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Miscellaneous - 56 STAGE COACH ROAD 4/30/2018
56 STAGE COACH ROAD 210/065.0-01540000.0 3697 / � -- Date.. . !�.... ....... t l ,aOR71y - - f TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACH This certifies that ........:............ ................ ...........< <............................... has permission to perform ........................�- _ wiring in the building of.................. .............................................. � r Q< � Pwcrc 'f at...... .....:.......... ......................... ................ orth And/ove ass. ... Lic.No.dd....` .. .................... ..................../.... d Fee.... ..�.:v� /J�� f ...... /f LECTRICAL INSPECTOR Check # `//! t,ammonwea[ o� ct,�ac%ee�¢((1 Official Use Only / Q --a cc� 1JePar(niaa(o`-}7 ire �ervices Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 11199] heave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR} All work to be performed in accordance with the Massachusetts Electrical Code \ -C,527 CMR 12.00 (PLE.lSE PRINT IiV INK OR TYPE.,ILL NFO 11,17MV) Date: �� City or "Town of. r7 d�> � To the In J ec oro FVh es: By this application time undersigned gives notice of his or her intention to perform the electrical-wok described below. Location (Street S Number) f Owner or Tenant U t Telephone No. Owner's Address �y� Is this permit in conjunction with a building t rmit? Yes ❑ No g (Check Appropriate Bos) Purpose of building J j`1rLLIt Utility Authorization No. Existing Scrvicc t\nips / oits Overhead ❑ Undbrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undord b No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Rork: ZOO Cumnletion ofthtable ntav be icaived by the Ins cctor of t vires. No.of Recessed Fixtures INo.of Ceil.-Susp.(Paddle)Fans iNo.of Total Transformers KVA No.of Lighting Outlets Lighting No.of)lot Tubs Generators KVA No.of Lighting Fixtures �Stivimmina Pool Above ❑ .In- ❑ t oo mergencv ig hung °rnd• arnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE AL UL%.IS \'o.of Zones No.of Switches No.of Gas Burners No.of lletection and Initiating Devices No.of Ranges Total �No.of Air Cond. Tons No.of Alertina Devices 1 at Pump \um' i \o.of Waste Disposers ger ('Pons , -NV No.of Self-Contained p ---— -- ............... --- e Totals: i I � Detectiott/Alertino Devices No.of Dishwashers Space/Area Heating tiV Municipal!` I h Local ❑ Connection ❑ Other No. of Dryers (Heating Appliances 1i}tr Security Systems: No.of Devices or Equivalent 1No. of Water INo. of NO. of .,,. I-Ienters K%V Data ,ririno- Si�tts Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs INo. of Motors Total IIP Telecommunications Wiring: i No.of Devices or Equivalent OTHER: .•Itiacn aaditional detail if deli-ed•o-as required by the inspecior of Wires. INSURLA\CE CO'N"ERACE: Unless ,vaived by the o%ner, no oerrmt 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 ih force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Z BOND ❑ OI TER ❑ (Specify:) Z�el Estimated Value of Electrical Work: (Ex)Siration Date) (When required by municipal policy.) Work to Start: Inspections to be rcauested in accordance with MEC Rule 10,and upon completion. I certifj•, under the pair and penalties of perjun•,that the information on this apPlicativtr is trite and co»rplete� FIRIM NAME: r t _ LIC.NO.: Licensee: J, /'i i3�� /2 Signature L1C.N0. T- (/f applicable, enrcr ••e.rempt'•inthelicensen:anb line.) Bus.Tel.No. > Address: _�!S y /tic'/E' i'//YG' �rif<� ��.�i�vr ,�ili2 O/� � Alt.Tel.No.: OWNER'S INSURANCE N"AIV ER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By niv signature below. I hereby wuiye this requirement. I am the(check onc)C1 owner ❑ o%yncr's agent. Owner/Agent Signature T lenhor.e Nv. P1:R:1fIT FLL: S IZT S office U34 only u E (fmalm nus sari of _ Oeeupanry A Fee t�tecked BOARD OF FIRE PREVeMON REGULATIONS SZ7 CUR 120U APPLICATION FOR PERMIT TO PERFORM ELECTRICAL—WORK All work,to be performed in ac=rdartce with the Massacrtusetts aectrical Code.SL7 CMR IZOO (PLEASE PRINT IN.INK OR TYPE ALL INFORMATION). - Oate or Town of NORTH ANTDOVER To the Inspector of Wres: . . . . _ _ . The udersigned applies for a permit to perform tate electrrical work described below. Location (Street & Number) 5K C>��� Owner or Tenant Cwner's Address Is this permit in ceniunction with a builcing �errnit: Yes — No (Check Appropriate Box) Purccse of Suiicir.g ������� Ilecmk>d& Utility AuthcriZatironn,�No. Existing SerAce,®b Amos '�`�0 Vcits Gverread 11: Uncgr:te L�-; No. of Meters New Service Amps _J Vols Cvemead f_- Unegmd C No. of Meters Numoer of Feeders and Ampacity Location and Nature at Proposed Eiec—cal ` arx Total No. or Ugnting Cuvets I No. at --'Cs I No. or :ranstarmers KVA I fNo. at �gat:ng =xtures -c -c Ganeramrs (CVA No. at E^ergency Ugnttng No. at Recectac:e Cutlets No. at Cil -surrers j Sarery Units No. at Switcn Cutters No_ or Sas Qumers I FIRE ALARMS No.W Zones 'azal No. at --election ana f No. of Ranges / ; No. Car.c. .ns I Initiating Devices I -eat alar otai No. :t 0iscosa s t Nc.ar'� n 'C:I f No. ter.Souncing L2ievices I . ., o s I No_ at reit Cantainec No. of Cisnwasners s-ace,Area r__.:rg C.V I .a:=c.:cniSouncing Zeviees ! — Munic:Dai No. at Orvers mea..- _awces C:� _near _ -Ctnar l ^ g Connec::on •— i No. at No. a: I Law :citage No. at Water Heaters tow Signs :noose winnc I + No. }ivcro Massage Tuos I No. at Motors - Total �P 1NSUFANC: CCVE?AGE: Pursuant to :rarect::rerner.s :. :!assacnusers yenerat Laws NC _ Insurance Pciic! in .a. e c Ccera^ens Caverage or ;ts su_s:antral ecuivaient. YES _1 I `:ave a current Uaciii su - __ tY ..__. nave suOminee vatic proof at same :n ;ne C"ics. Y=� NO = :t you ['ave cneCxeC lease innin3rB ;RB•'^1pe Ot coverage _v cnecxing the °cnate Dox. a INSURANCc- z BONO = OTHER _ ,Please S=ec.!