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No. 5a 10 — Date 0 /8 /v
MORTM TOWN OF NORTH ANDOVER
" A Certificate of Occupancy $
+ ; ; Building/Frame Permit Fee $
s�cwo)s�t� Foundation Permit Fee $
3. Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $ ,
TOTAL $ S a'
Building Inspector
X3459
Div. Public Works
PERMIT NO, 0�� APPLICATION FOR PERMIT TO BUILD*** ****NORTH ANDOVER, MA
MAP NO. LOT NO. 2. RECORD O/F/OWNERSHIP DATE BOOK PAGE
ZONE I SUB DIV. LOT NO. Sem /�QQ 3e_Hlme0 Aee-�- enclosed
LOCATION S �� J PURPOSE OF BUILDING
NO.OF STORIES Py Clrc77
a SIZE
OWNTj2'SNAVE o �
O f -
g
OWNER'S ADDRESS op N� BASEMENT OR SLAB q j
uSIZE OF FLOOR TIMBERS 1 I a x JD 2YD x /U 3
� RD
ARCHITECT'S NAME �Y O n _��,�) n/P
BUILDER'S NAME \ �()� I)/V SPAN
/1
DISTANCE TO NEAREST BUILDING >/00 7` f DIMENSIONS OF SILLS ax NO I-T
DISTANCE FROM STREET / DIMENSIONS OF POSTS 0.
DISTANCE FROM LOT LINES-SIDES a a REAR > 06 DIMENSIONS OF GIRDERS
AREA OF LOT - - -U6� c�FRONTAGE /�a v � Jee PxcP �cN HEIGHT FOUNDATION �� �� eel a 1�PJ �� THICKNESS 0�
SIZE OF FOOTING ~
IS BUILDING NEW f S
IS BUILDING ADDITION /"/6 MATERLAL OF CHIMNEY r0 !� fo,r AyQ e-L
IS BUILDING ALTERATION a IS BUILDING ON SOLID OR FILLED LAND l
Wli,L BUILDING CONFORM TO REQUIREMENTS OF CODE ` � IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANN' Aj 0 k/-10 IS BUILDING CONNECTED TO TOWN SEWER O
IS BUILDING CONNECTED TO NATURAL GAS LINEyes
FAIFL
S'3. I'RO$ERTY INFORMATION LAND COST
EST.BLDG.COST
ae
UT SECTIONS 1-3 EST.BLDG.COST PER SQ. FT.
EST. BLDG.COST PER ROOM
ERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO.
RAGES MUST CONFORM TO STATE FIRE REGULATIONS �. APPROVED BY:
E I7JLED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR
DATE FILED OWNERS TEL# ( 33 —
l I ` CONTR.TEL#
�n
CONTR.LIC# V
SIGNATURE OF-ONANER OR AUTHORIZED AGENT
122:PIA
H.I.C.# (�
FEE
PERMITGRANTED I � wvo p r
19
Revised 5/5/99 JN1
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FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
s
APPLICANT (7—AMCQM,�CVd)llr\) PC)RPOI bv) PHONE.A3-3605 j
LOCATION: Assessor's Map Number 3" PARCEL 0—
SUBDIVISION IJ� LOT (S) I�
STREET "Y96 Slr�d _ ii
ST. NUMBER��2 AcSc���W�
(4n
**************** **) j
*********************OFFICIAL USE ONLY******************* **************
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RECOMMENDATIONS OF TOWN AGENTS:. i�
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
I
COMMENTS h ��- l by
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TPLANNER DATE APPROVED �T 4
DATE REJECTED '
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
l DATE REJECTED
V SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED ` ''^" } `' ` �C�,f
COMMENTS
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PUBLIC WORKS RMATER CONNECTIO 7 — / 47-9S
DRIVEWAY PERO g f
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FIRE DEPARTMENT �#
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RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
Location
No. Date 7-14- t)`�
NORTH TOWN OF NORTH ANDOVER
O?O•�•`•o .•,SOA
Certificate of Occupancy $
41
Building/Frame Permit Fee $
E<�
cHus Foundation Permit Fee $
s�
Other Permit Fee $
Sewer Connection Fee $ i /
! Water Connection Fee $
TOTAL $
Building Inspector
`� rD139 08:cg 1,151-00 PAID Div. Public Works
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i,._ ,% z Name of;Applicant on Bullding Permit(below) lAddress of Property forPermit(below)t1.2. 12V°�r `111� rr
fa111 t'- a I 39 x is ' a "}it� � y
Y 4�,s k �, � / � � 7, 4 ,(,S..r ..` % t h r "A ^f. �'N'd `-
" � .' `:Map and'Parcel : ;:Purpose°of Application (check below)t �/' ,' "' ', �4,J� v,
k6 r3 tt 7 y E .;. .y i :" I .. •.k ,-r :'r' S, ,
``� y,4 Phone�Number�,oftAppllc11�ant. � 2 ;Single Family �!< Two Family 34
.R..:..:;.,sG ,:;:.:.,:aceta#d11;1�' t•^i' .*v x t-
t 4i y {x y \a s'`"4"A �'t}a'.,f,.'t ,P, w,, d t Y �4 t t:;. - _ �" s h;: "'Sran r�'r}F.`
4° b^I-the 11
under5i ned.a licant for the above, roe attest that;tlie attached buildin 1;= A "I
g'permit for which this it a
x# ,i{" 't form is;completed;doescomplyEwith,the;EXEMPTION:sectton,8 7 6 of-;the'North Andover.Growth:; iN rI,V%`.�z'
" % Management Bylaw �I;al o.0 ,,-,and providing t t., ,o, . does`not'absolve me-or:an a to.this ermit ', ' r . ' °"�}°� fix
';from the,�e uirements;of,obtainin `other, ermits re wired' nor,ta the`issuance,of.the Bu ding Permitil; `A_ ,'��i:,
Further,ltunderstand that'my.'inteipretation of:the`EXEMPTION?5tatus is°subject to review by9he'BuildingFt
i; � .
. 1.Ij Department and is,only�.officially accepted when,the11111, Building Permit Iiig issued.: �f ''rl`""
rt '}�.Pit,r .r: i�� F i dry 'n is' -'v` q 3r,�F:. .:;,...F ,, '`4.: ., y � A �Yi# ;
Based onpsectlon;8 7 6 of.the North Andover Growth,8ylaw the;above"lot and the work as'applied for`on the ``,� {a' i`
above lot,>.In the,building;permit1.application and;associated attachments,complies with one or more.of the xy ,l
' foilowrng sections"as indicated by,�a check mark .kt `a k
` -t I _ f
This is an applicationfar a bwlding permit.far the enla ement restoration,or reconstruction'of a dwellin in . .1 ":'.
tti :� ` existence as of the effectrve date of this by law provided that no adddional residential unit is created.• g1. rr
m �'w , -<;.,",i F,t rn + r'µ;9+k} .,.r ,- _ .. ,r. ,,;, 1.F. TM t _ 3 r 't y}.
: 1. , 4 u•4'.
1.
. a The lots)were_jL/was created pnor to Ma;y 6 (1996 are exempt from.the proviswns of th}s Section 8.7 of the Zoning ; -f a;, �;
S <}, .�'"+ .rf '� a.5 ` f L�'t ., ) n;,'/t til&xR.�:r,.{it X.. '.. i '' � Ind 7. t $�.1
;' This application is for dwelling, faraow and/or�moderate income•families or individuals,where all of the " ."
�r ,, r 4conditions•of 8:7.6,care met'and/or�represents,owellingrunitsffor senior.';residents,where occupancy of the units is. 1. "' r! - .`x`fi r,t''
il y,4r ,r K ustncied,to'senior.persons'through?a''properlyexecuted.and'recorded:deed restnctian running with the land For .: A, .. a � � f,�'.
t , M til rpases of this,Sedion senio„shall mean;persons�oyer therage of 55s, r
{ �c ,:
f�y p#.ri a-ay f.;i1 Ntirix.wr;�r. s, k'•P. .i.r ,d-rx rr. -' '§^g„,.1tr dMK�� y 1,� -r A 1.,
r.
