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HomeMy WebLinkAboutMiscellaneous - 6 GREEN HILL AVENUE 4/30/2018 6 GREEN HILL AVENUE 210/022.0-0096-0000.0 1 Date.....' ...�........�. . . ......... .. ,� OF NORTM,� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 88�cHus� This certifies that ....... .... ................ Y9A:... .... has permission for gas installation ...Y!i...........e/L....... . in the buildings of..... :�"0,t- -....................................................................:..... j at......../P............,... .1 �. 1.............................., North Andover, Mass. Fee -k) .. Lic. No. .....��1. °.. ................................................... ��i GAS INSPECTOR Check# (A �5 9314 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK ` CITY i1 = _ � MA DATE 17 JI PERMIT# JOBSITE ADDRESS -_ J��Q� OWNER'S NAME GOWNER ADDRESS ` TE FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL PMT ® RESIDENTIAL CLEARLY NEW:F-1 RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES NOF APPLIANCES 7 FLOORS- BSM' 1 2 3 1 4 5 6 7 8 1 9 10 11 12 13 14 BOILER ._. - j _ = _ IE _ .. I I BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER -.. - DRYER _... �1 _ .I A - - FIREPLACE -- FRYOLATOR FURNACE ( _ I�_ �- _ _ _J — _J t GENERATOR GRILLEJ � --- - - �^- -- E - - - - INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT _ L—� .._ ._._ _ —( -- - OVEN z T_ 1 L_ I L_ I POOL HEATER ROOM/SPACE HEATER _ ROOF TOP UNIT TEST UNI HEATER UNVENTED ROOM HEATER __ I WATER HEATER OTHER .............._.................... ... .......... .................. —i�f Imo--��z-_=�� L—__( _ INSURANCE COVERAGE — have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL,Ch.142 YES NO 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY P_(] OTHER TYPE INDEMNITY ® BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance cov"-11-;emeeY. A-r 142 of the Massachusetts General Laws,and that my signature on this permit application waives this re CHECK ONE ONLY: OWNER ® AGENT � SIGNATURE OF OWNER OR AGENT )plication re atrue and accurate to the best of my knowledge 1 hereby certify that all of the details and information I have submitted or entered regarding this appl will be in o pliance with all Pertinent provision of the ` and that all plumbing work and installations performed under the permit issued for this application Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 8736 S G ATURE PLUM BER-GASFITTERNAME ✓' _ (1(/� LICENSE# PAR SHIP[j# LLC®# MP El MGF El JP® JGF Q LPGI CORPORATION 23# el _I St COMPANY NAME: 7� t )1501 l--^-K� '--___ ADDRESS TEL (508) 295 CITY Vi/►� _ STATE ZIP . FAXL_ CELL = 83Zy6� EMAIL G✓ ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES i ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES a = b , AL OF MAS us , BERS AND - • '' • - i 'E® AS'A..Ma'�.STR ; W, RLl1{VICiFt--` r UESTAABOVE C(CGNSE l' = =W[7 f2"GE`STR MA 0i `! ID'j'__.. Q1/14 r,._��y',��_•t-•6•(.!�x?,:,4�Y:c'=: `. ::-•C:OiU11UtON1NEALTH OF IW ASSAC'tr# `,_ la 163=14n,Mimi _ _= PU]Uf-BERS AND OASFII`TERS -'=LI'CFN� 'D AS A JQU.RNFI'MANI?1.U11i1 i =TSS VES THEABOVELICENSET©= _ =' _ - :FARRZ--NGTON ;sem_ -I'6.5:r5 051OI114 ' u�/ vv/ LV1� t„,�� Vuuu,�Lu1V1 1\II WI I11L VUI\Jil\UVI 1t'1VL VL/ VL DATE(MMIDDrY” ��-- CERTIFICATE OF LIABILITY INSURANCE page 1 of 3. F08/29/2013 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER CONTACT 9villiq of Masaaehueette, Inc. NIAM I ONE C/o 26 Box Blvd. _NO._QM- 877-945 7378 FA%.No)! 888-467-2378 R. 0. sox 305191 D:rt ss ce tifica,te�g(rtWJ11Ja.GOlri NRObville, TN 37230-5191 I NSUR ER(8)AFFORDING COVERAGE NATO R INSURED INSURERA: The Chartor Oak Firo Snaurano9 Company 25615-001 R. H. White Conservation Company, Inc. INSURERS:TrevalArs Property Caeualty ccA>pany of Am 25674-003 41 Central street INSURERC:NatioA*l Union Piro Sneuranco Company o£ 79445-001 P. 0. Box 257 Auburn, MA 0150]. INSURER D;Travelers Indemnity Company 2565a-D01 INSURER F; INSURF,R F; COVERAGES CERTIFICATE NUMBER:20257680 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INT)ICATED. 