Loading...
HomeMy WebLinkAboutMiscellaneous - 36 PATTON LANE 4/30/2018N O d tui N NEW ENGLAND CLAIMS SERVICE, INC. Incorporated 1985 Reply Tor P.O. Box 345 Mansfield, MA 02048 TEL. (508} 337-8058 FAX (978} 927-3002 Li w Reply,To: g ` 131 Dodge Street, Suite 6 ASSOCIO h J Beverly, MA 01915 ' R+O(h[,F)AN MI�`��" TEL. f9781927-3000 URAWE k FAX (978} 927-3002 wrandall@newenglandclaims.com FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B To: Inspector of Buildings North Andover, MA RE: Insured: Heidi & Michael Yoken Property Address: 36 Patton Lane, North Andover, MA 01845 Cause of Loss/Date: Ice Dam/2-12-15 File/Claim No.: BOS53826 ' Claims has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, police number, date of loss and claim or file number. Section 3B. No insurer shall pay any claims (1) covering the loss, damage or destruction to a building or other structure, amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previously given written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city of town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty- three or section one hundred and twenty seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage or destruction pursuant to which the proceeds to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Very truly yours, ZIX z ?Jose Lantieri Adjuster jlantieri@sweetclaims.com 732-330-4295 Date .......... I-/- ........................ ORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that . . .............................................................. has permission to perform. ................................................................... wiring in the building of...... ............................... at '7& ....... . . ................ North Andover -,-,Mass. Fee.( .......... Lic. No .............. i 9LE �ICAL INSPM Check # .r Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No.`r Occupancy and Fee Checked Lev. 1/07] (�ravr hlanlrl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT W INK OR TYPE ALL INFORMATION) Date: 3 —&Q --H City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersignedgives notice of his or her intention to perform the electrical work described below. Location (Street & Number) �(1 ) r(l [ A h p Owner or Tenant Telephone No. Owner's Address C, IA t - Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building 0 \ky_ ( j !� Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: , Co letion ojth 11 bl b No, of Recessed Luminaires I o owm : No. of CeilSusp. (Paddle) Fans to a may a waived by the Me of Wires. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In ❑ o. o mergency ig g rnd. rnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and InitiatinLy Devices No. of Ranges f No. of Air Cond. Tons Tot No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons.. KW..... No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers ) Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Water No.KW No. of No. of No. of Devices or Equivalent Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunicationswiring: No. of Devices or Equivalent OTHER: ��11 Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: l obb .�tl (When required by municipal policy.) Work to Start: ae-N Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 5j� OND ❑ OTHER ❑ (Specify:) I certify, under t ains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: ' �e C, �'d(f LIC. NO.. -_II a,34 Licensee: i & Signature LIC. NO.: a (If applicable, enter "exempt" in the license number line.) Bus. Tel. No. Address: Alt. Tel. No.• C l i *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ) required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. J Owner/Agent Signature Telephone No. FPERm,T FEE: $ t% 1\ 4 �-tmj pec. 4- !I— D 8 41 The Commonwealth of Massachusetts s`� ! Department of industrial Accidents have hired the sub -contractors Office of Investigations listed on the attached sheet i 600 Washington Street Boston, MA 02111 d�; www.massgov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plambers Name (Business/Organization/individual): Address:01110e `i- city/state/Zip: Q j j 1_� f 0J i3l Phone Are you an employer? Check the appropriate box: 1. ❑ 1 am a employer with �, 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a.sole