• Y :} JAL T I.
This application is.a.part of.a development prnjectdwhich.voluntaril a reed to.a minimum 40% ermanent1. i Vis$ .
” reduction:in densi buildable lots below`the.:densi buildableilots;`'errn tted''under zoning and'feasible roen.the11;. i , 711. r:,
tY'( ) p
s,„ ��f�PfI� s4_denvi'onmental'conditions ofsthe,trad with the surplus'landiequal,ta"aCJeast ten buildable acres and permanently , `�'1._. "
},,,�,_,,.: esignated�as openspace`and/orsfarmland Th- land�to bepreserved shall be`protected from;development by,;an- J : ;<,rnM, k
a E Agricuitural�PreservationAestnction,ConservaUon`Restnd►ori,ded}cation to the;Town,'or other-.similar mechanism 'ick : y4,
��r ��,,s ;approved by the Planning Board that w01'ensure its protection` r t "` r, , F ': `
'1,y�Y: M,,} t rte'+ t v�'� ,,sR: "" ,k�'Tt' ~`= .,w�, i 3 }eqt F.«� t + `, .;} .. y,n s,�s'i'"3 ?,
z .} 3.. i +rJ. .;+. a::'. f t`.,,y,.,.z,,.f""ra. ,."u.#?s i.�:,'t r 7:?;�'`•S f .;` "'[`";J=: .ac t k:. t 16 tr kr s, ,
n + a + y _:This;application represents a<tract of,land existing and not held,byta;0evelaper in.common ownership with an is y �`,"'r7,,I
4 ; r+t adjacent parcel on the;,.effective date'of this Section d8:;7zshalLrece}ve`a one=time`exemption.from the Planned Growth �, nti�, -
,r " ;Rate and DeJelopment Scheduling provisians'for the,purpose of,constructing one,single.family dwelling unit on the. , > , 4' !r
rdtx r r< ; r '� l' "•,2 v,} �Xtd { Mj'ry .a:y'§.+. ,Kr1y• +C.:, @: ^e i ..
'111.{�;r " eparcel ' k 5 �+ .pk� . A ryr . we`d at l,1 J '; r xr ?tr c;,
' 't, f 144 a i{4i zl •+a( t i 4 ds y,. t y,:.? s d+r+ r of/4/3-•wti,-*45iy,+�" .ct r r '" - t t Y 4,�„'rZk w�.{�,St
9�. S Y, �r,W� '�t7i u h r�;'d S pa}a 4 S r,a4 >b,. .,, t t , = W:, 4kr % vx
z n ,t`.M!!�"" i Cr # .d« ;,r 'r Y „} uJ r -,r ;'. r
s�,,y, f This aPPlicatlan,represents a lot which is+read for,buildin ' " ' 'i
k 4, y g permits,"(i.e.rail otherpermits(from"all,other;boards and a. % � `_ J 1i.
}d,} Acammtssions have';beentreceived and;theiproject4is:inAcomp.liance with,those„permits);,and th.e 0evelopment,Schedule s ••
1 3-"t d�`does'not:accommodateYissuin a;buildin f ,. ` i •` uA, t�> '
+ FF .
1.
g g permit in1that Year,ione building'perrnit will:be issued per'Year per, n t�
j a ,, �` Development;until'such.time¢as;the'D Welopmept Schedule'accommadates issutn buildin $" rri"t�� J
" $' supply approved form U with'this IXEMPTIONai�s } �' ' = t g %g pe Applicant k w �� ��,
rmits must !;
n •'Yfi ti ! y .r -� f .,.7a 1 :s § f.• t lt,r "t +
t + 1. a ra dF nay R w> Y $r� ter±
aa' '?•,f *• w{h+A;`� 'L$".. tJ"r"�r.=+'> 1c..S;,i✓";: rsj .::;:ri .<sr :;,` ..w;':r' f.�S, C,-ark)1 "; _ t aa,mr v`t,' #1"+t,'�'t'F• '},&•'�Fi
5 k +
t ,mow u YAPle ise provide,;any and,all Information that,would assist,the,B6Hcling„Department in making a determinationi. 2 ::
„� that your,a pliraUontis allowed one orNmore'of the above,EXEMP.TIONS. x' x ti
.+.a 'Fr##�- i �Y; y , tY_':. . ,j i f 1'G.$'¢,�SeT.�('y�ay'I r�,.c.��+y§i@Ytl xaB�k'J«-: ,�Fv. 1' a t5 ,,v i k'r 'a� t�(+t ��i� ^r d`,jdA"yj��
N tj yip 111
Rl�4 }5, ,.;. ,r,f.'+ W t ;rte � •.>... ., !'S.°P.:•,,s� h.r,V), ;-,°"[..�.v+a ;,4 d4..��r./h«+"F,..4 35�,.;�fi F ..Y,F`.i 5`r `.,f 4. 6 ,• .o,J..7 K.,j4ir ,�A E. rfY,; .1 '1"� P�r.'��'K
y:
,t� �_! ;B si rnn below,;attesfitoithe`accura• -of the+information;provided and that:the:`attached buildin ermit is';,' ' ”` n 3”
ri Y 9 9 r. t cY '
.j _-,�. allowed„an':.E ,E,PTI.PN as'cited abovie F.urther'T” 'derstand)that;the submittal of=misleadin :,and or. a '' Y,`. y r3; ,f £
,a inaccurate. nformaUon 'onj a°checking~off of an`abo ekitem which does n'ot coni I whether done`to m tF. tr. <"ip
s F l
f°r yr 'gknowledge or not;is£grounds for�refusal:b ithe SO din ,Oe artment„to`issue'a`Buildin `:Permit:`. ix �' " '' w= c4 i'`a }i
r r::;;`T!t�' '; .it `} s W ivrx� �,
`�'dttt'e`�3�' x y d i#i,:k�i ei.9r4” p s -A� iK,,4 fl g: C :,.i?, ', i e fi rr'f}tr m r1
i'",},.£�-'?P yr, .,T.> ty ;_s+s ¢: Sr„� .St .e. J 1 r :. qty :: '4 fe'C'os ;X` K'-^.• q: f, u€,i..i`�}'s v .�,i;. .Y, F •4 :. ., t`�J r.r;`+° s,.' t"e air
r kt *kc R, a k t*S. iv ll� 11 it v.R k ,:, r a,h.,w-� t' n .+'",d._v t• F
+rr+, { i p`. ,<t� > ?. ,-C.rT"5 s" lLS` i a>". x n 2; t K F /I',- rY
T,€ '?z : +�'� pi. F, »N.,a3'd,a.ns,tF" d_:r:�,c['a?'`"k'n°t � y,ki•`•S i• 1 : t s s.,+� Su,
N�dt r Y r ignature o,:+ eraor uth,orized^Agent who signed;the Attached BuQding,Permit Date ' '_l'.
f'
} ,� , - a This form st be,4 chedto the Suildmg;Permit upon application for such,perrnit ° z'ir n'"J'
'' + Td c ru i� z t < ,. �r? t s s1 t{R,,;ar r,=v;' u;,tr, s' ys.. y N+ A 'x f ,£ t ti ,t 'l�: }., ,�'t� N;*,..
