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HomeMy WebLinkAboutMiscellaneous - 36 LANCASTER ROAD 4/30/2018l jf C Location ,3(,If No. `/ Date TOWN OF NORTH ANDOVER a Certificate of Occupancy $ Building/Frame Permit Fee $ sACHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check # r / Building Inspect6r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT RLP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING ts BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: s= Building Commissioneonspector of Buildin Date SECTION 1 -SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �oy6, /QC/ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Reqttired Provide Reqdred Provided ReqWred Provided 1.7 Weer Supply M.G.I-C.40. 54) 1.5. Flood Zone Infounation: 1.8 Sewerage Disposal System: Public ❑ Prh%W ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SEC'T'ION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record 11-114 0-1 3 (1 GQ IV C2� S -lt.- Name (Print) Address for Service: ;Iio,1PL, *o o oma-✓; 1- 01SyS Signature Telephone 2.2 Owner of Record: A" Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ 13,F 0 Company Name Registration Number .2S— cv�-,- 140A Pyr 4 SO . c7F7 f ? (it�Gi r'�0% G¢ OsoV Addre O Expiration Date Signature Telephone 00 rn X Z O v rn SECTION 4 - WORKERS COMPENSATION (M.G.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 ....... No ....... ❑ SECTION 5 Description of Proposed Work (check au annlicable ) New Construction, ❑. �«� .Eisl g Biding ❑ Repair(s) Q" Alterations(s)ipVt� Addition 11 ©n (= 1 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 1200 F O vim/ 1 ��VCi/' I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be OFFICIAL USE ONLY Completed by permit applicant r 1. Building (a) Building Permit Fee O Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 3 s 0 0 0 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT v 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTIO/N 7b OWNER/AUTHORIZED AGENT DECLARATION I, �ry�i� r�O�rO GLS_ as Owner/ thorized 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 Nam Si ature of Owne A en Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3 RD SPAN DM ENSIONS OF SILLS DIN ENSIONS OF POSTS DEV ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE cl1nsetts Massa eats ComJ"011 altlt °f lccid Tile rtrnent °f ln�ittstrial cepa Office of Investigations r Off atop Street hers �.„ 600 Wasl�ittb MA 02111 icianslPlum 1 ,a >< IElectr n 1,e ib BvWwnmass'gov/�erslContractOrs Please Prt t w utltl Fftda`it� B surancc anon `N 3 ork t'nfortn,Jtjon /oma 4g- lican "as' l � �.- - ,.Il)roa►,ii tltonllOdt t9 a I -I' �P qua)• ` �at�� 113ttsi»c, • D Phone #: of proj¢ct (reQ t ep`� TyP¢ construction New A�dCess' I/c, M d 1 6• ling b°X; contractor an Remode 1 ck th¢ appropr late tQ 1 ato a generae sub -contractors '► 0 Olition caty�StatclZ�p g. Q pem � Che hired th sheet. dition an employer 3 * have on the attached have Building ad dditions with — listed tors q. Q airs or a prey a employer di Or pa►t"tone) These sub-co"ttac ce ddition 1 1 aM ees (full an or pa�ner- comp• anion a 10 0 Electrical rC pairs or a s ers' oration and its bing eMPI a sole proprietor ees work 0 .Q plum tam and veno einplOy achy 5. Weare ha e '-excised th�1 Roof repairs vs 2 Q ship ba" me . any u ance officeof exemption Pe h e no 17.0 Other working ers' comp in right i t O and we 13. �r1O work work C. 152, No workeCs' s16h m al yee req ired•A olicy infonnati° affidavit lndicaun� n. reQuired owner do g 1 emplO suranee u co c°s¢dh,n must submit a 11c,04con�P Policy infurrnatio 1 Q 1 ani OLh Me workers' comp COMP in mP' ers their workers ,de c5inuactors nd their work' unci •ob sate r8A ed belo show a f then tr. V40 r my$elf• � Uir w hire outs con rotors a fife PaIIC insurance cion all work' d of the sub-' Below s tdl out the sec doing a the oa5»e c ,Plt)yees. ° theY are 'ho* ing bo'� � 1 must a1s icltin€ sheet • or fay � � hecks vitind aional ,ution insura11Cef licant that c „vt this aftida ttached an add' n / ' �nY app ho snV. ,r Durst a , "i'll n, � ` 'A v -{l=— w51srtha check thisbr w1)rKers V� No,„e° pate: n � (91 •.:�o"tractor that is provictin8 E,�piration �9 employer _ 5 iration date)• t um un p?3a c' exp information. any Name: (�_7 #' CitylStatelZiP "h¢r and hies of a cot C. (' the Policy nam Of crimes URp�R and a tine l Insurance t,ic. r9� ag¢ (showing Osition 1 Self -ins S �-e ration P• to the unp STOP V` vR policy ti or a decla 1 can lead Ot a the Office of n ofd c• ,3 (P �` ¢gsatio policy 1G1. e�;rltsies in the ��nay be lorwarde o Mare ,comp SCCtion 75 A Civil P lob Site M of the workers as well as statemen der of tb► ch a copy e as re4uired un risonment' that a copy unci correct. \tta e coverag imp Be advised is true to;ecur 00 d! or one-year Wit above Failure to 500. the violator crape veCitwation• anon P / fir up 00 a day againsttnsurance COv' form 3! © S t to X754' IA f°r f erjury that the in pate: p so P °t uP ations of the enal, lnvestig the pains c� z=-- hereby �e.