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HomeMy WebLinkAboutMiscellaneous - 48 HAWKINS LANE 4/30/2018 / 48 HAWKINS LANE 210/106.C-0123-0000.0 i I it I I I I i N° J7 . 7 Date.................................. gORTF� °�<"`°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ACHUSEt ) This certifies that . r _.- has permission to perform........... — - -' .............:..................................................... wiring in the building of .............. .................... ...................................... at.. �........ .......... ............ ,North Andover,Mass. Fee.�)`�..`........ Lic.No........ Ti ....................... .................. ELECTRICAL INSPECTOR Check #/. WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Official Use Only � Permit No. 2p nl 2XrE Co9w9Koy4VEALrDf o,'911ASSAC7TVSE77S Department of rPu6Crc Safety Occupancy&Fee Checked- '" BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print In ink or type all information) Date To the Inspector of Wires: f Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number � _&a2 i V! �6 ri/ �e Owner or Tenant_ r' _�� ( u Owner's Address � Is this permit in conjunction with a building permit Yes a No 0 (Check Appropriate Box) Purpose of Building I�i°C/��dl� .L� Utility Authorization No. Existing ServiceAmps Voits Overhead 0 Undgmd 0 No.of Meters N New Service Amps Volts Overhead 0 Undgmd 0 No.of Meters Number of Feeders and Ampacity w z 2`e Je C rz""vtp Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA r Above 0 In 0 No.of Lighting Fixtures Swimming Pool grnd 0 grnd 0 Generators KVA No.of Emergency Lighting Flo.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating INV Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage t No.of Water Heaters KW Signs Bailases Wiring i' No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws i Z have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES- NO = have submitted valid proof of same to the Office YES- NO - If you have checked YES please indicate the type of coverage by checking the appropriate box NSI URANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested Rough Final Signed underth enal fes of p ry: / FIRM NAME ✓ LIC.NO. / Licensee -e Signature O ng oc LIC.NO. rJ Bus.Tel No. Address fo �q�" S�Aloif`r,, /�' OWOAft Tel.No. 97 R'— PR4i Z/ OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts a General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) e Telephone No. PERMIT FEE $�y (Signature of Owner or Agent) Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Frederick & Kim Ahlholm Property Address: 48 Hawkins Lane Policy Number: BCGCWS Date/Cause of Loss: 6/15/2011, Water Damage File or Claim Number: 26588-R Claim 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, policy number, date of loss and claim or file number. Ryan Werner 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. il I 1"' L f/a'j /�- Si/gnaand Date ANDERSON ADJNT CO., INC. 50 Nashua uite 303 PO BLondonde03053 Dat qkq..).�. .....ZI......!�4 U NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING CH This certifies #-.g!.<......!..6.....�.A ................................ has permission to perform A.jd ...6.�.....LIU.44-11. .............................. wiring in the building of 4, Y-I ...... ................... ............................................. at..£S..�......4-.-,.1, North Andover,Mass. if:...... ...................... No Fee.K. ... Lic.No. 1ILFf................Pnimjc�� INSPECTO Check # 8252 Commonwealth of Massachusetts official Use Only Department of Fire Services Permit No. ?�5`2 BOARD OF FIRE PREVENTION REGMLATIONS Occupancy and Fee Checked [Rev. 1/07) (leave blank 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: - -a I - City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned giv notice of his or her intention to perform the electrical work described below. Location(Street&Number) -0# nit 4t„t14Ns I4NQ Owner or Tenant -S I W vti Telephone No. 7 Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ------❑ Und d g No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: -- rr bctcL Of JM Q w Completion o the followin table maybe waived by the Inspector o Wires. No.of Recessed Luminaires Z No.of Ceil-Susp.(Paddle)FansNo.of Total 2 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o,o mergency ig g d d. El Batte Units No.of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones + No.of Switches q No. of Gas Burners 140.of Detection and � No.of Ranges No. of Air Cond. Total i!961tii Devices 1 Tons No.of Alerting Devices No.of Waste Disposers eatPumP Number Tons KW No.of Self-Contained Totals:._._..._._ .__ _ .