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HomeMy WebLinkAboutMiscellaneous - 73 HAROLD STREET 4/30/2018r ' Date ..... ........................... W ;•t co TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that..LU / ti K � /,r c .......................................................................................... has permission to perform e n !c I? cj e 00 AMP s...... ..... �.............P.�.....:............... a......... wiring in the building of ....Pr --+e- . �..... ............................................................. 113 - t7 45- /-1 .. R D f S a .......... , North Andover, Mass. Fee .......5 ....... Lic. No. 80?A....... .. .p� ... ELECTRICALINSPE R *r Check #3� 4,W61 Vllll;ldl VSt; Permit No- - � Dyxust puG Sam ji BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy &Fee Che( APPLICATION FOR PRINT TO PERFORM ELECTRICAL WORK All work to be performed in accoid ce with the Massachusetts Electrical Code 552277 CMR 12/:00 (Please Print in ink or type all infortnation) Date/ To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number Owner or Tenant �� 4 Owner's -14, / Is this permit in conjunction with a building permit Yes 0 (Check Appropriate Box) J Purpose of Building (� / ( Utility Authorization No Existing Service Z00 Amps Volts Overhead 0 Undgmd 0 No. of Metl New Service�_Amps Voits Overhead 0 Undgmd 0 No. of Meta Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO, If have checked YES please indicate the type of coverage by checking the appropriate box - INSURANCE - BOND - OTHER (Please Specify) /) �, �, �y Estimated Value of. Electrical Works_ (Expiration Date) /��'�% Work to Start Inspection Date Resquested Rough RnaV '".'1 V Signed under the Penalties of perjury: FIRM NAME LIC. N s/ . �y...... l +-7 LIC. NO. sleLe" Df/e I�'/� / c G✓l / Bus. Tel No. ���'G�J / Addres J'' /�/W Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $�� (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In 0 No. of Lighting Fixtures Swimming Pool gmd 0 gmd 0 Generators KVA No. of Emergency Lighting No- of Receptacles Outlets No. of Oil Bumers Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone _ No, of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices _ Heat Total Total No. of Diposall No. Pumps Tons KW No. of Sounding Devices _ NoJ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices _ No. of Dryers Heating Devices KW 0 Municipal 0 Other Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Badases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO, If have checked YES please indicate the type of coverage by checking the appropriate box - INSURANCE - BOND - OTHER (Please Specify) /) �, �, �y Estimated Value of. Electrical Works_ (Expiration Date) /��'�% Work to Start Inspection Date Resquested Rough RnaV '".'1 V Signed under the Penalties of perjury: FIRM NAME LIC. N s/ . �y...... l +-7 LIC. NO. sleLe" Df/e I�'/� / c G✓l / Bus. Tel No. ���'G�J / Addres J'' /�/W Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $�� (Signature of Owner or Agent) N° 2145 Date .... U.b.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .........:.� .:,. � :..l. .L v...... ....... �. av......... � ............ has permission to perform ....� ?..u.� ....� ! ��!! ?..... S. F .e..f. �. Q- .......... wiring in the building of ......�...L.. �tt ..........:........'......................................... at ...... �.............. .` �t {A..... ......................... . North Andover; Mass. ' gee �/,c:) Q,t,1)... Lic. No. 7 .5..'J.!2... + .`. `.. .