+) (Exaranon Oatei Estimate, Value of Eectncal worx S Snal Warx to Start Im eC=cn �:a:a Aacues:ec: FiouSn` Signec uncer:tie Penalties of perjury: _ No. 3d 6�2 MRM NAME LScensea - G � SkSnatura A1C. NO. Q I � 1 Bus. Tai. No. -7210 .33 -��63' ACCress / V` `.�C `-'�"��" Alt. :al. CWNEa S iNSURr1NCE WAIVER: I am aware .+at T.e Lcer.sae =cos ret +ave :no insurance overage or its suostantial egtuvatenAgent t a re- E: ny Maszac:tU3etts Gdnerai Laws. arta ttut '•ry s:sratuf@ nn �rs permit acclicatien valves IntS reeWfement Qwn g (Please crieGt one) .� eiecrcne No. PERMIT FE S (signature of Owner or Agents �i i.-Qcation No. Date No^T� TOWN OF NORTH ANDOVER r + AL � Certificate of Occupancy $ 'ssAcMusEt� Building/Frame Permit Fee $ tS— e, Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � � ov Check # 15461 54G �� Building Inspector (f Y TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH'A ONE:OR TWO,FAMILY DWELLING .� BUILDING PERMIT NUMBER: DATE ISSUED: sc;? - q-nova e OAR Cr SIGNATURE: Bifilding Commissioner for of Buildings Date SECTION 1-SITE INFORMATION / 1.1 (Property Address: 1.2 Assessors Map and Parcel Number: Ald Map Number Parcel Nudber :3- Zoning Information: 1.4 Property Dimensions: Zoning Disf t Proposed Use I:A Area Frontage it 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required. Provide Required: Provided Required' Provided 1.7 water supply maix.40. S4) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public O Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ — SECTION 2-PROPERTY OWNERSHIP/AUTHORIZEI}.AGENT n 2.1 Owner of Record VC Q b6 eve Name(Print) dress for Service: j/ �' R75 �lrog Signature Telephone i .2.2 Owner of Record: Name Print Address for Service: _ s n Si ature Telephone A SECTION 3-CONSTRUCTION SERVICES 7� 3.1 Licensed Construction Supervisor: Not Applicable ❑ — A e 8yNe� ti CS O�6C�7 �� Licehsed;Construction Supervisor: License Number 1)n .avv� ,t Q zf _ Address S � I - -Loos 5? Wo 7 �Q Expiration Date S Signature Telephone ra 3.2 Registered Home Improvement Contractor Not Applicable ❑ C 14 Company Name n Registration Numberra Address r 99 Expiration Date 1 Signature Telephone 1\ s � r. SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) _ Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the,denial of the issuance.ofthipbuildipg permit. , Signed affidavit Attached Yes.......0 No.......0 SECT ION 5:Oestri tion of Pro "sed'Workcheck su:a` _ble New Construction ❑ Existing Building '0 Repai (s) 0 Alt rations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: SECTION 6 ESTIMATEDCONSTRUCTION COSTS;,., Item Estimated Cost(Dollar)to be Completed by permit a licant 1. Building (a)`Building-Permit Fee multiplier 2 . Electrical .(b) Estimated Totai::Cost.,of Construction 3 Plumbing Building Permit fee(,)x (b) 4 Mechanical AC 5 FireTrotecton 6 Total 1+2+3+4+5 Check"Number SECTION'7a'"OWNkR AUTRORIZATION'TU'BE'COIVIPLETED`WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I as Owner/Authorized Agent of subject property .Hereby.authorize _ to act on 'IAy behalf all matters rel tiv to work authorized by this'building permit application „ >/ q- K- 6Z Si tune of Owner Date .SECTION 7b OWNE UTHORIZED AGENT DECLARATION I ,as Owner/Authorized Agent of subject . .property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name ,.Si ature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB ST ND 'SIZE OF FLOOR TINMERS i 2 3 SPAN DIIv1ENSIONS,,OF SILLS DIMENSIONS OF POSTS ,I)RviENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDINGCONNECTEDTO NATURAL GAS LINE I � FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify t all necessary frorr Boards and Departments having jurisdiction have been obtain da Th s dl es notirs ieve the applicant and/or landowner from compliance with any applicable or requirements.Ve *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT rn P.0 povPHONE 2�-O/75- (D`6 LOCATION: Assessor's Map Number PARCEL 210 b(�rD Y ote orxx� 0 SUBDIVISION LOT(S) STREET S� ST. NUMBER S� ************�*******�***�***�►*�*****OFFICIAL USE RECOMM DATIONS OWN AGENTS: CONSERV TION ADM' STRATOR DATEAPPROVED � DATE REJECTED COMMENTS CdI G�e9q - TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED 6'7— DATE '7DATE REJECTED . T SEPTIC INSPECTOR-HEALTH DATE APPROVED V DATE REJECTED -------------- COMMENTS "I' s� (�yC��ha S d roa i-,6eS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm . ^ North Andover Building Department Tel: 978-688-954; DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the-debris resulting from this work shall be disposed of iri a properly licensed solid.waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Locatio. of Facility) r Signatu e f Permit Applicant L Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector �- U � ' � -� STo� R�TEf.�T►p� �ME�1T LOT 30 J I 3�4 '• 2 00.00 c I HEREBY CERTIFY THAT THE BUILDING p r ro' ON THIS PROPERTY IS NOT LOCATED a`tiH WITHIN THE FLOOD HAZARD ZONE AS G �AA,iG p SHOWN ON COMMUNITY PANEL NO.Z RICHc2. J KEENAN Nom. 30755 DATES REG. LAND tURVEYOR I I I I i i i I WV 4,'491 � 4 X.10 so 0.fl.be- -FoOPAJq.S PtT i 1 r .,JotSf..�C.-LA-5er$, fnr-c„n�Sr �ause_ - 0)4 15 v� t i + , t G)t' �rr�c�wa 4 C 5 « �No +N'1zSS SteG� v� CA 60 1 I I1 .} ; 'I j. } r ! .+ 1 - - - { i- + '. y C>.L• �J.�7 _ i I i L r I I r PJ- ,�� 'z� . ♦Nr <„� pec ,uS I i +- —,. _ t }- ,_ G ®�Ifec-5�". .(.S/Zu. t : i _ �/�f K�. .►Vl��j o„�r _I i i I r ` 1 t + 1 1 L 1 } 1 �. k - i• ; {• 1 .. _. 1 - r + { i.._ i + ! { f r � � 1- I i I I I I . . -. , el - - t. I 1 - - . -- - I + + + I tS��N . t� I I � � � ' r t I I I C 1It yj � f ' - - t T11 _ elf- fl -y f f t t I t - � ✓_ -. - + + I I I I I I i I I CL I t NORTH o ofAndover O z - Al-♦9► -°tea® O lover, Mass., LA COC MIC 1 �t ADRA7ED PPt'�,�5 S H E BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System • • BUILDING INSPECTOR THIS CERTIFIES THAT....