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IJJJL NSR TrpE0FIN3VRANCE DD SUB P POLICYEFF POLICY EXP POLICY NUMBER �mminnrvym LIMITS A GENt7iALLIABILITY VTC2000 97�R9948-13 9/7./2013 9/1/2014 EACNocCURRENCE 6_ 2,000,000 X COMMF,RCIAL GENERAL LIABILITY pppp TO RENTF,p PR� 8(Eeoceulanc:f ,� _ 300_p00 CLAIMS-MADE OCCUR MEDEXP(Anyone arson $ 10�000 PERSONAL&ADV INJURY S 2 DDD,000 GENERAL AGGREGATE $ e}J 000 000 GEN'LAGGREGATFLIMIT APPLIES PER; PRODUCTS-COMP/OPAGO $ X000 000 POLICY NRO LOC B AUTOMOBILE LIABILITY VTJCAP 977K955A-13 /1/2013 9/1/2014 � $ �a1IrEDSINGLF.I-IMIT $ 2"000,000 X ANY AUTO BODILY INJURY(Perpemon) $ ALI,OWNED SCHEDULED AUT08 AUTOS BODILY INJURY(Peraceldent) $ X HIREDAUTOS X NON-OWNED AUTOS araccldent $ X Com g Defl X Coll Ped C UMBRELLA LIAR $ OCCUR BE8766140 /1/2013 9/1/2014 EACHOCCURRENCE $ 5�000,000 EXCESS LIA6 F—ICLAIMS-MADE AGGREGATE $ _"000,000 DED $ RETENTIONS =0,000 S j� WOREMPLOYMP'LI AILITTION VTRRUB 9205A105-13 9/1/201.3 9/1 203,4 X p AND EMPLOYER8'LIABILITY y N I T„O�y Ll 0 ANY ICEFUM MS RIPARTNDED? CUTIVEN NIA VTC2KUB 9203A77A-13 9/3,/2013 9/1/$014 E.L.EACH ACCIDENT $ 1,000 000 FR OFFICER/MEMBI;REXCLUDED7 LLJJ Mandatorrbadnd E.L.DIAEA9E-EAEMPLpYF.E S 1,000,000 rn 104) U KII•i uN u d Of't;RATIONS below F,L,DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(AttaCII Aeord 101,Add]tonal Remarke Schadmla,If more ep see Is rmqulrad) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of =nlauzance AUTHORIZED REPRESENTATIVE C*11:4197604 Tp1:1694012 Cext::20287680 9)1988-2010 ACORD CORPORATION.All rightsroserv�d, NCORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Allison Soucy Property Address: 6 Green Hill Avenue Policy Number: HP3016274 • Date/Cause of Loss: 2/17/2015, Water/Ice Dams File or Claim Number: 31208-W Claim has been made involving loss damage or destruction of the above captioned ed pro ert Y, which may either exceed $1 000.00 or cause MASSACHUSETTS GENERAL LAWS,WS, CHAPTER 143, SECTION 6, to be applicable. If an notice under MASSACHUSETTS GENERAL LAWS pp Y , CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Wade Anderson On this date, I caused copies of this Notice to be se t to the persons named above e at the addresses indicated above by First Class Mail. Signature and Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Location � 1 Nb. a Date 6 a3 ti NORTH TOWN OF NORTH ANDOVER so o,ti0 �? O� Certificate of Occupancy $ + i Buiiding/Frame Permit Fee $ d7 '' Foundation Permit Fee $ s�c14USE Other Permit Fee $ _ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �0 ZL 13 Building Inspector 3 L 1606/28/99 507. RAID 13'22 Div. Public Works P F,12n7IT NO. c> APPLICATION FOR PERMIT TO BUILD'""" --NORTH ANDOVER, 7A NIA I,No . oZ,=D, LOTNO. / 4, 2. RECORDOFOWNE:RSHIP DATE BOOK PAGE %ilNl SIIII DIV. LOTNO. v 1 LOCATION PURPOSE OF BUILDING 0 WN1cWS NAME NO.OF STORIES SIZE e iC 0WNFIVS ADDItESS BASENIENT OR SLAM .all vnq ?11 S7 2N° 3Ru A11CIIITFC7'S NA NI I 11 � � SIZE OF I LOOK TIMBERS KERS I ItIIIH)L.R'S NANIIi `G, �_ ."T7 SPAN 1)1S'FANCE'1'0NEAREST111111.1)ING DIMENSIONS OF SILLS DIS I'ANCE FROM STREET LA 0 1 DIMENSIONS OF POSTS 111STAN(.EI'ItONILOWLINES-S)DES Ltot REAR 7 1 t 1)1NIENSION S0FGilt DERS AREA or LOT FRONTAGE \ 3 4?(�� Z c� \ HrIGIITOF FOUNDATION ``✓�`� T� '1 THICKNESS1CTHICKNESS �1 S,r. 1. IS BUILDING NEW fy 0 SIZE OF FOOTING x Zt ISBUILDINGADDITION \teS M AJERIAL OF CHIMNEY IS BUILDING ALTERATION t-JD IS BUILDING ON SOLID 012 FILLED LAND BUILDING CONrOIIM'r0 REOUIRENIEN'I-S OF CODE e� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY �J�J dQ -gC�► IS BUILDING CONNECTED TO TOWN SE\VER • ��T /, q C LL A� ` -- IS BUILDING CONNEC"fED"r0 N 7"URAL GAS LINE -- �1 -- INSTIICI'IONS 3. I'llOPEIITY IN 1,Olt1\IA,nON LAND COST --� EST. BLDG. COST h I'tC;E I PILI,olI'si--cr Ns 1-3 EST.I1LDG. cos-r PER SO. r"r. EST. I11.DG. COS"1'PrR AODM FLEC IZIC NIFTERS MAST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. IFD GARAGES NIIISTCONFORNI TO S'I'ATE FIRE REGULATIONS 4. APPROVED BY: Q r PLANS NIIIST B1_FILED AND AI'1'ROVED In'BUILDING INSPECTOR BUILDING INSPECTOR f DATE FILED O\VNERS TEL# � � r- D CONTR.TEI.