r11
"t�. }"' }k x 1x ,,S' r_ i• S i 1 ` x+ +t a r .a Y< + .Fd�
r tr'-a!+`"} A ,s/.r� ,t y , wt`�r ,, 4< - c '?,-T 45`,�' y S - < a S r x r
-A,xµ fi t , .'k 3 ctµq�1 i d L , rt zyA. ^,}.! s3ry r 7} .(' fd�' F'`k< {:ir yF. t ) - "A F t - A
d�,;,,,�`rr.,rt z"c 't X,' ,i ^ AS.n ,,i' sti _a •� a 7..' r.. ,; .} r' r i i s
r , ,i;p. S a i 'I s a K a f' dts f s +- n s r� t a�' �' `d"-i
'.y {p,r r ry ''` X i' 4 �,x.< v n "1�fi, Y,j °+ t',J i x� ;b +'.vim,t,"sl f w Y = - } 1 , ;'.11 �� f t t "' I t?*,,L,
uJ11
zva �� ;bcy d,4t� � fd ]I .� �s� GX ,;
t 'k` �}i. Y y r" d a •` 1; f J ' 'r jdil <y„ t'AN �Yv f 1 H,.7,,y?% ,�+y,`,.�
3j ,, fi` a, ` ' " �k' + , � Nlds t, x }. ;• t s `tit 3 fl�`��,,
.n+d ri 5 r a ru jk t-'r�'S `2 �� dI I'x a,t4 fit+:� sF�th e } ;1. 4 1. r n x 1.5 �-S ��ktl,
"t fix+4.§.a• t , Ia d x?,*r•to a ? {.,'` ,`�' 4w`' _-.. e rr.,t` { $ t i 0..�" " +.t, ,t11 -_'t"
` ! j", r:: k� „�v ;�'. } tr wr a rt
} 5.11 f 'x Y :r } },d., 1 ,' } N V 7 3.:r .� ,�,+7
.4; i a:• •,��.!'' , Yt r:i ,( ,i t [ }y J fid+ i .- £ " " e ,}' 4 5 I ,lac
s€ f!F -}.- .•e A j ? ea �h K"r"k� Mh "�'7 t.-1 i`� i + :"r 1' fik'� c C r r ,'',
` a:. _ ,}a L :t rf .,yi X'� '}`?. wk., .*r., s i ^tP ti},• .. t ,. _ " c . . .. ,,,ij Y4'',"4i l: �"3;1,
• t,
rrr+ ... .: . ... .. .... ..
...... .::::.::::::: :.::::::.::::::::::::::::::::::::::: .::::::.:::::.:::.:::::::::::::.::.::::.:::.::::...............................:....................
Town of North Andover Planning Board y
This form represents the schedule for allowing the following lots to be considered as eligible for
building permits under the Town of North Andover Growth Management by-law Section 8.7 of
the Zoning by-law. Pursuant to 8.7 .5 this Development Schedule must be filed in the Registry of
Deeds and be referenced on the deed of each of the lots below and be filed with the Planning
Board prior to the issuance of any building permit or permit for construction.
Name and Address of Applicant for Lots: Name of Development:
Cyrus Construction
P.O. Box 583 492 Salem - Form -A Lots
North Andover MA 01845
VI
Map and Parcel of Original Lot: Map 38 Parcel 2
Date of Application for Lots Division: December 4, 1998
Lots Covered by this Schedule: A, B, C, D
The Planning Board by their signature below, or a signature of a duly authorized representative,
do hereby establish for the above named development the following Development Schedule for
the purpose of Section 8.7 of the.Growth management By-Law. The applicant, their assignees,
successors and or subsequent property owners shall conform to the following schedule that limits
the eligibility of the following lot:: for building permits. This form must be filed in the Registry of
Deeds by the property owner or representative and be referenced on each deed for each of the G
following lots. Such deed reference for the coed of each lot shall at a minimum reference the
book and page in which this Development Schedule is filed and contain the language : 'This lot
is subject to a Development Schedule pursuant to the Town of North Andover Zoning By-Law all
owners, representatives, and future purchasers should avail themselves of said restriction by
reviewing the approved Development Schedule ins riled in Book insert here and Page insert here.
The fact that a lot is eligible for a building permit is subject to the limitation of the number of
building permits per year pursuant to section 8.7.2.d of the Zoning By-Law."
The Planning Board hereby schedule the lot(s) for the above development as follows:
Year Eligible Number of Building Office Use Building Office Use
Lots Eligible Date Lot Eligibility Notes
Completely Utilized
1999 1-
s
� I
Signature of Plannipg Board member: ;: rued Representative
Date (i
Signature of Property Owner or Authorized Representative
Date
i
i
ERMIT NO. APPLICATION FOR PERMIT TO BUILD******"NORTH ANDOVER, MA
2. RECORD OF OWNERSHIP DATE BOOK PAGE
IAP NO: 3 LOT NO. �/ e t .
:ONE SLtQDIV.LOTN0. Se, /- uD ze-HItme0 SAee�—encloSed
.00ATION C IN �'� J PURPOSE OF BUH DNG P� �� �r�C//.1
v 70
NO.OF STORIES �w SIZE
AVNER'S NAIN IE. O 4 e
)%N NEWS ^/ BASEbIENTORSLAB
\RCHITECT'S NAME I� � n _ SIZE OF FLOOR TIMBERS
U
,M,ll SPAN
3UILDER'SNAME C0� r t /tel] 'b&) IG
)ISTANCE TO NEAREST BUILDING >/0-0DIMENSIONS OF SILLS �x
DIMENSIONS OF POSTS
DISTANCE FROM STREET
DIMENSIONS OF GIRDERS
DISTANCE FROM LOT LINES-SIDES a a REAR 06 e THICI:NESS
AREA OF LOT -7i-S-066 FRONTAGE //� . � 0, Jee PXCP �sN HEIGHT OF FOUNDATION �� �� e} Q� �nP� h� -
. 7 p n
IS BUILDING NEW SIZE OF FOOTINGih _.
u - -�
L°-S
MATE klAL OF CHUMNEY Z o�0 e AYQ C.-Q�
IS BUILDING ADDITION /✓b
IS BUILDING ALTERATION DU IS BUILDING ON SOLID OR FILLED LAND
` e < IS BUILDING CONNECTED TO TOWN WATER
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE / `1
BOARD OF APPEALS ACTION,IF AN1 N U _.
IS BUILDING CONNECTED TO TOWN SE\VER
TS BUILDING CONNECTED TO NATURAL GAS LINE
LJ
LAND COST
INSTUCTIONS 3. PROPERTY INFORMATION
EST.BLDG.COST
EST.BLDG.COST PER SQ. FT.
PAGE l FILL OUT SECTIONS I-3 EST. BLDG.COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
4. APPROVED BY:
BUILDING INSPECTOR
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
OWNERS TE
L#
DATE FILED
CONTR.TEL#
gall, CONTR.LIC#
SIGNATURE OF-O)VNER OR AUTHORIZED AGENT H.LC.#
FEE $
:PERMIT GRANTED -
19
Revised 5/5/99 JNi,
r
-
u..r -�. ,�` _. . .:' _: :. .. .:.'-. •.s. -. :'- ^. .. ''- ,. .. . .. __ ., - ,. . .. _. �__ �_�- _-tea.-=-- --r.f.4:.'� %.
DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.
• _A. S B.p Y^; ...I ... rrmn A muco UMO Nn rIk
r
' I' I':TYPE OF`LOAN wtanes' I -- 1
1.1A 2.-FMIIA .Irc,lpltty,,hull,inap.^5, ' , �Yl
ARDIFF& MORSE, P.C. . 4•-VA 5• 3•X CONY.UNINS
_CON V.INS.