�..�..��.' �..meam 0,4 R c � ............................. .......................................'pjo Foundation has permission to erect... � .a. ..�... buildings on ....46...5 �A y V- �oae A.......... . Rough ... ..................... to be occupied as...OPZ.N....V e.0/` R e t41AC C )"16 oChimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. &SVA Isy •*$" i PLUMBING INSPECTOR 1 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR 4000W C Rough .........400.00#................................................•..................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. v PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 t' MAP 440. LOT NO. /.� _ 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE — z ZONE I SUB DIV. LOST NI r' LOCATION56 .►^�r�rii'_G` �it PURPOSE OF BUILDINGC�� �/ f _ OWNER'S NAMEJ/ lam-��'rr�1Gr�l�10 � NO. OF STORIES J SIZE OWNER'S ADDRESd5�7/C�.i�li BASEMENT OR SLAB _ ARCHITECT'S NAME _ <T SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �O'� SPAN ---- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW - SIZE OF FOOTING X IS BUILDING ADDITION /�,�'��j / � ..�J�� MATER:AL OF CHIMNEY IS BUILDING ALTERATION �� I ' is'G'di' � IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �/> IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH, SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. • ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED �UILDINQ INGPKCTOR _ SIGNATURE OF E OR UT6619&FD AGENT F E E OWNER TEL.# PERMIT GRANTED CONTR.TEL.N 19 CONTR.LIC.# H.I.C.aY A912-17 K _ 41 . _. - 8'11 ._. - - - __ _ g�� _ ..._ PW3954 I WRi&36 i ...-........---...�-____...i 621-4 BD36-0 636-3 o\ Dual r•. i waste I r- ciL /� i' I Tilt tray bins $ e— 1 PBS36 PBDL18 �. n PROPOSED O'BRIEN ` KITCHEN PLAN "A" { r { i Pe1830 ! PB306 ` Tray dividers I i x.18-3 x18 U02790 M x18 I � W1842 �PW3066--• ! i i _i i PUD3oso-3 { PW3721)Q4 �_ 4'0"l 357- 3'6--- -- 6'3- F US f t �5 d ?Jx 3 3 J3 xr t� 3 .. ON RM RM J A rt .a r kh. n`• g� n ~k � z-' tY acv, ar i5 S P 1 N �L O' O R T own of 4Andover No. dower, Mass., 19 LAKE A '9�COCNICNEWICK iV 1• v BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT......................................................... .. . �/n� .. .:, - .,.......................................................... Foundation has permission to*FM...... .,,,.,..... buildings on ...... ........ 7`,#- E'C.C�4r�7'7..,........ Rough tobe occupied as................. ....................................... ... .' ..�' . .. � .................................................................... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ........ ....................................... ..... . ... .. ..... ...... Service B DING 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. Smoke Det. N2 1341 I Date.... 0 TOWN OF NORTH ANDOVER 0 4 PERMIT FOR WIRING CH This certifies that ..... ....................................... has permission to perform ....... ...........y2.2'... ..Q.j ................. wiring in the building of........VK 12........... ........................... at ........'C North Andover,Mass. Fee.. ...... Lic.No. . . .............................................................. ELECTRICAL INSPECTOR c 4�2�1/97 09:23 40-00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 61%fyT No. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. -r PAGE 1 MAP i�O. LOT NO. ® 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZO!WE /� �,/ I SUB DIV. LOT NO. y I`OCATIO rACPURPOSE OF BUILDING sL OC.4,1-� OWNER'S NAME L ` NO. OF STORIES SIZE ` L C,00- GsA�'�OG-G OWNER'S ADDRESS sa /] ✓J � BASEMENT OR SLAB __S-S�6N�••+ ARCHITECT'S NAME /'- �! C� / C SIZE OF FLOOR TIMBERS IST L y � IND ��G 3Rp 7 BUILDER'S NAME &"r- BUILDER'S 4 C' 1�, �L � SPAN /Cf -- �� DISTANCE TO NEAREST BUILDING / 1.0 / DIMENSIONS OF SILLS - --- DISTANCE FROM STREET � / POSTS DISTANCE FROM LOT LINES-SIDES �} ®/'(l REAR !, %i GIRDERS AREA OF LOT / /1 J C' FRONTAGE L-zoo / HEIGHT OF FOUNDATION f THICKNESS IS BUILDING NEW ! SIZE OF FOOTING /2 X IS BUILDING ADDITION MATERIAL OF CHIMNEY G. i IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND �L/ WILL BUILDING CONFORM TO REQUIREMENTS OF CODEIS BUILDING CONNECTED TO TOWN WATER � BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED.TO NATURAL GAS LINE E it INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST ®S a p SEE BOTH SIDES EST. BLDG. COST Q PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. }� d EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. /T; , ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY �/ ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS ' PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ��` ' BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE OWNER TEL 62-8'- M •� PLANNING BOARD PERMIT G AN I CONTR.TEL. CONTR.LIC.10 1s BOARD OF SELECTMEN � 1 (JQ�M rr �,c�/`i-_S /'11 A-D 6 (9 L)T- 3171 1 3 7- A4JPPkI C47-/OA-2 BUILDING IOWECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY X STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICESLOT LINES AND EXACT DIMENSIONS OF _ j TH PO CHE a- BUILDINGS. APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLAC �' T CONSTRUCTIONS►�J"yy 2 FOUNDATION 8 INTERIOR FINISH CONCRETE jr CONCRETE BL'K. PINE BRICK OR STONE HARD"')— PIERS ARDWDPIERS PLASTER _ DRY WALL 3- BASEMENT AREA FUI'L' FIN. 8 M AREA _ ;a.•^'+^ ,, FIN. ATTIC AREA (( ,,... 'a+� NO BMT FIRE PLACES010 HEAD ROOM _ MODERN•KITCHEN - - - .� 4'"' �,,o.,•J* 4 WALLS I, 9 FLOORS 2.91� e' . x' CLAPBOARDS B 1 2JiL - - DROP SIDING CONCRETE l' WOOD SHINGLES EARTH ASPHALT SIDING HARD\'J'D ASBESTOS SIDING COMMCN VERT: SIDING ASPH. TILE {I_ i. STUCCO ON MASONRY J_ - STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ - BRICK ON FRAME ` CONIC. OR CINDER BLK. STONE O MASONRY WIRING STONE O _FRAME _ . SUPERIORPOOR 1 , ADEQUATE I NONE .?. 