proprietor or partner- listed on the attached sheet i ship and have no employees These sub -contractors have working for mein any capacity, workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [Nonworkers' comp. c. 1.52, § 1(4),'and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Deritoiition 9. ❑ Building addition 10.0 Electrical repairs or additions 11. [1 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other •Any applicant that checks bort# 1 must also fill out the section below showing their workers' compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers' camp. policy infomtation. I am an employer that is providing workers' compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/state/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cell , under the pa viand penalties of perjury that the information provided above is true and correct Phone #: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: i Information and Instructions VV Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written" An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'However the owner. of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance' coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should r be returned to the city or town that the application for the permit or license is being requested, noVthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self. -insured companies should enter their self-insurance- license number on the appropriate line. , City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. in addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under, "Job Site Address" the applicant should write "all locations in (city or town)." A copy of°the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-8.77-MASSAFE Revised 5-26-115 Fax # 617-727-7749 www.mass.gov/dia ... Date...... ........... TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTAL;;;;O ti This certifies that. has permission for gas installation --r- �. ............... in the buildings of ....... . . ................................. at L ......................... North Andover, Mass. Fee X0. Lic. No. �A .... ................ AS I CTOR Check .4 6386 MASSACHUSETTS UNDDRM APPUCATON FOR PERMIT TO DO GAS FTrnNG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS / Building LQ�ations 6 ��"l�C- .tJ LV Permit # a Amount $ 6/0 Owner's Name Uri New ❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type)nn Check one: Certificate Installing Company Name N AXA C L cprAr L-1 Corp Addre _ 20 02.1.5 j� tl.L" � � 13 Partner. Business Telephone 97A 1/23[:] Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: 1 have a current liability Insurance, policy or it's substantial equivalent. Yes ❑ No❑ If you have checked yes, please indi5atgAhe type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ {.o ..�.:. ..�:G. aL _. _11 _1 1_ _• _ , , •,.., . — — �La a 4ll Al I uiauuu , nave suommeu (or emerea) in above application are true and accurate to the best of my knowledge and that all plumbing work and insta ation perfor d under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse Sta� C�a� �Tde�and Chapter 142 of the General Laws. By: Title City/Town; APPROVED (OFFICE USE ONLY) Signaturf of Licensed lumber Or Gas Fitter ❑ Plumber a f0 q 6 k ❑ Gas Fitter License Number ❑ Master ffl—ourneyman w � O O W W oC p O z F 11 ; zoo33q S� ,215 IZt,7 (A ct ►. -f- 0, r Date..��'� 48 C**, t TM,4, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 41 �. SACMUS� y This certifies that ............... ..... "...."'."''.' ..� has permission to perform ;,� .. �................. plumbing in>the•buildings of ....�................. ate... `, .�. .... , North'Andover, Mass. Fee. Lic. No .....G.............:............ . 1 f PLUMfi1N�G .INSPECTOR Check N %c3� 7697 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS �nA ' Date0-7 Building Location 3; c q.l L4 Owners Name I�`��[ �pVl1� Permit ` %o Type of Occupancy Amount )'d 1 New rl Renovation Replacement L—:.1 Plans Submitted Yes No (Print or type)n� Check Certificate Igstalling Company Name T�q-. �Corp. Addressr 1 S S L L' � Partner. k usmess Telephone ., Qa 3 6 5 7 Cj Firm/Co. Name of Licensed Plumber: hAl-LO) Oet—ccyv%t_ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy IT Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installatiqps performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa h tt to Plumbing Code and Chapter 142 of the General Laws. By: ignaur 101 Zicens'e—d'mumoer Type of Plumbing License Title "% g6fo lCity/Town'11�icense um er Master Journeyman ❑ APPROVED (OFFICE USE ONLY i i J MMMMMMMMMMWMMMMMMMMMMM MM W 1 ..:' -.