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Home My WebLink AboutMiscellaneous - 40 PERLEY ROAD 4/30/2018 40 PERLEY ROAD 2101053.0-0013-0000.0 i North Andover Board of Assessors Public Access Page 1 of 1 NORTH North Andover Board of Assessors Ot lt�ao.aa"YO 10-r Y � 9SS"C""5� roperty Record Card Click Seal To Retum Parcel ID:210/053.0-0013-0000.0 FY:2012 Community :North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels t Search for Sales s '' Summary Residence Detached Structure Condo 40PERLEY ROAD Commercial Location: 40 PERLEY ROAD Owner Name: WINDLE,SUSAN Owner Address: 40 PERLEY ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:5-5 Land Area: 0.23 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 945 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 258,600 258,600 Building Value: 94,300 94,300 Land Value: 164,300 164,300 Market Land Value: 164,300 Chapter Land Value: LATEST SALE Sale Price: 1. Sale 08/30/2004 Date: Arms Length Sale F-NO-CONVNIENT Grantor: WINDLE,SUSAN Code: TR Cert Doc: Book: 9020 Page: 259 http://csc-ma.us/PROPAPP/display.do?linkld=1891128&town=NandoverPubAcc 5/17/2012 Residential Property Record Card PARCEL ID:210/053.0-0013-0000.0 MAP:053.0 BLOCK:0013 LOT:0000.0 PARCEL ADDRESSAO PERLEY ROAD FY:2012 PARCEL INFORMATION Use-Code: " 101 Sale Pri 1- Book Y 9020 Road Type: T J a. Inspect Date: _04/21/2008 Owner: Tax Class: T Sale Date 08/30/04 Page 259 Rd Condition P Meas Date 04/2172008 _ �-r r _. WINDLE,SUSAN Tot Fin Area: 945 g��'Sale Type P Cert/Doc: '�Traffic ''�M - Entrance: _ X TotLand Area 0.23 Sale Valid: F Water: Collect_"Id RRC s T _ - -- _ _ Address: Grantor WINDLE;SUSAN TR' Sewer. Inspect Reas. C 40 PERLEY ROAD NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style CO Tot Rooms: 5 ,Main Fn Area: 94.5 Attic Y_ NBHD CODE: 5 NBHD CLASS: 5 ZONE: R4 _ _. �. � — Story Height: 1.35 "Bedrooms' 2 Up Fn Area: Bsmt Area: 945 Seg – Type Code Method Sq-Ft Acres Influ Y/N Value Class - ,- w � �. - - _"-'__ -. ....._.�..__.. .... __.._ _ " 1 P 101 . S.•,re. m9946 0.230 164,316 Roof: G Full`Baths: 1�` =Add Fn Area' Fn Bsmt Area: Ext Wall AV' Half Baths: Unfin Area: 323 Bsmt Grade " MasonryTrim: "•-'"` _ _'"" `�`-""'""'"'-'""" """°'""" `°"'"' DETACHED STRUCTURE INFORMATION _- .__ -.� Foundation: ST 'Bath'dual: T RCNLD: 89695 Str Unit Msr-1 Msr-2 E-YR-BIt Grade Contl /oGood P/F/E/R "Cost- "Class�, —� : G1 S 216 0.00 1988 A A 50//%50 4,600 �� Kitch Qual: T Eff Yr-Built: 1962" Mkt Adj: Heat TyRc�_ HW_Ext Kitch¢ Year Built 1920Sound Value. _ n VALUATION INFORMATION Fuel Type: G Grade: AY' CostBldg: 89,700 Current Total: 258,600 Bldg: 94,300 Land: 164,300 MktLnd: 164,300 Fireplace 0 Bsmt Gar'Cap: Condition: A " _ Aft Str Val1: Prior Total: 258,600 Bldg: 94,300 Land: 164,300 MktLnd: 164,300 Central AC. N Bsmt Gar SF Pct pComplete:_ Att Str Val2: . _.« _. .:.. . .. Aft tGar SF: %Good P/F/E/R: /100/100/72 Porch Type Porch Area Porch Grade Factor E 203 P 12 SKETCH PHOTO 42S Ft! Xt 15 7 7 4 Y " FM8 4Ft sok ALI :. 945 S%Ft 3 q.Ft 10 23 � k .7 E 7 40 PERLEY ROAD 175 Sq.Ft25 Parcel ID:210/053.0-0013-0000.0 as of 5/17/12 Page 1 of 1 Date . � .l . . . . . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . . . ... b!�. . C. . . . . . . . . . . . . . . . . . . . . . . has permission for gas in tallation . . �!`!� T'�... . . . . . . . . . . . . in the buildings of." / 4�-�?"`'�. . . . . . . . . . . . . . . . . . Q C P 2 jc.�. at . . . . . . . .� . . . . . . . . .t. .�. . . . . . . . . . . . . . .North Andover, Mass. Fee . . . . . Lic. No. . . . . . . . . . . . . . . . . . . . . . . . GASINSPECTOR Check# 4 t d W3 8644 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: ;fJ lqvl o�v P/1 ,MA. Date: off- // Perini �E Building Location:_ P12 L ,i Owners Name: S. S'�.-• _ Type of Occupancy: Commercial❑ Educational❑ industrial❑ institutional❑ Residential New:❑ Alteration:❑ Renovation:❑ Replacement EK Plans Submitted: Yes❑ No❑ FIXTURES bi W W x }' N tY ~ rn m 0 W JU 0 to 0 = X ,`u Lu z to fn v to Z m O 0z 0 O IL po. ~ w rx _ ?