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL/ MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET ,.ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK .. ..._...:.,. ,r,...,N.^.,.r. ...>.._�.... M• .,,....,..s.. .....«,.<. .+ �M..»._.. M ,......M.......w.. SLATE NO PLUMBING 4 TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ k TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE . FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING — RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M►T 2nd _ ELECTRIC 1st. —I 3rd I NO HEATING SEWERI ATER___._F1MAL SL-H A`r-1 ®®®®®®F fi i'%L VLAMAN s® )F NORTIy own of A 054 _21RIVEWAY ENTRY PERMIT � 4 SK� �� Z ' A �E er, Mass. 19 r'/ 0,:? Pa i BOARD OF HEALTH PERMI LD THIS CERTIFIES THAT.... C � 44sov. � . .. . .. ................................. � BUILDING INSPECTOR mission •has per En .. ... •• Rough • Chimney to be occupied asJeAW&..4 ......................... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in f PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relati g to t Inspectildo o ,Alteration an Construction of Rough A&45 Ala Buildings in the Town of North Andove . X�� .. .► Final VIOLATION of the Zoning or Buil n�gu a ion ods t �s Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONST TION START Service •� Final ....... .............. �Y19 BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough { Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. i Building Inspector s i Location_ o2��04-C/� No. _DSS Date �Z NORTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ Say DO Building/Frame Permit Fee $ 'ss,aMUse< Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ p Q 4J Building nspec or Div. Public Works \r Town ofNorth Ando er BUILDING DEPARTMENT Homeowner License Exemption (Please print),., DATE JOB LOCATION Lam 3a S`��GE��,4�/( Yt� ��✓t/ FS r` Number Street Address Section of town "HOMEOWNER" C 6✓r/sn,ob �.v/� G �s me . ,,.. ; NaU Home Phone Work Phone PRESENT MAILING ADDRESS ✓v vc City Town GZ , '7 State Zip code .The current exemption for "homeowners" was extended to include owner 1occupied dwellings of six, units or less and to allow f engage an individual for hire who does not possess a license provide to , that the -owner acts as supervisor . provided (State Building Code , Section 109 . 1 . 1) ' 'DEFINITION OF HOMEOWNER: '. • Person(s) who owns a 'parc-el of land on which he/she resides or i . reside, on which there is , orris intended to be , a one to six famends to ing , attached or detached structures accessory to such use andfamifarm ,' ,'' structures . A 'person who constructs more than one home in a two-year period shall dot be considered a homeowner . Such "homeowner" shall to the Building Official , on a form acceptable to the Bulding Official , 'that he/she shall be responsible for all such, work performed un building permit . (Section 109 .1 .1 ) der they The undersigned "homeowner" assumes responsibility for com ].ian . : State Building Code and other applicable codes , by-laws , 'rules ce with the regulations . , ruple s and .' The undersigned "homeowner" certifies that he/she understands the Tow North Andover Building Department minimum inspection procedures and n of requirements and that he/she will comply with said procedures and . ,,,requirements . HOMEOWNER' S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 , 000 cubic feet , or larger , wi»11 be `required to complywithState Building Code Section 127 .0, Construction V Con tro�l . ,t 466 "_> 30 Stage coach Road,N.Andover Aquired October 13,1990 PRINCIPAL 10/15/88 Original Loan 1st Mtg. 358,000.00 Principal Not DrawnPaid (484.48) 357,515.52 INTEREST Interest and UC Paid 1st Mtg. (28,204.20) Interest Accrued and Due 71,478.58 43,274.38 ESCROW Escrow Received: (804.18) Escrow Disbursed: R.E.Taxes Fall 1988 R.E.Taxes 654.43 Spring 1989 R.E.Taxes 643.32 Fall 1989 R.E.Taxes 1,324.58 Spring 1990 R.E.Taxes 1,324.57 Public Works...Water 684.45 4,631.35 Appraisals Appraisal 2/21/90 150.00 150.00 Auctioneer Auction Advert 10/23/90 750.00 McGlaughlin Fee 10/23/90 1,280.00 2,030.00 Insurance Property Insurance 5/10/90 128.00 Property Insurance 5/17/90 2,843.00 Property Insurance 10/23/90 1,610.00 4,581.00 10,588.17 POST FORECLOSURE CAPITALIZED ITEMS: 10/30/90 Tax Stamps and Recording Fees 605.42 3/28/91 Anthony Rosa Electrician 2,000.00 3/28/91 Irish Plumbing 1,125.00 3/28/91 Jay Canty Carpentry 2,625.00 4/30/91 Jay Canty Carpentry 2,625.00 5/7/91 Irish Plumbing(Ruptured Pipes) 391.22 5!7/91 Atlantis Woodworking(Vanities) 1,210.00 5/7/91 Jay Canty Carpentry(Stock) 5,509.61 5/7/91 Dennis Surette(Plastering) 750.00 6/6/91 Jay Canty Carpentry 2,957.37 6/6/91 Neve Associates(Surveyor) 750.00 6/18/91 Colonial Floors(Hardwood) 1,066.00 6/18/91 Middletin Masonary 4,650.00 7/1/91 Jay Canty Carpentry 3,133.69 7/29/91 Irish Plumbing 562.50 7/29/91 DiFlumeri Ceramic Tile 2,400.00 7/29/91 Grays Appliance 1,175.80 8/15/91 Mike Irish Plumbing 825.00 11/20/91 Viking Tree 6,000.00 11/20/91 Lach Construction 3,465.00 12/18/91 Viking Tree 9,250.00 53,076.61 POST FORECLOSURE EXPENSE ITEMS: REO Operating Expense 11/30/90 Legal Costs of Foreclosure 7,308.71 1/31/91 Town of N.Andover Fall 90 1,238.23 4/30/91 Town of N.Andover Spring 91 1,171.05 4/30/91 Appraisers Group 200.00 4/30/91 Massachusetts Electric March Bill 5.52 5/7/91 Massachusetts Electric April Bill 10.09 6/18/91 Massachusetts Electric May Bill 8.86 7/29/91 Massachusetts Electric June Bill 10.67 7/29/91 Town of N.Andover 1st Tax 921.83 8/6/91 Proctor Home Warren Isurance 515.19 8/15/91 Town of N.Andover Water 79.00 8/15/91 Massachusetts Electric July Bill 23.00 9/19/91 Neve Associates(Surveyor) 2,536.75 10/15/91 Insurance 1,019.72 10/17/91 N.Shore Weekly-Legal Adv. 39.33 10/17/91 Town of N.Andover Water 14.40 10/30/91 Massachusetts Electric Sep Bill 5.60 10/30/91 Neve Associates(Surveyor) 987.99 11/14/91 Massachusetts Electric Oct Bill 6.92 11/26/91 Proctor Home Warren Isurance 203.94 11/27/91 Strattford Group Insurance 210.00 11/26/91 Proctor Home Warren Isurance 203.94 12/31/91 Massachusetts Electric Nov Bill 7.91 16,728.65 INVESTMENT IN PROPERTY 481,183.33 10/31/90 Write Down To Loan Loss Reserv. (77,309.11) 10/31/90 Interest Charged to Mtg.Income (43,274.38) 4/30/91 Write Down To Loss on OREO (16,500.00) Expensed Items-REO Operating (16,728.65) (153,812.14) CARRYING VALUE OF PROPERTY 327371.19 { DATE/ ` TIME �GM fife frDE/ NitP�FBER OF y d � W €-� SIGNED ltirr'; '.