__ .._._.._ ... Detection/Alertin Devices No,of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances Kms, Security Systems:* H No.of Water No.of No.of Devices or Equivalent eaters IOW Si s No.of Ballasts Data Wiring; No.of Devices or E uivalent No.Hydromassage Bathtubs No. of Motors Total HP Telecommunications iring: OTHER: No,of Devices or E ittivalent ,i1/� Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: — (When required by municipal policy.) Work to Start: �"'�, – Q S in 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 ❑ BOND ❑. OTHER ❑ (Specify:) I certify, p p under the sins and enalties of perjury,that the information on this application is true and complete. FIIZIVI NAME: _ �q,t Gl4v�tr¢caul d ''f S� Licensee: Signature LIC.NO.: (If applicable, enter"exempt"in the license number line.) LIC.NO.: Address: _' C' �, /s Bus.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires D „ „ Alt.Tel.No.: Department of Public Safety S Lice e: 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 Owner/Agent Signature Telephone No. PERMIT FEE:$ ea r' r 4 i �f. 1 s The Common weak of Massachusettf kj ! Department of Industrial Accidents Office of Investigations i'c�f f 600 Washington Street ti. Boston, MA 02111 {�j www.nxass.gov/dia Workers' Compensation Insitrance Affidavit: Builders/Contraetors/Eiectriciaas/Pfombers Applicant Information- Please Print Legibly Name(Business/brganiration/Individual); G Lcyt C V e Sob•1 p Address: 4 14 Urw et y Y City/State/Zip: t w% V14A l�Phone#: . `o ( --?-—} �j _G(�5 5 Are you an employer?Check the appropriate box: 1.❑ 1: am a employer with 4. Type of project(required): ❑ I am a general contractor and I employtew(fail and/or part-time).' have hired the sub-contractors 6. ®-New construction 2. am a.sole proprietor.or partner_ listed on the attached sheet._ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. C1 Demolition` working forme in any capacity, workers' comp.insurance. [No workers comp.insurance S. 9. ❑Building addition ' p ❑ We are a corporation and its required.) officers have exercised their 10.❑Electrical repairs or additions 3.[] I am a homeowner doing all work right of exemption per MGL 11.[]Plumbing repairs or additions o Comp. c..152, §I(4),'and we have no 1eqaired:]t employees. [No workers 12. Roof repairs insurance comp. insurance required.] 1 F Other `Any applicant that checks bw#I must also felt out the section below showing their workers'bompenswion pot icy information. T Homeowners who submit this affidavit indicating they are doing all work and than hire outside contractota must submit a new affidavit indicating such. 'Contractors that check this box must atmched an additional shwr showing,the name of the sub-eoottactors and their workers'comp,policy information. 1 am an employer that.is prou4rMg:workerscompensation insurance for nV employees: Below isthe policy and job site information. ° Insurance Company Name:_' l,.t a—cJl Policy#or Self-ins.Lic. p'I 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 c under the pains and penalties of perjury that the information provided above is true and eorrea Signature: twt Date.- Phone ate: Phone#: F ial use only. Do not write in.this area,to be completed by city or town officiaL or Town: Permit/License# ng Authority(circle one): I. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing inspector 6.Other Contact Person: Phone#: Information and Instructions 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,assDdiation,corporation or other legal entity,or any two or more ofthe'foregoing engaged in a joint enterprise,and including the legal representatives of a dec med 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, MOL 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 certificate(s)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 Acciderrts for confirmation of insurance coverage.. Also be sure to sign.and date the affidavit. The affidavit should, be returned to the city or town that the application for the permit or license is being requested, not'the Department of Industrial Accidents. Should you have any questions regarding the law or ifyou.am required to obtain a workers' compensation policy,please call the Department at the numberlisted below. Self.-insured companies should enter their self insurance'.license number on the appropriate'line. r' 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 applicanL 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 policyinformation(if necessary)and undor"Job Site Address"the applicant should write"all locations in (city or town)."A copy of tbe 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 Bcmfon, MA 02111 Tel.