading around pool. s of one dump truck for six hours for removal of fill during excavation - Installation of pool with filter and wall skimmer. The rice does not include: ny machine time over nine hours, additional machine time to be billed at (r 4 -per hour - Any trucking over six hours, dditional trucks to be billed at(?a} per hour I, Any dumping costs incurred for disposal of [edge or large rocks Re -seeding of grass around pool - Spreading of loam *Trucked in Water - Patio or fence around pool or any accessories, xcept as noted below - Additional fill, if necessary, for proper backfill or reshaping of hole - Disposal of large rocks Fue[ Connections - Heater Venting - Fuel Storage Tanks - Permits - Damage done to sprinkler systems or any buried items (ex. dry well, electrical lines, cables, etc.) in the access and pool overdig areas. St ping and removal will be subject to an extra charge. Yateor soil condition (ex. clay, peat, live sand, excessive rock, etc.) requiring Min. �Max. A,st9he pack of the hole will be subject to an extra charge of Use of the above will be at the discretion of the job supervisor. Customer is to supply access for all trucks It is the owner's responsibility to obtain the building permit or to assume the costs of necessary permits. EXTRAS - Vacuum Cleaner _Ladder(s) (2JO Diving Board Chemicals Maintenance Kit Lifeline Main Drain Solar Cover Fiberoptic Lights Neater . (r1-1 #VV Slide Caretaker 99 Pkg Environpool plus Pkg{ Environpool Pkg { Polaris Vac Sweep Polaris retrofit only Inline Chlorinator ❑ Patio, Electrical, or fence, see attached CONTRACT • Steps v7 W/ S 14 4 " } Filter' A {Cf.'d"� ) With!P Pump! Liner ✓(r.�. ) Coping Spa Miscellaneous S w i vx 0�4� Miscellaneous ( ^" ) t 2SD ) TOTAL EXTRAS BASIC POOL PRICE SUBTOTAL $ 56 3 5% MA SALES TAX 22 3 TOTAL $ LESS DEPOSIT 5%, minimum ,-7,7< BALANCE OF CONTRACT $ PAYMENTS: 1/3 Excavation. 1/3 Backfill, 1/3 System Start-up The buyer hereby agrees to pay in full, the total amount of this transaction upon start up of installed pool. You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Credit card payments not accepte contract amount BUYER -� 1--k -C1 nA aX SELL E lJ�t'`-'ti- CO -BUYER Z'd SIPCI O890LB ouI r014Qd 19100d RTtwvd 0 Q80:TT TO 92 ung Apr EU U1 U1:U9p f=amily Pools 8, Patios Inc 9706001949 �!'. � w iJ/!f TC1aHl'III.AN109R�1� P�• I•��!(.it�/i� 1•w. Board of Building Regulations and Standards ' HOME IMPROVEMENT CONTRACTOR Replebatlonl 118204 16xpirallion: 0 211 312 00 3 Type: Supplement Card FAMILY POOLS R PATIOS INC GLEN WIoaN 70 S. BROADWAY u , • .,�•,� LAWRENCE, MA 01843 Administrator " . --' �i s t$!»le4na ruuea(l% o f . •�la.>da�Ileedt2 Boars of Building Regulation$ and Standards HOME IMPROVEMENT CONTRACTOR Replttmtlon: 118204 t� F�xpintlon: 0211312003 Type; SupjdementCard FAMILY POOLS 8,$ATIOS INC CYNTHIA:GIANOPOULOS 70 S. BROADWAY a-, �' (�w✓ LAWREN011 MA01843 Administrator 1 f�%�e �ovramamveall�r. o�:: l(neeal�(leett2 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Repiatratlon: 118204 16 0"1101111 02/1312003 ;Type: Private Corporation FAMILYMOOLS l OATIOS INC YV ttw.W NOR6UlUS 70 B'BROV40WAY �. �' IAWRENCOMA 01843 Adminlitrotor License or registration valid ror indlvldul use only before the expiration date. Ir round return to: Board of Building Regulations and Stnndnrds One Ashburton Place Rm 1301 Boston, Me. 02108 Not valid without sign t -c License or registration valid far individul use only before the expiration date. If found return to; Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Me. 02108 I � �-`Not valid