# 95 ' - ; 7j CON'I'RJAC# SICi.!A'I'IIRE OF OWNER Olt AUTHORIZED AGENT �O F1�.1 � 11F.161 IT GRANTED G o�3 19`�'g- - -- --Revised 5/5/99 JN1 • O P ,f Nusz` � ��o2d, %0 C:1 !: 20 NORTL A 0 V E R OFFICE OF THE ZONLNG BOARD OF APPEALS Cl�A_- s�RE (iCR71 r '����ITZ, 't�. C,1,Ct;l;'SETTS 0[8 ; Any appeal shall be filed -a cf zn appeal within (20)days after the ..... � 9 ca e of tiling of t us notice NOTICE: OF DECISION in the office of the Town Cieri. Property at: 6 Green uiil Ave. Nr"JVIE: Frederic c C. Soucy I DA T E: 5/1 ic0 ADDRESS: 6 Greenhiil Ave. I FE T I T iCN: OOC 99 North Andover, iMA.04,845 NEARING: 6i11/99 � The Board of Appeals held a recuiar meeting on Tuesday evening, May 11, 1999 upon the application of Frederick C. Soucy, 6 Greenhiil Ave., North Andover, NIA requesting a variance from the requirements of Section 7, paragraph 7.3 for relief of a side&rear setbac! in order to construe:a shed, and fcr a rear setack,n order to construct a proposed addition of a dining room and family room to the main house, said prccemy is within the R-4 nine Distrct. The following members were present: William J. Sullivan, Walter F. Soule, George Esriey, Ellen McIntyre. The hearing was aaienised in the Lawrence Tribune on 4/27/99 a 514/99 and all abutters aver nelified by regular mail. No persons appeared in opposition to the petition. Upon a motion made by Eilen McIntyre and 2"d by George Eariey, the Board voted to GRANT a Variance (dimensional relief) from the requirements of Section 7, Paragraph 7.3 to allow relief of ncht side setback of 10' for ? === said shed. and relief cf rear setack of 25' for said shed, and for relief of rear setback fcr proposed addition of 4 feet. The granting of this variance is in accordance with the Flan of Land by Scott L. Giles:`13972, Registered Land Surleycr, dated Si13/99. Voting in favor. Wiiliam J. Sullivan, Walter'- Soule, Georgie E riey, E:!en VIclrPire. The Board finds that the petitioner has satisfied the provisions of Sec�.4en 10,paragraph 10.4 of the Zoning Eyiaw and that the granting of these variances will not adversely affect the neighbcmgod or derccate from the intent and purpose of the Zoning Bylaw. Note: The granting of ti ie Variance and/or Special Permit as requested by the applicant does not necessaniy ensure the granting of a building permit as the acpiicant must abide by all applicable local, state and federal and building codes and r egulaficns,prior to the issuance of a building permit as requested by the Building Commission. Scard of Ap teals, William J. Sb!ivan, Ct-airman i Zcning °card of;"ppea s ml/1ScgdecsicrlS 7.. 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 �z .c PHONE `�J —s 3 LOCATION: Assessor's Map Number v�a V PARCEL SUBDIVISION LOT (S) STREET \zn 6 h—u— ST. NUMBER * ********************* **************OFFICIAL USE ONLY*********************************** 1q ya(o Rea r-- C-AAC)l�►on� RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED /��J DATE REJECTED COMMENTS G CS /,c�2 �S (^/ (C 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 9197 jm - t n Registry of Deeds Northern District of Essex County Lawrence, MA 01840 ,.. t 06/10/99 /99 FREDERICK C 50UCY KB # 95 Rei Type FLAN 1:x.00 Inst 21 8° Copies 1.25 # 9G Rec: Topa CERT 10.00 8 2 Inst g_ 17 , Fostaiae 0..a� Total 24.58 ,. . t 40.00 9Fanen .a sh # 98 Change ,. - .. . .. Thomas Burke keTHANK BJ. , _ Register of Deeds North Andover Building Department Tet: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number q is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: G 10-PS6D-1 C., G k." % (Location of acility) Signature of Permit A plica Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector \R i w1f The Commonwealth of Massachusetts • Jt Department of Industrial Accidents Ctfice of lnvestiaatiens hl Boston, Mass. 02111 Workers' Compensation Insurance Affidavit flame Please Print flame: — l -�' L c c i c n: C.t v Phone C1 am a homeowner performing all work myself. CI am a sole proprietor and have no one working in any capacity I am an emclGvver providing workers' comcensaticn for my employees wer'ing on this job. Company name' LA-%-� _ Address j U' d City' f V r. v.