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HomeMy WebLinkAboutMiscellaneous - 59 HICKORY HILL ROAD 4/30/2018 59 HICKORY HILL ROAD 210/061.0-0086-0000.0 i I � f a—,f a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T TW9 Section for(Hriidd..Use oat V BUILDING PERMIT NUMBER DATE ISSUED: rn SIGNATURE: Building Commissioner/I for of Buildings Date z SECTION I-SITE INFORMATION ^ 1.1 Property.address: 1.2 Assessors Map and Parczl Number: dam/ PA Map Number Parcel Number 1.3 v Zoning Information: 1.4 Property Dimensions: Zonis g District Proposed Use Lot Areas Frontage(11) 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.40.5 54) 1.5. Flood Zone Infomution: 1.8 Sewerage Disposal System: D Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System :1 J SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Ar Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number M Address D Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Sv Company Name rn Registration Number r Address, r Z Expiration Date ^ Signature Telephone Y 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 of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check atl a lIcable New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: v SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be r,§¢ 3s OEL .;US�+ {NL Completed by permit applicant I. Building (a) Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 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 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 permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED 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 Sip-nature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TNMERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIv1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM 373 sf W) �g x t� INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements.Boom � _ N, Now NOOENNEEm APPLICANT M4 1-kLLaOa1 L,4yn&Cr PHONE 6Z03D^ 3q6 C--, ASSESSORS MAP NUMBER °� LOT NUMBER �lO SUBDIVISION J- / LOT NUMBER STREET �7 �Tr"f�Jl� //, STREET NUMBER464 ...........................................■.............................■. OFFICIAL USE ONLY RECOWAENDATIONS OF TOWN AGENTS DATE APPROVED W CONSERVATION ADMiNIISTRATO DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS Ad-/' IA) DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED ' DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE CER TIF/ED 'FOUNDA TION PLAN LOCATED /N SCALE DATE Scott L. Gi/es R,L.S. 50 Deer Meadow Road North Andover,Mass.. SZ.7 Mf y Z�Z S - k -20.5• . �• � \L o .. wlem ?UEI-DING DEPARTMI FNT / CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE N THE OFF OF THE BUIL DING/NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE IS FOR TH WITH THE ZONING DETERMINATION O -ZON/NG -1 BYLAWS OF CONFORMITY OR NOM-CONFORM/TYy,s �a rnav Ma WHEN CONSTRUCTED. ' z WHEN BUILT. MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 401 SOUTH BROADWAY,LAWRENC E MA.01843-3522 TEL:(978) 837-3335 FAX:(978) 837-3336 MORTGAGOR: JUDITH HALLOWAY LAMBERT DEED REF: .3792/2 10 LOCATION: 59 HICKORY HILL ROAD PLAN REF: 1 19 1 1 CITY,5TATE: N. ANDOVER, MA SCALE: 1 "=40' DATE: 5/G/05 JOB #: 205.02931 P055.5HED ENCROACHMENT yN�O I GO' 2 g� 060 .p10 �y9 G If 1 1 .3 1' LOT 1 22,025 5F± 5 7 HICKORY HILL ROAD CERTIFIED TO: WASHINGTON MUTUAL BANK FA Flood hazard zone has been determined by scale and is not necessarily accurate.Until definitive plans ,NSTRUMFNT SIJRVFY' RF-GOMMENDED are issued by HUD and/or a vertical control survey is performed,precise elevations cannot be determined. NOTE-* This mortgage Inspection was prepared spec{flcaltyy jbr mortgage purpose only and This mortgage inspection was prepared in accordance is not to be relied upon as a land or property '' '`_ . with the Technical Standards Ibr mortgage Ivan tine survey. used for recording. preparing deed �° ��� CI n1,a,`,.ti Inspections as adopted by the Massachusetts Board of descrtptwns, or construction No corners were �y<1d �'' S�-,� Registration of Pro/irssiorwl Engineers and Land set. Building location and offsets are "i� � JOHN Surveyors 250 CMR 605. approximately located on ground and ,r, I jluther state that in my pmfessional opinion that are rheum speciftca!!yy jbr zoning determination ! J. �' the structures shown conjbrm with the local zoning horizontal only and are not to be used to establish property {�� RUSSELI i1 dimensional setback requ{rernents at tlur time of construction or !{nes. The matters shown hereon are based on `l 3871- ;: ,1l/,� are exempt mar provisions of m.C.L CH.. �0-A Sec. V. client-,J1�rnished in/brmation and may be subject 'n r t to further out sales. takings. easements and rights > o t. P-party/House is not in Flood Hazar& Of way. and other matters of record and preserptive ;9 4' :,:;l� 2P—P2Fty/House is in a Flood Hazard Area or other rights. Northern Associates. Inc. assumes no q•Y;, :� _' 'w � . Jbrrnatior► is insuflUent to determine Flood mward. responsibility heroin to land auma s occupant. i;a a- -. Flood Hazard determined from latest Federal Flood accepts no responsibility jbr damages resulting from id s' 13-03, I ret{ar►ce byy anyone other than the said mortgagee and its assigns SInsurance Nate Ya in connection urith its proposed mortgage p morel 9a9 financing to said mortgagor. Date Zone a �• Location � ,+ No. /�S ' Date N°"TM TOWN OF NORTH ANDOVER 3? a OL F :jffijjwjjdj& p Certificate of Occupancy $ Building/Frame Permit Fee $ • Foundation Permit Fee $ f r 3 sACMUs Other Permit Fee $ -- Sewer Connection Fee $ � II&Or Connection Fee $ TOTAL B- �l Building Inspector f Div. Public Works G. 7- Location ` No. 2 Date ,'S-'"��' 9j, NORTH TOWN OF NORTH ANDOVER ..n Certificate-of=Occupancy $ D,U U a ;�0 rd r �1iCi6g(Frm� Permit Fee $ �+s AcNu E<� Foundation Permit Fee $ lt lJ U C) sS Other Permit Fee $ JMAY jS66 C10tion Fee $ —� Water CO ection Fee $ TOTAL $ D.O Z Building Inspector 6(j l 2 Div. Public Works Location S" 7 Na Date 4 -21-95 Of ORT1y a-j 0 NORTH ANDOVER err+ ! q bl �J���!�ff..w. f�_f Oocupancy $ �o +' Building/Frame Permit Fee $ 4 . AC UST, Foundation Permit Fee $ Wer,-je@njt j4g3 $ .44 SSS sewer Connection Fee $ Water Connection Fee $ !z":)� TOTAL • r. BuiIding.Inspector• i /%Div."Public Works PERMT WO. ' 1,5 2 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. �b �j PAGE 1 -� MAP 440. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE �'L I SUB DIV. LOT NO. 1 SD` l LOCATIO l (' _ PURPOSE OF BUILDING S)�l/ gAi I l y A � 1�.t OWNER'S NAME ) �� — NO. OF STORIES �7C SIZE Ca� �6�� OWNER'S ADDRESS I� BASEMENT OR SLAB 2 �/•b CO ARCHITECT'S NAME / SIZE OF FLOOR TIMBERS IST ✓J y I,\ 2ND 3RD BUILDER'S NAME -SPAN ) / DISTANCE TO NEARES BUILDING ..y /L`( DIMENSIONS OF SILLS��7 o DISTANCE FROM STREET „�. �/ POSTS C• Y �f / DISTANCE FROM LOT LINES—SIDES zo/+ REAR e'�/I GIRDERS 7� SE AREA OF LOT Z ,J � VV FRONTAGE7C•'��7 �-� HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW �1�!c/ !� SIZE OF FOOTING q ,0J X IS BUILDING ADDITION n MATER:AL OF CHIMNEY r` IS BUILDING ALTERATION A'/) IS BUILDING ON SOLID OR FILLED LAND 1 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY A , /1` IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION • LAND COSToe f9 SEE BOTH SIDES (J �O`^ . /' ,�11 EST. BLDG. COST M � � � � ,y �y� G V PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS I - 12 1fFMatY F&W KWff S ,�:Z b n U h EST. BLDG. COST PER ROOM ~►,►w F G1�T Cly ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING /'`z SEPTIC PERMIT NO.4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRER GULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING NSPECTOR s�P DATE FILED • WARD OR HEALTH SIGNATURE OF OWN UTHORIZED AGENT F Et 6 E 62Z PLANNING BOARD PERMIT GRANTED OWNER M# ?:z 6�.