# 617-727-4900 Ext 406 or 1-8.77-MASSAFE kevised 5-26-05 Fax#617-727-7744 www.mass.gov/dia Kritikos Associates Architects !OC) July 25,2008 Olde Towne Construction Mr.Kostas Apostolopoulos 216 Ipswich Road Boxford,MA 01921 RE: Ahlhohn Residence 48 Hawkins Lane N.Andover,MA 01845 Dear Kosta: Based on a visual observation at the above referenced project recently,and after conferring with my structural engineer,I recommend that the existing beam be removed and replaced as detailed in my sketches SK-1 and SK-2 dated 7-24-08 as submitted to you recently. If you have any questions,please feel free to call my office without hesitation.I will be happy to answer any questions that you may have. Very Truly Yours, KRITIKOS ASSOCIATES ARCHITECTS Phi ip A.Kritikos,RA.,Principal PK:hs 14 Olscu Road Peabody,MA 01960 (978)5314164 FAX(978)538-1391 E-Mail:ksarch@yahoo.com r 'u I 3 z rnZ O o m r n 3 n A Job Name: Ahiholm Residence Dote: 7_24-08 K r i t i k O s Associates 48 Hawkins Lane North Andover. MA n> tt� Architects Scale: As Noted pttlnntn9 DWG TITLE: ® 14 Olsen Street Peabody, MA 01960 t (978)531-4164 Far(978)538.1391 E-M.U.kaoch@yah- New Header PHILLIP k 4. e' KRITIKOS NO. 8360 PREPARED FOR Dwg.No. 6 y O[ABUDY, d MASS. �;`;. Mr. Fred Ahiholm ;;; 48 Hawkins Lane North Andover, MA a o cv �Y 0 L v Existing 9111 plate to New infill 6 \ be removed blocking/shimming _U Z �L as needed s (n Gut$ remove portion of o existing floor sheathing as Z Q necessary to accommodate +- new header v Existing 2"x 10" New (3) 111/4 N v header to be LVL header E removed s= N s N ns Z I o Q� 1 :00LLT t Z 4 l9 z 8 3 Z � N � h Oa w g 4 i .a o v b A Existing drywall to y e w remain-cut back as needed to accommodate installation of new header a H patch to match +� t Existing header New header Location No. Date TOWN OF NORTH ANDOVER 3? e•.I . OL � A Certificate of Occupancy $ b���e•� � CHUSEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ / TOTAL $ // Check # � 5u % 4 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING _. .:::: 'lE�j+}rS�Cfid�'`#�Oi'�iClAlE-U5C©131 BUILDING PERMIT MJ?v1BER: DATE ISSUED: C) t,5- dna � = SIGNATURE: Building Commissloner/Inso&tor of Buildings Date SECTION t-SITE INFORMATION 1.t 1.2 Assessors Map and Parcel Number: Property Address: 141 gw rc.t Ars t4wgT - -- /04 O 2.3 Map Number Parcel dumber \. 1.3 Zoning trilormation: 1.4 Property Dimensions: ZoningDistrict Pr osed Use Lot Area s F'ronta a ft) 1.6 BLraDMG SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide Required Provi ed Re red Provided o �o to oo* © /o 1 C !.S. Flood Zone Inlorutation: I.6 Sewerage Disposal System: Public 0 Private 1.7 Waren Supply nate C.�t0 O. Sd) Zone 'Outside Flood Zooe 4 Municipal 0 On Site Disposal System � � � SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT n 2.1 Owner of Record A Q Name(Print) Address for Service Signature Telephone R 2.2 Owner o1'Record: \ Name Print Address for Service: C IT Si na re Telephone ry SEC_ ON 3-CONSTRUCTION SERVICES �` 3.1 Licensed Construction Supervisor: Not Applicable 0 r Licensed Construction Supervisor; O n License Number Address Q // d pO t'.Jf'-7-3-1�71 G ( expiration Date Si -7 k—G re Telephone '...o 3 Registered Home Improvement Contractonr Not Applicable 0 Company Name t Registration Number ra Addre LD,fr Expiration Date � Signature Telephone 0 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 atfiidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes...... No.......0 SECTION 5 Descri tion of Pr;p'o'sed Work check all s licable New'Construction Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: -5-1 N., SECTION 6 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to t, ,rti$tx, yt` �T Completed by perniit a ltcant 1. Building ,f�� (a) Building Permit Fee ! `� Multi lier 2 Electrical (b) Estimated Total Cost of Construction 646 3 Plumbing Building Permit fee t•) x (b) / 4 Mechanical HVAC 5 Fire Protection 6 Total (I+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Aut e A ent subject property Hereby authorize Gl u"1�-� `� ��. � /�'�� to act on My be in 1 matters�r+elative t work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/ Ize gen f 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 Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2Nn— 3 SPAN DDAENSIONS OF SILLS DIIvIE•NSIONS OF POSTS DIMENSIONS OF GMDERS HE[GFIT OF FOUNDATION TIUCKNESS SIZE OF FOOTING X MATERIAL OF CI-MVINEY IS BTMDING ON SOLO)OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM p®o � INSTRUCTIONS- This form is used to verify that allnecessary approval/permits from c(f ".4 n Boards and Departments having jurisdiction have been obtained. This does not relieve the r applicant and or landowner from compliance with any applicable requirements. 1............................................................................ APPLICANT 4 PHONE l 7 C 9'7 71 2— ASSESSORS MAP NUMBER Ia LOT NUMBER SUBDIVISION LOT NUMBER STREET � — STREET NUMBER 1........................................................................... OFFICIAL USE ONLY 1■■■■■.