=Yr7t7Elf3 £A4LRNED� .OAC A(itAlk AtL �PiiON@P/ ,j/ SEE Y�11 AMPAD NO.23-176-400 SETS NO.23-376-200 SETS /457 4- (/(/7"-_c5 1�4,, e�� -C r�sib C Sc ���z-� ��ce� � . �tP N ?�. F 1 S. .fJ uTtLl �� SToLnA F=-r-eNT 101.1 �M EDIT LOT 50 I , 12�=ACAS r N Z� 3G4 2 00.00 � I HEREBY CERTIFY THAT THE BUILDING pr ON THIS PROPERTY IS NOT LOCATED WITHIN THE FLOOD HAZARD ZONE AS v JAMES SHOWN ON COMMUNITY PANEL NO.Z50008 kl"HARD l ,� ijt�j KEchA,`d IN No. 307 DATE REG. LANG URVEYOR v �J LAN . I HEREBY CERTIFY THAT THE BUILDING CERTIFIED PLOT PLAN IN ON THIS PROPERTY IS LOCATED AS SHOWN ABOVE AND COMPLIED WITH THE 1,.Cv,7H AW(:.,/.= iZ; MASS. ZONING BY-LAWS OF THETOWNOFI.I.A*(j�J= SCALE: IN.- MASS.WHEN CON TRUCTED. =4C. F-17 5=_P7. 6 James R. Keenan R.L.S. 2 D Street - DATE REG. LAND SURV YOR Winchester, Mass. 01890 a to, L 1 �� NORTly o n of n over RIVEWAY ENTRY PERM11J z < <� er, Mass. I�c�i �7, 19 F)\, HEW,,. `f Ica Q�G� Y l BOARD OF HEAL 'H PERkUiCc vir 40v� VTHIS CERTIFIES THAT.... I. LD ��.. .. ................................................ CmA11�& �E � � � �p �� BUILDING INSPECTOR haspermission to� .........................buildings on ... .. .. . .... ....... ....... ...... Rouah- 40C t��ta �. '1... � .. .., / C imney to be occupied as i provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relati g to t Inspectio ,Alteration an Construction of Rough 'Vr/'Vx to 'A714P4000firof 40 Buildings in the Town of North Andove . n Al VIOLATION of the Zoningor Buildin e-uTaTionAls 2s Permit. �g000, PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough $A?#J� 1-3/ UNLESS CONST TION START Service w Final ....... ... .... .......... ��....... /9 Q BUILDNGIINSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by Smoke Dot.4lZ Building Inspector CERTIFICATE OF USE ft OCCUPANCY 4 Building Permit Number 0 5 4 ( 19 9 1 ) Date MARCH 12 , 1 9 9 2 THIS CERTIFIES THAT THE BUILDING LOCATED ON 56 STAGECOACH ROAD ( L O T 3 0) MAY BE OCCUPIED AS SINGLE F A M I L Y DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. OF AORTH q� � O CERTIFICATE ISSUED TO C e n z n a.L 13 a n k 399 Hightand Avenue ADDRESS Y - 1 Snmo_nv s ��e, MA 0? 144 YAC SSACHUSS - Building Inspector 1YIN.l.7NVf1N.7L.t a.� wtur%ima rarrL.rL,taltuvt rvit.t*r-" ,P�V�B� ° r - (Type or Print) ;, 48 "f (� k, NORTH ANDOVER ,Mass. 4; , . Oates' 1` 46 Building Location u�'(,� Owners Name , •� New 'r] Renovation jam' Replacement [] Plans Sylbmitted , a FIXTURES ' z 0 N Z Y < 03 O 2 > p J W Y J P. d V h N d "T IC W O n 0: < < W tl a J x < 0. J No �r ii x ►- r• '" o o -j cc sc < o ac a w ac < x X x. le d 0 < W IG X id • < < < x to `" a < o a J < cc Qr ca < o x J m a o to r ;r. SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR f.#, 3RD FLOOR 4TH FLOOR STN FLOOR 6TH FLOOR 7TH FLOOR ' 6TH FLOOR (Print or Type) Check one: Certific440. Installing Company Name 1 < k .Lds �0�n �Jt_ _ M Corp. ; Address Partner. =_Le d oh Firm/Co. Business Telephone Name of Licensed Plumber: ocuw e o � Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type .of indemnity Bond y ❑ ❑ '�•rtf;m,_ Insurance Waiver: I, the undersigned, have been made aware- that the licensee Of this application does not have any one of the above three insurance caveragas. • Signature of owner/agent of ,property Owner Agents% 0 •, l bueby cettify Ibat all of Ute details and Wasmalion 1 l•a.c submittcd lot cnlcscd)is alw,.c application rite Itse WArwale to tbt Osat tN kmwkdge and"all plunsbint work and installslinnt 10ctfntnocd undct fc1614it lssucd for this applicatiow wiQ be in 400plium wI*so tiow"oI lubs Mt "Auscllt State Plumbiay Codc and(]uplct 142 of lite Qnaal Lives Vau!I�IIt;1�M til i By 1/ ' Title • Signature of 'Licensed Plumber Type of Plumbing License city/Town: J A DDnnvFn 7aFFlrF USE ONLYI . License Number Master 13 Journey"a _• Date. .C. . . . . . . . I� r b t µORTN., 3?�, �• ,•;�ao� TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,,SACNus� This certifies that-_: .1... . . . . . . . . . . :-. . . .? . . . 9 has permission to perfor - ,' -- f' 4 plumbing in the buildings of . . . . . . . . . . . . . at. . . . . . . . . . . . . . :!'�` . . . . . , North Andover, Mass. Lic. o..f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 12/08/47 14:41 25.40 PAID WHITE`. Applicant CANARY: Building Dept. PINK:Treasurer Location S-a� No. J�`r0 Date ` a TOWN OF NORTH ANDOVER 3? i. • O0 F 9 Certificate of Occupancy $ �'�s'•^° t<� Building/Frame Permit Fee $ 4CMU5 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # — 16424 Building Inspector i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: O/D DATE ISSUED: a DO 3 ic SIGNATURE: Building Commissionerfl for of BuildinE Date z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: J'rG� 57716 E Cae �7 Map Number Parcel Number A o 'V 1.3 Zoning Information: 1.4 Property Dimensions: O Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Aa-5 sz, Sifl'6 Name(Print) Address for Service: r Signature Telephone / 2.2 Owner of Record: W J'17 W�.