� CONTR.TEL.#_64 Z , 19 /9-y — CONTR.LIC.#4alZ_4 WARD OF SELECTMEN ' .• �� � 1710 74 Chi' . ' 607 BUILDING INSPECTOR . r , 3tii LENT BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY,,,,,,l S, RIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/1 1/1 FIN. ATTIC AREA NC) B M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"J'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY �_ • STUCCO ON FRAME I SI? BRICK ON MASONRY ATTIC STRS. 8 FLOOR BRICK ON FRAME I � � �,• CONC. OR CINDER BLK. ` STONE ON MASONRY WIRING y�#� STONE ON FRAME SUPERIOR II POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE 171 HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ t WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER - ROLL ROOFING MODERN FIXTURES TILE FLOOR ' TILE DADO r 7 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE b "rT FORCED HOT AIR FURN. TIMBER MS. LS. STEAM + -• STEEL B COLS. _ HOT W'T'R OR VAPOR WOOD RAFTE AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS OAl B'M'T 2nd ELECTRIC 1st 13rd NO HEATING '�` 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 local or state law, regulations or requirements. ****************Applicant fills[ out )� this section***************** APPLICANT: _ �/lD,�IQS .��• Z A.JaiJ/,t D Phone LOCATION: Assessor' s Ma�p� Number Parcel Subdivision I� ��M`r X11 1` Lot(s) Street l p �/` St. Number ************************Official Use Only************************ R�ECOMMENDATIONS OF TOWN AGENTS: Date Approved _ Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Health Agent Date Rejected Comments _ T WA) Public Works - sewer/water connections - driveway permit _ D,�f -17A Fire Department u W'I Received by Building Inspector Date L FI!rDiNG DEPARTMENT i Off' G� O o b 1 'r ` .4 kA u'0 D X22 f s - oo�s2a SON do bbl`2---:a^oa nd •o f�1 83110 o c� r-.ovW7y4 '?s'��Q os, 11005 ��� bbl X22 i a d d i0 CERTIFIED F'OUNDA TION PLA/V LOCATEDIN SCALE /"_ 40' DATE Scott L. G1/es R.L.S. 50 Deer Meadow Road North Andover,Mass. i-t i G lu p �4 Ste'7q oT z ' O �O wir o ewe 1;7e' E_DEN'G DEPAR a IkAEN / CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE a of THE OFFSETS OF THE 8U/L DING/NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE/S FOR THE WITH THE ZONING DETERMINATION OFZONING .13872 SY LAWS OF CONFORM/TY OR NON-CONFORM/TY Qd J2 6' DQ\U M� WHEN CONSTRUCTED. WHEN SU/L T. NORTH ToVM OfAndover � � 15t - � 19f� dover, Mass. /�1/�y / IIPADR "\ A T E D P 'x,95 H ��� f BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System A BUILDING INSPECTOR THIS CERTIFIES THAT...', /�.,l.�+I. J.....io.... of-A0��/�Ap••......• ........................................ Foundation g �� ' 0�Y. .#%f*,JP ltA.W.-Or' Rou h has permission to erect�.�i����l buildin s ong to be occupied as .. � .. . .. .. .. .. i Chimney provided that the person accepting this permit shall in every respect conform to the teof 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. JDAC0900 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT FOR FOUNDATION Rough REGULATEDGY PARA. 114.8-S. B.C. PERMIT EXPIRES IN 6 MONTHS Final S CONSTRUCTION 19. FEE PAI �� ELECTRICAL INSPECTOR PERMIT FOR FRAMEI�Ei����GS ,7v, . Rough DATE:.�-L�- FEE PAID• J_c BService `'''���"^�' UILDING INSPECTOR Final Occupancy Perrnit Required to Occicpy 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 PLANNING FINAL CONSERVATION FINAL Street No. /�9ww/lp oc� Smoke Det. c��n►�Q i�n►nT�R FI�IAI / A --I --Ii „ _ DRIVEWAY ENTRY PERMIT CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number__3 7 Date nILY 26, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 59 HICKORY HILL ROAD (1 of #1) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR GARAGE IN ACCORDANCE & DECK WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. pM�oT; tip CERTIFICATE ISSUED TO Thomas D. Zahoruiko 185 Hickory Hill Rd. ADDRESS �s3"`""s� Building Inspector NORTH t E ToVM Of over 0 No. 1 vi u = OCHIC y dower, Mass., 19A.'