�l� .,..�, Phcne . 3 Insurance Co (`�"-,A OL Folic•✓m -2-L LJ L �' Comcanv name: Address city: Phcne-: Insurance Cc. Policy T Failure to secure ccverace as re--uireo under Sec;ien 25A or MGL 152 can lead to the imp rien of criminal penalties of a r ne unto 51,cu0.00 andlcr one year✓'impnscnment as well as civil penalties in L e Perm c a STOP CRC'ER and a rine--, (�1 CC.CC) a day against me. I understand that a cccT:~is Stc[e.T.ent may to rOnNarced to the Or'Ice of Inv�zt;gaticns ct the'D'IA icr cc verace venric3ticn. I do here cen.,✓under,,e oeins -nd penaitie or pequry the se in�cr lion cr vi ed above is True and cc.rep:. SlcnClure V Gate l Print name Phcne T L� �- � Official use enly ,/0Gt'Nnte in This area to to completed by cty cr tewnic:ai Cry cr Tcwn (� Per„it/Licensinc � - - C-ufidir1G Dept [Check,d imrnediaie res.cnse is required ❑ Licensinc- Board selectman's Once Ccntac:,person: Phone Health Department C Other ORTH Town o �� �. �?� ..� -.. .. Andover 0 a 7 X LAKE -lO ndover, Mass., 40 /02 q A- COC MICNE. RATED P`P' 7PARC�EL SSAC HUSH IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT Ir �0 d .... . ..... . Y „(�? has permission to excavate and pour foundation at A .... ........ ..for the purpose of.. K Oz.. ...... .f Ia �'�!I�y... r�i 11�........�alab �II� <iw ,"_.. �.. IFr-, is.„ ts�t.t. 3•a[i �Ttiexperson Haccepting thispermltmustreturn,tp-the office of the Building Inspector a;certified�plot�planhow� of biiildin thereon before Foundation will be inspected. ►�} +-a5' e iZ '"S- b j� g VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. ...................... .00004 40 ... BUILDING INSPECTOR NORTH Town . of ` D; L ®ver .No. o;t(a o�� owerass r E d , M ., O Hii�W1� O '0 /go 9P RATE D S 5` BOARD OF HEALTH PERMIT T Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT. �rIC .. ...So c .. 111MA). t � 19 Foundation I4. X r, �ti........�/.... ...... .... v... Rough has permission to erect... Y. �...... buildings on......... ........ .. g ........ . .. .. . to be occupied as......... IIS/, /POO/N /.7 /e 4J 4 � �J����t�� Chimney .. . . . .. . . .. . .. .... ....... . . . .. . . . Ch' 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-La s relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. i B A O K'4 F-9- 1 o'R i atit 5' r e a r o,. s i%r-d +- * PLUMBING INSPECTOR y' Roar- e..i aolJi*k VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough MAP PERMIT EXPIRES IN 6 MONTHS Final LESS CONSTRUCTIO STAR ELECTRICAL INSPECTOR PARCEL Rough ..................................................... Service 00 BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. PLAN OF LAND IN .� NORTH ANDOVER, MASS. OWNED BY FREDERICK C. SOUCY& ALLISON E. WYLLIE assumed SCALE. 1"=30' DATE.3/30/99 0' 30' 60' 90' Scott L. Giles R.P.L.S. Frank. S. Giles 50 Deer Meadow Road North Andover, Mass. ' EXIST.HSE. EXIST.HSE. FND. FND. L i ' . Lu 130.00' Q µ./ sxlo F. ' N LOT#1 1 s �.. 13,000 S.F. W 26 364 S.F. PROP. ADD. o 40.5' C) 0 ' o EXIST. HSE. FND. o 1550 S.F. o SHED HSE.#16 HSE.#6 ' 38'+1- PORCH ` i� 130.00' GREEN HILL AVE. THE PROPERTY LINES SHOWN ARE THE LINES DIVIDING EXISTING OWNERSHIPS,AND `N Of STREETSTHE LINES OF AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS S OR WAYS ALREADY ESTABLISHED,AND NO - NEW LINES FOR DIVISION OF EXISTING ES 0. 13972 �o OWNS H!P OR W W Y A E SH3m.�� fFCISTERE� t LAND sJ THIS IS TO CERTIFY THAT I HAVE CONFORMED WITH THE RULES AND REGULATIONS OF THE 330 9� REGIS ERS OF DEEDS IN P EPARING THIS PLAN NORTH ANDOVER BOARD OF APPEALS NOTE: SEE ASSESSORS MAP 22 PARCEL 96. DEED BOOK 3187 PAGE 307. LOT 1 PLAN 4075. THE ZONING DISTRICT IS R-4. DATE OF FILING: i4 bATE OF HEARING: A DATE OF APPROVAL: 0 F = � REAR ELEVATION 1 r RIDGE VENT 1/2' CDX PLYWOOD SHEATHING RIDGE BEAM TYPICAL CROSS SECTION 2 X 10 AT 16' ❑ . 