■■■.■t.■■.................a..■.ttt■■■■■.■.■■■tt■■t■■.■.■....■.........■ . RECONffvIENDATIONS OF TOWN AGENTS 1■.■.t■ ■..■.1J■....■ ■...■■■....■.■.t..■t..■■.■■■■.■■.■t.■■....■........■ DATE APPROVED (� ONSERVATION ADMINISTRATOR . DATE REJECTED � COMMENDS ✓�'� �,V C�L OiF-d� w�l i- I C� 1 1 DATE APPROVED TOWN PLANNER DATE REJECTED COMIvviENTS DATE APPROVED F SP CT R-HEALTH DATE REJECTED DATE APPROVED kO J O SE INSPECTOR-HEALTH DATE REJECTED CONINlENTS r'` �.,b..,�t��l C�v��� Ing ((o�12I6 - PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMIvf'NTS RECEIVED BY BUILDING INSPECTOR DATE \ The Commonwealth of Massachusetts Department of Industrial Accidents ai - MICS 91IMS&YA(ons 600 Washington Street Boston, Mass. 02111 ~ Workers' Compensation Insurance Affidavit name: 4 Ce►y►'� �4�1��c9 � location C] I am< omen erfortning all work myself. I am a sole proprietor and have no one workinc in any capacity —10'1 am an employer providing workers' compensation for my employees working on this job. PO,is address- �.. Sd (a►'b-CAL"r, city'. II �� phone is ? �� iMur 111i'3i_c2.�f_ ,S'Ld1t'h 1111 �+�.J' Lb oolicva I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: pony name: addren:- city, phone I insurnnce co. policy# . comp�v.nsme• address: cirr. phone U• insorztntx cn roa r? Failure to secure coverage as required under Section 25A ol',*YIGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.m and/or one years'imprisonment as well as civil penalties in the form of:t STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify der the pains and penalties of perjury that the information provided above is true and correct Signature ��—�—� Ls), i-. Date C�tf Print name X,11 t t el Phone Cc.n,.ct ly do not write in this area to be completed by city or town o(Ticirl C permit/license# r7 Building Department C]Licensing Board on response is required CSdectmen'S Office CHealth Department n: phone a: n0thcr (rovuaf 7/95 PIA) FAMILY Pools & Patio Inc. CSL#010330 J s HIC# 118204 Sales • Service • Supplies WC# 156942897 70 So. Broadway• Lawrence, Massachusetts 01843 LIAB#CO 164095968 Tel: ( ) 688-8307 Fax: ( ) 688-1949 NAME ' Gd + 'Ki �DI DATE Z A f 20 0 ADDRESS t CITY h� - STATE F4.A Cs ZIP S� TELEPHONE _ 9?F_- 100-MR- Res. CROSS STREET &A #Aawi Au amn V Wk. EST. START DATE Vy IV FR COMPLETION DATE • PROPOSAL - We propose to furnish and install one r��.3g �iy u�r �� )QP.t✓� swimming pool for the sum of $ • OUD T rice for normal installation consists off: Nine hours total machine time including two trips for excavation, backfilling, and rough grading around pool. Use of one dump truck for six hours for removal of fill during excavation•Installation of pool with filter and wall skimmer. -t a price does not include: W `�S Any machine time over nine hours, additional machine time to be billed at(04-per hour•Any trucking over six hours, additional trucks to be billed at(7o)per hour•Any dumping costs incurred for disposal of ledge or large rocks Re-seeding of grass around poo •Spreading of loam•Trucked in Water• Patio or fence around pool or any accessories, except as noted below•Additional fill, if necessary,for proper backfill or reshaping of hole•Disposal of large rocks Fuel Connections•Heater Venting• Fuel Storage Tanks• Permits•Damage done to sprinkler systems or any buried items(ex.dry well, electrical lines,cables, etc.) in the access and pool overdig areas. Stumping and removal will be subject to an extra charge. ` Water or soil condition(ex.clay,peat, live sand,excessive rock,etc.) requiring Min. Max. a stone pack of the hole will be subject to an extra charge of c� von Use of the above will be at the discretion of the job supervisor. Customer is to supply access for all trucks It is the owner's responsibility to obtain the building permit or to assume the costs of necessary permits. • EXTRAS • • CONTRACT• f pS;� �" Vacuum Cleaner Steps Ladder(s)(20 Filter( (f S bm-6 Diving Board ( ) With P Put _JiAcl Chemicals Liner L r d 4, ) Maintenance Kit �.�•�i Coping Lifelines Spa Main Drain Miscellaneous ( ) Solar Cover ( ) Miscellaneous Fiberoptic Light ( ) Heater- TOTAL EXTRAS Slide _ ( ) BASIC POOL PRICE y �� Caretaker 99 Pkg ( ) Environpool plus Pkg -3 ) ZQU1f SUBTOTAL $ Environpool Pkg Polaris Vac Sweep 5%MA SALES TAX �W Polaris retrofit only .