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HomeMy WebLinkAboutMiscellaneous - 86 UNION STREET 4/30/2018N O O O (O Q O O W J O O O 1 The Commonwealth of Massachusetts Dcpartrricnf of hiblic Scfcry 'occ.rrawc, L Ice'tAcct��-- BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200x/90 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL -WORK All wrk to be periormed in act:otdanct .rith the Macuchuscns FJectrkal Code. S27 CMR 12.00 (PLEASE PRINT iN INR OR TYPE ALL INFORHAMN) Date f -`e --,- —,� City or Towa of Al- /�y�. To the Inspector of Wires: The uncorsigned applies for a permit to perform the electrical work described below, Location (Street b Number) 0.'ner or Tenant_ re Owner's Address Is this permit in conjunction with a building permit: Yes Q --WE] ((Reck Appropriate Box) A:rpose of Building.qh Utility Authorization N0, Existing Ser.ice Amps / / Z<fC7 vol74 ts Overhead ^ t dgrd C No. of ::et,�.ts_/ He- Service Amps / Volts Overbead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs '.o. of Lighting Fixtures Swisaing Pool Above grnd. ❑ t No, of Receptacle outlets /0 No. of Switch Outlets No, of Ranges Nc of Disposals of Dishwashers No. of Dryers No. of Water Nesters KW No. Hydro Massage Tubs =R: No. of Oil Burners / No. of Cas Burners No. of Air Cond. No. of Heat lot Pups TO Space/Area Heating Heating Devices No, of o. Silrns Ball No. of Motors 0 Total HP a J Al 0,1- NO- of Transformers . ❑ Generators KVA No. of Emergency Lighting Ba.tteEX Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No, of Self Contained Detection/Sounding Devices Local ❑ MunicipalOther Connection Low Voltage INSURANCE COVERAGE: Pursuant to the requirements of Massschusetts General Laws I have a current Liabillt Insurance Policy including Com leted equivalent. YES NO p Operations Coverage or its substantial If you have checked YESj please aindica[etthe typed of coverage f Of Dy checking the to this cappropriate box. INSURANCE OND" MUM [] (Please Specify) Estimated Value of Electrical Work S piration ate Work to Start — In Date Requested: Roughy✓ // /fid Final Signed under the penalties of perjury: Q y FIRM NA?SE LIC.. N0. ,J Licensee ��-Alf,sf,-Ta' Signature ,� LIC. NO. I.ddress%— OL4e7--Alt. �� Bus. Iel. No. Z/off/ A1C. Tel. No, �'S INSURANCE WAIVER: I am aware that the Licensee does 6'0t have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General ws�tAat mysignature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No, PERMIT FEE S�7 U t Signature of Owner or Agent Date... ' qo;...... %..... 363 NOR7p TOWN OF NORTH ANDOVER PERMIT FOR WIRING ACMUSEt E This certifies that...............`:z-... ................... has permission to perform k�z,-4..?'-;�7�...... 2� wiring in the building of Cn aC� t��Hl at .�,.�......1�-- ............:.................................. . North An�..s.. C�-uvFee ...55..... Lic. Np�l 1�1�-3 ................... ................... E ECTRICAL INSPECTOR C�.�-aj-L.�I WHITE: Applicant CANARY: Building Dept. PINK: Treasurer _. A8/051% 09:10 55.00 PAID Location- -N 0. ocation-lo. Date 0 N°RTH TOWN OF NORTH ANDOVER Ot,"S° 1,., tiO p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ ►� SACHus — — Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ lo uilding Inspector Div. Public Works WI I a a 0 m 07 4A i p�W W 0 Z CC O Z I0 O _J m d Lo IY Z 3 0 W O W N 0 Z O< J m 4 o 0 n 0 W 0 `" z J N rc 0 ,. w N W m IF W Ir W i F C 0 J LL 4 W N m 0 p O H 7 1 m L W d N1 Z_ N m Z a � z IN, j N 1 ^ O u 9L \�o Z 10 0 I p V L Z ` O g C 7 N m Z Y 0 -�v tl! F 1 F , W z we 0 W V Z a 1 < Z N W O 0 < N W fll F w H z IN U -1 z 0 z 0 = u < al o 0 z t > 0 m m W N J J N IL 0 to z 0 N z < i L 0 N K W O K W � 0 a < W F Z 0 rc t� N W 0 N i N W Z J F 0 J I 0 IL 0 Wu LL J z 0 h W < 19 Z F 0 0 4 LL 0 W N a N F. Z 0 0 p 7 1 m , N1 Z_ N m N � 61 N j N 1 W O 1 //�� (J �JJ�� 1 0 I p V L Z F � O g C W m Z Y 0 -�v tl! F 1 F , we o uW x 0 J_ z m W a al o m 0 o 0 z t > 0 m m W W j o�; rc rc J 0 m a F U p o U n U d a Z J < W J U m m m U Y j z 0 z 0 7 < N Z F J