•� V `—�� Ie inl. S' d hV city r►r to►vn'►.ix- Si nature'� ✓ ��7 CJS ne eotnplete in this arelh tri itllJicense # plumbing O►�e'_ write perm 5• po ►rot ► Inspector Ic.ial use only- A. Electrics Ufl wn Clerk Town; le on¢); 3• CitylTo City or �uthOrity (Cir le oilBuildingOePartment Phone W. Iss Board of Health 2 6 Other coot, tet Pt -N NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws chapter 148 Section I OA. The debris will be disposed of in: %u,tAPs4-r (Location of Facility) Signature of Permit Applicant Fire Department Sign off����J~ -� Dumpster Permit Date U) m m m N m m W CO) � d CO) Cl) 10 0 co n Z .y! O :vni. CL =. CO) aco c O CD CD o r CD CD o CDD os ov 23. C CD co) CD_. d O Cn I CD � O CA O 'vCD CD Z O O CCD 0 0 M � CD z d y 0 CD c H N OatA CD n .� O H�nmC =r CL „* o ns� o m O O O y CD O � O : m N = > > 0 CA CD C2 w -� iCO+� p O 0 25. C., O H C'! CM o D c ? o; a CL �.m . cc o �_ : • � m m y CDco C CL N H n d Q N O : O 5 �. m co ? y Q : O H � CD CO 'O r *** o m o cao CD ^► CO Wim: a� .� co): CD C.: o CD m m o� n � H It O I � Cn 00 do Cn O p7 ►z-3 Irl � a- tom-' � �• "ti to y a- a 0.cn G1' O x y 7� � 7d Q O C CD (( ✓lz� "V/ 0�✓l�bJ2�ae�6 � � Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR - _Registration: 139640 Expiration: 7/28/2007 Type: Supplement Card i INTERLOCK INDUSTRIESINC KEITH O'DONOGHUE 6 #7-25 WALPOLE PARK SOUTH WALPOLE, MA 02081 i ; Administrator NOV 10,2005 18:15 Keith Bartling 61794.55444 page 7 Agreement Between INTERLOCK INDUSTRIES, INC. Unit i, 25 Walpole ark South Walpole, MA 02081 Registered as a Massachusetts Home Improvement Gontractor ria: o.tr;I (", ,,.. Customer Service. 1 -866 -588 -ROOF Name MA A j< A �-/? fl�CW �� /��. _(the.,Buyer") Job Address — ��_ AAJCAS- City/Town . ,V_41?zd AyL6yc- e, )-n Factory Use Only 250268 Date ////,o S7 - Phone 6�J,02,S_ -Wr? Zip Buyer's Homo Address�A-W....__7 _. Zip r�J/—ECS The Buyer is the, rogistered owner of the land and premise; described in the job address above (the °Pr�rnises' 1 rid reby conlr•arls"wif Interlock Industries, Inc. (the "Contractor") and authorizes the Contractor to furnish all necessary materials and labor to install, construct and place the improvements according to the following specifications, terms and conditions (the "Specifications") at the Premises. SPECIFICATIONS YES NO ROOFING MATERIAL_ YE NO Shingle - Color Location for Shipment _QRLiW /►y...__.. _ ✓ .- Flash Skylights N3mber / __ - ✓ ___.. w`_ Flash Vents __... Underlayment ✓— Snow Guards ... 13 /R00F REMOVAL _ ✓ Strip existing root --. layers Haul away roof debris and pay refuse fees. Note location for bin Supply1/t` plywood. Q- M_ n~ Z7 OWNER Supply adequate electrical power. BC mons;Ne f", all 'n, ��f^.� y^ l 7 nrhpr tier nq�lr� roof repairs. (ie) Roof decking, fascia hoards, etc. Roof repair work may be undertaken by Interlock at a cost to be mu,,ually agreed in advance between the parties I ce FA THIS CONTRACT INCLUDE ON -PRORATED, LIFE ME LABOR & PRODUCT WARRANTY' ON ALL INTERLOCK MANUFACTURED PRODUCTS- WARRANTY IS SENT DIRECTLY TO BUYER AFTER COMPLETION AND PAYMENT IN FULL. WARRANTY tS TRANSFERABLE. 04 _.. Sales Price $ JD® Financing Requested _ Yes ZNo 1 Sales Tax Pre -Approved Interest Rate 10.9% to 14.9% 1 Sub -Total Payment not to exceed $ I Down Payment $ -tom n Total Balance nn Completion $ _ .r I MAKE ALL CHECKS PAYABLE TO: INTERLOCK INDUSTRIES, INC. Do not sign this contract it there are any blank spaces. t- - IN WITNESS WHEREOF, the Buyer and Contractor hEavp hereunto signed Lnerr names iris .% udy ui rl.. ., . � �.