? A a DRATED P? `� ,9S H �.� BOARD OF HEALTH Food/Kitchen PERMIT T Septic System/ z.,k' , BUILDING INSPECTOR /j.I.. I. .....10 ..Z/�4 0����o........... THIS CERTIFIES THAT.... ... ......................................... Foundation has permission to erectM.#j#.#4g.( buildin son Axio-tiMAU.-Orl Rough,51-4 000, to be occupied as.JAMI.C.A.�..,00M.Ofty..40� 4 � 1 . . �. �. f Chimney provided that the person accepting this permit shall in every respect conform to the ter s 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 I 30 Buildings in the Town of North Andover. D �►�� PL B G INSPECTOR of the Zoning or Building Regulations Voids this Permit. PERMIT FOR FOUNDATION OW fo � �� VIOLATION9 9 9 REGULATED GY PARA. 114.8-S. &C► PERMIT EXPIRES IN 6 MONTHS n S CONSTRUCTION �A� FEE PAI ELE RIC FISP CTOR PERMIT FOR FRAME/�1� '� moo, RDughQ DATES:1.2. FEE PAID: .�W .. .. ... .... ........ ... Service �lC BUILDING INSPECTOR Final t Occmancj� I'errrt 't Re aired to Occupy Building GAS INSPECTOR Display In a Conspicuous Place on-the Premises — Do Not Remove �2 L� No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner /� �" CONSERVATION IeIC� b N Street No. " ` PLANNING � �INAL � Smoke Det. ' ; DRIVEWAY FNTRY PERMIT___ 12 _ -a Date2 6 7..../Z..... ............. TOWN OF NORTH ANDOVER 40 10" PERMIT FOR WIRING C This certifies that ...... ........./.,,/............................. .. ................ ..... ... .......... .. . .... has permission to perform ............. wiring in the building of... ............................. ........ ......ice' North Andover,Mass. .......... ............................... . Lic. ................................. .................. No ...... -/5- �� --ELEMICAL INSPECTOR 03/16/99 12:20 40.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer THEG0W0NWFALTHOFM1MClYi1S,= Office Use only / DFPART11gZVlOFPI1BLICSAFETY Permit No. � a v BOARDOFmEPREVE MONREGMTI0ASR7091100 ' - Occupancy&Fees Checked `—� APPLICATIONFOR PERMU TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Z �� I 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) A�' y AZL Owner or Tenant y Owner's Address Is this permit in conjunction with a building permit: Yes rM No F-1 (Check Appropriate Box) Purpose of Building d( GL/��� Utility Authorization No. Existing Service iia O Amps Ll Overhead Q Underground r7 No.of Meters New Service Amps / Volts Overhead = Underground No.of Meters — Number of Feeders and Ampacity Location and Nature,of Proposed Electrical Work No.if Lighting Outlets No.of Hot Tubs No.ofTransfotmers Total KVA No.of Lighting Fixtures ` Swimming Pool Above Below Generators KVA / ground 11 eround No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets /) V No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pum s Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained lfl,11-44 6469UWiT a Detection/Sounding Devices No.of`Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER' IrsrrarceCoyaage Aasua:cbtheta�tmema>$ dn�GaieralLaws I ha`e a axi=Lmbfl ty lane=Pobcy irducr tial CaAraW crus sttf�rart d te4nalax YES ® NO E] resu Ihatm=dvalidpaofofsawotheOffix YES NO If}cuha<etf>F�dcedYES,Pieaseindica�thet}peofcaaagebY gate INSURANCE BOND OU-IER (P1seSpeafy) f g Expu-atirnrn Daae Fsturmied Vahred'Eletical Wak S Wak tD Start 3 / 1rcir Date Ragrestad Rant _.S1Jc 9 /)M Forel OZ/p Q, C p Sigted underTie Pamities of rr / FIRM NAME 5?W la G S�Z �2;�7 Sigr� LicenseNo BusrressTelNo. G o-F- X-S—F— Addiess o/v Al Tel.Na OWNER'S INSURANCE WAIVER;Iamawated-AtheL.icamdoes�the imra=amaageoritssubswdale#vala;tasm#uJbyM GateralLaws and int mysigmtiaecrithis pan1applic"ryai;,esthisMuTott (Please check one) Owner Agent Telephone No. PERMIT FEE S Location / Mr /61' No. 060 Date I H0RTH TOWN OF NORTH ANDOVER f � � „ Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ —? cMus — s� t i Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ _ TOTAL $ 6 's 4( 7D,7 s" 1'it( r`.