� Inline Chlorinator _ TOTAL ^ $ ?323 y ❑ Patio,Electrical,or fence,see attached LESS DEPOSIT 5%minimumV►• BALANCE OF CONTRACT $ ' j Z"� ✓ PAYMENTS: 1/3 Excavation, 1/3 Backfill, 1/3 System Start-up The buyer hereby agrees to pay in full, the total amount of this transaction upon start up of installed pool.You, the Buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Credit card payments not accepted on contract mount BUYER SELLER �/ /,� �^ CO-BUYER t N r -` Board of Buildingq Regulations One Ashburton Place, Fpm 1301 Boston, Ma 02108-1618 Llcertse: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 07/19/1960 m Number. CS 010330 Expires:07/19/2003 Restricted To: 00 m m m ca WILLIAM C POULOS m 70 S BROADWAY m LAWRENCE, MA 01843 U � Tr.no: 11987 •., Keep trop for receipt and change of address notincatkwL v A ' :a. BOARD OF BUILDING REGI ATIONS a. L3cens= CONSTRUCTION SUPERVISOR A Nva .f CS 010330 a&um dw 07/1911960 E Expisx 07H82003 Tr.no: 11967 q Rea- ion To: 00 w. WILLLW C POULOS 70 S BROADWAY �`���+/ A✓ V rt rl • 10 W N t Apr 20 01 01 : 05p Farnily fools & Patios Inc 9706BUIS49 p. 2 ��`'••'• � ✓ti a�atxrnoxoea(JG o uu0a Board of Building Regulations and standards License or registration valid for individul use only 1 HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Aepletratlon: 118204 Board of Building Regulations and Stondnrds One Ashburton Place Rm 1301 �tplragon: 02!1312003 Boston,Na.02108 'type: Supplement Card FAMILY POOLS R PATIOS INC GLEN WIOGIN Q TO 8.BROADWAY u _.-�Pru•� �Q ••�,� u.Ji �-�— LAWRENCE,MA 01843 Administrator Not valid without sigr l c _ '+t'�� � _ . ._•.��(NR1ItO r(p,¢Q(fIf•o,.i�(af.at>/utde(tJ '1Cexk.. Bard o(Building Regulations and standards License or registration valid for individul use only .'' before the expiration date. U found return to: HO MS IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards ar. Registration: 118204 One Ashburton Place Rm 1301 x �E,Icpintlon: 02fiY2003 Boston,hia.02108 i Type: Supplement Card 1 Aw:l `t^IfFAMILY POOLS&;gATiOS INC OYNTHIA GUWOPOULOS ti To 8.BROADWAY 2,1,«.. ,� b_ sg•�try!. i.�• Not valid wI 'Opt signs Pre LAWRENCE;MA 01843 Adnloletrator 1•y /R4 &M,"O1r((1¢ftld G/v`:�1.(7ddQC�(Iafx[O Board of Building Regulations and Standards License or registration valid for individul use only �. ►`.� before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Re st �.,ratlon: 118204 One Ashburton Place Rm 1301 • l tpineonc 02/1312003 Boston,MA.02108 J 'I i ;Type: private Corporation FAMILYMOOLS�• L'ATIOS INC ut' . WI WSROA�MWt�i3ULU5 .-� �` - TO 0:BR01l041'AY h k c•;' VWRIINCEJ}MA 01843 Adminlslrator Not valid witout gnttturt f.Y. ' .h,4.: x ) . -A-CORP,. C E RTI F A- B NSU03/09%zooi rKWEIR (617)646-5000 FAX (61Y3844-5108 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Elliot, Whi ttior, Hardy A Roy HOLDER.THIS CERTIFICATE DOES NOT AMEND,LX7END OR •Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, ST Putnam Street INSURERS AFFORDING COVERAGE Winthrop, MA 02152 om y Poo at o Co. , Inc. t nenta Ins. Co. 92 South Broadway INSURER I' �- Lawrence, MA 01843 INSURER IN6UpER 0 IN6VRER E THR P e c'.LOW HAVE 05IFN . .I D 10 THECVE FOR Ttle POLIC I PERIODC JI NDI 10 ANY REQUIREMENT.TERM OR CCNDIT10N OF ANY CONTRACT OR OTHER DOCUMENT'MTH RESPECT TO WHICH 71410 CEFITIFICATE MA"BC ISSUED on MAY PEgTAIN,THE RISURANCE AFFORDEDBY THE"ClICIE6 DESCRIBED HEREIN IS SUBJECT TO ALL THE TBRMR,EXCLUSIONS AND CONDITIONS OF SUCH POLICIGS.AOOREOATG LIMITS FMOYYN IAAY HAVE BEEN REDUCED 8Y PAID CLAIMS. TYPB OF INIVRANOR POLICY NUMBER DATE(A"70,N), E LIMITS OENERALLUUPLnY C164025968 12/31/2000 12/31/2001 EP.ch01cvRRENCS { 50000 COMMERCIAL GENERAL LIAXILIT'Y FIFE DAMAGE(My em Ike) { 500 OLASJE MA DQ a OOCUR MED 90(Any em Preen) 1 _ 5o A FER600AL A ADV INJURY 1 5000 GENERAL A601kEOATE 1 10000,119 OEN'LAOOR! ToA EL��►MpIYAPPuEE CCR' PRODUCTS•COMPMP ACO { I opnn POLICY JFCT tOC AVTOMOSLaLIABLLm 038607 12/31/2000 12 73171ooi COM{WF,DSINOL:LIMIT ANYAWO Me41 ieMS) j{ 1000 000 A)A 01fAK0 AUT 01 SOOLY IN:URY j A 6CNEOULED.WTOS ) (P61 Posen) NMIEO AVTO4 , I BODILY INJURY I IPO seee.nn { NON•OwMEb AUTQ9 _„•_"� 1 PROPERTY DAMAGE S OAMOt LIAIILTFY AUTO 4NLY.EA ACCIDSNr ! ANY a” I OTHER THAN EA AGC S AUTO ONLY: AGO ! EXCEIB LIABILITY EACH OCCURFENCE S OMUR. M CLAIMS MA01 AGGREGATE S Deouc?IBLE !� R!TlWTION { ' { MfORRtIIaCOMPENIAnONANo 164095968 12731/2000 12/31/2001 1 AMR14h I judR EMPLOYERS'UAMITY E.L.EACH 40�:OENT { A I L.DISEASE-EA EMPLOYE { E.L.DWASE•POLICY LIMIT S I ADDITIONµ%IMVREtr INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE OBSCAIIED FOLLIES 20 CANCELLSO IEPORE THE EXPIRATION DATE'HEREOF,THE ISSUING COMPANi WILIENDEAVOR TD MAIL DAYS WRITTEN NOTICE,TO THE OERTIFIVATE HOLDER NAMED TO"IF LEFT, OUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OILIOATION OR LIAIA ITY of NY Igno UPON 711[ oNPANY, AGENTS OR REFRISENfAMIS, For Information Purposes Only D t � c &8'Plain Panels(08-009-5) 234'4T Pian Panels(08-016-5) 2-r Plan Panels(OS-018-5) E-�y-�.