+•,•, r,�n ♦h n+ 7., rF-, r, ornnf that Ihp rnntrart0 r haF rfiSrtUt P. The contractor and the lloineuWr ler heieby inil tL. i !y' Lay, :c concerning this Contract, the Contractor nla� S;,bmlill soy' ;l'Sf ulQ 3 i r'"''op nrh;fratinn ror%iir'p whir`h ha¢ hRen nporovpd by the Office of Consumer Affairs and Business Regulation incl the' consumer sh?ll he required to submit to such arbitration as provided in M c 14 Signed Per; er NTERLOCK INDUSTRIES, C. Siqned Buyer Witness This Agreement is a binding agreament and contract between the parties. lhi, IS FIUL d cfeU:: Ilpl. ib i�;K, J v li ui CC y r i1nl.,,q;:fn If tinanning is required, the Buyer hereby authorizes the Contraciur to obtain ffo&t in`cr r tic i and the Pr.iye �P Phi ?q'PAS' n,nvirie and sign all necess Iry documents~ required by any third party financial institulior. lo cornplele the Financing. ilnmediatHty on regrlest. The Bever hereby acknowledges reralpt of this Agreement. Seo reverse of Agreement for additional terms and conditions All surplus material is the property of the Contractor Forrn COWMA-00<X VA a Location 3 6 L A VC �5 � ` No. --5-413 Date NORTH TOWN OF NORTH ANDOVER OL f' 9 Certificate Occupancy of $ SACHUS Building/Frame Permit Fee $ a a 0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ p7 D Check # J q 6 I Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI a OVATOR DEMOLISH A ONE OR -TWO FAMILY DWELLING s � r BUILDING PERMIT NUMBER: DATE ISSUED: _ C/1 a �� SIGNATURE: t Building Commissionerfl for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3� L A s t0-1 014 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage R 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required— Provided Re fired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record MA21� IZ ie v�,v�'� 3 L a,� cwsf �c-c a Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: !r Name Print Address for Service: .1 Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 -S A -�•e s "Te 5 t -A Licensed Construction Supervisor: C 5 O S 4 i 1$ License Number 5- S *- A 5��-68�--moa 3 Expiration Date Signa re Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number C�J� (� �t/ 1/f0 Addre G^� �^ ` $ Expiration Date Si natu Tele hone Ma M X ic "'i Z O l� z M 90 O mn ic r M r z ^ Q 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 affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work(check all a Hcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: F061 R,?-tg �CGK 119RCTION 6 - F.CTTMAT1Wn (`nVQc rDir!'TrnV rnr�rr Item Estimated Cost (Dollar) to be r �` {IV, SSE 01+7LY x� Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of ---Z" top 0 -- Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 $' o 00 Check Number Fr'-lL,zi l lVr'q 1 V Dr, 1, V1V1rLr 1 h.V W IMN OR I OWNERS AGENT OR CONTRACTAPPLIES FOR BUIIMI .DING PERT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. 01 rarwc ur vwrier Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, —S'A ^"'e --, 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 -5- s Tt s �-�► Print N e Signature of wner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 ND 3fw SPAN DIlbIENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 -. c,d- — a tis 1fD-Kj-"Q 8,0 FORM - U -LOT RELEASE FORM 3--`� 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. i....s.moss..•s.ss....s.■.moss ssssssss.■.■....ssss...ss..ssss...ss...s....won APPLICANT M A a kc- c r -......r PHONE '+ 7 S— S 1. S9 ASSESSORS MAP NUMBER 1 n L( LOT NUMBER ) °7 N COh4N4ENTS RECEIVED BY BUILDING INSPECTOR DATE SUBDIVISION LOT NUMBER STREET �- +a ^ c .A 5 �' -c rL STREET NUMBER ...*..............s............................■........sass....s....sman ..s■ OFFICIAL USE ONLY ............................................................................ RECOMMENDATIONS OF TOWN AGENTS own ..ss...ss.. ■ ........"....ass.mss■ ■DATEssssssAPPROVssa..D.sssssss.....ss.ss■ E� d � CONSERVATION ADMINIS OR DATE REJECTED CONDAENTS s DATE APPROVED TOWN PLANNER DATE REJECTED CONMENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH COMMENTS DATE REJECTED PUBLIC WORKS — SEWER { WATER CONNECTIONS DRIVEWAY PERNIIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COh4N4ENTS RECEIVED BY BUILDING INSPECTOR DATE The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers` Compensation'.Insurance Affi-davit Name Please Print Name: _70, �-• e s �-� S t vo Location: i e dcx� i S City N A "l a o ✓.-vz. ,i-) A Phone # am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity' . 1 am an employer providing workers' compensation for my employees working on this job. Comnanv name. FaiAue to secure coverage as required under Section 25A or WX 152 cafe teed to the krgm4w of cr n*W► penautm cine he up too $'l.! andtor one yeeW AW -4 01[f)(ILM acme understand that a copy of this statement may be forwarded to the ofrioe of Irwestigations ct the DA for coverage vernka ioi►. t do hereby cerbiy w7der Me pa&= and penalties 0FPe17wy that the infamm Ww provided above is &W aW correct Signature Da#e 3/ g l°. y Print name 54-'a Phis g 74- 6 8 a - aoa 3 offiew use only do not write in this area to be completed by city or town Wiic iar City or Town . Q Bu%hrtgr C]check I mr ate response is requked p Lic n ra Ba p Se%tm ws i Contact person_ Phone A E] Health Uepar I] Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be , disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant 3Zgza V Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Building and Remodeling 5 APPLETON STREET NORTH ANDOVER, MA 01845 (978) 682 2023 fax / Phone Proposal Submitted To: Kerry and Mark Rieumont 36 Lancaster Rd North Andover, MA 01845 Job: Shed Proposal March 1, 2004 Job Description: Home Phone: (978) 975-8689 Work Phone: (617) Obtain building permit Complete removal of all demolition and construction materials generated by Testa Building and Remodeling and its subcontractors. CONSTRUCTION: NEW DECK: Remove old deck and re frame a new deck from sun room over to the bath room wall. The deck will come across straight to where it is currently and then curve over to the comer of the house where the bath room is. The decking will be Trex . There will be p v c lattice around the bottom of the deck and a door for access . The railing will be custom made out of p v c trim the look will be 2 x 4 top and bottom rails with a 2 x 2 baluster COST OF THE DECK WILL BE $13,485 A finance charge of V/2% per month (18% per year) will apply to all accounts over 30 days past due. In the event collection activity is required the customer shall be responsible for all costs associated with collection, including reasonable attorney's fees. I propose hereby to furnish material and labor complete in accordance with above specifications, for the sum of: $ AMOUNT TO BE DETERMINED ON WHICH OPTIONS ARE PICKED One-third to start, one-third after insulation, one-third upon completion. Authorized signature I reserve the right to cancel this contract if not accepted in -30_ days Signature, Signature Proposal 2 SHED: Build a 12 x 8 shed. Making it match the house as close as possible. There will be one door and two windows. Clear primed trim and clear primed cedar clap boards. There will be blown out rakes . The roof shingles will be a thirty year architectural to match the house. This price is just to build it and finish the out side . COST OF SHED WILL BE $ 8590 NO ALLOWANCE FOR PAINTING ,STAINING Em 8 5) A P f 0 w3 U � n -,r A r. Px yt o J s+ � o ri a r .� � � y � m F Em 8 5) A P f 0 w3 O z ;w MIT" O GO co O c O a� w _cc H O v CO) C O cc _cc O. C** rm, i O v GD C. CO2 G A� 0 CD a� L o �- CL cmQ C O gyp=•+ C J 0 CD Z CD O. CO2 C C LU 0 LU W W LU U) o w �'o U) w o a x U � w � pG w x O N .� w z U) cn MIT" O GO co O c O a� w _cc H O v CO) C O cc _cc O. C** rm, i O v GD C. CO2 G A� 0 CD a� L o �- CL cmQ C O gyp=•+ C J 0 CD Z CD O. CO2 C C LU 0 LU W W LU U) C � m C ' O O N V c O. C �p cm •t o . o 02Ea� °3c� a N o �C IS a cm x : ��'J:• m c :ham E ED . O � E .fl av CL �:♦ y m' = ID cc 44 t O Q! •�c 5 m co y ' Z O c am c cp �+ N m m •O+ rr Z F.. �&, r� 2L= s .vi Z oc �E cs o d m O� gC#* Z A m� a ` == C F- ~ 06*- m 5 MIT" O GO co O c O a� w _cc H O v CO) C O cc _cc O. C** rm, i O v GD C. CO2 G A� 0 CD a� L o �- CL cmQ C O gyp=•+ C J 0 CD Z CD O. CO2 C C LU 0 LU W W LU U) Locus Q`Ru _ � e - RON u tI=- �lC-C�AG� P -E AC,T7/ T2J ST G1 N Q O d0S hi C� l C Q// N, y 9 �0 / 1¢�1��`� 8 U f go' F 0 S � gy d O NI ( rzo� n C \ C �6p c a� a, I/ _ � e - RON u tI=- �lC-C�AG� P -E AC,T7/ T2J ST G1 N Q O d0S hi C� l C y 9 1¢�1��`� 8 U go' F 0 S � d O C C \ C �6p c a� a, so� , A Date Tpwiv r.� NpR PFR MIT F TN qNo This O O ce�ll'es . R w/R/NG VER h that ssion t o r witjngin t pert � at heb�ldiri9Of cheek (!} c�'J E��-x_ dOver, Mass. / THE COMMONWEALTHOFMASSACHUSETTS Office Use only DEPARTA4ENTOFPUBIICS4FEIY Permit No. -10 -2) BOAROOFFIREPREVEVHONREGUTAHONS527CMR12 00 dD Occupancy &Fees Checked APPLICATTONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date_ Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) -J�2 I -14-1V C AS7Te /2 f? iV Owner or Tenant j,7- U /yj p !t/ 7— Owner's Owner's Address Is this permit in conjunction with a building permit: Yes © No (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Uri Amps,/ �Volts Overhead M Underground ®r No. of Meters New Service Amps / Volts Overhead r-1 Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 6L ��;o e7 61 Z -- No. No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below -Generators KVA round round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones, No. of Ranges No. of Air Cond. Total Tons No. of Detection and 1�1o. of Disposals No. of Heat Total Total Pum s Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW t No. of Self Contained # Detection/Sounding Devices Local Municipal r-1 Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors 3 Total HP OTHER• lFMM=CDM1age. NualatDdicmqtmmictzofMassadmsemCtneialIaws Ihawawntytbabilitylnstr&=Pblicyurkx