`y'raj� O Name Print Address for Service: z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ c Licensed Constroctiimn Supervisor: License Number mn Address Expiration Date � S' -rte Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ )V-6 Company Name f Q o 3 J M Registration Number Address Expiration Date V S e Telephone �. I A SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ,�.; bFFICIAL IISE(IRNLY Completed by permit applicant ' .,., ....: . ..s,,. .nn .m..exxcxc.xuax.n.c.„ .,. ...,., ='Yid <r' •:s_' ,. ..., 1. Building e—V p (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (@) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH DING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, � ALJ as Ownethorized Agent o bject 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 Na Si e caner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIWNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 a Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1amanem ' employer providing workers compensation for my employees working on this job. Company name: LIS Address 30 Ci Phone# e _ Insurance.Co. Poli # fi C6, Company name: Address City Phone:* Insurance hone#- Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the and/or one years'imprisonment_as_we[Las_cti�7 -ORDF t_oFrnmnal P of,a fine up to si,5op.00 understand that a ��n�Snrm�f a ST9P]OtDRK9RDER arld_afaoe-cf($1DA.tD)-ajday � 1 copy of this statement may be forwarded to the office of Instigations of the DIA for coverage verification. do hereby cerrdy under the pains and that the fnharmabbn provided above is bus and correct. Signature Date__ L , 2 — 3 Print name Official use only do not write in this area to be completed by city or town officiar I City or Town Pern7ftAicensing D Building Dept pcheck if immediate response rs required .0 Licensing Board E] Selectman's Office Contact person: Phone# E] Health Department Ei Other I North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number Sqe . n3 is that.the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S.1 50 A., The debris will a disposed of in: �U� t `7- (Location of Facility) Signature of Permit Applicant � z -3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector E ISI aBOARD OF BUILDING REGULATIONS, LicenseCONSTRUCTION*SUPERVISOR . �Number.�CS 068139 Birthdate 01/14/1956 m f Expl t:>01/14/2004 Tr nos 131.3.1 RP$trlC�dd'. oil i, KENNETH R,CARNE GROVE-LAND, MA 01834 / gdministrator. `Mtn ; k", P;mDUCrR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LOHR INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 111 State Street HOLDER. THIS CERTIFICATE DOES NOT AMENn, MEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES Boston MA 0210SI- COMPANY AFFORDING COVERAGE (617) 227-1660 AGRANITE STATE INSURANCE COMPANY INSURED COMPANY A. B. CARNES, INC. , 1 0 ESSEX INSURANCE COMPANY 30 ARROWHEAD FARM ROAD COMPANY C SOXFORD MA 01921- COMPANY (978) 535-1366 D ISSUE.D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD , j..a P" THIS 16 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF Imsu POLICY EFFECTIVE POLICY EXPIRATION LTR RANCE POLICY NUMBER DATE(MmfoDNY) DATE IMM/DD/YY) LIMM 13 GENERAL LIABILITY GENERAL AGGREGATE t2, 000, 000 X 1: COMMERCIAL GENERAL LIAEHUTY 3CC8164R-3 02/23/03 02/23/04 PwmcTs-cQmpr.-P AGG s2,000 ' 000 CLAIMS MACE FX]CCCUFl PeASONAL&APV INJURY $1, 000, 000 OWNIiWS&CONTRACTOR'S PROT EACH OCCURRENCES 1, 000, — -900 FIM OAMAGE(Any one fire) MED EXP(Any one person) $ AUTOMOBILE LIABILITY ANY AuTo COINISNED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULEDAUTOS 500ILYINijcly (Per pamon) HIRED AUTOS NON-OWNED AUTOS BODILYINJURY (Poe 2LcidurTo PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY-EA AccioE-�rj 8 ANY AUTO OTHER THAN AUTO CNLy. EACH ACCUENT I EXCESS LIABILITY A00REMATE S EACH OCCURRENCE is UVORELLA FOAM EACH OCC AGGREGATE REGA' AGGREGATE OTKR THAN UMBRELLA rORM_ A WORKERS COMPENSATION AND TORY LAI ."Y L X CYSLIATU- IEMPLOYEFIS'UABILfTY THE PROPFRETOw WC6740557 08/01/03 08/01/04 EL EACH ACCIDENT $100'. 000 PART NER$MXEGUTrlE INOL I—rissAsE-POLICY LIMIT s500 , 000 OFF ARE: EXCL. ---------- I , OTHER EL DISEASE-EA EMPLOYEE 310 0 0 0 0 DESCRIPTION OF OPEFtATtON3/LOCATIONSIVENICLMSPECLAL ITEMS x t m; SHOULD ANY OF T14B ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TME EXPIRATtON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR Ti o MAIL 3 0 DAYS.-VAW"C"OTICr TO THErRTnl MT"NAMED TO THE LEFT, MAIL.SUOTI s: POSE /I )SURE TOOBLIGATION OR LIABILITY API'd KIND UPON CO A ITS NTS OR REPRESENTATrVEZ. AU .......... 041'W".`0 m Jos } . .Proposal A.B. CARNES, INC. 30 ARROWHEAD FARM RD. BOXFORD, MA. 01921-2642 Page 1 of 1 (978) 887-1431 Office (978) 887-1432 Fax Barry Carnes, President Mass,Builders License No.000230 Contractors Registration.No 100733 Proposal Submitted To: MRS. OBRIEN Date. May 19,2003 56 STAGE COACH RD Job Name SAME NORTH ANDOVER, MA 01845-3140 Job Location 978-689-9064 Wwk Phorre WE PROPOSE TO hereby to furnish material and labor-complete in accordance with specifications below,for the sum of: Ninety Four Hundred Fifty Dollars($9,450.00) Payment to be made as follows,,$300.00 Deposit, Balance Upon Completion NOtce:All home improvement contractors and subtractors engaged in home improvement contracting,unless specifically exempt from registration by provisions Authorized of Chapter 142A of the General Laws,must be registered with the Commonwealth Signature of Massachusetts. Inquiries about registration and status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place,Room (Agent) 1301,Boston;MA 02108 Note:This proposal may be withdrawn by us rT not accepted within 30 days. We hereby submit specifications.and.estimates for. ROOF WORK ® STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES COVER EXTERIOR WALLS AND FOLIAGE W-ITryHTARPS TO HELP PREVENT DAMAGE. INSTALL ICE&INATEB SHIELD SUC FEET WIDE AT4LEADING EDGE tiF OF24, INSTALLCE 8c 911ATER Slil LD IN1iL(Sp A OUND ALL�ROOF PEKE CRATIONSCOVER BALANCE OF ROOF DECK WITH FIFi EN.POUND tNDERLAYMEMT PAPER ® COVER ALL PERIMETERS WITH 8-INCHALUMINUM DRIP EDGE. ® INSTALL RIDGE VENT OR.