HomeMy WebLinkAboutMiscellaneous - 8 EDMANDS ROAD 4/30/2018N
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0
June 3, 2016
Michael Winston & Associates, LLC
Innovative Risk Specialists
POB 10721
Bedford, New Hampshire 03110
Tel: 603-494-2366 - Fax: 888-306-8106 - E-mail: michaelwinston@comcast.net
Building Commissioner/Building Inspector
Board of Selectman/Board of Health
1600 Osgood St. Suite 2043
North Andover, MA 01845
RE: Von Hoehn
8 Edmands Road
North Andover, MA 01845
Type of Loss: Tree
Date of Loss: June 1, 2016
Policy: HO17092389
Claim number: HC220628
Our File #: MW16-151 Location of Loss: Same
To whom it may concern:
The above captioned claim has been made involving damages or destruction of property which may exceed
$1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice
under Massachusetts General Laws, Chapter 139B is appropriate, please direct it to the attention of the
undersigned and include a reference to the captioned insured, location, policy number, date of loss, cause 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 via first class mail.
Sincerely,
Michael Winston
Adjuster
N° •5 5 5 Date............. /.,..
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ........(T.e l.A......
..:.. ........ ....................................................
has permission to perform %-1..
:,.. fir ................................................
wiring in the building of ........... ir:i...... # I)P.&..................................
r- ��s
at.......,.....r-.,..j.......!!...............�..1�.�........................ „North Ando/vie j1�Iass/�
Fee..7�..<w. Lic. No.PA.;P.` o..... ...
(ELECTRICAL INSPECTOR
Check # _ J
f / /
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
UCt'A/(JM&V1 UP PUBL1U.WP-1 Y Permit No.
BOARD OFFIREPREVEWONREGMTIOI KSR70912-(x0
VA Occupancy & Fees CheckedPPLICATTONFOR PERW 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) Date /3 Q
Town of North Andover
The undersisned avvlies for a hermit to verform the electrical work described below.
Location (Street 1
Owner or Tenant
Owner's Address
To the Inspector of Wires:
Is this permit in conjunction with a building permit: Yes No F-1 (Check Appropriate Box) Do-7oZ
Purpose of Building �,(/j� �� ,, _/ ty '
��l�44C1�f�cS Utili Authorizafion No.
Existing Service _ //-7Q� Amps D/ Volts Overhead L0 Underground No. of Meters
New Service e Amps a %Q Volts Overhead [50 Underground No. of Meters
Number of Feeders and Ampacity ,
Location and Nature of Proposed Electrical Work' 4 �4 41-?•P��WQ !E
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
_.�
KVA
No. of Lighting Fixtures /
Swimming Pool Above
Below
Generators
KVA
(�ground"
owid
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
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
Othrr
Connections
No. of Water Heaters KW
I No. of No. of
I No. Hydro Massage Tubs
OTHER
HP
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andiidnV seonfluspemitvmi esftle4am nL �f
(Please check one) Owner o Agent ®
Telephone No. PERMIT FEE
Nn
C _ G �
Date. ! ... `.. ... .
N° 4023
"...... �tio TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that . !..�%/� !�� .....�. �•�• • • • •
has permission to perform.... � �!O`.................
plumbing in the buildings of ..........
at . e�- . f c1��' �. ` '..`.�... /( .... • ... • • • , North Andover, Mass.
Fee Lic. No.. ........ ... .....
PLUMBING INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
1
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS r
Building Location
New M
Renovation
Owners Name
of
Replacement
FIXTURES
Date --d ^ % —Gl/
,sPe mit #
Amount
I
Plans Submitted YesNo
(Print orCompany
e) p y �' � � y w � � Check one: Certificate
InstallingCom an Name lGV ? 6=r n f S Corp
Address 44 /LGC,1 S SZ Partner.
f'L
Business Telephone !� ((J`(Q— T d 0 Finn/Co.
Name ofLicensed Plumber `F"/P-to-ICC k Lj*�a It --e
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 11 Other type of indemnity R Bond
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three ' ce
Signature Owner Agent �---
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu/ may/��y�7��te Flu2bg Codepnd Chapter 14 ie General Laws.
i�✓ ��� �2. .SSA I Q
Title
City/Town
,D (OFFICE USE ONLY
Type of Plumbing License
a53.
icense um er Master® Journeyman �G
c
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i
'•
-
•
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--..---=.----.---m..--..-
(Print orCompany
e) p y �' � � y w � � Check one: Certificate
InstallingCom an Name lGV ? 6=r n f S Corp
Address 44 /LGC,1 S SZ Partner.
f'L
Business Telephone !� ((J`(Q— T d 0 Finn/Co.