12 SCALEi 1/4' = 1'-0' �6 R-30C INSULATION EAVES DETAILi /' FINISH 2ND FLOOR 1 X 10 PINE FASCIA 1 X 8 PINE SOFFIT ; CONTINUOUS SOFFIT VENT ' METAL DRIP EDGE ICE/WATER MEMBRANE AT EAVES TYPICAL EXTERIOR WALL, GUTTER AS NOTED ON ELEVATION DRAWINGS 3/4' T&G PLYWOOD SIDING ------------------------ NAIL _-___--__-_ ______NAIL & GLUE TO FRAMING TYVEK OR EQUAL BUILDING WRAP 1/2' CDX PLYWOOD SHEATING 2 X 4 STUDS AT 16' O.C. R-19 INSULATION R-13 FIBERGLAS INSULATI❑N POLY VAPOR BARRIER 1/2' GYPSUM WALLBOARD SILL ASSEMBLYi FINISH IST FLOOR ANCHOR BOLTS/STRAPS AT 8' O.C. / -`------MATCH EXISTING FLOOR ELEVATION 2 - 2 X 6 TREATED SILL SILL SEAL INSULATION GASKET CONTINU❑US RIBBON JOIST BOX SILL �`._ . % FINIS GRADE 2 X 12 AT 16' O.C. FLOOR JOISTS SLOPE • J • C3 z DAMPROOf ING ` CONTINUOUS BRIDGING AT CENTER SPAN o Z POURED IN PLACE CONCRETE FOUNDATION & FOOTING 0'-10' 0'-5' `' °. 0'_5• PERIMETER FOUNDATION DRAINi ` 4' DIAMETER PERFORATED PVC PIPE 3/4' CRUSHED STONE 4• vv vvvvvvvvvvvvvvvvvvvvvvvvvvv p . '- FILTER FABRIC ENCLOSURE DISCHARGE DRAIN T❑ APPROVED 'L❑W 1'-8' POINT' 0 NFIRM ADEQUATE SOIL BEARING CAPACITY 4' THICK CONCRETE SLAB POLY VAPOR BARRIER 8' GRANULAR BASE 61-6# 13'-0' 'AND RSEN' T2642 X 2 'ANDERSEN' TW2 42 X 2 RIDGE BEAM CATHEDRAL CEILING FIRST FLOOR PLA N 0 2 - 1 3/4' X 11 7/8' o i. MICR❑LAM LVL CEILING FAN cu m I x SCALEi 1/4' = 1'-0' I N a RAILING & BALLUSTERS FAMILY ROOM N ` LJ 12' HT. WALL F' won W T ❑ C P z A M ti a 3 ( I REMOVE EXISTING Z WALL _ ¢ o W m d DN 14R TO BMT. ALIG N WALLS I DC — — -� • L_ x x 1 NEW' SINK EATING z I BATH \--i' W DE C.❑ BEAM PROVIDE' WALL 4 X 4 POST 2 - 1 3/4' X 9 1/2' Lo SPACE FOR KITCHEN I ❑LAM LVL SWITCHES _ TYPICAL AT END BEAM H w REF. STOVE DELETE EXISTING EXISTING WALLS & REFRAME STAIRS AS SHOWN, T REMAIN 5/8' TYPE X GWB - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i t RIGHT ELEVATION SCALE, 1/4' = V-O' El 0 11 IL LEFT ELEVATI❑N SCALES 1/4' = 1'-0' CERTIFIED PLOT PLAN assumed LOCATED IN NORTH ANDOVER, MASS. to,(��/ a SCALE.1 30' DATE :7/19/99 `a� �1 Scott L. Giles R.P.L.S. 2 8�4- 1910PAO(d Frank. S. Giles 50 Deer Meadow Road /� North Andover, Mass. C��p / e e/V `k ko NOTE: SEE VARIANCE PREVIOUSLY GRANTED, /27 C/) 130.00' O N LOT#1 13,000 S.F. W 26' EXIST. r n ADD. V Q) 40.5' o 0 Q; EXIST. HSE. FND. o 1550 S.F. HSE.#6 38'+/- rP6RCH 1 N 130.00' GREEN HILL AVE. I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE �P�tN Or a THE OFFSETS OF THE BUILDING INSPECTOR ONLYo''� S SHOWN COMPLY AND SUCH USE IS FOR THE C1 WITH THE ZONING DETERMINATION OF ZONING 3972 0 s BYLAWS JSTER CONFORMITY OR NON-CONFORMITY EOo NORTH ANDOVER l LAIN s WHEN BUILT WHEN CONSTRUCTED. 0RTEy Town 0 10. Andover No.4 to y —P �OLA AKE Ol ildover, Mass., �J COCMICMEWICK drr3?''^T� ar rF I "ATED �SSACaUSE I Fun LAt;AVAT1 (') N AND FuUNUA 1--lu" N , ...C.4 0 THIS CERTIFIES THAT . ... r &f i • has permission to excavate and pour foundation at for the purpose of............. ............... .............f ... .... XF....... ........, �........................ .. The person accepting this permit must return to,the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. `p,* 5i./,e (R j h 1� 4- p,51 kca r m N s h e C-1 I �- !�/ ��e d r o�✓ �1c�ci c�-ni� S VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. ............................. . .............. BUILDING INSPEC'T'OR PEfUttT No. APPLICATION FOR PERMIT TO BUILD — NUKI" ANuuvER, n.v►aa. - MAP X10. LOT NO. a RECORD OF OWNERSHIP JDATE V (BOOK 'PAGE ZONE SUB DIV. LOT NO. 1 LOCATION O PURPOSE or SUILDINGQ OWNE11'S NAME �J NO. Or •TORICS f12 OWNER'S ADDRESS WASEMENT OR SLAW ARCHITECT'S NAME 11112[ OF FLOOR TIMBERS 19T 2114D 2RD BUILDER'S NAME *PAN ` .DISTANCE TO NEAREST ILDING DIMENSIONS Or SILLS DISTANCE r110M STREET POSTS DISTANCE FROM LOT LINES -- SIDES REAR I GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW - - SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER If BUILDING CONNECTED TO NATURAL GAS LINE a PROPERTY INFORMATION INSTRUCTIONS LAND COST SEE BOTH SIDES EST. ■LOG. COST !00 EST. BLDG. COST PER 00. PAGE I FILL OUT SECTIONS i - a EST. BLDG. COST P" 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 STAT[ FIRE REGULATIONS PLANS MUBT BE FILED A p APP OVED BY BUILDING INSPECTOR GATE D /O ` r SWILDIN6 INSPS+CToR SIGNATURE OF OWNC UTHORIZED AGFWT Owners Tel 4E Contrac� Tele OMKANIT &RAMTRD \� Contra. Lic # t4ORT Town of - over No. �,K : w dover, Mass., D G o`Z� 197, 0 -T9 COCH ICME WW ICK yV�• A0 E S E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT ...... .. ......