-®-..-.--M .............E ,.' MMMMMMMOM MWOMMMMOMMMONOMN (Print or type)n� Check Certificate Igstalling Company Name T�q-. �Corp. Addressr 1 S S L L' � Partner. k usmess Telephone ., Qa 3 6 5 7 Cj Firm/Co. Name of Licensed Plumber: hAl-LO) Oet—ccyv%t_ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy IT Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installatiqps performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa h tt to Plumbing Code and Chapter 142 of the General Laws. By: ignaur 101 Zicens'e—d'mumoer Type of Plumbing License Title "% g6fo lCity/Town'11�icense um er Master Journeyman ❑ APPROVED (OFFICE USE ONLY Date. ..,.:—. !J .. ....... j.ao ,°aryl ° 0TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION K"_. This certifies that has permission for gas installation ...%.. L L f . in the buildings of ............................ at . k, ..... ..... ; North -Andover, Mass. Fee.. . ? :... Lic. No.. ...... ........ GASINSPECTOR r Check# 3671 y4 I', MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING Wfint of Typal t, nttr. .Mass. G Date Cs ' i.S_ -� 1 - Permit # Building Location _ 'Owner's Name . Type of Occupancy s ,� New Renovation [j Replacet�t.40 , Plans Submitted: Yesp ° No p Installing,Crampany Name CALLAHAN AIR CONDITIONING & BEATING Address 91 BELMONT STREET NQ - ANDQVFR . MA _ n t RA 5 Business Telephone 978=689=9233 Name of Ucensed•Plurnber or Gas Fitter K. 1Check one: L�/Corporation •0 Partnership 0 Flrm/Co. Cerfflcate # 1�ZL C INSURANCE COVERAGE-- I OVERAGE;i have a current HabBly Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes IS No O If you have checked ym please indicate the type coverage by checking the appropriate box A Iiabfiity Insurance policy fad' Other type of Indemnity O Bond 13 OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application watves tuts requtrcmcnL Check one: Ownerp Agent p Signature at Owmet of ownst s Agent - I ha eby eeftity that aq of the details and Infofination I gars submitted for entwedi in above application are true and awnts to the best of my knowledge and that aH pkmibing work and Installations pedotmed under the permit Issued for this APPttcatten wlll be in compliartee with All pertMent Provisions of the Massachusetts State Gas Cade and Chapter 142 of the , eras t3y Tj of Ucenw. Plumber nil to c LRwised Pkfmber or Gas FAter Title Gasfitter M=3440 Master dense Number City/Town .fowneyman MTr10Yt: a: � N V O m Ct J W } o C r aC W 2 ut < = 2 W W D > W G x 13 O i U. ty w ..� h W us C S O d Y. = O O J V C > C d ! O SUB-8SMT. 8ASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing,Crampany Name CALLAHAN AIR CONDITIONING & BEATING Address 91 BELMONT STREET NQ - ANDQVFR . MA _ n t RA 5 Business Telephone 978=689=9233 Name of Ucensed•Plurnber or Gas Fitter K. 1Check one: L�/Corporation •0 Partnership 0 Flrm/Co. Cerfflcate # 1�ZL C INSURANCE COVERAGE-- I OVERAGE;i have a current HabBly Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes IS No O If you have checked ym please indicate the type coverage by checking the appropriate box A Iiabfiity Insurance policy fad' Other type of Indemnity O Bond 13 OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application watves tuts requtrcmcnL Check one: Ownerp Agent p Signature at Owmet of ownst s Agent - I ha eby eeftity that aq of the details and Infofination I gars submitted for entwedi in above application are true and awnts to the best of my knowledge and that aH pkmibing work and Installations pedotmed under the permit Issued for this APPttcatten wlll be in compliartee with All pertMent Provisions of the Massachusetts State Gas Cade and Chapter 142 of the , eras t3y Tj of Ucenw. Plumber nil to c LRwised Pkfmber or Gas FAter Title Gasfitter M=3440 Master dense Number City/Town .fowneyman MTr10Yt: Location Z i`-',--777-�,u No. I94, Date T1,A71 oi.. N°"7" TOWN OF NORTH ANDOVER p Certificate of Occupancy $ ►, ,' Building/Frame Permit Fee $ f ssACNUSEt Foundation P it Fee $ e e %ooL a $ S.5 p�,p® %ewer Conpection Fee $ �late';C31�n�nection Fee $ M TOTAL (Q11ep $ �' Building Inspector Div. Public Works IPERJIIT*NO.