(.... ELECTRICAL INSPECTOR C � 0 �71 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THE COMWOIVWEALTHOFMASSACHUSE7TS DEPARTMENT OFPUBLIC SAFETY BOARD OFFIRE PREVENI70NREGULATIONS 527CMR 12.1110 Office Use onlx Permit No. Occupancy & Fees Checked APPLICATION FOR PERMIT TO PERFORM FTECTRICAL 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 s e/ 7,, ,2aa.) 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) rJ /71 Pd 1] S' Tenant 1R 7,„ ,4.2./ 2 Owner's Address Is this permit in conjunction with a building permit: Yes Ea No E3 (Check Appropriate Box) Purpose of Building Pp(/ p(.p Utility Authorization No. (7d ) 7.) J Existing Service Amps / Volts Overhead Underground 0 No. of Meters New Service /%a Amps /4/ a £/(,Jolts Overhead ED Underground ED No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1 r./A//zti /02:•1;r4/5 , e r a c-. 4-42 No. of Lighting Outlets Nt. of Lighting Fixtures No. of Receptacle Outlets li No. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers No. of Dryers No. of Water Heaters No..Hydro Massage Tubs ti O1;pER• KW t No. of Hot Tubs No. of Transformers Swimming Pool Above ED Below ^ Generators ground ground t No. of Oil Burners No. of Emergency Lighting Battery Units Total KVA KVA No. of Gas Burners No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Heat Total - Total No. of Detection and Pumps Tons KW Initiating Devices Space Area Heating KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Heating Devices KW _ Local ED Municipal Connections No. of No. of Signs - Bailasis No. of Motors Total HP h>xuraceCoter. PasuanttottetequireirezatMassaclusettsGersall2WS I have a a inert i.iabtldy hmraize Pblry indt>d'ntg Canplde Ihmesutxr»tteckelidptoatifsametothe0llie YES INSURANCE a BOND OTHER Cckeagea•is subsertial egihelet YES i cuhai.edhededYES,pleaseixfotethetypeofoo eragebycheddngihe 1111 wcdctoStat a0D' InspecticnDaieRequested F1RMNAME ef*,�� Other No ll (PleaseSpedfy) (/ ExpiraliortDate EstirrriadVaiuecfE ieai Wade $ Final Ra l LicaseNo. Lir�at9ee /as (2? 2? 7'i 2; � �LSigma=! GL- G� �'�L--�� Lke seNo BttTd1.Na 7S. (- 5Y3 -SCf S AiTei Na /n" 7 — OWNER'SIN5URANCEWAIVER;IanawarethattheLieensedoes not howtiteicstrareoomagetrissrbsarttiaietgrivalatasreguiredbyNfassachsettsGeaalLaws wdtha mysignatiaecnttaspemitapp mwai�sttsrely. (Please check one) Owner ED Agent Telephone No. PERMIT FEE $ ( /(1r� f off n N2 2/-50 NOR7F� 0 Date .:.r :./7 .. ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING r l This certifies that . ' `KK ..........................:.................................... has permission to perform.!:.-::: ............ :...................... ............................... wiring in the building of ........ .................................................. at ......?...:.....:�[:� -�^�Y. ' .// , North Andover, Mass. Fee... :.............. Lic. No�//ice .....:."...�� `��=?�................. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. �X> Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: 1412% -Al 15UeuQr To theIn pector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) / 3 Ila----iLrvvW St Owner or Tenant Telephone Na Owner's Address SAM4E M 9le- t;S7- yes Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Boz) Purpose of Building �S1,71k 1�i i<h,. G�ot,� �in�. Utility Authorization No. Existing Service b Amps /ao / o?ya Volts Overhead 9 Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Meters _L No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans o. of otal Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Ve ❑ - ❑ red. red. o. o cy rg g Batte Units Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total 3 Tons s No. of Alerting Devices g No. of Waste Disposers eat Totals umber ons .....