� >U.K.�` .............. BUILDING INSPECTOR .....................................f.:................................................. Foundation has permission to erect....l�n./�1 r,✓....19V/buildings on ........1;.......�r.. ... .!... ! ........................... Rough t0 be occupied as...... . I..�l,c�if..... . A,,,�t../. ............. ......./ .. I4t !1cxN.f"..�. l�.ti .. 5. ....................... Chimney provided that the perm acc'bpting this permit Shall in every resp conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S ARTS ELECTRICAL INSPECTORRough ...................... ........... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. o� �) Burner �.-ecq r Street No. r 4 k b CH Det. - N22033 Date.... r :.r..��. f yORTM 1 o TOWN OF NORTH ANDOVER '° PERMIT FOR WIRING +O'er.°•�,�� SSACHUSE� This certifies that ........ C �t....... 1............................................ has permission to perform ......... S�. ..c�:..f.`Q........ ..'?.ri .......... wiring in the building of............o,!. .` ..{. ............................................... at.......cr..... .......At..5d....................... .North Ando�veerr,,Mass. tFee. ., Lic.No. �J / ..... A5.,.nt.......... /11LECTRICALINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer m col 'L�i�.� UF1 UST �T office Use only _ LE'A4R7.t3EVTOFPUPLICS IFE^lY: PerniitNo. BOARD OFFMPREYEMONREGU.A77OiNS S?7,CW R l -00 -: • Occupancy dc.Fees Checked Al Lil 1.A7YO Y FOR R.L:i1�1Y111_ TO PliiCdL'i0RMEL=CAL Y i�'O ALL WORK TO BE'PERFORrMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL.CODE;527 C,'\IR 12:00 - (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) , Date o� ...,Town of.North Andover: _ To the Inspector of Wires: . The undersigned applies fora permit to perforin the electrical work described below: .--.-..PARCEL Location(Street.&Number) - - OwnerorTenant Stec) Snr ,r_'2( Owner's Address3n'_D -Is this permit in conjunction with a building.permit:. - Yes No (Check ate _ . .. -- Gv4(�b{)Purpose of Building -Utility Authorization No. ... Existing Service Amps / Volts Overhead.: Underground r7 No.of Meters `.!, Neyw Service �Q�_ Amps /2t Volts Overhead ®`Underground No.of Meters Numbef of Feeders and Ampacity - LWation and Nature of Proposed Electrical.Work S-eSv t,Cw C,•C�q No..of Lighting Outlets No.of Hot.Tubs No.of Transformers Total - - KVA No.of Lighting Fixtures Swinuning Pool .Above" Below Generators -- KVA - -.... ground and No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners ' No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones a. Tons _ No,of Disposals No.of, -- Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of II)ryers 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 - In�aanoeCo�aage Assim�iditiei�ats6flvl�ada�IsC�lIaws IbawaalamImb&y> Pcncymclt>d%C=P]ee CO%uageod>issi>ltalec� YES E:1 NO 0 Il>av &bmttedvabdp dcfsametothe0fceYES M NO If3wlawd3x dYFS,*&Tz &-e pecfwwrd Fbydiadmigdm INSURANCE E] BOND OTHER F-1 (PleaseSpe* ETmhcnDahD- \\ EstnEdedvahrdacbmlWak$ WodctoShatt d ' Final SigoedimdaTiePmrhm cffp3jW FI);;N� Ltae�eNa ucar P�e\<_ Q;`-w1yw� Sig=xe =apt 0 �,f )3t l� is 4 C .{, mTeLNa K l -33 Address\2�`\ c�c.��W� S ��iC)-P_V� AIL TCL Na -- OWNER'SINSURANCEWAIVER,Iamao),=ti-uttheLrensedoesathaw rina m= critssutdantialeexaiva)entasmpffedl_'1V1<ud�GmnlIzm and#ntmy%pawmrnitispmritapp}imimwam' d-liSm#=mi (Please check one) Owner Agent �� d Telephone No. PERMIT FEE$ rs_macure of caner or Agem No 1961 Date.Z�..r—)...... ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING It sACNuS Ihis certifies that ...... ................................................................................. has permission to perform ..................................................... wiring in the building of......................... .................................................... at....... ........... .North Andover,Mass. !N Fee-:.'O' ................. Lic. .......................n....... .. ...................... ELECTRICAL INSPECrOR YA WHITE:Applicant CANARY: Building Dept. PINK:Treasurer „..: 7 :L,ONMON EALTHO 'L� �U� Office Use only LEP,4Rff1& TOFPMLICSr1= P�mit No. < BOARD OFFNEPREVEVHOiVREGU A77ONS527GY1R12:00 �1r--rry Occupancy&Fees Checked APPIIICA170NF0RPERA1flT T0FERF0"==CAL 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) Date 10- _2Z /�l Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. PARCEL Location(Street&.Number) Owner or Tenant F.eea2 �'v c Owner's Address q Is this permitin conjunction with-a-building permit: - - Yes No (Check Appropriate Box) Purpose of Building �( //�„,' Utility Authorization No. Existing Service -0 d Amps P o / P-raVolts Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampaciry _ Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of LightingFixttaes Swimming Pool Above. Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Bumers No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. i Total 3 FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and _ Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local MunicipaL. Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER. 2 r`i 6 iLe h se—,! A/G Q, R A9i 4E` 17/7,,o"�e h>ris�iceC Asstm�totbe eaial�efNlassadatseltsC�aallaws YES NO Iha�aa>zzeraI�yh�uaaoce�cYIIrhldalgC�e orilsst>�alecgri�a)errt IhaveWbiigedmbdptoofofs=btic-Ofce YES F7 if mhmdod�edYES,*aemkatedre peofwzagebyd326m�itr INSURANU ,�Bc� F7 011-Ix [7 ( ) 42 �JA6 ES�Valwc[Decbcal%k$ Wo”Stmt hTecfimDatcReqrsted Rargh Final Signedt.m��ieA�Iakiesofpajtuy: I.icer>reNo. A��Sa � F1I2MNAME a I-Msee Sismature ° L.cereNo amx:ssTeL-i\b e x a Arlle�? AIL Tel.Na OWNER'SINSURANCEWAIVE ;IanawatedmttlrLice=doesrmthAwtruistuartce cov=T crrtsaitn>tales}�asregmedbyMassadmisetGairalLaws arrlthatmysi�ahaernthispmrritapp} ttirnwai�s tins re4mzrrart (Please check one) Owner 7 Agent Telephone No. PERNIIT FEE$ Jrtmamre of Uwner or OcnL N-° 1 807 Date.r!'3 .t- ' ........ NORTF� ° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHU This certifies that.;= ................... ... ............................................... i has permission to perform ....,-.--,-3 ......................................... wiring in the building of -... ............... lt.Z�..... ..a - .... .. ........ ,North Andover,Mass. ,t.Fee 7.... Lic.No'9.Pds�`'i ... ELECTRICAL INSPECTOR � l 08/10/9914:35 75.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer V ,t•... ..'`+."' ver,ThE 'W l� TH®FARSMC=v' "SOfficeuseonly DEPARTM.FNfOFPUBLICS4 E7YPerrrut No.BO*OF MEPREVFJVI70NREGULA770AS527CW 12.00 Occupancy&Fees CheckedPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (1 (PLEASE PRLN-T IN INK OR TYPE ALL INFORMATION) Date Town of North Andovertijgp, V To the Ins e for f Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street &Number) ��r h\\\ Ave— Owner PARCEL or Tenant sn ye z Owner's .Address 1 Is this permit in conjunction with a building permit: Yes-1No a (Check Appropriate Box) Purpose of Building WP-M Utility Authorization No. Existing Service Amps / Volts Overhead F7 Underground .a No. of Meters \e%v Service Amps / Volts Overhead = Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work G6 C-- i No.Of Lighting outlets No.of Hot Tubs No.of Transformers Total KVA No of Lighting Fixtures ` Swimming Pool Above Below Generators KVA _ r and eround 17 N'o.iof Receptacle Outlets No.of0d Burners No.of Emergency Lighting Battery Units No of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No of Disposals N'o.of Heat Total Total No.of Detection and Pumps Tons KW o.of ing.Ding D No of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No of Dryers Heating Devices KW Local Municipal Other � Cortnec F7 No of Wale,Heaters KW No.of No.of Sims Bailasts No Hvcro,Massage Tubs No.of Motors Total HP .o OTHER- lnsu Caere Rastm�t sa the cl�vlassdd Ca�rai laws I Fare a a3re�Liability htzrar Peticy Ca r>pie� °�Coaa�cr iLs st# atl ec�ivala� YES v0 1 have a bmmEd valid aoofofsame so the Owe YES U NV Ifjcu have chej,e YES,please rdme tie type cfcg, e by d'eJtg ttte apprt�z-.