without Signa use License or registration valid for individul use only before the expiration date. If round return lo: Board or Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Me. 02108 Not valid without rfgnnture ACORD,N C E RTI F A B L�1'NSU 03/09/zool ' 617646-5000 FAX (617)$4&-5108 Elliot, Whittier, Hardy & Roy Insurance Agency, Inc. ST Putnam Street Winthrop, HA 0215z ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH18 CERTIFICATE DOES NOT AMEND, EM -NO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE rl1M y Pool A Patio Co. , Inc. 92 South Broadway Lawrence, MA 01843 IN&IJAER A Transcontinental ins. C_0_. INSURER I v INW(ERO INSURER 0 _ Ed INSURER E GUVCFV1UKV H P IISIED8FLOWHAVE 86PN155UEUTOIHEIN5UHEU1'IAM=UPutweFLRA InoFVLILTVcnwvInvwnIcv.nvlvrl1r,;; virw ANY REQUIREMENT. TERM OR CCNDITION OF ANY CONTRACT OR OTHER DOCUMENT'MTH RESPECT TO WHICH THIS CEPTIFICATE MAS BE ISSUED OR MAY PERTAIN, THE IN6URANCE AFFOADE7 BY TIRE nJLICIEE DESC AHED 14AGIN IB SUBJECT TO ALL TME T9RM6, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AOOREOATC LIMITS SMOYVN IAAY NAVE BEEN REDUCED BY PAID CLAIMS. TYPE oil INEVRANCa POLICY NUMBER DATE MN/DD E LIMITS A M OEhIRALL"LITY COMMERCIAL OINERAL LIA/ILm OL"6 MAN a OCCUR 164095968 12/31/2000 12/31/2001 CP.ChO'iUVRFENt;6 1 50000 FIRE DAMAGE (Any em Ilny 1 50000. MED 9X0 (Any m» Pa -tan) I so FeR6(VIAL a AW INJURY I S00 OENERALAOOREOATE 1 00 ,1n•APPuE FIR OENLAq"G^TSLME POLICY LOC PRODUCT! • COMPIOP ACO I 100001X) A AVTOMOIIL/LIABILm ANY AUTO ALL 00M C AU10$ SCHEDULED.AVTOS NATO AUTO$ NDN -OWNED AU109 038607 I I 12/31/Z000 1 i 12/31/2001 coMjvp swot: LIMIT (e . Noidwty $ 1 N 0 ODDLY IN:UNY (PN Porion) 1 i BODILY INJURY Ion Atlbdtnt) ! ( PROPERTY DAMAGE (PAI EatdlMl ! 0ARAOILIA910Y ANY AUTO I AU70(*1.Y.EARCCIDSNT 1 OTHER THAN EA ACC S AUTO ONLY: A6011 1XCEII LIABILITY OCCUR CLAILIS MAOI oeoucneLE RETENTION $ I EACH DCCURI IENCE s AOOREOATE 7 ! ! A WOR11LRICOMPINIATIONARD EMPLOYERI'LIABLITY 16409s%& 12/31/2000 1Z/31/2001 T IIB R E.L. EACH A.CC:DENY $ S L. DIBEA9C • CA EMPLbYC $ E.L. DISEASE • POLICY LIIAT $ RATIO I CERTIFICATE HOLDER l l ADDITIONAL IMVRED: INSURER LETTER L:APIL:t44.A I Ivn SHOULD ANY OF THE ADDU$ 00CNI11$0 POLI:IIC 00 CANCELLOD IEPORE THE EXPIRATION DATE 'HEREOF, THE ISSUING CO! PAW WILL CMUFAVOR 10 MAIL DAY$ WRITTEN NOTICE TO THE CERTIFICATE NOLOER NAMED TO THE LEFT, OUT FAILURE TO MAIL $UCH NOTICE WALL IMPOSE NO011WAT10N OR LIAOIL17Y GMT UPON THe O.4IPANY, AGENT$ OR REFRISW4tATWIt For Information Purposes Only r ooe ee IA ur OD �o � ....� NOS NOiqqi� Q CST w1% 4&46" CRR Ids' ZBD TO.-I(OJ,; crA rR PART HER INC. FUiod IUWMU $Brims ho4l bWn dwhMITWd Gly Mae ave imnsad by BUD aikVlw in aran4c Y owdya s s Azat MerrAm ddawmAt baa aA iz"aaa U) m m m U) 0 CO) C � N .O CD a 0 t O -0o n' c 0 c CO) -v E cl) CD 0 .7 �F CD Com' CD CO) 0 CD 0 c CD M "C=N-.�o =• 3Emm� COS - n b O ` ' O zcm O N' Cf �` 7 n. Wm : j CD N O Cr L= m N CO) a .. CD _ am O m C7 1 o N O d 0 a = T ZCL = O1 d N K � .co m C O - t. 0 m d=� m N CL y CD 14C 3E m O � O O � M "C=N-.