---F G N J K J 4 r Radna Corners rob-lal) 17-Tumbuile Broca(08-214) SIZE A B C D E F G H J K L 1-Steel Hardware IGt(08-204) x 16' rr V Y4' Y 14'._]_s•6- 4.6• 4.6' 1" 4•a' 1-16x32 Straight Coping Set 6'Radius(10-001) m,t,n o..o„o t3 4 1-r Radius Coping Comer Set(10-138) PM SM 16' s1 S'6' Y<� E' 1<' S'6' 4'6' 4.6' 7• 2'z' 1-TO liner(see options below) • 2� g� 6'Step-Remove 1408-009-5)8'ponel and TURNR1U0-E 1408016-5)4'panel Insert 1-{01.006)6'step, 2408-017-5)3'panels and 1408.214) PAWL * tumbuckle brace. 8'Step-Remove 1-(08-009-5)8'pmlel and pefLATE"'" 'gr 1408416-5)4'poneL insert 1401-002)8'step, \ 2408-018-5)r panels and 1-(08-214) tumbudde brace. kepi 4.8'plain panels(08-009-5)with: 1 TE 1-8'skimmer panel(08-011-5) s M 2-8'inlet panels(08-010.5) 1-8'light panel(08-012-5) '• 8' 4" NSPI TYPE 11 8, 6, 00 3� 8' 4' TOPAZ STERLING STONETM (03403.2) (03-1`03-2) (03-1103.2) NON DIVING UNERS PNP a d.r..e.d a pacl a ad as io H4(03-840-2) 1-8(03-P40-2) S-14(03.1140.2) . TM eoclwe.lr a FOR RUJSMATK PURPOSES Oran. �-j•ER��' �r w4na roots®.>-Sre UMM curt, . • PM ae.s air s u mp..owoe.—.m o tad w s..Or R waTME.el YtO�eL R1l1432i77! to 90o r>,..dQ&fflww er and,•-0h i,.I b So.ww q.el 'e"a/ ..r.tr_"Mft.tows.a asoom..°e. PC LS point of corners- by i,..�. a.+.e...r w d—- g�- --»-�-� rt...tyg.rd t:�.t...teidads b..�idord pmb std M PNP w t..e..b1.e+o tas•lm..am err.T- • a Ifdi.r�g6m�s.Leuv.bbe wd-A imm V=u p6a w�ireoov.ieti.. .W6 �•� c...• •.....• STR-006 a.tu6 ti naooau.'.uu.toon.ad i..rb�ad Spa a Fool r"ad.e..io.e..de. a oe..g eopody of 2D00 W. �.Eam.aia+dd d? ifa� d awed. a &M basd.s m.as.cod�ova e..qw t.wo,q..d rwr.Tft * kty.r 1`^a tag F6P w.ami..ed w.n e.rgo«w.end toar."<f a ewol con mu and wwv Pod. Fa iniern�aia�m�an.r� nr.n..n i Pmt 6'anew tt.eMd:np Fi w:ds ud.r bas eF Pa�aiarid .onpads,..s: r+e.ad Sm b Peo11a../e.2111 Euro+ a..a.e+�T6�.sm.biy A.iat�dl.rii �� Aw....Ai..e.One VA 22314-7a3/636� 1 1• • CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE.1"=50' DATE.10/12/2001 Scott L. Giles R.P.L.S. Frank. S. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. LOT#4 N E"o3�06ry existing pits LOT#3 0 47,987 S.F. N PLAN#10973 �v N.E.R.D. M. M X to QQ Ee-0 'a HAWKINS 0 co LANE � o 60'+1 — Q.Qoa� � c. W PQP`O SUN m SD Pe pe i n m � T Sep�`6 0 d%sOl `L x 0o LOT#2 06 2osoo, oI I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE tK of THE OFFSETS OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE 1S FOR THE 3 � ES y WITH THE ZONING DETERMINATION OF ZONING . 13972 �Q BYLAWS OF CONFORMITY OR NON-CONFORMITY �tSTEA� NORTH ANDOVER �(E LAO WHEN BUILT WHEN CONSTRUCTED. �� n i � —•- 2?3.a o P � � / / UG / �svic1- O �6cDG 3 Z x [A , .T /Nc 134. 71 j C;u j i SI,4� S� nG I N. 44 D 6`/ Z)fs. / c�u7 131.5 i D 8 �, X3 .2 /NL X3/,64 'p.r _� INS- l►b•2I ( 1 r Nc. 114.57 �u,l �u✓ � 114. � 57 LAJcar, L�.� h vv-- }�Gf�t ; �iG 1u 4-6/ lc C41 - _. •i. <; i� �="i�l.r �/, ���• r�"i-�L �ici�/N'Cl �'�N 4F MHOMAS �SS��� f <+ 10 5 MORRIS No. 610 ti lCl 0\'o t-3LX13 l,1 , '` 'C- d.0 W i (ww nt �d�-� S'4k1TAlt ✓f_ s-j - SgOo MORTGAGE PLOT PLAN EK St2VEY k,1 .ROYAL STREET, LAWRENCE, MA. 01841 Tel. 508-975-1413 4QRTOAGOR AHLHOLMDEED REF. 3336 PG, 54 ADDRESS OF PRINCIPLE BUILDING PLAN REF. 10973 '48`-HAWKINS LANE MA. DATE OF INSPECTION JANUARY 19, 1993 N. ""ANDOVER, SCALE: 1 " = 40, y I LOT 3 o© 479987 s.f. DECK n STORY WOOD LOT 4 30' 1 ACCESS EASEMENT �p HAWKINS LOT 2 LANE NOP �` vs I FURTHER SATE THAT IN MY PROFESSIONAL N, This.mortgage kapection was prepared No.35M OPINION the prinCIDIG structure/s and accessory and is not to` CONFORM si*N y.for mortgage Purposes o* o outbulIdings. n �` "'d u y yAs a taP dtfrna a` ,lun hafl w1d v�y0� zonwith g orddiinan�,and thatnoencheoacchhments �s other than the $01W.nortg�es SUR of.ma)or improvements either way across in asi9ns connection-with its prop Property lines exospt as shown. ' �npnck►q to sold Mortgagor. . : fALM �1QN Tp1.:, ®t. property Is not In a flood Hazard Area. D2 Property >a in a Flood Hazard Ana od Hazard. This osrtlffcatlon.is based on the location of survey maw i]3 Information det�m frt t etlatest ermineF 1 Flood of.others. and does'not represent a property survey. Flood offs shorn are not to be used for the establishment of insurance Rate MOP Panel# prapo ty ums. s M Y ` e Town of North Andover t►ORTh Office of the Health Department Community Development and Services Division 27 Charles Street 4 . ,•°; North Andover,Massachusetts 01845 9Ss°wwreogcaus�s� Sandra Starr Telephone (978)688-9540 Health Director Fax (978)688-9542 October 1,2001 Mr. and Mrs.Fred Ahlhom 48 Hawkins Lane North Andover,MA 01845 Re: Application for inground pool proposed at 48 Hawkins Lane,North Andover,MA Dear Mr. and Mrs.Ahlhom: The Health Department has reviewed your application for an inground pool. The application was denied on October 1,2001 for the following reason: 1. X Missing information 2. Passing Title 5 inspection of septic system may be required 3. Location of structure not acceptable To address the problem(s): f#1 is checked, please supply: (not applicable) b. Certified plot plan showing house,septic system and proposed project in scale including associated grading,limit of work and any structures associated with the inground pool,such as a concrete patio or deck,pool shed and necessary fence enclosure. If#2 is checked: a. Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and whether it is operating properly: OR b. Tie-in to municipal sewer If#3 is checked: a. Relocate the project Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, B ' n J.LaGrasse, Health Inspector Cc: Family Pools and Patio,70 South Broadway,Lawrence,MA 01843 Building Department File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-953.5 NORTH own of �E° Andover No. - �. h DSA COC-C-9,40dover, Mass., ORATED S H � BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... .r ..... I.-M......A-41—.. &...v...................................................... Foundation I� u has permission to erect..... ........ ..I........ buildings on ... 7..$....0.8. ,.K.1 . ►...........A Rough N �00' N r�. r Chimney to be occupied as....I.......Ci*.................�.0..............................�.......................�............. .A.�.................................... y provided that the person accepting this permit shall in every respect conform to the terr>ils of the application on file in Final this office, and to the provisions of the Codes and By-laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 06".73 „i,$auw PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S ARTS ELECTRICAL INSPECTOR Rough .... ................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ' Date.. . NORTH TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION . 9 SACMUSEtt �- This certifies that l has permission for gas in thation/,.��A?— . : . . in the building's offf��` .1�� �p-;� �.L �. . . . . . . . . at f r�; .�~✓- �:���� .X41J./(-,<North Andover, Mass. Fee.-)�O. Lic. NoI.:5" 7.3. G GAS INSPECTOR Check# S', 31 MASSACHUSEM UNIFORM APPUCATON PERNIlT TO DO GAS FPITING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS S 1� Building Locations ^ S Permit# ✓ ///_ Amount$ ©� O ner' Name New Renovation Replacemen Plans Submitted Cn o o z H w z z o a o w w U H z Cn H z H z H OU. a � � a H O SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR STH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) Check one: Certificate Installin Company Name � orp. ��� Address Partner. usmes a ep one Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked yes,please i ate the type coverage by checking the appropriate box. 13Liability insurance policy Other type of indemnity 13 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 0 Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. gnature of Licensed P1 r Or fitter By' Plumber Title City/Town [:I Gas Fitter Lit,e um er/ ,�, Master tl APPROVED(OFFICE USE ONLY) Journeyman 01� Office use Only The Commonwealth of Massachusetts Permit No. � Department of Public Safety 3/90°�'"' �` tee Checked (love blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12.00 RULE 8 Effective 1/188 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 14:00 (PLEASE PRINT IN INK OR TYPE ALL INTORHATION) Date O-� City or Town of ( �l ��c�M� To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below.•• Location (Street ti Number) �GA,oaki l S C,cn P Owner or Tenants 1'C P r4 A--1 h11 CIO ) ' O•mer's Address 5e/r7R— Is this permit in conjunction with a building permit: YePRI No ❑ (Check Appropriate Box) Purpose of Building__ _Utility Authorization N0. 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 �j L P ✓Sq Seca eo�l ��ta../ i?I•*�i ro o a, o� e, r o 0,0% S No. of Lighting Outlets No. of Hot Iubs No. of Iransfor'meis T�A1 No. of Lighting Fixtures D Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA o No. of Receptacle Outlets No. of Oil Burners No. o f Emergency Lighting Z No. of Switch Outlets No. of Gas Burners FIRE ALARMS No.•of Zones s No. of Ranges No. of Air Cond, Total No. of Detection and tons Initiating Devices No. of Disposals No. of Heat Total Total W Pum s Tons KW No. of'Stounding Devices J ¢ No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Munibipal ❑Other Conneb.tion No. of Water Heaters KW Si of o. of Low Voltage F Signs Ballasts Wiring O No. Hydro Massage Tubs Ito. of Motors Total PP OTHER: ---14AR 2 51997 - e INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws' I have a current Liability Insurance Policy including Completed Operations Coverage:o-r its substantial equivalent. YES E] NO❑ I have submitted valid proof of same to this office. YES[3 NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE © BOND ❑ OTHER ❑ (Please Specify) (Expiration ate Estimated Value of Electrical Work S y Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME__De V eau 6� lLLIC. No. // �CSO►Q Licensee amen N Deveau Signature y.