TConTlek- Coveageoritssubsta tWeqtrivalent YES ED NO IbavusubmiWdvalidpmofofsametotheOffi= YES Ifyou haw drdod YES, pkmc ftxh= dr, typeofcom ageby drddngthebox INSURANCE BOND OIHQtEJ (P1ea9eSpacily)-All Xa Eshm&dVahrofEJec"Wotk $ ads O b WotktoSlait lrWechonDa1BReWes[ed Rough Final SigV tmderTie Rmilies ofperjury: FIRMNAME A)9V/W D ,i Z6 eA(7 i-1 Iic wNo. Lion f1r O i /L%�i�Q C///1/ Si'. Civ, -rt_ licemeNo BusalessTelNo. Arkfit cc �l l�� C 43 SC / C /1 S7—Al P ,;,-2- GZ. 2 AIL Tel No. OWNER'SINSURANCEWAIVER;IamawaredratdteLmwdoesnothavediemsuI=mverageoritssubslanbalequivalentasmgtlitedbyMaw mseusCtneaLaws and that my signah m on dris permit application waives this iDquitwrtit. (Please check one) Owner Agent T ` p -r/ Telephone No. PERMIT FEE $_ Signature ot Uwner or Agent Date .... .: �' '� .. . . J. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ...... �'.:.. 1.. .4��.. �- s has permission for gas installation in the buildings of .. t .. ��-�-? t <•. r� c.�-�..- ................ at ........ - North Andover, Mass. Fee 17 U .... Lic. No...........- Q .......... . GAS 1ST TOR Check # �� 4.449 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FrrHNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations IA-1�,e� New Renovation Owner's Name Date _.i�. p % z 3 QQ Replacement ❑ Plans Submitted 0 Permit # Amount $ c5e. tv SUB-BASEM ENT BASEMENT 1ST. FLOOR LND..FLOOR ;RD. FLOOR � w ;TH. � ;TH. TH. FLOOR FLOOR U a O F O W w d a O OW ,,,,, O F CS W d d T �w F 0 A d Z W NrAO W SUB-BASEM ENT BASEMENT 1ST. FLOOR LND..FLOOR ;RD. FLOOR ITH. FLOOR ;TH. FLOOR ;TH. TH. FLOOR FLOOR TH. FLOOR _ r4 � .�.�� lc�r�c� �.vs�� vc iia.✓ tor tYPe Gone: Certificate Installing Company Name S�G,*/C Z;;., CG. `d:= C - Corp. Addreszo Partner. V 0 AJ 11 BusineselephFim/Co. Nan mor GaFe ueitter1 00�yv Ce 7v�"a' •• 3 3 C7" INSUaANCE COVERAGE Check one - I have a current liability Insurance poli rt's substantial equivalent. Yes Noo Ifyou have checked �, please indi a the type coverage by checking the appropriate box- liability oxLiability insurance policy Other type of indemnity ED Bond 0 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner D Agent 0 i hereby certify that all of the details and information I have submitted (or entered) in above application are true andaccurate to the best of my knowledge and that all plumbing work and installations performed Permit for this application will be in compliance with all pertinent provisions of assac us State Gas C�of the General Laws. OVED (OFFICE USE ONLY) Signature of. Plumber Gas Fitter Taster 0 Journeyman sed Plurf4ber Or Gas Fitter G License Mrnbtr Location No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Ss•'° • E<� Building/Frame Permit Fee $ +cHus Foundation Permit Fee $ Other Permit Fee TOTAL 2 ,? ? `'u Z 70 -" Check # n 16476 Building Inspecto TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: td 3 17 1 DATE ISSUED: 6 _ / '�'—a UQ 3 SIGNATURE: Building Commissioner/Inspector of Built SECTION I- SITE INFORMATION I. 1 Property Address: ,36 L,&Pjcaett5R'Rcw tJaR,- cWOR" t,/� G. aaa� N( 1.2 Assessors Map and Parcel Number: o4. a g Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 4 ae?1 15&.4 Zoning District PTOPOSM Use Lot Areas Frontage (ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required I Provide Required_ I Provided Required Provided 10' 10' 1 1 p ' 1.7 Watcr S N M.G.L.C.40. 54) l._. Flood Zone Information: 1.8 Sew a Disposal System: Public Private Q - Zone Outside Flood Zone YID Municipal On Site Disposal System SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 'ilStOrIC Dick: Yes NO 2.1 Owner of Record �/&K4 K�(� % NarRe (Print) __ — Sigrlature 2.2 Owner of Record: Name Print �6 �NCA� lam• A�►R . NCSs. o�� Address for Service Telephone Address for Service: Signature Tele. SECTION 3 - CONSTRUCTION SERVICES T 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: 6 R Ucb. ►o• Biller/cDL01�(02- Add s 7.2= 79 2 4AC itgnature Telephone i.2 Registered Home Improvement ike ,ompany Name coj:�DUbli c.'Rd. tQua u lug W.bjj�(fco, Wo. oir-V-21 va T )a 72- 7944 Not Applicable 0 License Number C5 0 �Z,7 QQQ Expiration ate 414((Y4 Not Applicable ❑ � I j 377'2 Registration Number 7a Expiration Date SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 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 Y s ....:..0 No....... SECTION 5 Descript' n of Proposed Work (check all applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Description of Proposed Work: . OGbS��Ca�;rAs,7CrQ '*OtXV' tNbRo_M0 "butt-rE �-CWCRET1-_ �I►rnmi N � � � �®��S SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to