�o =• 3Emm� COS - n b O ` ' O zcm O N' Cf �` 7 n. Wm : j V 0 - n0 = : 0 a .. CD a m o =_:� 7C o W m N a k* 1 Cl. ` K � .co :� Q :� 0 CL O lb col s CD 14C 3E m N m •� 0n9"S �. �q 0 m O c b O ` cn CO) 7 n. z m °= 0 - _ °= ►-�+ .. CD a C/) 1 7C o Hco a d 1 � .co _ O lb col s c o _ Nil �q 0 ti p c b w o r-°� cn 7 n. 0 vCc m °= 0 - ►d °= 0 oCc a �' �. c 7C o 91 1 L �O y 0 0 c SENT BY: DISCREET; 0782761317; MAR -20-02 i2-55PM; IConstruction Sequence (Installation of Pool) 345 Candlestick Road, North Andover. MA 01845 Phase 1: Family Pools & Patio, Inc 70 South Broadway Lawrence Me 01843 has been given the contract to furnish and install one pool, excavaton, backfilling and rough grading around the pool. Estimated start time is Early April 2002 and expected time to complete is estimated around 10 —14 days. Phase it: PAb, Triad Associates, Inc 100 Downing Avenue, Haverhill, MA 01830 has been given the contract to furnish all material and labor necessary to complete the poured concrete according to job plan. Deck area around the pool will be a poured aggregate finish. Triad will grade and compact deck area, use structural steel, form and pour aggregate with plastic joint and cantilever edge. Estimated start time is mid April (after pool is installed) and expected work time is 10 —14 days. Phase III: Pro Fence, Inc 835 Woburn Street Wilmington, MA 01887 has been given the contract to furnish and install fencing around the pool area. A temporary fence will be installed immediately after the pool has been excavated and installed. Upon completion on the decking a permanent fence will be installed around the pool area. Estimated start time is end on April 2002 and work is expected to take 3 — 5 days. Phase IV: Excavated area will be landscaped as needed and seeded for grass growth after the completion on phases 1,11 and III. It is estimated that the project will take 30 - 45 days pending contactors availability and weather conditions. For any additional information please contact John or Debi Miller, property owners. at 978-946-9406. .1i 3731 Date ..... /. O TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... !.... G.(j .......{ ...J..........:t....C(.........c..t..G.�....r...,. ....... has permission to perform ......... ........................... 1.......................................... wiring in the building of ...... V"'. )....... (J. P . l ................................................... at 1... �..:.! �:.... n � orth Andover, Fee.... �..0 Lic. No... �.-.?{.! �............^.r. z^ �. �. ��`z LECTR16AL IN P Check # TBEC7l�M1VIO THOFM�IS Office Use only DEPARTMWOFP MIX, 'AFE!'p BOARDOFFII:EPRME M7O1V Permit No. EL 3 / I�1xl1lATI0111SS27Cr�IR1�lJl� Occupancy & Fees Checked ------------ APPLICATION.FOR PE MI'T TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WMI THE MASSACHUSSfS ELECMCAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date `'`3 d 1' 8� Town of North Andover To the Inspector of Wires: The and erstgne app tes fur a permit to perform the electrical work described below. Location (Street & Number) �S%sI—Ijo,� Owner or Tenant Z�P � / , , 7;, / _ rovi i/ Owner's Address 's this permit in conjunction with a building permit: Ycs ED No (Check Appropriate Box) 'urpose ofBuilding d` �'C /��H C . p Utility Authorization — .. tY No. ,xisting Service Amps^ /.Volts Overhead 0 U WWVUW C:J No. of Meters 'ew Service �� Amps / Volts Overhead �-- C3 U" Q No. ofMeters umber of Feeders and Ampacity kation and Nature of Proposed Electrical Work'-6 orm 'l v O o ' f fo. of Lighting Outlets Na of Hot Tubs - )f water I ANO*or of AirCond. of Heat Ta Tt e Area Heating ng.Devices KW fMoim* 1 FDtE ALARMS No. ofZ )Dft w Torae Na ofD *W bs KW bevices KW Na ofsoyrft:,D., Na ofse(fCteiued: g`D�cvices . Kw Looe Na of 0 Comrcetions Q.. e(.o�e� Pls�taeitb>}tero�usana��Geetes�ilauta . ant'ntI�yhs�>iar�t+ePkalicyindttdng � � Y$ �NO . beniftad�aGdP1XfCisWM1othe0&r-- YO No ) iebjaih�dtedoee�YES�pkase' ezdt i II`ISURANCE WAIVER; IammvAethattheIxeedney,Ub Sguftmantsper", tLvsiA]S9 stacumena Teck one) Owner Q Agent ED 19 /J Z,"A Telephone No. PERMIT FEE