Name ofLicensed Plumber `F"/P-to-ICC k Lj*�a It --e
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 11 Other type of indemnity R Bond
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three ' ce
Signature Owner Agent �---
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu/ may/��y�7��te Flu2bg Codepnd Chapter 14 ie General Laws.
i�✓ ��� �2. .SSA I Q
Title
City/Town
,D (OFFICE USE ONLY
Type of Plumbing License
a53.
icense um er Master® Journeyman �G
Location °
No. SD
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ C9 Y)(
Foundation Permit Fee $
Other Permit Fee
TOTAL
Check # 3 0 0$
$
14,660 x
/ Building Inspector
_y TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI: - RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING
�,� � ,n .,.:- _ z � .. :�� "'; "fix s a � '§'-. 5 if � ",` n'Y��^� � • ��.
c&.•, s}t4 Tv. a.n• zi_ ,..�,nx,-;. _ .,,. 1 ,,4_..,'^x�'`"rs.»s.�•'
BUILDING PERMIT NUMBER: (SQ ^� DATE ISSUED:
SIGNATURE:
6��-
BuildingCommissionii/lETEtor of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
dE °' ()0-n(j S
mad
1.2 Assessors Map and Parcel
a(
Map Number
Number:
3'7
Parcel Number
_
\Icon Hcy --Iii
1.3 Zoning Information:
I2 4 1-1co
Zoning District Proposed Use
S-�
1.4 Property Dimensions:
4-7a S -
Lot Area (sf)
Frontage ft
1.6 BUILDING SETBACKS ft
(�
"I
-1 -7nq
Front Yard
Side Yard
Rear Yard
Required Provide
Required Provided
Required
Provided
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
1.7 Water` Supply M.G.L.C.40. 54)
Public U Private ❑
1.5. Flood Zone Information:
Zone Outside Flood Zone ❑
1.8
Municipal
Sewerage Disposal System:
0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
\Icon Hcy --Iii
9 d rnAd
s Yid
Na t)
Address for Service:
(�
"I
-1 -7nq
Si ture
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable ❑
Licensed Consiruction Supervisor:
License Number
Address
Expiration Date
Signature
Telephone
3.2 Registered Home Improvement Contractor
Not Applicable
Von Fbfkn
Company Name
1B 6dnia d )�J
Kb ako ,,,,n,,,., mn
(� `�,�^-
Registration Number
Addres
Q� —' !
Expiration Date
Si ture Telephone
SECTION 4 - WORKERS COMPENSATION (XG.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.
Si ned affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work check all applicable)
New Construction V I
Existing Building ❑
Repair(s) ❑
Alterations(s) —0
Addition
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Description of Proposed Work:
ILE (add<<na 0-. Second -fpoy
4hPSA
�
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be(1FF'ICIAI.
C6mpletedbypermit applicant
r
USE tNY
t
1. Building
(a) Building Permit Fee
Multiplier
ZOO
2 Electrical
(b) Estimated Total Cost of
Construction
` , 1 c
(� y V
3 Plumbing
Building Permit fee (a) X (b)
cq Q�
4 Mechanical HVAC
5 Fire Protection
r-
6 Total 1+2+3+4+5
1
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building 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
r
Print Name t
Signature of Owner/Aent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TINMERS 1 ST 2ND 3RD
SPAN
DIN ENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDFZ G ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
_ Town of, North Andover
0 tt,.ec ,y yo
RECEIVED
JOYCE gRADSHAti4 Office of the, Building Department
TOWN C�I��NCIU unity. Development and Services Division
TH AK. els
NOR William J. Scott, Division Director
: I b 27 Clia rtes Street U
"s,A�HS
1000 DEC 20 All: North Andover, Massachusetts 01815
D. Robert Nicetta Telephone (978) 658-9515
8uiltlirl� Con1119issi,o 1crFax (978)688-9512
This is to certify that twenty (20) days
Any appeals shall be filed NOTICE OF DECISION have elapsed from date of decision, filed
hthout filing of an e
within(20)days after the Yc2r2000 pad /.0 oat
date of filing of this notice Property at: 8 Edmonds Road Joyce A Bradahaus
in the office of the Town Clerk. Town Cie*
NAME: Von Hoehn
DATE: 12/19/2000
ADDRESS: 8 Edmonds Road
PETITION: 034-2000
North Andover. MA 01845
HEARING: 12/12/2000
oa
The Board of Appeals held a regular meeting on Tuesday, December 12, 2000, at 7:30 PM upon the
application of Von Hoehn, 8 Edmonds Road, North Andover, MA for a variance from S7, P 7.3 for
right side setback in order to add 3 bedrooms and one bath, and for a Special Permit from S9, P 9.2 to allow
construction of said proposed 2"d story addition to a pre-existing non -conforming structure on a non-
conforming lot within the R4 Zoning District.