G. File Number d`1
84190 7,.Loan Number
SETTLEMENT STATEMENT 8• Mortgage Ins.Case No. 1
C. NOTE: .71r(s jo-!t
furnished to glut you a rtaemtnt,of actual settlement costs.'Amounu paid to and by the satlemrnt agent are shown,
/ram marked'(P,O,C)•weer paid outside the dosing; rhry art shown herr jot mounts
pararionan u
D.NAME AND ADDRESS OF BORROWER: pERSON F
725 BOXFORD STREET ARb7S R pulp and are not included in the totals.
DALTY*•TRUST - JOSIiPII I LLICH
N0. ANDOVER', 01845 " ,.Trustee
E NAME,ADDRESS AND TIN OF SELLER: MICHAEL J. DEMIRDJIAN l
, DEBRA M. DEMIRDJIAN
F.NAME AND ADDRESS OF LENDER; NVERS �e N c-p c(`DASAVINGS BANK `
is
ONE CONANT�STREET
G.PROPERTY LOCATION: Vv v
DANVERS, MA 01923 � 1
492 SALEM STREET N0. ANDOVER MA 0184.5
Property or Services Received I
1. H•SETTLEMENT AGENT "1099S RE, pt .
PLACE OF S ;
ARDIFF & MOSp,C I
SETTLEMENT: TIN #042936393
55 FERNCROFT ROAD
I. SETTLEMENT DATE. DANVERS,-, MA 01923
06 10 9.9 1i
SUMMARYPORiDORRO , r
WER S,I,;TRANSACT10NIy lllyi i.l'll l s f�N y r'j1:(I j(IK' IjN
lA0• CROSS,IMOUNT DUE FROM BORROWER; I'"�' UT�IIk1ARY"'0$''
I SBLLBRS";;TRANSACfTON'
IDI.Contract sales price 400. GROSSdAlO
UNP
102.Personal ProS
perty 401.Contract sales price DUE TO ElLSR'
103.Settlement charges to borrowerpine !4001 f
' 402.Personal property
104. 403.:... "
105.
404 -
4 ry
Adjustments for items paid by sel/erin advance
403 ... ...
IO).City/town taxes
z
06-10-99 to 06-30-99
I(17.County axes ^Adjusrmrnu for items paid by seller in advance
406.City/town taxes
t0 .__ .
108.Asxessntenu
06-10-991006-30-99
407.County taxes _
109. to
408.Assessments
110. 409. :. to
11I. CLOSINGADJUSTMENT _ 410.
112. 411. s
113. ADJUSTMENT
412. CLOSING AD
114, 413.•
115. "
i 414:
116. 415.......
' 120.CROSS AMOUNT OUR FROM BORROWER-
41G
200•"4'UOUNfS=PA/D;BY/OR 1N'BE11A1�i 410 GROSS AMOUNP DUE TO SELLER I '
201.Deposit or earnest money OF:BORROWER FI
G'i a!SAO''REDUCITONS i1N.LtlOUNF
201.Principal amount of new loans 221350.0o 301.Excess deposrt(srr instructions)
()).st advance k 207,310.00 .
DUE rO;S�r1 FA
' 203•Existing loan(s) taken subject to 502.Settlement•charges to seller(linr/400)..
I04.
303.Existing 102n(s) taken subject to
205 ' --�- 504.Payoff of first mortgage loan
206. 505:Payof.0 secorRl mortgage loan
207. 306.
- .
208, 507, I
209. 508.
Adjustments for irrms unpaid by stller 509
210.Cirygown axes Adjustmtnn jot iremr unpaid by srUrr
211.County taxes . tocity/toL;;
to 510. wn taxes
212.Assessments to is
to 311.County.axes
113. to
512,Assessments• I
' 214. to
513. FY'98.TAXES + INT
215. 514. FY'99 ES + INT 4,241.29
TAX
t q.
216. 315 4,200.29 I4.
, I
217. ,.. 316 •.... .
218.
5I7.:.. +
219.
319.
" TOTAL`PAID BY/FOR
' 220. .. .: ,,.....
1
REDUC77ON'
BORROWER 320 TI 1MOUN/
JAO,;CISH< .
AT,SE7TL6MRNP�1t720AfQ17fBORRO , v DUE SELLER
301.Gross amount•duefrom �A(- li !I t"a �Ry°t(+116Ap';GSII 4T'S r, I
borrower(line 1101 * h7TLF.NEIIT,'.,TOATROM':S t
302.Less amounts paid by/for bOrrower(hne 110)'s GOL Gross amount due to seller(line 420).. 13014
602.Less reductions in amoum due seller(lint S20) ,r
t. JOJ.;,G1Slf.(;„Y•,a FROM). ( pX<:'TO),BORROWER I`
TAXPAYER IDENTIFICATION NUMBER SOLICITATION:SELLER 603,CAS11.( X - TO) ( FROM '
Yw tar ) SELLER
I "rtd by Iceropmrbe ARDIFF;MORSE,P. O.00 y '
k4nific,llon rtmhr.you nu be a. C.NIA you eRlrCl
Unkr R!uhke ofperlury,.1 Miry �civil a MMmI pny,kr i�rporedpk � +.�'ulon ninlber.I!you do,m ARDIFFp MORSE.P.C,rllh
wre(a.+ddrtn ad w Idenificuion nmber(U b duvn In Rem E+m vd rlwl d h chrckrJ for acuncy.J Yl i
. nn0er aovn on W e nrnrcvy h o0'e'arRCl ueWyer IdernlflCYkn amber. .,
Thr lnfomml-e'-Q_Q in Blak,E.GJI I rd l rc cel k l .. .. ' I'
iLCIiOn will be Inpaed m you If Ihir hem it '^p01t"x w INormuion W b M
he Inemil Remise&rvke.If
... ...... 4 reponey rd re IRS 4urminer enl h hu rcr reported. Yui tae nquirtd b file c rtlu ..
i. ... fib• _
f ... n r b t t ir<rce peruhy or akr
bon
UD.19�JW1WL ,M l t
._.. ., 3
1 -,1111005.2t
L. Nee 21
SETTLEMENT CHARGES
nidi
. "700..TOTAG'.SAI,ES/BROKER.S.�;COhiMISS10NI°J;"s!�;:4'iTi°n;,�,ri!fllJ�,rrdil'' '!??ril,I ';h.,;.A ht,t,
EASED ON PRICE 6.4
PAID FROM
PAID FROM
Division of Commission (line 700)as follows
701. $ I•/ BORROWER'S SELLER'S
702. S to FUNDS AT FUNDS AT '
to SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704
Ir Is'BopyTI�MSItPA1 6!I hII6C11,
CP/1)N1k'/771aMOAN,r"c'I�gIPF�In�4hMppP� "�I°F';:i:N:Vl91',Ilrl"lu!isjg:a t
SOI. LoanOrigination'Pee d;!arlr I;411:i�iaN01, d 5I
%' DANVERS''SAVINGS BANK .
802. Loan Discount`-"' :• '
803. A praisal'Fee to
GASPERONI"&.'COMPANY --
804. Credit Re rt to
805. Lender's Ills ction Fee to
806, Monga e'Insurance'Alication`Fee to
807. Assumption"Fee to
808. PLOT .PLAN'FEE''to EASTERN,LAND SURVEY
809• FLOOD CERT FEE to FZDS
810.
Sl i.
.c
812. ;'f
813.
814.
900'l7F�S REQUIRFDBY'IFNDER'7YI'BE!PAID%N:'ADVANCE ar,
901. Interest from t ......
" "
r
902. Mortgage Insurance Premiumfar
months to
903. 11126MInsunhhce Premium for
Year to
904.
I000yRESERVES'DEPOSRED:,4IIN'LF7dpER;; j'.!'Iii1:a.P: j 4 I,;,.:., .
1001.Hazard Insurance V,
1002.Mortgage Insurance per month
months ® S r month
' 1007. City to tants. . months
1004.County roperty taxa rmonth
months ® $ per month
1005.Annual assessments
WG. months ® $.., r month
1007. months ®:S per,month .. .
1008. months ® S per month
1100.11ILEs"C1f 1RGES`'' d ti i t y :1
1101.Settlement or closing fee to
'Y'
1102. Abstract or title search to
1103.Title examination'to JIM NEILSEN
1104.Title insurance'binder to - �-
1105. Document' reparation`to` 'j
1106. Notary fee to
' 1107.Attorney's fee to
• ARD IFF &'MORSE P.C.
i (includes above items numberir,1103' 1105 1106"
I 1108.Title insurance`to" "T TITLE INS )
URANCE COMPANY
{ (includes about Items numbers;
1109. Lender's coverage' 1 750.00 S )
1110.Owner's coverage 700 000 00
S •
1111• OBTAIN PROCESS DISCHARGE(S) to ARDIFF & MORSE P.C.
i 1112. SELLER�ATTORNEY'FEE`to MINASIAN
1113. '& MINASIAN ''`'
1200..GOVERNA{EN7"r''RECORDI11 NG I';IN11 D 177�ryS `;CHARGES
1201. Recording fees: Deed S ' �' r
25.00' Mortgage S ' •29:00 :Release $ 40,00
1202.Cit/county ux/sumps: Decd S
1203.State tax/scams :959Mortgage S
Dced S .88
1204. :Mortgage $
' 1
1205. RECORD'MLC'to'REGISTER O 'F DEEDS'
1
.'1300.'ADDI770N1L':SEI7IFAlENI CNARCE� ,
1701•
MUNICIPAI;•LIEN�CERTIFICATE to TOWN OF NO I'll:• .:.'