__. o. o - n e ontae Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security steers: No. of vices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications WHIng: No. of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCES BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work:00(Expiration Date) �0 ..— (When required by municipal policy.) Work to Start: V2 8 DU Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: Thomas J Argento Jr. Electrician LIC. NO.: Al 1137 Licensee: Thomas J. Argento Signature tpT,vy LIC. NO.: E16356 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-263-2971 Address: 260 Massachusetts Avenue Boxborough, MA 01719 Alt. Tel. No.:- fax 266-9670 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. u A � Y u W i uP-4 q • s 1� W Y< _ < v V N ts s s s t � fvV ol um 6-s R H sr U `O *CUP (j -v, or Lu Z Waw LD =in o: .. GAS a Ua CA L Q O Z m ,ry In AS A RECOJOfiIEMECTRTIC I 19M IM UCE W TO THOMAS J ARSINTO JR Im PASS AVE a 1NXSORO NA 01719-0000 $571t! Location �73 No. Date U TOWN OF NORTH ANDOVER a • : Certificate Occupancy $ ; of �SJACMUSEt� Building/Frame Permit Fee $ , + Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r / �i 3 7 J Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: / DATE ISSUED: SIGNATURE: Building Comnidsioner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: gy2� & l,� ""L// Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Dia6c—t Proposed Use Lot Areas Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided ReqWred Provided 1.7 Water Supply M.GLC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zona Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record z / z, Name Print) Address for Service: Signature Telephone 2.2 Owner of Record: /111111h Y / Z/Z, Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ��7 Licens Construction Supervisor: � r 6Aa4<-,,11 / License Number Address ` O - %Q 6a��, a4l� 7� _ 737Co Expiration Date Signature � Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name V Registration Number 7- 7- Address, -67 Expiration Date Si nature —telephone 9 r 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 ....... ❑ SECTION 5 Description of Proposed Work check applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: <e /j - I SECTION 6 - FSTTMATF.D CnNQTRTTrT11n1V rnCTc Item Estimated Cost (Dollar) to be Com leted by permit applicant {# £IA , USE oNLy, 1. Building _ (a) Building Permit Fee Multiplier /�, 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 �c.�,iivi� is vYv1�I.ictluinviCiGA11V1�1 IV lir, %-UiVlYLh1hJJ WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, :3�r �9/ , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative t work authorizeAy this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, ,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 Signature of Owner/Agent Date Town of North Andover I NORTH q O SS4E0 6 6 i t Building Department o 27 Charles Street North Andover Massachusetts 01845 0 978 688-9545 Fax 978 688-9542 .. A�'01rro �Pa` •(� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: 4;J'�2 Facility location Signature of Ap icant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: VL) t +L -S Location: s5 , e14-6 ,4GNIT S - City No 4t -i J d U e— 9- M & Phone F7am a homeowner performing all work myself. =I am a sole proprietor and have no one working in any capacity [ZrTl am an employer providing workers' compensation for my employees working on this job. Company name: "' g zmd/ Address �� / ��'�isl 'S City: / ,'6 • �f� �Ur�'l � Phone* Insurance Co.