.IAN 30'0. AM9:34
The following members were present: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, John Pallone, and
EllLn McIntyre.
Upon a motion made by Ellen McIntyre, and 2"d by Walter F. Soule, the Board voted to GRANT a
dimensional Variance for relief of a front setback of 13' and relief of a side setback of 10' in order to add m
3 bedrooms and one bath and to GRANT a Special Permit to allow construction of a 2"d story addition ony
the condition that the construction will be no more than the proposed 2"d floor and that the roof line will not Q
exceed 28' 8" in height. In accordance with the Plan of Land by: Scott Giles, PLS, #13972, 50 Deer Z
Meadow Road, North Andover, MA., Rev. 1.1/20/2000. Voting in favor: WJS/WFS/RV/JP/EM. O
10.3 Variances and Appeals Qy+
The Zoning Board of Appeals shall have power upon appeal to grant variances from the terms of this Zoning Bylaw
where the Board finds that owing to circumstances relating to soil conditions, shape, or topography of the land or -06
structure and especially affecting such land or structures but not affecting generally the zoning district in general, a
literal enforcement of the provisions of this bylaw will involve substantial hardship, financial or otherwise, to the
petitioner or applicant, and that desirable relief may be granted without substantially detriment to the public good and
without nullifying or substantially derogating from the intent or purpose of this Bylaw.
Furthermore, if the rights authorized by the variance are not exercised within one (1) year of the date of the grant, they
shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted
under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which
the Special Permit was granted unless substantial use or construction has commenced, they shall lapse and may be re-
established only after notice, and a new hearing.
By ordu of the Zaning Board of Appeals,
Raymond Vivenz ", acting Chairnian
I'ti .\I?10/Dcisii111s206){)/$''' .li i;l i`.i?i`•:(ic;i�- i; i'(:\:tii.kt' 10'(?.'.l.illt,Sa• ;;i i'I..'.\.''•.l\:i.
AJ'TEST:
A True Copy
Town Clerk
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Locationg -
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
�7s'�•° '�� Building/Frame Permit Fee $
s+cMU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
17432` (.1p
- � �r
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
7777,77....._..... ., .. _ ... ..a.>.:.... i. tenant a... .,
BUILDING PERMIT NUMBER: L DATE ISSUED:
SIGNATURE:
Building Commissicrn—er/Inspector of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
ReqWred _ Provided
1.7 Water Supply M.G.L.C.40. 54) • 1.5. Flood Zone Information:
Public ❑ Private 0 Zone Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
Historic District: Yes No
2.1 Owner of Record
N me (Print) Address for Service
; lw�
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
i nature Tele hone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
it
Licensed Construction Supervisor:
Address r
- *
Signature Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
V
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SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 2506)
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 all
applicable)
New Construction ❑
Existing Building ❑
Repair(s) ❑
Alterations(s) ❑
Addition ❑
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
1. Building
Estimated Cost (Dollar) to be
Com leted by permit applicant
OI?F`ICi�II USE O,y
(a) Building Permit Fee
Multi lien
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (8) X (b)
D
4 Mechanical(HVAC)
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
WNERS AGENT OR CONTRACTOR PLIES FOR BUILDING PERMIT
1- 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
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
SiNature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TMERS 1 2 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DEMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
. - CORM 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***********************
k% APPLICANT l�lwl. N PHONE+Z I f C
LOCATION: Assessor's Map Number.
PARCEL
SUBDIVISION LOT (S)
STREET T. NUMBER
*****************************************OFFICIAL USE ONLY***********************
I RECON RENDATIONS OF TOWN AGENTS:
ATION ADMINI$,7`RATOR -
COMMENTS
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
DATE APPROVED (a R
DATE REJECTED �`—
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
0
e
Town of North Andover
ci T{.tw 46V
Building Department
'
27 Charles Streetn
o
North Andover, MA. 01845;se�r.°:�£<
,
D. Robert Nicetta
Building Commissioner
(978) 688-9545
(978) 688-9542. Fax
HOMEOWNER LICENSE EXEMPTION
Please print.