1302, COURIER'FEES to FEDEX"' ANDOVER
_. 1307• RECORD'PLAN to'REGISTER"OF'DEEDS
' Uoa• RECO
RD"ASSIGN°OF'CONTRACTS
"to''REGISTER`OF'DEEDS
1305. RECORD-COVE-NOT>TO°ENCUMBER to REGISTER OF DEEDS
1306• RECORD TRUSTEE CERT to REGISTER OF DEEDS
1307. -
1308. .
1400'."
SE1TI�3NEAT' CIURQES i tenor ony!lnrs 103"Section`?and 302.'Section K)
t
1 lout tutfullr raked tit MCI-] Snllernne stun
. uwacllon ii 1 atUtr,cent Iba I cW7 D-1�Sel lug r^Y 1ro_ttdre tnd belief.b h a Int W,tcauu, tWentry of all real ;;-dc. M 9
h have raxlred a of Su omr., W
.. ... ..mon mr,
SE ER '
To tit beth of my Iro_kdae,tit IWD•t
of de tn111111 a Irarta[I{gr, � SUretrtra
of INt NJcA I hoe RnWW is a Um and te,urale tatoora of Ut BUYER)
. . furdt_Nth_cre rocelred W tare bcm a_IIIb,dirban,d Fry it .
ARDI
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WARNING:f 11 It a
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The Commonwealth of Massachusetts
U i
Department of Industrial Accidents
d Office of Investigations
Boston, Mass. 02111
Workers'Compensation Insurance Affidavit
i
Name Please Print
Name:
Location:
Ci Phone #
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
F-1
0 I am an employer providing workers' compensation for my employees working on this job.
Company name: C_y& � CoQ&Tcuc I 1 bQ Co 9,P0 R.A1) b Q
Address P. 0 r 0x
City �1 l� r�t� TON 011 [ Phone#: CA 3- J 4 S -
Insurance Co Policy#
Company name YIV` Cc A C' Uq N N CR,
Address
Ci W_A 'M Phone#: S� 1
Insurance Co Policy#
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00
and/or one years'imprisonment.as well.as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby certify under t ains and penalties of perjury that the information provided above is true and correct. y
Signature - I&
I Date J
Print name �� Se G� r e( ),(,k Phone# 0 3 3
Official use only do not write in this area to be completed by city or town official'
City or Town Permit/Licensing
Building Dept
❑Check if immediate response is required E] Licensing Board
Selectman's Office
Contact person: Phone#: Health Department
El Other
r .l ,ee . . . ... r.. vrr.� I� �V� L VI 1�,17"\WILL.I,I l y JIV ,7;Vif: `%1V1./I.."r u' 'v.�
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'PROD(10ER,,'S e ' ` %t �` 1. ,'_ '„I';m Y THIS?CERTIFICATE IS ISSUED AS A MATTER,OF{INFO MATION tT �”
�I E;r yr1 7 "' u ;�{ R. OIJL''`()AND{CO NFERS,NO1,RIGHTS UPON TFiE;CERTIFICATE.1 t 1--`4 r- 'hl
I',- C�!J;;+McCartty InsiAgency, Inc. 1 ��' HOLDER,'THIS CER71FfCATE�DOES'.NOT.AMEND'>EXTEND,OR w' cti"
'229iFr doyer:'.,Street'. a'��',,z l 'ALTERIfHE?COVERAGE:'AFFORDED,BY..THE;POL'ICIE$'BELOW. :,., „j`
. F1i'lmi ngton MA 01887 `k iu �In`'.*?e „ COMPANIES�AFFORDING COVERAGE �.'.: �, s*,
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�+ y t'f %1-:.. A1"' zCOMP�ANY�+x"1 +,-11i, r r i ,w :, y ;?
+P`honeNo'''978=657'=5100' Fax No. 978-658-9185 �' i I
� i��' A�l�iatiht'MaryT'and'`Irisurarice Group ''� '�
=ar;v �. i. y , y
=��x"i.'k INSURED x
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I..I/ a7�'r ;',": r,Ij, 8'i '': ,,P,rbella` Inclemnit Ins Co-. 'd
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(,,+ t' F }+t I COMPANY ,(k
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AS, ,r r''`kti�;;Cyrus,,Construction Corp. , I -C.., ' Reliance NationalF 11.1. tr y'
>�� gIY'''(`�'PO Box:,583 a: jf` , r ,i sil,r ,
I v 4,5} " 1l COMPANYt + rli j,,i�', y (f,f I!,F1v J. ( H y. am
p Y � <f No'.Andover M7>. 0]845 rI c t; , y
x, I yxr+ 1. '� D,, Maryland Casualty ja + x>)
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THIS ISiTO'CERTIFY THAT THE•POLICIES.OF INSURANCE LISTED 'QWKA THE INSURED'NAMED'ABOVEFOR;THE�POLICY,PERIOD , a� ; `
y 4ti' ! ,
YA .S R., J 1 4.r'( 1
9;, .•,INDICATED;NOTWITHSTANDING ANY REQUIREMENT,rTERM,OR'CONDITION OF1ANY;CONTRACT;OR.;OTHER DOCUMENT 1NITH RESPECT..TO WHICH THIS , t ^fir ' ate.,;
t.. +.CE I IFICATE'MAY,BE?ISSUED,OR MAY PERTAIN,THE INSURANCE'AFFORDED�BYgTHE POLICIES_OESCRIBED HEREIN IS'SUBJECT,-TOOALL;THE�fiERMS;,Y, r't' " ���
�a t.5 I'll{{'EXCL'USION§'AND'CONDITIONS'OFSLjCH POLICIES:LIMITS`SHOWN`MAYNAVEiBEEN_,REDUCED BYiPAID;CLAIM%S�.t)„ , _: r.i ,W.11;N , i'10" t r',f;,,., tiyaa .j
!N 1;NO16�!i.1 r((,'Z ° r .rr...a'Ft y !" ,;< . : t:r r( kP f.)irl � k;e •' f�tirr=aku:. i,:
*�*�-� . ,Yt " ' .OLICY EFFECTNE r POLICY EXPIRATION; +, z I /!
f'fLY,'' -LTR ,;.. TYPE OF INSURANCE 'POLICY NUMBER pgTE/MMIDOrr�y/YY//�, i• `.'DATE MM/DD/�/Y) y'' 't r` 'LIMBS .I °'�
1F� 1 I 11 tc ( ,F FJ. 0. ( "'l 1.
.ti -'� •° ' ,$
5 „".r GENERAL 11A81LITY ✓ v i, _ P i,
"la n r 1 r R5 GENERAIAGGREGATE t. S 1000000 t,51 PJ
Oil Ar( ,X4 'COMMERCIALGENERALLIABILRY SCP33893315 98 10/0`1/98 10/01/99 �PRODUCTS•�COMP/OPAGG' S?1000000,.::= ri J
per nn Y�pi t{+ nk ?l` =i t �,l1,JCn 1 C=
�r , ,tq, I CLAIMS MAO t OCCUR i51'S(} { ,
!(� s PERSONAL'BADVINJURY S 500000: lar
a , r,, , .. , - ,t t 1 r' ,,
y�F fo' Y r.! OWNERS 8 CONTRACTOR S PROT ( ( ' } =i3
6 {s n:
q x..r * .;.:{ ';_;._.e:. _' -�' s :r: , FREOAMAGE.(AnC netire S OOOO 54rti -'ik,
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'w I.; ,7 x y ) 50000 1,.