(- --- Building Inspector "I 3u ' G 03/1615`3 tC �? Div. Public Works l R s PERMIT NO. © APPLICATION FOR PERMIT TO BUILD******* NORTH ANDOVER, MA NI%P NO. LOT.NO. 2. RECORD OF OWNI.KS111P DATE BOOK PAGE 7t)NE SUB DIV. 1.0 U NO. - L {/l� I()t 4 I ION PUKPOSE OF BUII DING LSI f7 `_� cl �( SIZE ()\VNEK'SNAn1L• C LI ^LCC ()WNER'S ADDRESS 52 ;`L Om i i � BASEMENT OR SLAB E(-I'S III EI'S NAME 1� 1 SIZE OF FI.00R TIMBERS I 2 ND 3 RD J31MDER'SNAME KEEjj SPAN DISTANCE I ONEARESTBUILIAW; DIMENSIONS OF SILLS DIS IANC E I-K()M STREET DIMENSIONS 01=PO)ST S DIS IANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE I IEIGI I7 OF FOUNDATION THICKNESS IS BI I I LDI W;NEW S17E OF FOOTI NG X 15 BtAI.DING ADDITION MATERIAL OF CIBMNEY IS BIJI LDI W;ALTERATION) IS BUI III NG ON SOL_1 D OR FILLED LAND WILL BUILDING CONFORM TO RECK IIREMENT'S OF CODE IS BUILDING CONJNECTED TO TOWN WATER BOARD O F APPEALS ACTION,IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONJNECTED TO NATURAL GAS LINE INS[_IICl'IONS 3. PROPI:R'FY IN FOR 111A'FION 1300 LAND COST rF-,e / 6 C ! ESI.BLDG.COST PAG[: I FII I.O(!f SECTIONS 1-3 /? EST. BLDG.COST PER SQ.FT. EST. BLDG.COST PER RO(_)M EI ECTRIC METERS MUST BE ON(XITSIDE OF BUILDING SEPTIC PERMIT NO. All GARAGES MUST C(NJF(N(M TO STATE FIRE REGULA'noNS 4. APPROVED BY: /o PLANS MIDST BE FILED AND APPROVED BY BUILDING INSPECTOR BI I11. G INSPECTOR DA I S III ED OWNERS TELN CON4TRAYIP 9� S Z D CONTRA]C4 S g Z T JI SI(: • 111 (k OWNER(HR A I I 1 k N2171iD A(;GNT Q Q III $ 5-1- ___ _ fl.I.C.N I'I KNIII 6RANI1-1) 19 c i I i I Lo oo f+u � I o � 1 hz ESQ T l i I � i i b(�j ' ZJ��PI'"b � N• bS ��'�+� HOME IMPROVEMENT CONTRACTOR Registration 108383 Type - DBA Expiration 08/18/00 KEEN CONSTRUCTION CO. Kenneth B. Keen G� Hewitt Ave ADMINISTRATOR No. Andover MA 01845 '_ ✓IAC 1�0�/77i17L(Y77,f(/(�7�� O�,'l'U.UJ:iCLC1/u;i('��J ` - Tile Commonwealth of Massachusetts 4 R. ( Department of Industrial Accidents Mce o/leyestlgatlens 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit `� J name: /`� C/JNL r'n f�� 1�!✓E/ locations �Z Z c W ; [l AJ C ciA//f phonstt -- M I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers' compensation for my employees working on this job. comnary mase: ' . address-..... ..... ci phone#- insurance co: poly# Cl I am a•sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnanx name•• address: situ• phone#- insurances4, poli # comnanv:name: ' address cilL. phone#; insurance co:. pa�icy#. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under t pain and penalties of perjury that the information provided above is true and correct r Signature ` 'L y Date r�Z Print name Phone# o fficially do not write in this area to be completed by city or town official permit/license# r7 Building Department C]Licensing Board mediate response is required C3Selectmen's Office C]Health Department n: phone q; nOther (re ued 3195 PIA) {i Town off . dover •.��v-.L 1 Wth, Andover, Mass., a) /jt/gp AV h �. n BOARD OF HEALTH Food/Kitchen ERMI T D I P T Septic System THIS CERTIFIES THAT....*411C4�"T44C Sh~" Idy BUILDING INSPECTOR ........................... .. ...... ..................... ..... Foundation has permission to erect.. M..s. ,...,. .... buildings on .........`S� < < A Y W ......................................�........ Rough to be occupied as.... ..... . " �''�'f R . .................... Q lie p 4��.�Y... . . . . .� � � �' Chimney 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 provisionsof 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 � G1�� RIN/t V O �.� NNiHS) Final o _ I 0 �T N L S tJ (r���h�J,� ',t ELECTRICAL INSPECTOR Rough ......... .......... .. ............... ................................... Service BUILDING INSPECTOR Final . C.IC( 1 Lpr:lllt"y PF,'77,1.11=iit'c(t.