I� DATE I9 - 16--9
.10 JOB LOCATION O 4S
Number Street Address Map / lot
"HOMEOWNER !/ Onl
Name Home Phone Work Phone
PRESENT MAILING ADDRESS iM
City Town
State
The current exemption for "homedwners" was extended to include owner -occupied dwellings
of two units or less and to allow such homeowners to engage an individual for hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1)
DEFINITION OF HOMEWOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one or two family dwelling, attached or detached structures ac-
cessory to such use and/or farm structures. A person who constructs more than one a home in a
two-year period shall not be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other
Applicable codes, by-laws, rules and regulations,
The undersigned "homeowner" certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and requirements./
HOMEOWNER'S SIGNATURE O!_—
APPROVAL OF BUILDING OFFIC
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+lepartment of PubUr —Aafetq
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only - 1 � � /- �
Permit No. -1
Occupancy ,& Fee Checked
3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 q,
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
(X* or Town of NOR`�H_ ANDD $ To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) ST
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes l� No ❑ (Check Appropriate Box) a
Purpose of Building /< « Utility Authorization No. �o y
Existing Service �lw Amps/ -,70 Volts �lpH e head ❑ Undgrnd ❑ No. of Meters �—
Z Volts �verhead ❑ Undgrnd ❑ No. of Meters
New Service �— Amps /20 — 90 �`�'
.— A,,?irZfr5
Number of Feeders and Ampacity
Location and Nature of Prop sed Electrical Work _S�?
, aj it
mSt7�
—
Total
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers KVA
Above 1n
Swimming i=poi grnd ❑ grnd ❑
Generators KVA —
No. of Lighting Fixtures
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners I
Battery Units
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
No. of Switch O:itlet=_
Total
No. of Ranges
Nc. of Air_Cond. tons
Initiating Devices
No. of Sounding Devices
No. of Self Contained
No. of Disposals
No.of Heat Total Total
Pumps Tons KW
::pace/Area Heating KW
Detection/Sounding Devices 1
No. of Dishwashers
Municipal
Local ❑ Connection ❑Other
`
Heating Devices KVJ
of Dryers
No. of No of
_..._.
Low Voltage
No. of Water Heaters .
Ballasts
I ... _ _ _
Signs,
Si s
Wirin
_ , irinq
No. Hydro Massage Tubs
I No. of Motors Total HP
OTHER:
INSURANC COVERAGE: Pursuant to the requirements of Massachusetts general Laws _
NO _
1 have a cent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ I
have subrriitted valid proof of same to the Office. YES = NO -- If you have checked YES, please indicate the type of coverage by
checking the apro riate box. ! /�
INS I#fjANCE BOND OTHER (Please Specify) (Expiration Date)
i.
Estimated Value of Electrical Vork $
Work to Start '"
Inspection Date Requested: Rough Final
Signed unE;6R
allies of perjury: 02�
/ LIC. NO.
FIRM NAGC9
>gnauLIC. NO.
Licenseeg 3S
Bus. Tel. No.
Alt. Tel. No. s�
Address
OWNER'S INSURANCE WAIVER: I am aware that the Lice see 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
*** C E R T I F I C A T E OF
I N S U R A N C E
RECT
Date: 12113/95
n"ARK
INSURANCE AGENCY, INC.
V17q
This certificate is issued as a matter of information only and confers
L, P .. _TR.-: -'- --
no rights upon the certificata holder. +::is certificate does not amend
NORTH ANDOVER, MA 01845
extend or alter the coverage afforded by the policies below,
,-----------------------------------------------------------------------
401-T7T-5T7%
COMPANIES AFFORDING COVERAGE
- u -------------------------------------------------;
SRE
0 nnR
' r t • i Norfolk
Lo;:,piny Letter A: orfoik.:s Dedham: Mutual
Jeffrey P. Hoen Electric
Company Letter D:
Company Let _Pr C,.
Company Letter D.
Methuen, MA 01844
Company Letter E:
Thi_ is to cerci that t..P bolicies of insurance listed
below have been issued to the insured named above ,or t,,P po__-
:-'lou indicated, net withstanding any re uiremPnt,
term or condition of any contract or other document with respect to !.T..4. l
this certificate may hP 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.
Ltr' Type of Insurance Policy Number
' policy Effective , Policy Expiration ; All Limits in Whole Dollars
------------------------------------- .------------------
--------------------------------------- -----------------------------------
----------------------------------=-_-_1
C.. _, a I--agility
' general Aggregate $ 500,000
A x Commercial General Liab.