`. s ' t MED EXP(Any orie person) ": S "),
1."! '`Ar;(;AUTOMOBILE LIABILITY1.
L
"�u° r} ^` ` r ` I .., t ' !• c , COMBINED SINGLE LIMIT S 1000000 -'' ,,
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YFy� >$'; ANY AUTO
Q3N51692 O1 98 05/27/98 05/27/99:
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iv 4� J'+� ALL OW
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r,�I` '�yh _ ,4. , , , . _ f. w ,: t..._ BODILY INJURY'
"' IX SCHEDULED AUTOS ? '', (Per person) S s
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r: , R = k ' f ,
h,,� �,^�X3 HIRED AUTOS , tc� I , 1.t
�h''4 5J r+ �I: N {= e,'.:BODILY INJURY `, I
4.. w rt
It.t 5,$i,; NON•OWNEDAUTOS , y`= r +,Y (Per accident) ;,+, $ �;
r), i tt 1 t+ t` i;
\'� a"�, pil^.1 1`?T y : 1 cI % 5 t PROPERTY DAMAGE r S *l s ' ,y ti
• ,.&'.,.:.F.,.", ,...%,1ti i r.}: }X yr r
ref, ±yl SGAR1GE LIABILITY'S +
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7 `. IR kANY AUTO',' 19AUTO ONLY EA ACCIDENT 4 }`r
I , OTHER THAN'AUTO ONLY. S r�� 'S, 5
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AGGREGATE': S t
a ? {tic.EXCESS LIABILITY
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L :�r c,l F°rS P tt+•:Y r1. % t EACH OCCURRENCE-,: $
3+.,�4' �;y`'UMBRELLA FORM AGGREGATE .. S t
h r vf�{!� ?'J' ,';OTHER THAN UMBRELLA FORM % s
Fa WORKERS COMPENSATION AND WC STATU• DTH-
}f1..•"y iEMPIOYER5 LIABILITYr TORY LIMITS ER :'. t
I 1wr {i ` l.-1 6 "+ EL EACH AdCIDENT S 100000 S '(i it;
Ck cT E PROPRIETOR/{ t1°,t I,,C
,, wci .6R10UB470X5421 96 11'/04/98 11/04/99.' EL•DISEASE.POLICYLIMIT`: S'500000` . t k..,x ,�r,
�C FPARTNERS/EXECUTIVE' !:,
3/��S;iOFFICERSARE:.;' ` , ,'!•. EXCL M1,,-,,;( ELOISEASE EA EMPLOYEE 5'100000- i1
�NS p OTHER
I.+� �Dt Install/Builders .R BR92193441 l.I. >i.: 12/05/96 12/05/98I. ` >F
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DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS r.'
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1.gpj,'•t+�k! CERTIFICATE HOLDER ' ,: CANCELLATION - f1. _
h r, TOTOPSF: ra�SSHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE '
5 r
{t ry r r x} ;EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL J , r'r /
X A 1., =F t `,1. -4 r !i dr E_: r ,1 5j`1 t!>t(
� Cir r fw t. r �1 O j`�'DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT dhi d' .{
tt r�,Fr 1 rFty. tj ,,, n !f ? N(p , - , .. i , t ry Rl� SCJ
L} --,4( y�r"+f r t, r :F . c'Y + f BUT FAILURE`O M tf�ILSSUCH NOTICE SHALL IMPOSE NO OBLIGATION OR L-A q. TY t'r�;'i '>;.
11d5 fir?. 'id. I(y. +v.OFfANY,KINDUPON THE LOMPANY:ITS AGENTS OR REPRESENTATIVES i ;Ys ?
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?° TOWN OF NORTH ANDOVER
p _ DIVISION OF PUBLIC WORI{S '
334 OSGOOD STREET
NORTH ANDOVER,MASSACHUSETTS 01845
Telephone(974)685-0950
F4x0978)6XS-9 73
June 1, 1999
FORM U & DRIVEWAY APPLICATIONS
PROPOSED DRIVEWAY PLAN-'a plan which is required to show the dimensions of the lot,the location of
the proposed driveway and the building(s)it services,the type of street pavement,type of existing sidewalk,type
of curbing, location of any permanent structures within ten (10) feet of the driveway such as utility poles,
hydrants,catch basins,stone bounds,etc.The plan shall be submitted to the Engineering Department for review.
If the plan is approved then a driveway permit can be issued.(See Sketch Plan Attached)
CREATION OF A CURB CUT-If there is existing curbing where the new driveway is to be located,then it
must be removed to create the proper ramp from the gutter.The new driveway shall not protrude into the gutter.
In any instance the new curb cut shall not allow surface water to enter the property.(See Sketch B)
EXISTING SIDEWALK SURFACES-If there is an existing curbing and/or sidewalk the new driveway shall
match the existing material and shall be a minimum of 4"thick. The contractor shall provide a detail showing the
thickness of material,number of layer's,reinforcement and sub-base.
DIG SAFE NUMBER-The applicant shall and have a.valid Dig Safe number
CONTRACTOR-The Contractor doing the work shall have all insurance's required and be in good standing
with the Town.
DRIVEWAY PERMIT-The permit shall be good for thirty(30)days and may not be transferred without prior
written approval by the Town of North Andover.
INSPECTIONS - The Contractor MUST notify the Town 24 hours prior to commencing construction. The
completed work must be inspected and signed off by the Town,within 48 hours of completion.
C:WORDIDRIVEWAYS\FORM U&DRIVEWAY APPLICATIONS
Division
of No th A+adover OB c�Po SSD .�y' GBJAY P�i9N
Division ofrpublic Works SHEET NO, 2. OF
` 384 Osgood
Street CALCULATEDBV.-+Z WIQ P DATE
North Andover,MA 01845 ,
CHECKED BY DATE
SCALE `r � •'
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PROFU
TYPICAL DfWAY
N.T.S.
NOTE: 1.) ALL DRIVEWAY APRONS TO BE PAVED WITH 3".BITUMINOUS CONCRETE.
2.) DRIVEWAYS SHALL NOT BE INSTALLED IN LOCATIONS WHERE STONE BOUNDS ARE PROPOSED.
TOWN OF NORTH ANDOVER, MASSACHUSETTS
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET,01845 '
Telephone(508)685-0950
Fax(508)688-957
f I IORTN
O Mo
O 9
t r
s r
y93SNC MUSEt 9
DRIVEWAY PERMIT
Date: -
LOCATION: xa
BUILDER: phone:
r✓/1Z+'S �'Qit/si
J
OWNER: ��,Phone:
The North Andover Superintendent of Highway Utilities 8+Operations MUST be notified of the
grade and set-back from street established in any driveway entry onto any street or way maintained by
the TOWN. Call the Highway Superintendent's Office,before finish grading and surfacing for approval
of such entry.
FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT.
Remarks: Approval:
h
lliJ "7
Professional Land Surveyors Et Civil Engineers
ESSEX SURVEY SERVICE 1958 - 1986 w
OSBORN PALMER 1911 1970 .
BRADFORD & WEED 1885 1972
PLOT PLAN OF LAND F
LOCATED IN
liv011712 MASS.
i
i
t
t
IGS L �;
E
log 1
I
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IN t
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1 h Z��,�
ORTEy
v
own o � o ndover
a -4
rTVIA
19
o; ndover, Mass.,
coc..CHEW cn
ADRATED Plf�'
ONLY 'SSACHUS
L� `�` a4-; ,. 114.E S. B.C.
FPPT- P
— EEE PAI®
FOR
:3S EXCAVATION AND
FOUNDATION
THIS CERTIFIES THAT .. ..n V, P C o 'V
.... 81..
has permission to excavate and pour foundation at AciC....-10Y...... ?a.._.
....... ...... .....
S
forthe purpose of...... �.>I .. .. C..... �Ay.....�................/....... ...........................................
� ,0 Q, The person accepting this per must return to the office of the Building• g Inspector a certified plot plan show
®CC Sol, of building thereon before Foundation will be inspected.
VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS
The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS
assurance that a permit for entire building structure will be granted.
I''x'_. i t`• . ; .— .}�� � �'t. '`LE�rli ti's`v � ._`"s
Y i'Pt". 114.`-S. B.C.
... . .. ..... ........i644.40% ..........
' "` BUILDING INSI'I-VTO Z
Location 7 cl -S F S L o ' C
No. � Date y f
NORTq TOWN OF NORTH ANDOVER
F " • 09 Certificate of Occupancy $
i 414 ; ; Building/Frame Permit Fee $
��s•"'°'�<�
cMuFoundation Permit Fee $
s� sE
Other Permit Fee $ _
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ 0 ��
Building Inspector
X3468
Div. Public Works
***NORTH ANDOVER, MA
PERMIT NO. SC�6 APPLICATION FOR PERMIT TO BUILD* K - .
MAP NO. LOT NO. A•• 2. RECORD O/F/OWNERSIIIP DATE BOOK PAGE
TONE p► SUB DIV. LO'i'NO. ffr )e-p- /kD SeHleme+✓f Aet - encIOSQ�
LOCA ION ?it PURPOSE OF BUILDING
- � (�O\\'N 'SNAME NO.OF STORIES -7 C�o
SIZE c
ON\'NER'SADDRESS �� O NQ� BASENIENT ORSLAB IIll
ARCHITECT'S NAME �� C C) n _ �� n/P SIZE OF FLOOR TIMBERS I r a x JD 2�U X �V 3R° ax
BUILDER'SNADIE l?61V61 C } /o �� SPAN
DISTANCE TO NEAREST BUILDING >/Oo DIMENSIONS OF SILLS �X� I
DISTANCE FROM STREET / DIMENSIONS OF POSTS 1
DISTANCE FROM LOT LIMES-SIDES a a REAR VD to DIMENSIONS OF GIRDERS 1 '
AREA OF LOT Cbb ��FRONTAGE //C� (� JCe PXCP �aN HEIGfiTOF FOUNDATION ee- I aj 1 PJ �} THICI:NESS 0
IS BUILDING NEW s SIZE OF FOOTING {, h
IS BUILDING ADDITION MATERLAL OF CHIMNEY Ze C-O A,)
IS BUILDING ALTERATION A-) b IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO ItEQUIREDIENTS OF CODE ( eJ IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANN' /10 A,),e IS BUILDING CONNECTED TO TOWN SEWER Q O
IS BUILDING CONNECTED TO NATURAL GAS LINE es
INSWC-FIONS"3.'I'ROI'ERTY INFORMATION LAND COST
EST. BLDG.COST 1j 3 040 - - --
PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PER SQ. FT. J -
EST. BLDG.COST PER ROOM
ELECTRIC DIETERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO.
d
ATTACIIED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. APPROVEI)BY: Q /fjZ
PLANS MUST BE FI1tD AND APPROVED BY BUILDING INSPECTOR BUILDING INSPEC"FOR
' DATE FILED OWNERS TEL# � �_-3
CONTR.TEI.#
CONTR.LIC# l%
SIGNATURE OF-O\\TER OR AUTHORIZED AGENT
�, 1{.I.C.# V
FEE $ / ® !-
1'ERMTI'CRANTED / 19
/ J l/✓` w0c f� l
Revised 5/5/99 JA'I
All L
NORTH
.Town ® OL over
h
�A cocM, e - dover, Mass.,
Iq / qgy
ORATED PP�\��5
S 5�
BOARD OF HEALTH
Food/Kitchen
PERMIT Septic System
THIS CERTIFIES THAT....... .... .r..u...s......C'aV M V ��� Co� BUILDING INSPECTOR
Y. ...................................
...................4114
.............
...... Foundation
has permission to erect...............) buildings on .�1 C y a wo S'E- FRough
...............
to be occupied as.... .. a s��Jl ��r � �'ri Chimney
a
....................... .................. ... ...................................... ............... ........ ....
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final
Buildings in the Town of North Andover.
PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
M03 8 PERMIT EXPIRES IN 6 MONTHS Final
PUNLESS CONSTRUCTION T S ELECTRICAL INSPECTOR
Rough
0
........... .... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
No Lathing or Dry Wall To Be Done Final
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
Street No.
SEE REVERSE SIDE Smoke Det.
Building Permit Worksheet
C Residential
S d 1e m , 6� /Pe��
Sino FAM, 02 S v,c,
o rn -77j;+a.
Fx�3 6 - 5 / o "` o 6 = �3 S / o 0.-
G1U GE -.Q x a6 = 57a o a o Oa 0.-
Fouroc lov•►- O VAI v L o 1�ena �' spa 6 F 0
IbI 300
--166000 -0 0 6.50 = a y6, ---
ti
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number C5-R4 Date 313 10-D
THIS CERTIFIES
/ THAT /
THE BUILDING LOCATED ON _ / ccs c?/(ew 51'
MAY BE OCCUPIED AS &V-9Ie �/ � �� d,�c��- IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
j,,
"°"T"^ CERTIFICATE ISSUED TO {�'sa d /�'e,I t/
° �.. 4
ADDRESS 0 q,�83
a 41
s �
CMU' Building Inspector
NORT#q
Town OL over
No. c6'
'p
O _t- Iliq
E dover, Mass.,
I-
44 ORATEO PI? C,
5�
BOARD OF HEALTH
PERMIT Food/Kitchen
Septic System 3/3 a a
THIS CERTIFIES THAT.....C��...1r.V s.......0 .yJ. .. V !vim C0.0 BUILDING INSPECTOR
...................... ......
......................... ................. Foundation��� /�/�9
has permission to erect...................... . buildings on .�/Otc....*V4..a.. ...........a .1q - sbuildinRouughe�/b( /�to be occupied as... .. .. .is � ... a ' ..off.S7F�II �w�/tr ���'ri Chimney
........................................ ........ ........
provided that the person accepting this permit shall in every respect conform to the terms 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. PLUM
INSPECTO
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS `
P UNLESS CONSTRUCTION T S ELEC I E
oug
1 BUILDING INSPECTOR 3 �d
• in
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove oh/Y
No Lathing or Dry wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
J/ e IW /V Street No. Y 0(3, �
3
SEE REVERSE SIDE 't' Smoke Det. •Z ?'°�
Z '
NORTH "
01'0*.0 ,6 eta
OL
O
A [Ot�twt�tF V
7 A01'"110 p4P (y
9SSACHUSS�
APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
ADDRESS/LOCATION OF PROPERTY : Xelln 11tfe rac
DATE REQUESTED FILED/READY FOR INSPECTION
CLOSING DATE ON PROPERTY: �� b
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK'AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME
FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE
CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES.
SIGNED
ROUTING
CONSERVATION
PLANNING E2/
DPW - WATER METER
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED
PRIOR TO �J MITTAL OF THE OC UP CY/If1SPECTION REQUEST
DPW
Signature
File: OC form revised 618/98
gU4'�..�ii'vG D
Y
3/30/00
To: North Andover Building Department
Attention: Michael McGuire - inspector
From: Richard and Annette Imprescia
Regarding: Final occupancy permit Lot C 498 Salem Street
Dear Mr. McGuire,
Please let this letter serve as our position on final occupancy for 498 Salem Street. We
want to issue a final permit because of our concern about the
understand that you do not wa p y
condition of the driveway.
We are not concerned and understand that we take full responsibility for the ramifications
of having an unpaved driveway. We understand access could be impeded due to rain or
adverse weather conditions. We are comfortable with any issues that may arise due to the
current conditions of the driveway.
We hold the Town of North Andover harmless for any issue regarding the driveway
condition.
Sincerely,
II
Richard and Annette Imprescia
Date
N� 433
.. MORTFr TOWN OF NORTH ANDOVER
3? �.r -- .• of
A PERMIT FOR PLUMBING
s o a
,SSACNUS�
r / e
This certifies that . . % �:*. -. . . . . '. . . . . . . . . . . . . . . .
has permission to perform . . . :, . . s!. . . . .
plumbing in the buildingst �^ ::�. . . .� . . . . . . . . . . . .
at . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . ..... . . . . . North Andover, Mass.