om leted by permit applicant 0,,4IGIALIJSE ONLY f 1. Building n�ypG .C. Com (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of,� Construction Uao 3 Plumbing Building Permit fee (a) X (b) &iao --� 4 Mechanical HVAC —` 5 Fire Protection -- 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION'TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, s Owner/ f subject property Hereby authorize ©1 ` '� - �- tc to act on My behalf', in all matters relative to work authorized this building permit applicatipri j Signature of ONA Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/A ori Agent o 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 Pr t a e I Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST2 No3 RD SPAN DIMENSIONS OF SILLS D[MENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF Cl-E[MNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL, GAS LINE 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. ............. a ■ ............................ ■ ■ ..... ■ ■ ■ ....... ■ ............. ■ ■ APPLICANT A*M I lU • 1 UC • PHONE 9 272 - 794& ASSESSORS MAP NUMBER SUBDIVISION 1(>4- • D LOT NUMBER © f -7-4 LOT NUMBER IIA STREET `-� "�` STREET NUMBER # ✓�J .............................................■...■........................■a OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS ............................................................../n. ......... DATE APPROVED l T 03 CONSERVATION ADMINIS OR DATE REJECTED CONAVIENTS TOWN PLANNER CON VIENTS DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED SEPTIC INSPECTOR - HEALTH CONK EENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DA I auvut Jame(.,' lar0-8"caxuhgn .-j 21211"" -a!>o ti. 'i�cwr I I �'- 4s aeqf 1"20-4 9 sA Amvemrmnae Wnrtompn Onrp. of kmft4cap Inc. AND 172 RE NNUMM MORTGAGE INSPECTION PLAN gl�-W _60 d Board of Building Regulations One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 03/14/1934 Number: CS 027999 Expires: 03/14/2004 Restricted To: 00 RODNEY P ANDREWS 1647 LOWELL RD CONCORD, MA 01742 g T V� ar►vnto�rusealt% ,lfi '4. BOARD OF BUILDING REGULATIONS t License: CONSTRUCTION SUPERVISOR I Number. CS 027999 Birthdate: 03/14/1934 ` Expires: 03/14/2004 Tr. no: 17067 Restricted: 00 RODNEY P ANDREWS' j 1647 LOWELL RD (.,e.,..e,r, CONCORD, MA 01742 Administrator Tr. no: 17067 Keep top for receipt and change of address notification. Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration ANDREWS GUNITE CO., INC. RODNEY ANDREWS 6 REPUBLIC RD N BILLERICA, MA 01862 Board of Building Reguiadons and Standards HOME IMPROVEMENT CONTRACTOR r Registration: 113772 Expiration: 07/1512003 Type. Private Corporauon ANDREWS GUNITE CO.. INC. RODNEY ANDREWS 6 REPUBLIC RD N 811 1 ERICA, MA 01862 Admintstnwr Registration: 113772 Type: Private Corooration Expiration: 07/15/2003 Update Address and return card. Mark reason for change. Address Renewal f Employment Lost Card License or registration valid for individul use oniy before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 IWO,�� �. a ACDRD CERTIFICATE OF LIABILITY' INSURANCE CSR 5 DATE(MMIDD/YYYY) ANDREWS 03/06/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kittredge Insurance Agency Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 276 W MlSt P 0 B 1129 ! ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . an ., OX Northboro MA 01532 r Phone:508-393-7744 INSURERS AFFORDING COVERAGE NAIC# i INSURED INSURER A: American Casualty Co/Reading INSURER B: Transportation Insurance Co.1 20494 Andrews Gunite Co., Inc. INSURER C: Valley Forge Insurance Co. 205_08__ 1 6 Republic Road INSURER D: North Billerica MA 01862 - ------ - - - INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN LTR AUU­— NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION i DATE MMIDO/YY LIMITS A GENERAL LIABILITY X COMMERCIALGENERAL LIABILITY CLAIMS MADE l X , OCCUR 2048661231 03/01/03 03/01/04 EACH OCCURRENCE S 1000000 PREMi's ESOE. occurence) S 50000 MED EXP (Any one person) S 5000 PERSONAL 8 ADV INJURY S 1000000 — I GENERAL AGGREGATE 5 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: `l POLICY PE 0 LOC PRODUCTS -COMP/OP AGG $ 10000 0 O C AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 1081829964 03/01/03 03/01/04 � COMBINED SINGLE LIMIT I (Ea accident) $1000000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ ---""I I PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO IE�OTHER AUTO ONLY - EA ACCIDENT $ THAN EA ACC I S AUTO ONLY: AGG $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE 7X— DEDUCTIBLE si RETENTION $10000 2048660466 03/01/03 03/01/04 EACHOCCURRENCE$ 2000000 AGGREGATE ^5-200-0000 — - "--- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE j OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 2048661276 03/01/03 03/01/04 M v, - TORY LIMITS ER _ E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 "--- E.L. DISEASE - POLICY LIMIT I S 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SAMPLE CERTIFICATE FOR INSURANCE VERIFICATION PURPOSES BLAN001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION) DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR TIVE ACORD 25 (2001/08) — f _© ACORD CQ ORATION 1 Fj LU o CL z w cn z cx pE-� U C ° w° w°' a, U w w U a � w GG WO W chi w H d ro w W W w r� ° cn O ° cn LU o CL z a t O! s .v CD O CD Z O D N 0 .E co L CL co C 0 CD 0 m N 0 v .CL N C 0 v L V co CL N w+W C CM C : M� M�y� WCo W �dwm, LLJ 0 Cn W Ir W w w Cn o O H • c O W Im O eU O A ca a ECF • L eo Ow a. OES a. E a m .. Q7 fl: ev H � N to 1 O E m �: CD 00 _ = O xi-r•�p� Cf • ac= m cc a � Q i m C O Z � m o m w p y o►— N m m _ RE C C oc Vf E d= c = o coo _ CL W.0O aoy•g CD a m _O a t O! s .v CD O CD Z O D N 0 .E co L CL co C 0 CD 0 m N 0 v .CL N C 0 v L V co CL N w+W C CM C : M� M�y� WCo W �dwm, LLJ 0 Cn W Ir W w w Cn rr -2 3/16' -C ta "q 2-0 W I` DID 'P W SO 4:1 70 CN 7D cl jA > z Ir il-) i x 0' ITO 0 70" m 0 YO Cl 70 A 3 z M .7 -k 1 11 c Z > IM\. 'I J —A 11 z -1, - I- 14 kh I I CA iij m n 1 5/6" 7j I i r1l < < < <mrt < < W 70 , r n, 11P n, %I, m m n, LO rm- If, �,p F, W rr t"- 70 <<<<<<< m fil a 11 It 11 if < m LA F— ,3 < fr 0 T- F tm )MO CJM70 U r V m -4 z C) -FT '-4 z UD M %A T z f- w mill Is C"� 1Tj N( TrSl it W. < — -- — -- — 1 6.5- i _ ' I SAI ITI I I I r 70 2 < < < < 7D If u u u It v v .z I K i C. ry > AA Z > > 0 T. -4 0 3:- 0 1A N 4 1> z 1> e'v 7 a C: I r r kh ITI LA -E V- aE 10 zn m M r1l 3. x C1 70 z < < rp OTTi mem £4, Np M z < x 111% 1>11 72 T '0 z cl� Q 2UT -4 Fr Fr Ln v7p � =! 7D 70 TY, KzLl Gj 'z— RQ 'T C) T. LA tr F: Ln Fq "t. -M4 70 Ln -k Al O G Tr > > C') LO Z, rr r- -4 IT -4 < C� Am C4 > CA r, 6 r YF Rp Mt, � T' m 70 T- 2; )> 'r T 10 INC E i, nA P171 �p 114 Ir m rp cp, m m p Q Z LO COP -n z r- — 1: (') � m z c, rn T" 0 a '20 Q �) -4 1? 3� F, p z m 70 z m 3 kA Z86 tR 6 C) c M Q ,,� "p-, <�, ') M-4 > C) -4 .,n 43 M -< m T- > (1) _3 Q� r -1, � 'D 1p '00 10 z F, � 70 > 03 0" T- Fr 70 z z -n CZ, W z < rn > La z ir C) 34 P CD (T% M kA 70 A 70 ir %J, Q1 Q) 9 f1i � C) tn I CS -1 > ?s Ac JO ia m 31 z 'D z fr ILA z > 01 ➢ C) a X. V) 713 r, -TrTT1= z CD -C :p r- 6 W 3, z CA :.! p C-) ><i;< r- m z Cf Q) -k Z z > 10 3- z C) WO 7Q )> Tr kh Ul v Location .310 No. "? Date IZ Wo3 TOWN OF NORTH Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fes. 4' #' S40 Sewer Conn4' -�-I g y Water Connectiop%'Pee TOTAL IGd'y!-73v ANDOVER $ ,,-;t 3 $ C vp $--- ,, n 3 C Building Inspector Div. Public Works 7.o7'/7 ;.Location G� No. a Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other;Permit Fee $ $ Sewer Connection Fee Water Connection Fee rJUM 3 p 1%3A L 6220 Building Inspector Div. Public Works Location r� �Gd / 7 No. Date 6, fi Na oT :,ti TOWN OF NORTH ANDOVER d 4L Certificate of Occupancy $ A Building/Frame Permit Fee $ �ssACMusEt� Foundation Permit Fee $ th'kPermit Fee $ Sewer -'connection Fee $ %r%�• Water Connection Fee $ /�Q�• TOTAL` $ �� ✓•.�. U1V / , a - O 1993 Building Inspector 9 P Div! Public Works Cf Fa PO A r r ZIR s q > A O ,, > A > y i p ? r r __ r O 0 n O z A 3 o y m c 0 z O r -m A > O Z A ai a e m> 1 ; w m 0 i m O A m q o i m Z > m r 0 y Z N 0 7 J i i Z O � i n r Q Q� r O n Cf Fa PO A r r ZIR s M q > A O ,, > A > y i p ? r r __ r O 0 n O z A 3 o y m c 0 z O r -m A > O Z A ai a e m> o i n m O Z m A m i c w n m n i> q z > M 0 i m O A m q o i m Z > m r 0 y Z N 0 7 i i i Z i n r r r O n i >ARR0� m O 0 v; n n n 0 C o Z0 (a0p O C . M ,'� v X A rI �) m a g o z 0 N X z o Z 0. z c w o a i n 0 A m M q > A O ,, > A > y i p ? r r __ r O 0 n O z A 3 o y m c 0 z O r -m A > O Z m C 0 z O 0 p •� z N> m c>>>> 0 z O Zm. m m r 0A of n m 3 0 i r m o i o N m A 3 i A m o i n m O Z m A m i c m> r O= A g z i mXw n m n i> q z > M 0 i m O A m q o i m Z > m r 0 y Z N 0 3 D 0 c 0 o i > m O 0 O z C N C . A rI �) m Q N Q Z 0. 0 n 0 A m O Z m D > A m 1 m q m q 9 q m Z O 9 N C C C O = z z 0 q 3 0 A 9 r 0 r 0 _C r 0 r 0>z A r m 1 0 - q O m m '� m m m m 0 0 0 0 r 0 O q O i 0 i MO •On n 0 O O O Z n _ Z p c On 0 A A m 0 LN m m O Z Z Z q = O ZO a 9 q 1 > r c 0 m m m Z > A q r\ q m m Z m m m m O O 0 Z A q q A q t O O O Z 0 0 0 m > O O r 1 I N C z z O * -4 0 O N r z D m x I �O m zI Z 0 A 0 � o D m M f� j z O .. 