' Prod-comp/ops Agg. $ 50,:,000
Clai,us Made OccurrPrce ' R0T36T3
' 0811%/95 08i1i,''gh Per IJ Adver In =0''•.000
Owner's 4 Cont. Protective
' Each Occurrence 5001000
, Damage Any 1 Fire 50.006
Med Exp Any I Per 5,000
---,---------------------------------+-----------------+-------------------1-------------------t-----------------------------------
Automobile Liability
�r Any Auto Ali awned Autos ,
' Combined 51L
, i Booiy per . _rsorE y
Hired Autos Scheduled Autos
per Accide-:t
Non -Owned Autos
' Property Damage
Garage Liability
--- ---------------------------------- .-----------------'-------------------.-------------------4-----------------------------------
i Excess Liability ,
, ! , Each Occurrence $
umbrella Form Other
Aggregate
------------------------------------- .-----------------
,---------------------------------------4-----------------------------------
Statutory Limits
Worker's Compensation
' ' Each Accident
and '
Disease -Policy Limit
' '
' Employer's Liability
Disease -Each Employee $
---'---------------------------------+-----------------t—=-----------------s-------------------'h----------------------------------
Other
:
! ,
,
--------------------------------------------------------------
Description of Operations iLocations/VehiclES/L EEE a' Items
_ IIRTlF1CATE HOLDER =_____________________:___________________ CANCEE!I,TION
'LL
Should any of the above described policies be canclied before the
:s
expiration date thereof, the issuing Company viii endeavor t%! maill
10 days written notice to the certificate holder named to the left
but failure to mail such notice shall impose no obligation or lia-
bility of any kind upon the company,"its agents or representatives,
'----------------------}----
Authorized "representative
-^'�'� f`isI- -- is..r +„za .�'�.Y�s` : a . �tr�..^'' °i ~` :�;�Jb•tX -� -'' •..t: r`:..: _ . .. 77 a..�
` Date.....: ..,�
a 1° 312
NoarM
TOWN OF NORTH ANDOVER
o p
t PERMIT FOR WIRING A
,SSACMUS� _ p�
�^
This certifies that ....... .. ... ..`....:....... N.......��.... �":............:.
has permission to perform ............• 1. . ... ...............v............1 ................
wiring in the building of .........(. .......7
ec.........:.
at ........ .... A0..6 ........ F .......... , Nort dover, Mass
Fee.........•. Lic. No. ,''a M....��. ............................
ELECTRIC L SPECTOR. d
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
No.: 2 q (el -
Date
C,
TOWN OF NORTH ANDOVER""
BUILDING DEPARTMENT
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee cc
wilding Inspector
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B R In' N S R E YINIC, L D S
4
TOWN of NORTH ANDOVER
AFFIDAVIT
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Type of Work:
Ad / Est. cos
ovo
Address of Work ¢�d9'1Q`y► �S /� d
Owner Name: 11A n Yo 67A 4
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reasou(s): Fcr office Use Only
Work excluded by law F -emit Nb.
-Job under $11000 Date
Building not owner -occupied
Owner pulling own permit
Other (specify)
Notice is hereby given that:
Signer ur3er pe alties of perjury:
I hereby apply for a permit as the ent of th owner:
Date ContractoriName Registration No.
OR:
Notwithstanding the above notice,
owner of the above proper y:
Date Owne
I hereby apply for a permit as the
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No. 3 Date a
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $ 8
v
Water Connection Fee $
TOTAL $
Building Inspector .a
i
M37
Div. Public Works
l�ll
PER'%frr NO. c APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP d40.
LOT NO.
�Q �"�
(
2 RECORD OF OWNERSHIP 'DATE
BOOK 'PAGE
ZONE
SUB DIV. LOT NO.
F
LOCATION
PURPOSE OF BUILDING
V%y� C I�
OWNER'S NAME 6,
,V
V
NO. OF STORIES � SIZE
riI/ �/ [10
OWNER'S ADDRESS
X EZmAki
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BASEMENT OR SLAB a�� �
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ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME /� �0 / 1�
�'
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DIMENSIONS OF SILLS � ��i
DISTANCE TO NEAREST BUILDING 0 1
V
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,
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l
Cc' 1 Uy�
DISTANCE FROM LOT LINES -SIDES
/ REAR leo
GIRDERS _v
AREA OF LOT I�. iG
V I (
FRONTAGE � t
DYJ
HEIGHT OF FOUNDATION 1
THICKNESS �2(t
IS BUILDING NEW
SIZE OF FOOTING
X
S BUILDING ADDITIONC-V�
l• 1
MATERIAL OF CHIMNEY
C
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
SDLI
ILL BUILDING CONFORM TO REQUIREMENTS OF CODE V
l
IS BUILDING CONNECTED TO TOWN WATER
V5
I6OARD OF APPEALS ACTION. IF ANY ---91
l/
IS
IS BUILDING CONNECTED TO TOWN bFJNER
IS BUILDING CONNECTED TO NATUR L GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND PP /yOfVED BY BUILDING INSPECTOR
DATE FALED
V
OF OWNER OR AUTI/ORIZED AGENT
FEE
PERMIT GRANTED 19
. AM - Jill
a 7 I
DEW
DEW
3 PROPERTY INFORMATION
LAND COST
LDG. COST 000
1 Q
EST. BLDG. COST PER SQ. IFT.