®AS NEEDED ROOF LOUVERS.FOR ADDED ATTIC..VENTILATION... ® COVERSOILPIPES WITH NEW RUBBER FLASHING BOOTS. ® COUNTER FLASH CHIMNEY($),WITH ALUMINUM.FLASHING AS NEEDED. ® RE-LEAD CHIMNEY. CUTALL EXISTING TAR AND LEAD FROM TWO(IF NEEDED)CHIMNEY(S),CUT NEW REGLET,CEMENT NEW LEAD IN PLACE WITH HYDRAULIC CEMENT,PLEASE ADD$500.00 EACH TO ABOVE PRICE 171 REBUILD CHIMNEY FROM ROOF DECK UP WITH NEW OR USED BRICK. ADD TO ABOVEPRICE. ® COVER ROOF SURFACE WITH BIRD,CERTAINTEED WOODSCAPE FORTIES. ® REPLACE DEFECTIVE ROOF DECKING WITH CDX PLYWOOD AT AN ADDITIONAL COST OF 2.65 PER FOOT. ❑ SHINGLES ARE TO BE STORM NAILED..(USE SIX NAILS PER SHINGLE) [1 INSTALL SKYLIGHTS PROVIDED BY CUSTOMER.FRAME ROOF DECK AS NEEDED,.PROPERLY FLASH UNITS WITH FLASHING KIT(S). PROVIDED.THE INTERIOR FINISH WORK TO BE PERFORMED BY CUSTOMER.PLEASE ADD TO ABOVE PRICE. ❑ REMOVE EXISTING GUTTERS❑INSTALL NEW SEAMLESS.032 ALUMINUM GUTTERS USING THE POSITIVE LOCKING BAR HANGER SYSTEM. ❑ REPLACE FASCIA BOARDS.AS NEEDED WITH#2 PINE PRIMED,ADD PER FOOT TO ABOVE PRICE. ❑ INSTALL NEw:ALUMINUM DOWNSPOUTS. POP RIVET ALL CONNECTIONS. CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. OBTAIN ALL PERMITS AND CARRY ALL NECESSARY INSURANCE AS REQUIRED BY LAW. WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. HAND NAIL ONLY,gNO NAIL GUNS TO BE USED: SPECIAL INSTRUCTIONS: THE CHIMNEY FLASHING LOOKS SUSPECT.TRIMMING THE FLASHING AND PROPERLY WEAVING THE SHINGLES INTO THE FLASHING SHOULD CORRECT THE FLASHING AND ITS SHODDY APPEARANCE.IF THIS CANNOT BE DONE,WE WILL REFLASH THE CHIMNEY(S)AS PROPOSED ABOVE. PLEASE SIGN AND RETURN ONE COPY,SO THAT WE CAN PROMPTLY SCHEDULE THIS PROJECT FOR YOU.ALSO,PLEASE FEEL FREE TO CALL ME AT ANYTIME,WITH QUESTIONS YOU MIGHT HAVE.THANK YOUI BARRY WARRANTY-All work warranted to be free of installation defects for 5 years,limited to installed item and its repair only. Material warranted by mfg:to be free of defects for 40 years, see mfg.warranty for exact warranty performance. Customer has legal right under federal law to cancel this contract without penalty or obligation within three business days from acceptance date by mail or telegram sent to A.B. Carnes,Inc.,at the address above. See reverse side for cancellation procedures. Once all items in this contract are completed as agreed,customer has 3 days to fulfill payment schedule or pay all attorney and legal fees incurred by A.B.Carnes with interest of 1112%per month on the unpaid balance. All parties agree that all disputes over$2000.00 will be settled through binding,arbitration as provided by the American Arbitration Association.Please see reverse side,Arbitration of Disputes. NORTH ToverE 04" Of No. 9'0 % z A dover, Mass. If, cocHic cYc 1 f %ADRATED S H E BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D /,�� BUILDING INSPECTOR THIS CERTIFIES THAT.......... s' Q ••••••••• Foundation ,w has permission to erect.....5..... ..!... ....... buildings on ... f ... Rough S... - 1 Co d .....f.... .. .. . ...... .. ko* r 0 �► 5 t S �/ r�i Chimney to be occupied as........................................................................................................................................................................ 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 Insp tion, Alteration and Construction of Buildings in the Town of North Andover. em SI/Sy 9'0 �► PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations.Voids this Permit. - Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ........ ............... ...............,:........................ Service BUILDING INSPECTOR Final Occupancy .Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. 1 Location � ` No. �E � Date 6 0-1 NORTFr TOWN OF NORTH ANDOVER 3? •.. OL Certificate of Occupancy $ ;�s• SEt�' Building/Frame Permit Fee $ r F' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ !13 Check # OZ 16423 AA44 G�-�-- Building Inspector t ,i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING / BUILDING PERMIT NUMBER: Z-/9 C DATE ISSUED: / dD X 2 ic SIGNATURE: iiiiiii Building Commissioner/IEyector dBuildings Date Z SECTION I-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: '^ f1 0--a-,C1.3 Zoning�Inform(, Map Number Parcel Number Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage 11 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water S ly M.GL.C.40. M) 1.5. Flood Zone Information: / 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone b/ Municipal ❑ On Site Disposal System J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Yr i CN", .A 0 �A- LQ- Name(Print) Address for Service: \ 01-)E - -1-vi u 1 Signature ( Telephone Sim 2.2 Owner of Record: Q Name Print Address for Servic . Signature Telephone 9 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number mn Address Expiration Date ic Signature Telephone r' } 3.2 Registered Home Improvement Contractor Not Applicable Company Name M Registration Number r Address INSIMI z Expiration Date P� Signature Telephone �9� SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildin it. Signed affidavit Attached Yes.......❑ W......❑ SECTION 5 Descrit' n of Proposed Work check all iicable New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition r . Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Ctoo 10,S00.—SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OM01J-, L UNEx{64Vy a� Completed by permit applicant 1. Building (a) Building Permit Fee �p (,;it -601000 Multiplier x $Oo 2 Electrical (b) Estimated Total Cost of / 'A.c-)00 Construction 3 Plumbing ©b Building Permit fee(a)X(b) 4 Mechanical HVAC >/r 5 Fire Protection 6 Total 1+2+3+4+53 L 1 0 O 0 1 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pen-nit application. Signature of Owner Date SECTION 7ttb OW(pNER/AUTHOR��IZED AGENT DECLARATION as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name r Si nature of Owner/A ent Date NO. OF STORIES SIZE $ BASEMENT OR SLAB ��, , SIZE OF FLOOR TI vIBERS 'y l o 1sT 2 3 1 SPAN (A I - DIMENSIONS OF SILLS (a a k b DIMENSIONS OF POSTS jEA DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING (©u )(an" X MATERIAL,OF CHIMNEY Yv`1A IS BUILDING ON SOLID OR FII LED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE s, 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*********************** APPLICANT \&M at O Q_ PHONEOff LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREETST. NUMBER_ ************************************OFFICIAL USE ONLY***************************** **** RECgffiMENDATIONS OFT _W.N AGENTS: < c CONtERVATION ADMINISTRAT DATE APPROVED JcS o3 DATE REJECTED COMMENTS �1n VdS 4c11�:'l `FJO r oT rJ1� TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm f NORT{i 9 O �t�eo 6 + OL o Town of North Andover Building Department 27 Charles Street �9SSACHU`����� North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print.q DATE `'4" O JOB LOCATION kcyu Number tio `l (� Street Addreds SecT n of Town "HOMEOWNER C� D i 1iV �7� C� 1'�r1 I q21 —64(n Y1 X00 Number Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. D &FL51 SHEET NO. OF LAB FURNITURE INSTALLATIONS & SALES CALCULATED BY DATE 11 River Street, P.O. BOX 499 CHECKED BY DATE MIDDLETON, MASSACHUSETTS 01949 SCALE (978) 646-0600• FAX(978)646-0601 .. . ........ ,I - 11 --- --t— V� 7 E � E , , ! 3 r i _ , . , i r ..... r ! f r 000 g ....... r � �.._ 1. i E , I i � r _ T El it, y. Q p a � — i � € JOB LFSHEET NO. OF LAB FURNITURE INSTALLATIONS & SALES CALCULATED BY DATE 11 River Street, P.O. BOX 499. CHECKED BY DATE MIDDLETON, MASSACHUSETTS 01949 SCALE (978) 646-0600• FAX(978)646-0601 Ci , } , € i - ! i _ I _..... 1 € € l�- € a I t , € I � - I k € , Vey . 1 S J: I i 1 ' , , t -I z I ` E = F I JOB 1 '(°;f 4-J `CL YAG., SHEET NO. OF LAB FURNITURE INSTALLATIONS & SALES CALCULATED BY DATE 11 River Street, P.O. Box 499 CHECKED BY DATE MIDDLETON, MASSACHUSETTS 01949 SCALE (978) 646-0600• FAX(978) 646-0601 i _ I E j j ! .... 6 � , � f 3 [ j --I �- I I � f � � � r r � E I I F � � ............... ' i 7 ` -,- ad ! w F � Me . i € I Gt - CLe i _ ' co } 1 i 0 lao .. ........E t v , I JOB SHEET NO. OF LAB FURNITURE INSTALLATIONS & SALES CALCULATED BY DATE 11 River Street, P.O. Box 499 CHECKED BY DATE MIDDLETON, MASSACHUSETTS 01949 (978) 646-0600•FAX(978) 646-0601 SCALE .._.. ...,._ � � Q....... � ! <....-.v+-.�,.-.y�-tea"-•�.:,-...r.,.,yu ___ E E. f k . y � 7 III E t r` ! r I r } � f , I �-- , r E , a f ( E a E , i , + r , r 1 i € ' E : 3 e 1 r '. t , 1 , } i r p , l i ' , r i i l , f � r~ Gca. 1 ...-. ....,.«.,a..e..3.....•-may _ i € , r , r t tt t , [I v a - tlice-a^�f�.+�+++�5s+€:vru.>+won•RrrrnA�neeYss<x� E JOB &FIS SHEET NO. OF LAB FURNITURE INSTALLATIONS & SALES CALCULATED BY DATE 11 River Street, P.O. Box 499 CHECKED BY DATE MIDDLETON, MASSACHUSETTS 01949 (978) 646-0600• FAX(978) 646-0601 SCALE l ; ......._ �itY,Au ol%c.. i 77 I 7 , i E , ! - ¢ r t i 1 r i II N r _ z3 uavww»v�vm,� , € " I F , , t 1 , , i . IT ....... ............ k I , r }o SSE s / 1 Y . --�F .�.�J_.•.�.....__ .5.�.wt:,Aew� r ;.. ..,n.-.. �.� � �' PJM� � ��. .� !s .�:;1�..)C�.X �.S r• a t7'> i h $'' c r rte, � i XV 6 1 NORTH ® ® E dover 0 �% No. - � - - i -ago o�A C0 .1c� dower, Mass., ORATED S u G r7 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......�II ,►. .!`.,/..a. ...... 1 .. ................................ �� ����� Foundation I � has permission to erect....1..�1.. .�T....... buildings on .... ..d........ ...ac s...... mm..i&........ Rough to be occupied as. ..... � �n�u....w ...C�. . '. .Q. ..Is........q..N.O.'cr....................... 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-lawsting to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 104 1>7 * ' ) 30 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR C Rough Service .... ........... .4. . ...... .......... ...... UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 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. Oi cha.el D. & Darlene M. Hall BUYER: _-------- - ra , . A ` 00 x LOT 4A-A, 10 ul � n un N y y; Q rr rG 3 -r Trij i 114.42 r MORTGAGE INSPECTION PLAN TO THE (Assurance Mortgage Corp of America ILOCATh IN AND ITS 711M INSURERS. N O R T H A N D O V E R 1 CERTIFY THAT I HAVE EXAMINED THE PREMISES AND THE BUILDINGS SHOWN DO.( ) - N TO THE zON1�10 LAWS AND AMENDMENtS� I.�.(FRONT. SIDE, R REAR YARD SETBACK ONLY) MASSACHUSETTS OF O r t n AnCI Over WHEN CONSTRUCTED. OR ARE EXEMPT FROM VIOLATION ENFORCEMENT AC710H UNDER MASS. G.L TITLE VII. CHAPTER 40A, SECTION 7. UNLESS OTHERWISE NOTED. I FURTHER CERTIFY THAT THIS PROPERTY IS not LOCATED IN THE ESTABLISHED FLOOD DEED HAZARD AREA.COMMUNITY PANEL NO.:250098 0010B DATE: 6/15 /83 BOOK 3045 EXAMINATION OF THE RECORDS IS MADE ONLY SUBSEQUENT TO THE RECORDED DATE OF THE 158 LATEST DEED AND DOER NOT INCLUDE VERIFYING THE ACCURACY OF THE DEED DESCRIPTION PACE PREVIOUS TO ITS DATE OF RECORD. CERT. NO. THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED DATE OF THE LATEST DEED OF RECORD. WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY LME IT IS ADVISED PLAN BK. PAGE..__., THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. 9(� Em. PUN / DATED IS TIFICATTON IS BASED ON THE LOCATION OF:SURVEY M OF OTHERS, AND DOES NOT REPRESENT A PROPERTY SURVEY. VERIFICATION OF SURVEY ,, AND OFFSETS, As SHOWN, June 1 h' MAY BE ACCOMPLISHED ONLY BY AN ACCURATE, INSTRU % R7•i , 1 9 9 4 SCALE: 1 THIS CERTIFICATION To BE USED FOR M'd��'�a E p a��5� , ONLY. � 40 ' OFFSETS AS SHOWN A ::(1 T TO BE. USED FOR THE ESTABLISHMEN. Ofd PFOR�f TYe•LIN 'I LL>c�Ut'529 Kos BRADFORD ``a.t..... J 9;129 r a�°o�/'' ENGINEERING CO. V�✓ P.O. BOX 1244 .urn ... ................ ----- ^ - HAVM"LL MA. 01931