-i�YSI� -M)Urjz K, /�S Policy # Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct: Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official []Check if immediate response is required Building Dept Contact person: Phone A FORM WORKMAN'S COMPENSATION ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other 14 x w A x ao n► u; o O w a to a v cn o w z z z p w O w c -C U m C u: w a a O u: co C w pG O u a w W p cG v cn C w x O U aw. d p d C w z A w P-4 C m z cn Q o cn UJ o � z o m co 00 O ; O CD • nc �a cv o � N EQ CDCF a �► N J>E E C) CD E CL Nc m � m m h N CIO � 3 0.5 CO) C C po. y 110 O E CD E- oa ms m V N O G � Z ev o cm c CL c Q i i m C •O = m o 0 :n •-. "m$~ r C 'fl r,., C r •� •ca n= O = Z o Co •N O LU E CD om== g n 2.5 O 'fl 2 w0 a O cc CLF. ca CD CD L.. CL Co C O CD cc ME CO2 O H c ,o V O .0 _m Q. CO2 O V co C. CO) E CD CM C O .c p -v co OO m ui 0 CO LU VJ Ir w W W Location 73 ►-I '4�. L -,, S, (=�-7" No. 475 Date NORTH TOWN OF NORTH ANDOVER Os,,�C OL A Certificate of Occupancy $ i :: Building/Frame Permit Fee $ SSA�NUs Foundation Permit Fee $ /. Other Permit Fee ►� 7,.'a $ "2 Sewer Connection Fee $ Water Connection Fee $ TOTAL 1/15/99 13:50 �) 25.00 PAID /) a,�-47tt Building Inspector Div. Public Works 71 I= J C\ J z � C N c C Ail G /) o4. N I iC i V O ♦ ` v F- U a Q ~ G 11 lo / cn �- O co) ^ F cn F- N 7 C U L Ca 7 o a 7 a Q i O rGi cGd , W C c O O p ci O z U C U � F- - z �.y Y^� }Or N N o uj Lncn G Z cA N La h Z� � N i p ` 1 i^ ,-. 0 w U o Q Y U W � - z (1 IX vii wG a C U E- M G C W W W Z Z z 'Z G -[ L- Z z z z c G n G I= J C\ h C Ail o4. I am no= V v F- U Q 11 lo cn �- O W ^ cn F- N 7 C U L 7 a , C c F U � - z N o uj Lncn G Z cA N La h Z� i p ` 1 i^ ,-. 0 w I= Town of North Andover F NORTH MAP 040OFFICE OF 3�°,�•`6 oL UNITY DEVELOPMENT AND SERVICES A PARCEL O d to� 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT 9SSncHuS�� Director DEMOLITION OF BUILDING AFFIDAVIT (978)688-9531 Fax(978)688-9542 DATE l `� OWNER'S NAME & ADDRESS ���� �" A 2 f Z ZVN'ls ST 00 41ave P4oi9(-1-- LOCATION OF PROPERTY TO DEMOLISH r r A R oL t? ©' DESCRIPTION0-wti�egrg�- g2,,aC.oe.(- w/wao� �o� (IAWWE— CONTRACTOR'S NAME & ADDRESS P�- �X cn�vai t G;t1 % %d �d Fv Sr_ /�! pld �{2 ; ✓i?a d'! F V,57 TELEPHONE NoN G LE TAXES Z h_ Y._.... y A, FIRE kl/T (k —fift� // -sl' / EXTERMINATOR —ox) S^/C-/b DUMPSTER - ON/OFF STREET DIG SAFE NUMBER 19 %'? � OW ZS 7/ DATE REC'D /dQ// z `BOARD OF APPEALS 688-9541 BUILDING 688-9545 BLDG. INSPECTOR CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number `t %51 Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: er-026e7T0JMc-((0 Location of Facility f Signatur of PCdnit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector A21 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Location: 0 ,+1?oL lJ 5t- nM h--th" t4lppoflz%n 111# :" 1 `�-V Rei- h+Y t�-v5-t- Phone f 7R6 ?Igg66 am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. © Company name: f C.TLe- 6 (C e-ry EK C A-V T 6 Z n G Address % 7D dy)cFo4at S'T (ee-r City: 1V0 C A ✓i Phone #• i X 6 % ' % 2 2 V 0 Company name: Address City: Phone #• WC Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herby certify un der the pains and penalties of perjury that the information provided above is true and correct. Signature k" Date � 9 Print name Cc T<f-f l ��� Phone # 9 6 i -.2,2 % ej Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Lincensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other / 0. W 001 001 7 tfi r Iro- zF '7 -6 '1+1 _ .e. � ...t, Dol ool oat c o0 Cj 0.01 ao) 00 1 001 oni DO) 0 001 val � O 001 G nnr V aoi vol 001 001 0' oal o� o6 o 7 f" 001 00 1. .001 , v0.1 �t c- 0 0 CD ool 001 001 001 i co �icn O � 007 0. W 001 001 r -6 '1+1 a oat c o0 G ao) 00 1 001 oni 0 val � O 001 G V vol 001 oal o� o6 o 7 f" zt, .001 , v0.1 �t c- 0 0 CD ool 