EST. BLDG. COST PER ROOM
SEPTIC, PERMIT NO.
i
4 APPROVED BY
BUILDING INSPtQTOR
OWNER TEL.# t ` 032,
t
CONTR. TEL. //
CONTR. LIC. ✓✓/ l �S O"`I1®
10
BUILDING RECORD
I OCCUPANCY 12
SINGLE FAMILY I s;oRlEs 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.
B'M'T 2nd � ELECTRIC r�r
est 13rd I NO HEATING
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
3 1 2 13
PINE
HARDW D
CONCRETE
CONCRETE EL K.
BRICK OR 3fd-Nb
PIERS
PLASTER
DRY WAIL
_
UNFIN.
3 BASEMENT
RE
FIN. B M AREA
_
FIN. ATTIC AREA
_
N_O 8 M T
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
_
4 WALLS I 9 FLOORS
CLAPBOARDS
B
_
L
2 3
�_
_
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_
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STUCCO ON MASONRY
_
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ATTIC STRS. 8 FLOOR I_
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WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I J POOR _
ADEQUATE NONE
rj OF
10 PLUMBING
GABLEHIP
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MANSARD
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_
FLAT
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WATER CLOSET
_
ASPHALT SHINGLES
LAVATORY,
WOOD SHINGES
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SLATE
NO PLUMBING
_
TAR 8 GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
TILE FLOOR
TILE DADO
6 FRAMING IL
11 HEATING
WOOD JOIST
PIPELESS FURNACE
'FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
GAS
OIL
7 NO. OF ROOMS
B'M'T 2nd � ELECTRIC r�r
est 13rd I NO HEATING
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- ---- --- - ----T
BRIAN REYNOLDS
(508) 682-8132
REYNOLDS CONSTRUCTION
GENERAL CONTRACTING
FOUNDATION TO FINISH
Licensed and Insured 9 Bartlett St. - Suite 205
Mass. License # 065490 Andover, MA 01810
C �
FORM U - VERIFICATION FORM t
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*****section*****************APPLICANT: 1V (0 �2 1 th V_� Phone & 0 bl � d 7
LOCATION: Assessor's Map Number Parcel 0032
Subdivision
Street
************************Official
RECO DA ONS TO AGENTS:
Llo Ise—,ation AAdmiff1ii-strator
Use Only************************
Date approved
13/61&
Date Rejected
Cell k, 42 Date Approved F3
Town Planner Date Rejected
Comments V"5' lXl mcdln%L\Qa�
Food Inspector -Health
Septic Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Date Approved
Date Rejected
Date Approved
Date Rejected
Received by Building Inspector Date
Lots)
^II
C`I YVl G o, JS
-Pa
St. Number
1—
************************Official
RECO DA ONS TO AGENTS:
Llo Ise—,ation AAdmiff1ii-strator
Use Only************************
Date approved
13/61&
Date Rejected
Cell k, 42 Date Approved F3
Town Planner Date Rejected
Comments V"5' lXl mcdln%L\Qa�
Food Inspector -Health
Septic Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Date Approved
Date Rejected
Date Approved
Date Rejected
Received by Building Inspector Date
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PLAN VIEW
CUSTOMER -- BRIAN B REYNOLDS
DATE 08/08/96 REF BBR0002
10,
7' 3
JACKSON LUMBER &
215 MARKET STREET
LAWRENCE, MA
MILLWORK CO.,INC.
LOAD AND SUPPORT: Your deck will support a 87 PSF live load. Posts have 48" below -ground
post support.
DECK AND POST HEIGHT: You selected a height of 36" from the top of decking to level ground.
The top of the deck support posts will therefore be 25.25" above ground level. Your salesperson
can provide information for uneven or sloped ground.