�z1_ C� �C) t.0 q)y BullC l�l� GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner I Street No. SEE REVERSE SIDE Smoke Det. y Office Use Only u LfgMMVn Wf# If .41agoar41tSMS Permit No. iBepartment of Ptthllt '9�afetg Occupancy& Fee Checke _(L v. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3/90 (leave blank) -A-h 'w APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 V(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date a—Y-� (%fir or Town of NORTH ANnOVER _ To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) -(�C4V-aG Owner or Tenant � A-E- Owner's Address Is this permit in conjunction with a building permit: Yes No LJ (Check Appropriate Box) Purpose of Building Q1�5 ���.+1 vl-C_- Utility Authorization No. Existing Service Amps __l Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps __J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /4,41� No. of Transformers Total No. of Lighting Outlets n� No. of Hot Tubs KVA No. of Lighting Fixtures I Swimming Pool Above In- g 9 grnd. ❑ grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets I No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Air Cond. No. of Ranges I tons Initiating Devices Heat Total Total No.of No. of Disposals Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices Local Municipal ❑Other No. of Dryers Heating Devices KW ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Operations Coverage or its substantial equivalent. YES O have submitted valid proof of same to the Office. YES _-ANO - If you have checked YES, please indicate the type of coverage by checking the appro ate box. INSURANCE _ BOND ` OTHER Z (Please Specify) J J (Expiration Date) Estimated Value of Electrical Work s Work to Start Inspection Date Requested: Rough 71 / 1 Final Signed under the Penalties of perjury: FIRM NAME ,-,M A-� �>t -— LIC. NO. Licensee ML ,(—, Q�. :±:L Signature LIC. NO. Z7 D Bus. Tel. No. Address Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x•6565 Date.......11.........../.1... ....... 24 34 NORT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING ,SSACMUSEt This certifies that ....... .. .. ...................................... . ......... has permission to perform ................/.f. . ........................................ .................. wiring in the building of................ ........ .............................. .. .............. .North Andover,Mass. Lic.Nofzl..",?. ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Location S L � No. 3 Date a� i I! pfi",�oT;�ti TOWN OF NORTH ANDOVER a 3? �� • ppL 1 A p Certificate of Occupancy $ Building/Frame Permit Fee $ sAcMus`� Foundation Permit Fee $ Other Permit FeA-0D+ t Sewer Connection Fee $ Water Connection F $ i' TOTAL $ a Building Inspector 8691 Div. Public Works r � PERJI[T NO.\ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER MASS. "PAGE 1 MAP•td0. �� LOT NO. cc�+.� 2 RECORD OF OWNERSHIP DATE BOOK :PAGE — ZONE I SUB DIV. LOT TNNO. 1 r i LOCATION t�Q y�(�� / PURPOSE OF BUILDING m OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS (�� e, _J BASEMENT OR SLAB A ARCHITECT'S NAME J SIZE OF FLOOR TIMBERS I' IST .3,1& 2ND 3RD BUILDER'S NAME AVu 1 / va SPAN DISTANCE TO NEAREST BUILDING Yo DIMENSIONS OF SILLS DISTANCE FROM STREET Z 6� 7` •' POSTS DISTANCE FROM LOT LINES-SIDES 2d �. REAR J�� GIRDERS `,/td AREA OF LOT Z Z/OZ t� FRONTAGE / HEIGHT OF FOUNDATION( �� f 4 Vl THICKNESS AIA IS BUILDING NEW A !oJ SIZE OF FOOTING (4 j�!!"�•� X ," IS BUILDING ADDITION MATERIAL OF CHIMNEY •.au V IS BUILDING ALTERATION �� IS BUILDING ON SOLID OR FILLED LAND S WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER Y� BOARD OF APPEALS ACTION. IF ANY1, IS BUILDING CONNECTED TO TOWN SEWER �V IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST ��Xy SEE BOTH BIDES EST. BLDG. COST V�L� PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. COST PER ROOM BLDG. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. � dO : 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 �3 / BOARD OF HEALTH BIGN URE OF OWNER OR AU R4ED-AGEttf F E E PLANNING BOARD PERMIT GRANTED 1 ee •c ••l t U 19 C�LJJJ �g� K J1,� BOARD OF SELECTMEN lo7b'7q BUILDING INSPECTOR f _ BUILDING RECORD 1 OCCUPANCY 12 \ SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI, FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS%OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT' I ` AREA FULL FIN. BMT AREA 1/ 1/2 ', FIN. ATTIC AREA - \ NO BMT FIRE PLACES _ - HEAD ROOM MODERN KITCHEN 4 WALLS I 9• FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINES EARTH GL ASPHALT SIDING HARD"./D ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME_ BRICK ON MASONRY --s..� ATTIC STRS. 8 FLOOR _ BRICK ON-FRAME CONC. OR-CINDER'B1K. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY •- WOOD SHINGES KITCHEN SINK - � SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL Bst^T-13rd I NOHEATING itAORT oVM of , over 0 -a No. - I rtt over, Mass. lgqS 0 CO "'�ATE BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..... ......................... Foundation has permission to erect.A-0�."' Q............. buildings on Rough to be occupied as-MYCL(a...Pu.bieA;��. A40 c6iJ.....6.......K. (........ 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 EXP MONTHS Final ELECTRICAL INSPECTOR UNLESS CON U S T Rough ............... Service BUILDING PECTOR 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 PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT P I t 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: �am LeiL Phone 6 LOCATION: Assessor' s Map Number �� � Parcel to subdivision Lot(s) Street C�� G� l � St. Number S ial Use Only************************ RECOMMENDATIO TQ4N S: Date Approved (— Conservation Administrator Date Rejected Comments , 11 tP o Date Approved =� - Town Planner Date Rejected Comments HAgent Date Approved Health A g Date Rejected Comments Public Works - sewer/water connections /7�/ /A) 7-1,l-�5 - driveway permit ��j i.J r7 ,- /GL ._ Fire Department Received by Building Inspector Date �. �..x E..l' t' �'•1`,`: fit <•�'+•,. z 1 0 ' '•C'S':c -'�i`�:1 �r.2:'.Y:•}'�:-. •�u:•..' h` 1 .�,•:�'P': .!':: f.-.i:..P.# CERT/F/ED' FOU.ND,Q T/O/I/'PLAN LOCATED /N SCALE DATE Scott L. Gi/es R.L.S. . 50 Deer Meadow Road North Andover,Mass. a SZ 79 . a_ scv { oa / I . � ADDiTgnl�� R•T%F,.Y THAT - OFFSETS. SHOWN ARE FOR THE USE vat" Of THEE,OFFSETS: OF THE BU%L D/!I/G/N-SPEC TOR r: ONLY :� � ���� . sh�Q1%YN COMPLY ` _AND SUCH USE/S FOR THE i ° N • �LY/Th!:THEZOMAIG . DE'TERWIVAT/ON-: OF ZONING AWS 0/. CO/VFORM/TY:OR-NON-_CONfOil TY s Fc' E f ao v e Ma WHE/V CONn ST .GYHEN Bl//L T' R�CTED. F' >� t NORT Town of L - 4Andover � L O NO .15. J o' ort " dover, Mass., k y 19q CUC 111Cnt WICK �. ORATED E BOARD OF HEALTH Food/Kitchen PERMIT,"; T Septic System BUILDING.INSPECTOR THIS CERTIFIES THAT 71��A.... s....�� $E. ................................................................................... Foundation I has permission to erect.,�X4.t�,�f�............. buildings on ...r�..�. .....'�'t�K.�.Z. .....'1� .....�............•.•••...... 1 to be occupied as,t4CLIq...�� i s��.....�A.Q�'�1:4 .'4- ...... .......... Chimney provided that the person accepting this permit shall In every respect conform to the terms of the applicati� on file in ...... this office P Y ff and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction ofC24(qb Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final (6-7 (01 PERMIT EXPMONTHS ELECTRICAL I SPEC R UNLESS CON U.. .. . .......VAA.L Ro ss..... . .... . . ............... Service BUILDING PECTOR �L 1) /C,5� Final l l 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 PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. ` SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT Oct