001 0 £•M dv3n4 6ui.'k .. lz C4 O W1, x A x v V cn O z z Q '� o o w o w c_ x U w O U U m o n: w O w V a W <U� o o4 v chi w w a z o c� w" 000�U z w x a w A a rr w w O z cn = V V -Lc i C4 O W1, x A x v V cn O z z Q '� o o w o w c_ x U w O U U m o n: w O w V a W <U� o o4 v chi w w a z o c� w" 000�U z w x a w A a rr w w O z cn T ui o t � O O CO O O v I y y .c+ L- CL CD f� C O V m CA O O .7 Q a COO O V O C m CO)CL LLJ 0 U) LLJ U) rr 1 W W CcW LLJ1 N c� 0 c s o ` C N O = V V -Lc (V m m • -•: as :r,o= CD Nom'' 3 Ea m S .tea e y i r0. O - � O CD j Qf a.� E j O Cal I m L c N N N 4 _ m O lU:A N O N N c O E m _ mo •� CLL) m -Cc, �o = • � co m :mom M >Zo c�c cm CL N m = O s ,Glmc N � a .E y... Z W N o y a g _� •` N �OCD _ m 06 m O O CO O O v I y y .c+ L- CL CD f� C O V m CA O O .7 Q a COO O V O C m CO)CL LLJ 0 U) LLJ U) rr 1 W W CcW LLJ1 N Location Z44 ac, /o/ Date % /C" NpRTot TOWN OF NORTH ANDOVER 0 p Certificate of Occupancy $ Building/Frame Permit Fee $ C� s'••�° •'stn Foundation Permit Fee $ s�CHU Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ S Building Inspector i J .P U Z 08/04/99 11:22 25.00 PAID Div. Public Works w � L SL cam, W IM d M 16, z� � F w c c w- c � _ 4 F G C z r � � C z ° • � N M � C T U F z 1 M N C c CI c z• ^'k Q Ll C _ s= C C Z w fi Za O w c rOr� l� O rr� V y] Z F s w i L ) o C c z � c L � M 16, z� � F w c c w- c ? F G C r � � C • � N M � C T U F 1 M N C c CI c z• F w c w- c ? ' G C d u W Q c L u c� a U bb u O UO z x W w w v czi cn as c O �• C L 1 :oy :::. 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J Nz _ z T G � a N z LLI L J N / _ f7 z m < L ^ D L 3 z - :J t/1 1' < Z .� L l+ < < 1 w T - .. C Nz _ z T G 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 flLLS OUT THIS SECTION'"***********�`*�""'`�""`** APPLICANT PHONE LOCATION: Assessor's Map Number. PARCEL SUBDIVI LOT (S) STREE 1 ST. NUMBERt,�f ********* ***************OFFICIAL USE RECOMM DATIONS OF TOWN AGENTS: maid CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED 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 1 Revised 9197 Jim I DEC -27-37 SAT 22:24 HAILLIE.CO`. -t aT 7 94.60 t.0'f 6 loss A N 617 944 6112 rILd`RIM 5 -mu -r Ly _ l F TMW PLAN Is NAND ON A TME SU"VIY (NOT AN NtTAUMGW eUpp," AND la TO ea Usso FOR MORTROi PUAPO"o ONLY. TMEREPOPIL THE O"3ET9 As 8"C" 6"OLK0 NOT Be UMD TO 6ATA@LION PAOPCM V l wAi_ E SS E yC COUNTY DEED REFERENCE: PLAN REFERENCE: PLWOBK. PG. 26y K PL. , 2V �4T Z PL. CERT. NO. —fiz— PG. '---� I hereby certify that the existing building is located approxlrnalely as shown and was not In violation of the zoning bylaws at the time of construction. This building is nal located in a Flood Hazard Area, FLOOD HAZARD COMMUNITY NO. 8500 90 BOUNDARY MAP NO. 00036 EFFECTIVE 2a+N93 _1 OF THOMAS BAILLIE No, 38032 REGISTERED LAND SURVEYOR a� DATE: /,2,•.11 —4) ifR Lar 9 ' APR i r . PLAN OF LAND IN NORTH —McNVMf WT" #PPM. aAV Cy 7b1414 T. 4 9 MMA CALLA MAi1Q 4 IN.- Z 0 FEET SAILL,IE & COMPANY CIVIL ENGINEERS & LAND SURVEYORS 33 HOWARD STREET READING, MA 01867 (91T) 94&-2767 r i 010 �ti �Q�� 1' 0 �� �t ✓1 ✓yl S{l f✓ G w Q -C o r ° v a cn 0 z z Q o : w t rL E U cL w 0 �'' °7n iu w O u w U U.12 W 'coo c i " � m ii x o UO C7 ..can cG ca z w Q a CO d cn o cn 2 ri CD O C' L .p.� U O CD Z d O ti 4 C ICD Ccm y Q :2 coLA — •E m m L O Co CL ~ CD O CD O m B 0. a. Q, Q C O= C !D vO _J = 'a o a? c Z CL) CL V CO) O C •� C cc CO) 0 U) Lli U) IrW W ccLL) w c CO '�..:c0 JVoc � c � O O = 0 IL w e`v H EQ :dit0 o a N 4: C� o O CM &S E m _v ' CO m is y CD N N : Cm O =N C c y O C O v E m v 7B cm s� r..� 4 CoQ C ox'mot N m V y co'> Z o Aoao f- Q. p N h �O. 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