JOISTS: Set joists on top of beams, 16" center to center.
NOTE: The design may require knee braces and bridging between joists. Your materials list includes
the necessary items. The suggested design is not a finished building plan. You are responsible for
all measurements being correct, for verifying that the design (and any substitutions or modifications
that you make) meets all local building codes and requirements. To verify that the suggested design,
and any substitutions or modifications, is consistent with conditions at the construction site,
review the design with your architect. Also consult your architect for proper construction and use
of materials in the structure.
Be sure to follow the deck construction detail available from your store salesperson.
BILL OF MATERIALS AND LABOR PRICING
CUSTOMER: BRIAN B REYNOLDS
DATE: 08/08/96 REF: BBR0002
SALESMAN # STEVE REID
---------------------------------------------------------------------------
SUMMARY
---------------------------------------------------------------------------
LUMBER MATERIALS $ 1312.31
OTHER MATERIALS $ 386.56
TOTAL $ 1698.87 (148.00 SQ FT, $11.48 PER SQ FT)
LABOR PRICING $ 1798.45 (148.00 SQ FT, $12.15 PER SQ FT)
TOTAL $ 3497.32 (148.00 SQ FT, $23.63 PER SQ FT)
WOOD TYPES USED IN DECK
DECK PLANKS
STAIR TREAD
STRINGERS
JOISTS
FASCIA
LEDGERS
BEAMS
GROUND POSTS
RAIL POSTS
RAIL CAPS
RAIL SPINDLES
OTHER RAIL MEMBERS
WESTERN RED CEDAR STK
WESTERN RED CEDAR STK
PRESSURE TREATED CCA.40
PRESSURE TREATED CCA.40
PRESSURE TREATED CCA.40
PRESSURE TREATED CCA.40
PRESSURE TREATED CCA.40
PRESSURE TREATED CCA.40
WESTERN RED CEDAR CLEAR
WESTERN RED CEDAR CLEAR
WESTERN RED CEDAR CLEAR
WESTERN RED CEDAR CLEAR
TO COMPLETE YOUR DECK THE FOLLOWING TOOLS ARE REQUIRED:
CIRCULAR SAW HAMMER CRESCENT WRENCH
CHALK LINE RAFTER SQUARE 2' LEVEL
CEMENT TROWEL MEASURING TAPE SHOVEL
WHEEL BARROW BRACE & BITS
BILL OF MATERIALS --- OTHER MATERIALS
CUSTOMER: BRIAN B REYNOLDS
DATE: 08/08/96 REF: BBR0002
SALESMAN # STEVE REID
---------------------------------------------------------------------------
COMPONENT
---------------------------------------------------------------------------
SKU
QUANTITY
DESCRIPTION
JOIST HANGER,10IN
5093
8
EACH
2X10 SGL JOIST HANGER
JOIST HANGER NAILS
6925
2
(1#)
1-1/2" JOIST HANGER NAIL
BEAM BRACKET
6635
4
PAIR
4X4 POST CAP (AC4)
16D NAILS
54131
8
(1#)
16D PT GALV NAILS
10D NAILS
54130
1
(1#)
10D PT GALV NAILS
12D NAILS
5126
5
(1#)
12D PT GALV NAILS
8D NAILS
54129
5
(1#)
8D PT GALV NAILS
LAG SCREW
708L
4
EACH
MISC. LAG SCREW
WASHER
708W
100
EACH
MISC. WASHER
TIE -DOWN STRAP
6293
14
EACH
STRONG -TIE STRAP ST2122
LATTICE 4X8
OUTLAT48
6
EACH
4X8 PT LATTICE
RAILING BOLT,6IN
708RB6
28
EACH
6" RAIL BOLT
NUT
708N
48
EACH
MISC. NUT
ANCHOR BOLT
708AB
5
EACH
8" ANCHOR BOLT
FOUNDATION BRKT,4X4
6630
5
EACH
4X4 POST BASE (AB44)
BEAM BOLT,8IN
708BB8
20
EACH
8" BEAM BOLT
SONO TUBE
TUBE1212
2
EACH
12" X 12' SONOTUBE
CONCRETE,80LB
CONCRMIX
34
BAG
80# CONCRETE MIX
BILL OF MATERIALS --- LUMBER
CUSTOMER: BRIAN B REYNOLDS
DATE: 08/08/96 REF: BBR0002
SALESMAN # STEVE REID
---------------------------------------------------------------------------
COMPONENT
SKU
QUANTITY
DESCRIPTION
WOOD TYPE