< W � o > V lu z O -i tW- F O z -J 0 W N z W W W W Z W >- X m '' Q WW W O a z 0 W 2 > Z t•- _ v d t¢? 0 = T J 0 IL tY W ui > > 0 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3mj FLOOR 4 FLOOR 5 FLOOR 1 6 FLOOR 7 FLOOR to 8 FLOOR J ,� Check One Only Certificate m Installing Company Name: ❑Corporation Address: ry CifyiTown: J�'i lam/`t(,��Pvt State: ,c--� t� ❑Partnership Business Tel: Ci��a�ub - ? Fax: ��1 o�lCPartnership' 21irm/Company Name of Licensed PiumbarlGas Fitter. INSURANCE COVERAGE: I have a current Rabilit Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes E No❑ tf you have checked Yes please indicate the type of coverage by checking the appropriate box below. A liabilityinsurance policy Other � p y � type of indemnity ❑ Bond ❑ N r� OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waves this requirement. Check One Only Owner ❑ Agent ❑ 01 Si nature of Owner or Owner's Agent By checidng this box Q;i hereby certify that all of the details and information i have submitted(or entered)regarding this application aretrue and accurate to the best of my Knowledge and that all plumbing work and Installations performed under the permit issued for this application will be in r compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. I� TLicense: By ffPlumber TitleC1 Gas Fitter Signature of n Plumber/Gas Fitter `S ❑Master / eyman Citylrown f ourn LP Installer aller License Number: APPROVED OFFICE USE ONLY) II 2 I E i • pIAI E t k 1 e� The Commonwealth of Massachusetts Department of IndustrialAccidents nn Office of Investigations 600 Washington Street Boston,MA. 02111 www.mass.gov/ilia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly LVaMC(Business/Organization/Individual): �¢ kddress:� _ity/State/Zip: 17� uv,, MA p] WV Phone#: L ,re you an employer?Check the appropriate box: Type of project(required): ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors I am a sole proprietor or partner- listed on the attached sheet. ? E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.F1 Electrical repairs or additions required.] officers have exercised their ❑ I am a homeowner doing all work right of exemption per MGL 11.['lfumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] y applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. itractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. n tin employer that is providing workers'compensation insurance for my employees. Below is the policy and job site rrmation. trance Company Name: .cy#or Self-ins.Lid.#: Expiration Date: Site Address: City/State/Zip:, „gn,&ypit 0.7/4 ich a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). ure to secure coverage as required tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 P to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ;stigations of the DIA for insurance coverage verification. hereby certi&under the pa' s andpenalti fperjury that the information provided above is true and correct. :afore: Date: y� le#• CL 2,L (ficial use only. Do not write in this area,to be completed by city or town official. 'ity or Town: Permit/License 4 ;suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector .Other nnfarf Pvrenrn• Phnnr#c 9 - \ r ;COMMONWEALTH OF MASSACHUSETT& P PLUMBERS AND GASFITTERS LICENSED AS It JOURNEYMAN:PLUMBERS1 ISSUES THE ABOVE LICENSE TO- ..'C R'ATG B O..CRA'IG 'B. ADAM: 6 `WHITE. AVE ITE.TAME N '11A 01844-6234 % , ,.::. ':':26318 05/O1/14�'• 183.r;7., .. m e o • ` 09876 Date .�.�?J. . . . . • �� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . . . . . ! !. . . . . .1. . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . 'A . . plumbing i the buil ings of. . 11W.l .. . . . . . . . . . . . . . . . at . . . ,North Andover, Mass. Fee . Lic. No . . �. . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check# I� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town• 5��.. /9 r, j ,MA, Date: o'? c Pennit# Building Location: �Y/') J, P/j , Owners Name: S Cl S'G,� Type of Occupancy: Commercial❑ Educational❑ Industrial ❑ Institutional❑ Residential New:❑ Alteration:❑ Renovation: ❑ Replacement: ❑/ Plans Submitted: Yes❑ No❑ FIXTURES z U N � W Z H Z a) a U N 0 Z N* w a w I t- — ¢ vs a x LL I,_ a �° a o o w z w rn Z v IL _ o o t- = o l•- a ? rr er z = ¢ s' a Y w w Q Q y v_, p r- > > O o p z z ¢ m or o n ,i i Y g a U) (j) w ta• o SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 3 5 FLOOR i; FLOOR � 7 FLOOR 8 FLOOR -:;7 Installing Company Name: } jp� Check One Only Certificate# _ v _ L ❑Corporation .c Address l� i jt-ylCityfFown: 77`1 a L:L'�-. Stats. v 3 d .1�LjXel.l: Z1p Code: dla��:l El Partnership Business Tet: 7 Fax•7>,yU frZo_jo rm&mpany Name of Licensed Plumber. .4:1 ' cC INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch. 142 Yese"N'o❑ If you have checked Yes,please indicate the ,v type of coverage by checking the appropriate box below. A 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 � I! Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner ❑ Agent ❑ C I hereby certify that all of the detafts and Information I have submitted for entered)regarding this application are true and accurate to the best of my 5 Knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be in compliance with all Pertinent provision of the Massachusetts state Plumbing Code and Chapter 142 of the General taws. 6y Type of License: S Title Signature of Lice ed lumber (dumber 9 City/Town ❑Master APPROVED OFFICE USE ONLY (266umeyman License Number: C a �' f I •9 I ��1� �� I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Ut www.massgov/dia Workers' Compensation Insurance davit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly NaMC(Business/Organization/Individual): //��Uc J / ¢ kddress: Dity/State/Zip: I Utv,, MA 0 2 Phone#: 7 W,a CT- y?,f .re you an employer?Check the appropriate box: Type of project(required): ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors _ ❑-am a sole proprietor or partner- listed on the attached sheet. ? F1 Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g• ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their ❑ I am a homeowner doing all work right of exemption per MGL 1 LB umbing repairs or additions myself.[No workers' comp. a 152,§1(4),and we have no 12.❑Roof repairs insurance required.] employees.[No workers' q ] 13.❑Other comp.insurance required.] y applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. )meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. itractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. u irn employer that is providing workers'compensation insurance for my employees. Below is the policy and job site irmation. trance Company Name: .cy#or Self-ins.Lid.#: Expiration Date: Site Address: City/State/Zip: YN 4 ich a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). are to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 P to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of :stigations of the DIA for insurance coverage verification. hereby certify sander the pa• s and penalti f perjury that the information provided above is true and correct. .store: Date: y� !ficial use only. Do not write in this area,to be completed by city or town official. 'ity or Town: Permit/License# ;suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Other nntart Parenn• PhnnP#c lk is - -COMMONWEALTH OF MASSACHUSETTS` Q PL``UMBERS AND GASFIT.TERS LICENSED AS A .JOURNEYMAN.PLUMBER ISSUES THE ABOVE LICENSE TO : S' CRAIG B.: ADAM c LTE. AVE 14ETRUE N 'llA n 181414 623.'4 t ,:263`18 05/O1/14� 1835►7:3 l.. Im Qommrl- Am Location y No. Date ,.ORT" TOWN OF NORTH ANDOVER 0�4 �io , ,ti0 A Certificate of Occupancy $ t;��IWAL ; + Building/Frame Permit Fee $ ,s.. 