� I D APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP d40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK "PAGE ZONE SUB DIV. LOT NO. — LOCATION 3 iO�D/.� PURPOSE OF BUILDING 1 4 j C_ , _ _ _ _ rX OWNER'S NAME £ f1 r, 1 WltOWNER'S ADDRESS f 1u r1vkVm NO. OF STORIES SIZE BASEMENT OR SLAB JeS I cr i ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD / BUILDER'S NAMESOvTti CjlOe���4 j'.0 Poo[ �l, �f SPAN -- DISTANCE TO NEAREST BUILDING yP DIMENSIONS OF SILLS --- DISTANCE FROM STREET `- POSTS DISTANCE FROM LOT LINES SIDES 11 �/ ,� i�,p' Y Q REAR V GIRDERS AREA OF LOT J:� + FRONTAGE "2 ,+ - V HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW L S SIZE OF FOOTING X IS BUILDING ADDITION ��11 �1CC Y '✓Dry {` �V MATERIAL OF CHIMNEY IS BUILDING ALTERATION W IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Gsi C „6 9[`�1 CO L IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FI ED Np APPROVED BY BUILDING INSPE// R DATE FILED SIGNATURE OF OWNEFF OR AUTHORIZED i FEE 19S '—' PERMIT GRANTED m 19 g 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST // va fl 00 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPECTOR 'NV1d 101d S30V1d3U SIH. 'a3SOdwiu3dns '013 'S3E)vu -V°J 'S3H0210d H11M 'S9NIO11f18 d0 SNOISN3WIO 10VX3 4NV S3N1'1 101 W02ld 30NV1S10 dNV 101dOSNOISN3WIC 10VX3 MOHS1Sf1W N01103S SIHl ZI 010331 JNiaiina MOdVA 210 8.1.M IOH S10:) 'B 'SW9 1331S WV31S _ S10J 7 'SW9 83SW11 'N21f13 41V lOH 03:)dOJ 3:)VNMf13 SS313dId 1SIOf 000M ONIIV3H II I ONIWVMd 9 OOVO 3111 _ 21o013 3111 _ S3Mf11X13 N21300W ONHOOd 11021 83MOH3 llV1S 13AV80 T 21V1 ONI9Wflld ON 31V1S ANIS N3HD11A 130NIHS 000M A2101VAV1 S310NIHS 11VHdSV _ 13S010 d31VM 03HS 1V13 I'XI3 LIW21131101OaVSNVW 132i9WV�J X13 EI H1V9 dIH 319V0 ONI9Wf11d OI dood 5 800d r-1 31JOIOdoS 3WVdl NO 3NO1S ONIMIM ASNOSVW NO 3NO1S 'A19 2130NI:) i O 'JNO:) —I dool3 8 's8ls 0111V A2INOSVW NO AQI219 I I 3WVM3 NO 0:):)f11S NOl^lWO� ONIOIS SOIIIIIV O n\GdVH ON101S 11VHdSV _ HldV3 S310NIHS 000M 313dDNOD `ON101S dOM E L l 9 S021V09dVlD SMOO14 6 S11VM b N3HD1lA NUCIOW W0021 (JV3H 0NIIV3H ON _I Pic I ls1 P"L V3dV :)I11V N13 51MID313 110 11(13 _V3MV SWOON 40 'ON L SVO S2131V3H 11N1 EXAM 1NVIOVM ONINO1110NOD illy _ sd313Va DOOM 'NV1d 101d S30V1d3U SIH. 'a3SOdwiu3dns '013 'S3E)vu -V°J 'S3H0210d H11M 'S9NIO11f18 d0 SNOISN3WIO 10VX3 4NV S3N1'1 101 W02ld 30NV1S10 dNV 101dOSNOISN3WIC 10VX3 MOHS1Sf1W N01103S SIHl ZI 010331 JNiaiina MOdVA 210 8.1.M IOH S10:) 'B 'SW9 1331S WV31S _ S10J 7 'SW9 83SW11 'N21f13 41V lOH 03:)dOJ 3:)VNMf13 SS313dId 1SIOf 000M ONIIV3H II I ONIWVMd 9 OOVO 3111 _ 21o013 3111 _ S3Mf11X13 N21300W ONHOOd 11021 83MOH3 llV1S 13AV80 T 21V1 ONI9Wflld ON 31V1S ANIS N3HD11A 130NIHS 000M A2101VAV1 S310NIHS 11VHdSV _ 13S010 d31VM 03HS 1V13 I'XI3 LIW21131101OaVSNVW 132i9WV�J X13 EI H1V9 dIH 319V0 ONI9Wf11d OI dood 5 800d r-1 31JOIOdoS 3WVdl NO 3NO1S ONIMIM ASNOSVW NO 3NO1S 'A19 2130NI:) i O 'JNO:) —I dool3 8 's8ls 0111V A2INOSVW NO AQI219 I I 3WVM3 NO 0:):)f11S NOl^lWO� ONIOIS SOIIIIIV O n\GdVH ON101S 11VHdSV _ HldV3 S310NIHS 000M 313dDNOD `ON101S dOM E L l 9 S021V09dVlD SMOO14 6 S11VM b II 1N3W3SV9 : £ 11VM ANO I. 31d HSINId 210IM31NI 8 11 I NOI1VGNf10d Z NOIlonHISN00 _ S1N3W1MVdV S3DI330 AlIWV3 'mnW S31H0!S A1IWV3 31�JNIS AON Vd (1000 I N3HD1lA NUCIOW W0021 (JV3H S3DVld 3dlJ 1.W. ON V3dV :)I11V N13 % I/1 . %i V3dV .IMA 'N13 11(13 _V3MV II 1N3W3SV9 : £ 11VM ANO I. 31d HSINId 210IM31NI 8 11 I NOI1VGNf10d Z NOIlonHISN00 _ S1N3W1MVdV S3DI330 AlIWV3 'mnW S31H0!S A1IWV3 31�JNIS AON Vd (1000 I w C� z O T v POP I eD a my '7 e a • z 0t 9c 0 O U) CD w T w W w w T w T O w 0 m <. t0 T t0 'p W 3 t0 7 S T .W 1" � C W m y c o �_ mIA z v N n n O _ mm .a n (A —i .4 T T m T 0 00 0 _ z CC7 I /� /,A/ 7Lr,. Al 4 u r / / / • / /3ox ou ///•.�v Al 1J 41 /vE � S4lE_LNZ�NIN� i It 0 oV. yo off. C,�+ o Etc ph ,n -,�" n $ y O o - h� b o- o � N oV. yo off. C,�+ o Etc ph IN WoR��� "^OG�� i �M baN r� �b aW L`1 �. k\ 10 O i a m O r y O ti a� - o LA b �FR S113 a N b Sa A.:I L :. IN WoR��� "^OG�� i �M baN r� �b aW L`1 �. k\ 10 O i a m O o 3 w i i GI 0.j \ N zo Q� l^ rn F yN o r. v w ti ,. o 0 0 o p o 0 0 O