00 -1111111 I IL t W W uI hlVl� Z c a o: N0 A O 0Q ^�1 1T1I I I I I I �I a3Q W x J O0 0 vi a t9 J U f - W 0 Z Ooa _ Z5N — 0mU J LL m W01 y ENW Z �0N ., O x u wQ W WWF E Q ¢ w — d 3o v) ap ILU co It N N W It W aZZ IL �Z7 01 Z a V. x 0 uNF- WW W_Z O W a N N a D F0< U Z a U 0 i 1-. 4, --- a � Z 8Z z J 11 z O X -1111111 11 z = hlVl� YC7 z z I FFI� O y N m 0Q ^�1 1T1I I I I I I 073 w o 0 0 0 x J Q u a �llz = O O O mN ro I I I I¢ H z 0V _p V Q y w J u Q~ at9iw�¢Z¢LL Q <z(90wZ y u x W ., O x Z W i Q ¢ w — d O ap u co w ;?aQmz N Z aZZ m Q ZZ'mO 01 V 0-il x 0 S S 0 V O x a I a a D ,� ,� .0 O U w 2 V Q Q � j I ,FF H Q W J .•. Z-lT� 0 U K N V V OOY ][ N �' M m 'Q m N '.0'='S O Q O N O O � Z 8Z z Q z O X T m z N z � a rH YC7 z z X O y N m 0Q w 073 w o 0 0 0 x J Q u a �llz N Q^ m O 3 Q z O YZ Z a z N z t u�.ZZ z aoQe O���a Y 00 Q z xiv,W �- O J J = mN x O H z 0V W z x V Q y w J u Q~ at9iw�¢Z¢LL Q <z(90wZ Wu u x W d0 O x Z i O 0 o i J O aZZ _ vi Zzzf 0 s O x waZ w r www W O \ 0 �xN�nS00ZzocZZ a � j 000 H Q W J .•. W H 27� K N V V OOY ][ N �' M m 'Q m N '.0'='S O Q O N O O Y O uZ00 U W W N W m °°i Q Qa NI Q 0 V m 2 - pa G, 7I T�l01 r " a 4 u Q Q Z a LL aZ z Q 2� 0 S �- O W x t U' z y W x O H z 0V W z x V Q y w J u Q~ Q <z(90wZ u x W d0 w x 0 _ � 0 s O O O r b H Q z 10$ 1;--1Wg n m 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: • ��6 Phone LOCATION: Assessor's Map Number /2�11411_zp Parcel --/ z,4 — Subdivision Lots) Street St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved -15111lq5 Conservation Administrator Date Rejected Comments Date Approved Town Plante Date Rejected Comments Food Inspector -Health S. 'd '_ 22�1—) Septic Inspector -Health Comments Public Works - sewer/water connections driveway permit -Fire Department 7 �1.r Received by Building Inspector 2 9 m Date Approved Date Rejected Date Approved Date Rejected �/4-/913 Date r N CERTIFIED FOUNDA TION PL AN LOCATED /N ",rz.-r 4 A.-, SCALE /". �' DATE Scott L. Gi/es R. L. S. 50 Deer Meadow Road North Andover, Mass. -- 4.; * -- OT 1 4-s, `-'c,-r+ S 41 Fe R JUN Q E ► I A C- A / CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUIL DING /NSPEC TOR ONLY y SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZON/NG's s H BY LAWS OF CONFORMITY OR NON -CONFORMITY isrEa WHEN CONSTRUCTED.+ u� WHEN BUIL T. COI) 10 St Z CD O CL r CD � CD n� O v CL Q CD O .. Q O CO CD CD CO) CD O H 'v d Q H .0 C• CD C CO) d CD CD r� CD CD y� CD y 0 O CCD O C CD n O z C: n 0 z !C� �5-19_C O C < c N m .0 ti �-O m n m 0cc C a o N m �Ec a=Tw N. m CD O m N CA O CA CD �CD o CD 2 n o � _ 0 O aCc Zc.o = O N n �o m �H'R# G CL,.... s C m N C3 CD �n m N tm 3 90 y It d f � C O W �C O. = � y Q N O •� m W CD ' = m O 0 0 0 OCD 1 CO) O �7 CD ag W o CD d m C, = C o = CD. ?� O w O w CD aGc M :; =- O aCc = G CD O ^ 'C p CL 7C W o t/ M y 0 0 c 0 Lor 1°5 a I CERT/FY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING SY LAWS OF NDS. A�iQ�1I�R .MA *-)43 CERTIFIED FOUNDA T/ON PLAN LOCATED IN No,AmDoyER.,MA SCALE:I"= le DATE ;x••13.93 Scott L. Gi/es R. L. S. 50 Deer Meadow Rood North Andover, Mgss. uwr 17 4S,537 g.F. Lor I5 LJUL 2QNG ®EPARTIMENIT i (53.2Z' _L.AANCI'STEK ?CAD R Z'7S,C& OFFSETS SHOWN ARE FOR THE USE OF THE SUIL DING /NSPEC TOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON- CONFORMITY WHEN CONSTRUCTED. Location /Z2J �a/�/i a-3 1. s' l 7 , No. Date 153 r TOWN OF NORTH ANDOVER AmaMAKY.1 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee K/NgWermit Fee Sewer Connection Fee Water Connection Fee $ ThAL It Builtling Inspector k V- 6363 Div. Public Works ATE �Yo w n o NORTH ANDOVE It 1'1,i\,NN1N(;. & t;t)t1ll�ll!N1'1'1' 1)1:�'lsl,()1'l111N'1' KAHWI :Id I I.P. NJ: LSO )N. 1 )11(1:(: I ()11 CHIMNEY APPLICAIIOIJ ANO I'E13111' FERN 1'1'. # �3 )CATION / a 2 j I UNFR' S NAME: Ltt f r�/ iyic JILDER'S NAME: ' ' ' �) iy �L(✓ ' iSON' S NAME: : M6 (U c �, I F"� kSON'S ADDRESS: ISON' S TELEPHONE: JERIAL OF CHIMNEY: f3 +A) i, �, f I►ERIOR CHIMNEY: A/ L'XI LRIOR CIIIMNEY: 1/ fftiWER AND SIZE OF FLUES: / /a . a ! FX/ f I CKNESS OF HEARTH: ;,U chbiney o4 OvAenCace con( un to .ths' I(e.riublemell-C6 u() -tile code and have -(((Ce.3 and _gutatiow been neeebed: -- -- ,TE: F2 .GNATURE OF MASON: _RMIT GRANTED:/ )BERT NICETTA :ILDING INSPECTOR ;SPECTEO: ra F E E :MARKS: _ SOLID BLOCK REQU111F"1) THIS PERMIT I,ICISr GE OISPLAYEO 014 IHE PUMAS CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 263 Date OCTOBER 6, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON LOT 17 LANCASTER ROAD (#36) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/22 CAR GARAG$N ACCORDANCE & SUNROOM & DECK WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. °"'" OCERTIFICATE ISSUED TO Qi'��o °` ,J ADDRESS Y �NU'5 . A. J. 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