'r1 loop 'SSAcausEt -� a�,,►Foundation Permit Fee $ 1Df�r Permit Fee $ Sewe�GoY�y1f,ection Fee $ 0, 4 Wate�Conner 6n Fee $ Op,OTOT A9I $ ®�"C1 building Inspector Div. Public Works PER-,flT NO.. _s APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. �- PAGE 1 MAP d40. LOT NO. 2 RECORD OF OWNERSHIP iDATE (BOOK 'PAGE ZONE �. I SUB DIV. LOT NO. LOCATION 101,6 PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES ZE OWNER'S ADDRESS D BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET " POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST 3 ,f" L(l G', PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST AkR SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR � DATE F ED BOARD OF HEALTH i SIGNATURE OF OWN OR AUTHORIZES AGENT F E E PLANNING BOARD PERMIT GRANTED 19 r -;f6J OWNER TEL # BOARD OF SELECTMEN . W CONTR.TEL.# T- 3 CONTR.LIC.# 0 & r BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ a 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D _ PIERS PLASTER _ _ DRY WALL UNFIN. 34 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/. '/r '/, FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAL ROOM MODERN KITCHEN 4 WALES I 9 FLOORS CLAPBOARDS B 1 22 f 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMMON _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY ST4CCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME Co C. OR CINDER BILK. STCENE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13BATH 13 FIXE_ GAMBREL MANSARD TOILET RM. 12 FIX.1 _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. _ STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd O HEATING I i �R sew d FJ A.w at vsr.J.`�....�.,o...�. F I ii A� SEW"FI AY �. - �F'��„;r�s't �^ c� -` � _ �.....e-��...,.--_ � ..•� F. �. { - 6 OLA novero =. 4! .� . VIM H er, MassC HE WIC oR ? SS BOARD OF HEALTH E R M I LD • r � THIS CERTIFIES THAT.. , . ... ....��`�. �. ...................... BUILDING INSPECTOR has permission to erec ��. .. buildings on .. .4. 'y.... !. Rough to be occupied as. .¢��.CWJr.%..#4$f%4'401111R.00*7 604//r40V/0' 14V .,�`. ......... Chimney .w Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS CTION STARTS Rough Service w Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector PERMIT NO. � � APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 I MAP NO. LOT NO. 12 RECORD OF OWNERSHIP iDATE (BOOK PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING g ewe& _ OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS JBASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2`ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET '" "" POSTS DISTANCE FROM LOT LINES—SIDES REAR _ '" "� GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER a BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST iy PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FTZ EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED D APPRO TEED BY BUILDING INSPECTOR DATE FILED / BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT ® g FEE PLANNING BOARD PERMIT GRANTED,/ 19 BOARD OF SELECTMEN • v BUILDING IN R r ;'4 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ B 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW'D PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/, V_ '/, FIN. ATTIC AREA _ NO B'M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW'D ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. _ STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR II POOR _ ADEQUATE 1 NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH )3 FIX. GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING 4 w MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 31812011 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.3B NORTH ANDOVER HEALTH DEPT. NORTH ANDOVER TOWN HALL NORTH ANDOVER MA 01845 M�jl{/�] {d� (j 9 1 11�1\ it -f iT 0 S 1 TOWN OF NQRTHI ANDOYRA HEALTH DEr-AR—r MENT Re: Insured: SUSAN A.WINDLE Property Address: 40 PERLEY RD, NORTH ANDOVER,MA 01845 Policy Number: 0788469 Type Loss: All Other Section I Losses Date of Loss: 0310512011 Claim Number: 286439 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 I