�- // I �NOI /s13804 Address • Box /024 Ameaburt /1J / / Bus. Tel. NO. O Alt. Tel. No; 3 66-963-27- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance-coverage or its sub- stantial equivalent as required by Massachusetts General Laws, an t at my Signature on this permit application waives this requirement. Owner Agent (Please check otte Y dd Telephone No. RHIT FEES Signature of Owner or Agent Dater/. .. ...6. ..../....../...... 829 NORTH O�t.�ao x.11` 3j `0� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �1SSAcmUSEt This certifies that ...� ttf 4 .........-.. ems. A'...c ............................... has permission to perform ..... ......... wiring in the building of...A.i k!�..v......................................................... at..... . ... !`.t? North Andover Mass. Fee..p ...:.q).. Lic.No. 1. /.......................................................... ELECTRICAL INSPECTOR G w 03/27/97 13:33 25.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer PERMIT NQ. / 9 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. V/ PAGE 1 MAP +40. /�I _ LOT NO. 0123 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE ZU``NE ! I SUB DIV. LOT NO. �- i LOCATION PURPOSE OF BUILDING 4- OWNER'S NAME Ql� NO. OF STORIES ,y SIZ1-f 7tW46 OWNER'S ADDRESS BASEMENT OR SLAB _ ARCHITECT'S NAME TT OO SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME ' SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET '" "�OSTS 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 �r IS BUILDING ALTERATION . -Gc-M IS BUILDING ON SOLID OR FILLEDI LAND S��A WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER er \ BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER AID IS BUILDING CONNECTED TO NATURAL GAS LINE S INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST Al000 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST.CLOG. COST PER ROOM SEPTIC PER t p1=. ELECTRIC METEP6 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 FILED 7��/T 7 �T SUILDING INSPECTOR SIGNATU5poOF OWNER QO AUTHORIZED AGENT F E E OWNERTEL.# 6+ 7-3972- PERMIT GRANTED 136 19 ^ CONTR.TEL.# �- CONTR.LIC.# H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES HIS SECTION MUSTSHOW EXACT DIMENSIONSOF LOT AND DISTANCE FROM T 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 I_ CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T AREA _ '/ 1/1 1/1 FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDH✓'D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY - ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) F-LATJ SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY / WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE 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 lft 13rd 11 NO HEATING aNational°Brand 45-606 Eye-Ease 45-306 2-Pack 11 ttiais Date Made in USA Prepared By Approved By - 1 2 3 4 5 6 f � 1 I 1 2 2 3 3 4 4 5 5 6 _ 6 7 7 8 8 9 l 9 10 10 11 11 12 12 13 13 14 i 14 15 15 16 16 f 7 -- -- 17 18 19 19 20 20 21 21 22 22 23 — ---- - - - + - I + J - - --- - _ 23 24 r 24 25 •� - t- 25 26 26 27 yil 27 28 j I 28 29 F I i 29 30 i t + 71 30 31 31 { � 32 32 JIFT 33 I _ POW 33 34 34 35 — - - � i 35 36 f 1 - 36 37 3838 39 - - 41-t - ' 39 I 40 —-- 1 2 3 4 5 — b 1 1 . 2 2 3 3 4 -T-Jfl� 4 5 5 6 6 7 7 8 8 9 9 10 10 11 � 11 12 12 13 13 14 i 14 15 f i 15 16 I i 16 17 18 19 — - - - -- - i I 19 t + - 20 120 21 - - - - - - 21 22 22 23 _ 23 24 L 24 jT, -ftj 25 25 26 26 27 I 27 28 - - - - -- — t � 28 29 1 29 + - - - - - 30 i 30 31 31 32 � � 32 33 33 34 i 34 35 I 35 3636 37 38 38 39 — — -- -- --- - I I 39 40 LLL I 40 TE 1 i T40RTjy Town of Andover No. Cl 77V7 0LAKE dover, Mass., 1 9( .C.CHEW11C TED A WARD OF HEALTH Food/Kitchen PERMIT . T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....................................... ........ ................................ Founclation has permission to wW....A4,, z,........... buildings on ......`�..a....../-/,#��//.05.......A44,01JUE.......... Rough to be occupied as................................. /6)e lq6 9- Chimney S�/...... A. ........... ............................. provided that the person accepting this permit shall in every respect conform to the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S ELECTRICAL INSPECTOR Rough ................................. .. ............... .... .............................................. Service BUIL G INSPECTOR Final Occupancy Permit Required to ccupy Building GAS INSPECTOR R Display in a Conspicuous Place on the Premises — Do Not Remove Fiough nal No Lathing or Dry -Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Bumer Street No. Smoke Det.