Fee-I/4. . . . .Lic. No.� c. .
PI.0 BIS INSPECTOR
,.� . A
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
a
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print Or Type)
Mass. Date Permit # 7 j�
Buiding Location _ _� - ��- Owner's Name
Type of Occupa ✓
New Q Renovation ❑ Replacement ❑ Pla Submitted: Yes ❑ No ❑
FIXTURES
z
Z N <
Z Y F j N
N N ✓1 O Z Z W W
Y J #A < h' Z 0 Z w Q. p
SN - H h S V)
U ¢ m N W - p < 0 Z ¢ ¢
WUf
¢ f W p 3 J Q �. < Y W LL Y W
W S < S 3 = p Z = Y a O N Z Z W H O u =
r u > r 0 D V) z 0 0 <
< ~ < < 2 w < < 0 < < ¢ ¢ ¢ O <
3 Y J 0 0 O O J 3 = f- 0 1i V < 3 ¢ 41 O
SUB—8SMT.
8ASEMENT
IST FLOOR %
]RO FLOOR
4TH FLOOR
( STN FLOOR
6Th FLOOR
7TH FLOOR
F-1 I I I I
BTHFLOOR
4,
Instaliing Company Name Q r` �� f� y s Check one: CerOicale
Address 7 lir _jH� (/Corporation
a �,�-.� ❑ Partnership
Business Telephone d S9 Y ?z, ❑ Firm/Co.
Name of Licensed Plumber '_.
INSURANCE COVERAGE:
1 have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes A I No ❑ ,r
If you have checked yM. please Indicate the type coverage by checking the appropriate box.
A liability insurance policy P Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee docs not have the Insurance coverage requlrcd by
Chapter 142 of the Mass. General Laws, and that my signature on this permit applicationCone:
heck waives this requirement.
Owner Cl Agent❑
Signature of Owner or O.mer's enl j
I hereby cerlity that all of the details and information I have submitted(a entarad)in above appl"tion are true and accurate to tha best of my
knowledge and tnat all plumbing work and installations performed under the permit issued for this application will ba in compliance with all
periinani provisions of the tdas.,% huselts State Plumbing Code d Chapter 142 of the Laws.
j
�
By
�rgnalure o cen u
Title
Type of License: ►Aastar [� Journeyman❑
Cay/Town -7 Li"nsa Number
I
' I
BELOW/FOR OFFICE USE ONLY
FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
� FEE .
A
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
ff�I
1
I
NAMES ;TYPE OF BUILDING r
f-
LOCATION OF BUILDING
PLUMBER
I
PERMIT GRANTED
r
' DATE 19
PLUMBING INSPECTOR
3 5 1 8 Date .:
f
&OR£H TOWN OF NORTH ANDOVER
of PERMIT FOR GAS INSTALLATION
� « 9
Y i
• o .� i
�9SSAC HUSEt
This certifies that . . ? ✓ . . . . . . . . . . . . . . . . .
has permission for gas installation . .:. . ... . . . . . . . . . . . . . . . . .
in the buildings of . . . ! �. . . . . . . . . . . . . . . . . . . . . . . .
at . f . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass.
Fee 4 . . . . . . Lic. No.. . . . . . . . . !. f. a !t.. . . . . . . . . .
GAS INSS E UOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type) -
� �.'-cr_ , Mass. Date ��= Z�' . 19 `-vim— Permit #
Building Location p d - _Owner's Name
UyType of Occupancy—�'
r
New Renovation p Replacement p Plans Submitted: YesQ No ❑
N
N yJ �B
Y Y rt 0
y� N U F Y
W W N Q O U
V J K F Q } = Z 0 f- W
z o W m z
Q m of F y w 0 a c b 4
¢ a WQ = z r 0 o >OL) Uj W
W W N J z Q = 2 S C7 W ~ W U
W W O > W F' �. W
V F Z J ~ J= f F- s v! m Y O 2 W O rw S
z w < C �_ r
Q + Q Q O O W O t1
< w > > D a F- O
U C
SUB—BSMT.
BASEMENT 1 B
1ST FLOOR
2ND FLOOR
ARD FLOOR
4TMFLOOR
5TH FLOOR
6TNFLOOR
7TH FLOOR
BTM FLOOR
Installing Company Name 3111 4nx Check one: Certificate
ddress f% �-�`—��- ' -�� - f� /Corporation
❑ Partnership
Le
Business Telephone 6/ J? d 3 .4 r ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
rhave
ANCE COVERAGE:
I a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes � No ❑
have checked yes, please Indicate the type coverage by checking the appropriate box.
A liability insurance policy A Other type of indemnity❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage require by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application
heck waives this requirement.
Owner❑ Agent ❑
Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts Stale Gas Code and Chapter 142 of the Gen Laws. n
T f License: ✓ c �///
BY umber Signature of LicensedMUMDer or Gas hiter
Title fitter
sten License Number sq- -7 G4�
City/Town Journeyman
BELOW FOR OFFICE USE ONLY CTS
PROGRES NS ECTION
FINAL INSPECTION SKETCHES
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME 3 TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
i
{
1 '
i
PERMIT GRANTED
DATE t9
GAS INSPECTOR
I
N° 2 2 3 2 Date.....3. . R.,,I..CJ
NaRTM
TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
SACMUS�
Thiscertifies that .................. ..... .. .j ............. .w�.,.T.................
has permission to perform .... ..........................................................................
wiringin the building of........................ .. .....................ort...............o..................
tit................. ......... ... .. ........... .................. .Nh Andver s.
''Fee... Lic.No. ............. ............... :::.............l....T....................
A,�
G /�ELECl'RICAL IK(SPECTOR
, /Z
5
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
T1EECOW0AWE4LTH0Fh14MCHVSE77S Officeonly P—
BOARD
DEPARTAENTOFPUBLICS MY Permit No. � (�J�OFFIREPREVFW0NRB9MTI01 N527CMR12'W
Occupancy&Fees Checked
UAVPPUCATION FOR PERMIT TO PERFORM=C MCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:001,9-11dj
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat �/
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number) Z-/
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes a No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts 16>erhe d Underground No.of Meters
New Service AmpsVolts Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work t
w. .
No.of Lighting Outlets No.of HITUN No.of Transformers Total
KVA
No.of Lighting Fixtures Swi in Pool \Above Below Generators KVA
tand ground
No.of Receptacle Outlets 6.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets r
No.of Gas Burners
No.of Ranges No.of Air Cord. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Municipal
No.
Other
Connections
No.of Water Heaters KW No.of No.of
a Signs Bailasis
Nydro Massage Tubs No.of Motors Total HP
OTHER
hwwwCoveage I'urs�t9�tktett�gtmart�ttsofM�du Ga�alTaws a
Ilta�eaanaYliabtliryhmrarePt:tityittchdatgCar Cote orilss�ttlsia}maial YES NO
Iha%ew miuedva1idprafofssmevhe0fce YES F 1 NO [:] Ifjwha%edxdmdYES,pkmmk*th NxcfaomWbydrdmtgthe
box
r7 BOND M OTS a pk=Spa*)
FVaatimDtaie
Fst;ni*dVakjedE1xhd Wdk$
WorkioSwrt hapacrmDweRaWc oed Rough Fria!
Signed t J3%1?l;rah0 cfperjtay.
FIRM NAME LiagseNa
Licatsee Sigrtatiae LtoazseNo
BtsirxssTetNa
A AkTd?sh
OWNM'SMJRANMWA1VQt;Iamaw=drttheLi=edo not ethermimnem►e or-ils stbMtW eWnakrtas mluirW byMmmchtsm GervElLaws
andfatmysigtsahremthispear Wpii=mwanesthismgl'z m
(Please check one) Ownera Agent 1
Telephone No. PERMIT FEE U6