---------------------------------------------------------------------------
DECKING
CEDARSTK54608
8
EA
5/4X6 8'
RED CEDAR
STK
DECKING
CEDARSTK54610
26
EA
5/4X6 10'
RED CEDAR
STK
APRON FRAME
OUT2416
2
EA
2X4 16'
PT PINE
APRON FRAME
OUT2412
3
EA
2X4 12'
PT PINE
APRON FRAME
OUT2410
4
EA
2X4 10'
PT PINE
RAIL CAP
CED2608
3
EA
2X6 8'
RED CEDAR
CLEAR
RAIL CAP
CED2612
1
EA
2X6 12'
RED CEDAR
CLEAR
HORIZONTAL RAILS
CED2416
4
EA
2X4 16'
RED CEDAR
CLEAR
HORIZONTAL RAILS
CED2410
2
EA
2X4 10'
RED CEDAR
CLEAR
VERTICAL RAILS
CBAL36
66
EA
2X2 36"
RED CEDAR
CLEAR
RAIL POST
448CED
6
EA
4X4 8' D&BTR
RED CEDAR
CLEAR
STAIR POST
448CED
1
EA
4X4 8' D&BTR
RED CEDAR
CLEAR
STAIR STRINGER
OUT21212
2
EA
2X12 12'
PT PINE
STAIR TREAD
CEDARSTK54608
5
EA
5/4X6 8'
RED CEDAR
STK
BEAMS
OUT2108
1
EA
2X10 8'
PT PINE
BEAMS
OUT21010
2
EA
2X10 10'
PT PINE
JOISTS
OUT21012
3
EA
2X10 12'
PT PINE
JOISTS
OUT21016
4
EA
2X10 16'
PT PINE
FASCIA
OUT21016
1
EA
2X10 16'
PT PINE
FASCIA
OUT21010
1
EA
2X10 10'
PT PINE
FASCIA
OUT21012
1
EA
2X10 12'
PT PINE
FASCIA
OUT2108
1
EA
2X10 8'
PT PINE
LEDGER
OUT21016
1
EA
2X10 16'
PT PINE
LEDGER
OUT21010
1
EA
2X10 10'
PT PINE
LEDGER
OUT21012
1
EA
2X10 12'
PT PINE
LEDGER
OUT2108
2
EA
2X10 8'
PT PINE
STAIR HANDRAIL/CAP
CED2612
1
EA
2X6 12'
RED CEDAR
CLEAR
HORZ. STAIR RAILS
CED2416
1
EA
2X4 16'
RED CEDAR
CLEAR
VERT. STAIR RAILS
CBAL36
20
EA
2X2 36"
RED CEDAR
CLEAR
GROUND POSTS
OUT4416
1
EA
4X4 16'
PT PINE
4. 8813-2
• Subdivision of Lot '17 Block 7 shown on plan 9813B sh.2
N Filed with Cert. of Title No. 1406 North Registry District of Essex County
LAND IN NORTH ANDOVER
April 5, 1941.
Arthur R. Nicholson, Engineer.
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14 Separate certificates of title may be issued
(H for lots JV-and.ZZA .......... ds shown hereon
-I By the Court
4�
Recorder.
R.-- 7/8. o2
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Copy of part of plan
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LAND RE61STRATION OFFICE
-
APR. 29, 1941 -
Scale of this plan 20 feet to an inch
C 8 Humphrey, Engineer for Court .,
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18.
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54.85
40.87
4-9.00
R :758.02
ED Al A A/ D,5
14 Separate certificates of title may be issued
(H for lots JV-and.ZZA .......... ds shown hereon
-I By the Court
4�
Recorder.
R.-- 7/8. o2
:5
16,
Copy of part of plan
- fik-d n -
LAND RE61STRATION OFFICE
-
APR. 29, 1941 -
Scale of this plan 20 feet to an inch
C 8 Humphrey, Engineer for Court .,
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OIR
8813--2
Subdivieion of Lot 17 — Block 7 shown on plan 8813D sh.2
Filed with Cert, of Title No. 1406 North Registry District of Essex County
LAND IN NORTH ANDOVER
April 5, 1941.
Arthur R. Nicholson, Engineer.
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for.../.o.ts.... 17..A...a.ad../..7...8.......... es shown hereon
1 By the Court
W1
•lU�Y....l.�. i9... Recorder.
R... 7/8.o2
MEM
Copy of part of plan
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LAND R£61STRAT/ON OFFICE
APR. Z9, 1941
Scale of this plan Zo feet to an incl,
C ti Humphrey. fn9ineer for Court .
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