�z� [INSURANCE BOND OU-ER a (P1ee SpecilY) Ewart Date Estirrmd tart � (-2'`\\ C� V'alt2 ictl Wait S Wain to S �Rq� �h Sig, ta�v e , ofperj y. FIRM NAIL Lia 1seNa GoS QX S+ C r mac J Lax crse? �, �0�� BusinesTeLNa -7� l- 32��1 'Ct 37:� ,:,, 12��� SG��� S� ��,>,e��-ems oa�� ��� AiTeL\c O WN-R'S L'NELRANCE WATVER;1 an zro,=diat±r L=isc cDm rnt[fny if e r<ararx e ccs a3s sharaiat e# z as m#i2 i by� C Lars and tti mysig m-reat this p=mapp6=m waives this=== (Please check orae) Owner Agent Telephone No. PERMIT FEE S a Date. 192 s OF NO oT 6,,ti - TOWN OF NORTH ANDOVER . `+ ? 0A PERMIT FOR GAS INSTALLATION SACH This certifies.that :, R . . :�j. P V.. . . . . . has permission for go,i s'allay n ) in the buildings of . .Q.v. _ . at . . c j.�. : . . .-f. North Andover,.Mass. Fee. . :'. Lic No.. x.(.4.7. . . . . ... . owOAsINSPECTOR WHITE:Applican CANARY: Building.Dept. PINK:Treasurer. GOLD.File n � J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN_ G (Print or Type) l NORTH ANDOVER Mass. Date �uilding Location G' G/L(ycWh lL C Adz Permit #�� 3 ' Owners Name -Mr iAr_-:s • New 77 Renovation Q Replacement dans Submitted D FIXTUP_I fn w N Zin oNc _o a N LU = t- aO x z o F Z m 0 r w o o Q a � a ul-CC s .. Z t- v� > 4 N c v = � d Q o o W LU LU 0 W z r, W 0 Z U. 2 d W < m d ,u > C W < G < < O O W E O W N SUSi—BSTMT. BASEMENT i IST FLOOR 2ND FLOOR 3R11 FLOOR ' 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TK FLOOR STH FLOOR (Print or Type) Check one: Certificate Installing Company Name_6zy_' 6,-&CA Q Corp. Address J� 1 10A'ao Q Partner. N6. Aa'Tz�oczq K_ Firm/Co. Business Telephone: /� Name of Licensed Plumber or Gas Fitter HAz H . i . uCp• Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Q Other type of indemnity Q Bond Q Insurance Waiver: I , the undersigned, have been made aware that the licensee of this p i tajn not have any one of the above three insurance coverages. Inature-qf o ne a enof property Owner Agent Q I hereby certify that all of the dctails and information t have submitted (or entered)in above application are true and accurate to the best of my knowledge and Mat all plumbing worm and installations perfomted under Permit isseed for this application wilt-be to eompiianoa With all peattneat provisions of the Massachusetts State Gas Codc and Chapter 142 of the General Laws. By TYPE LICENSE: 4 ' Plumber Title Gasfitter- Signature of Licensed City/Town: aster Plumber or Gasfitter Journeyman I I APPROVED (OFFICE USE ONLY) License Number Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec 3B To: Building Commissioner or Inspector of Buildings RECEIVED City Hall North Andover, MA 01845 AUG 2 7 2007 TOWN HEA�THNORTH DEPARTN E�TER RE: Insured: Frederick&Allison Soucy Property Address: 6 Green Hill Avenue,North Andover, MA 01845 Cause of Loss/Date: loss due to Water Damage Loss of 7/5/2007 File or Claim No: BOSO44977 Claim has been made involving loss, damage or destruction of the above captioned property,which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 313 is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Mark Randall Adjuster On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. 6 d Q Signature Date NEW ENGLAND CLAIMS SERVICE, INC. 100 CONIFER HILL DRIVE, SUITE 308 DANVERS, MA 01923 Phone:1978)777-9900 FAX:{978}774-9296 NEW ENGLAND CLAIMS SERMCE, INC. Incorporated 1985 ❑ Reply To i'�`'@� Reply To ❑ P.O. BOX 345 100 CONIFER HILL DRIVE, SUITE 308 N"I ~t DANVERS, MA O1923 MANSFIELD MA 02048 ";°°""��� > UNDI:PENDENI , TEL. (508) 337-8058 AD9Us ERS TEL. (978) 777-9900 DY FAX (508)339-5835 FAX (978) 774-9296 wrandall@newenglandclaims.com RECEIVED Form of Notice of Casualty Loss to Building NOV 2'S 2005 Under MASS. GEN. LAVAS, Ch. 139, Sec. 3B TOWN OF NORTH ANDOVER HEALTH DEPARTMENT To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectmen RE: Insured: Property Address: r�� G�- 4,— Policy Number: . Date/Cause of Loss: � — File or Claim Number: ���'z� Claim has been made involving loss, damage or destruction of the above- captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and, include a reference to the captioned insured,'location, policy number, date of loss and claim or file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Clms Adjuster to