W F W F W I � J F 0 FZ 0 0 i Ir O 0 0 0 I W � 0 a < W F Z 0 rc t� N W 0 N i N W Z J F 0 J I 0 IL 0 Wu LL J z 0 h W < 19 Z F 0 0 4 LL 0 W N a N F. Z 0 j 7 1 m , N1 Z_ N N � 61 N j N 1 I O 1 0 0 I F F � W W 0 rW� tl! F 1 F , 0 0 0 0 J_ J_ F iL 1 0 N I m W W j W < < m q d i t I i I F. Z I 0 61 I O rW� p 0 f °J l � Y 0 I � W I Z I 0 O W O z Z ! m < W i < O W W i O W LL. d z I> -�i min C. N A A AC A n Z Z O Z 3 r, D D�nOo:~ 0 A Z -D O W >>rO3 vaonn AnZ� C Dip-i�i -� N= 0 mmBT O� D 0 OmmA Z;=m 0-��W NO0;� T OZ I• iOy�QOI�N<D< Z0 y C >0oOO O 0'" 3 X r p m N w O ZDT N;3 O G1 0C M Z< C D �_ {{ O O N s 3 I O T Ov A Cm Z A N x Z 29 C1 O C1 O O Q A A Z Z Z 0 I I 0 D ma00 D A DO• Z -D O W vaonn AnZ� N D;N D CZ -� N= 0 O� D m n y _ 0-��W NO0;� C 0-, NS�n CA LA 0O (A 0'" 3 r p mm �m w O ZDT N;3 O G1 M 0 C {{ O O N s 3 m A Z O Z ^ 0 Z M C noN N -0 1 C ► iLL O m j 7:-2 1 ZI W O n x D A n _ ,^ W ; T T m Z _ T_ Z � ti 19r„ Z O T N A 0 --0 mf Z Z O y Z D i D A O 2 N N 0 m 0 •� 0 N D > m z m LII" Irl I I" Z D II IIII"N_ H _I IIII I�I�iI" SON N Zm mmo 80- D0 jpzZ �COX C �X-Nj D 0 40 00* mim mx -j ZD I N_ f1 tn0� ;azv_ mN3 jTj- M DAN m 0 NCjzA 6F 00 or "up0 r -� ?�z 4v xv xD Onz xn mm (0 11 � m 00 3 f, 2/28/97 09:51 TEMO, INC. DAVID 4 DICK BROWN x c FILENAME: 97W1194 02/28/97 0 a 0 O 0 m N A m Z X >p m TEMO b" STRESS SKIN P MELS � x b FLOOR JOISTS z z a 0 0 m 0 F- m rno M n N r o U)rn to zO D AA O 0 o j Am rn o �rn 0 N • c M m N T) C) -n -i m z a C A Q m a x A N m D ti z X rn x O i ? m ° D i e ° 0 x ' m *? x rn O p A z z x Q a mwAm L44rn N z Q y m rn rn �0mm A N A N � � E ti m •zi n mrnAmm X a N A n a as O D a ad av ° ®® a ®®® > m r x x x x x X _ O x x x O x x x x � - Q� 1 CLIENT/PROJ. PH. ( ) DATE REMSIONS SNELL DRAWN BY: DAVID CENTORBI CK'D BY. MEASURED BY: DATE: SCALE:1/4"=1' 0 0 O 0 N X >p TEMO b" STRESS SKIN P MELS � x b FLOOR JOISTS (p � 'v0/G 0 0 m n N y ",40111 uv:5u TEMO, INC. DAVID-+DICK BROWN 1/1 2/28/97 09:53 »M, INC. D qD¥m3 BRAN R! FILENAME: 97 ,A g4 02/28/97 a m a » , °[ k >E m \ \ � Alq 7@ k� } ` 9 § 2 m f( >R ", 0 A , A� , E G , > �2 ` // 2 ¥ @ r z / m g . a ? & « {+mow:T. 22' / � (FROST DEPTH) }( §`JoR m li \k §/ © D; in ' �^• �` �P« SIJ r -A >� ,r§� S� §m lx °» " R k� )) §\92 QI {\m .m 2> (�2f7 >2 °za ,7� I Q■ , @#E2 02K\ �!K 9 k� ( r1l �2 ��� r 2� U X x J ) \«9R6k7 377!9& 22�®© 7 ,7\§kZR. J%»\}• X 11 \�2r- \ / 6 > ;a G m -k -fl r w zma» q§0 X- )��§§\ro f((po)k m�0(3�2 �ƒ(Z �nM0 43 Z! m ) $q� § \ . I / i Ti >KP ° m�G 2/% © %§� t Q§n § a92 % SENT/ KJ ) R7REMSIONS SNELL o9mBtG� 3NTORB at eSC: MEASURE BY DATE: NONE FORM U - VERIFICATIOY FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *****************Applicant fills out this section****************** APPLICANT: iC'"�t 1iV l�C� ESu C24 Phone LOCATION: Subdivision Assessor's Map Number Parcel Lots) Street F(p Li✓ld AJ c57. St. Number .0 ************************Official Use Only************************ RECOMMEPDATIONS OF TOWN AGENTS: Cons e ation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date HOUSE WALL INDICATE TYPE OF SIDING ON HQUSE ❑ FRAME ❑ ALUMINUM ❑ BRICK ❑ STONE IF STONE ❑ ROUGH ❑ SMOOTH INDICATE ROOFWALL MOUNT BY MARKING MOUNT DOTTED UNES SOLID 4 f FASCIA .. -ROOF_ ji MOUNT I TOP OF EXISTING I DOORS A PROPOSED I -WINDOW MOUNT I EXISTING STEP DOWN FLOOR TF — CEMENT OR DECK GUARANTEE PROGRAM (FOR INSTALLED PRODUCTS ONLY) ....�_.____�..•-•--_..�— GRADE FIVE YEAR WORKMANSHIP GUARANTEE All workmanship is guaranteed for five (5) full years from the date of installation There will be no charge for labor or material due to faulty workmanship in that 5 year period. TEMO MANUFACTURER'S GUARANTEES AND WARRANTIES American Profiles Co., Inc. also guarantees that it will mail on receipt of final payment all manufacturer's guarantees and/or warranties for type of product purchased from American Profiles. American Profiles Co., Inc. also guarantees that each type of product purchased will carry a manufacturer's guarantee and/or a warranty. (Excluded from these guarantees and warranties are defects or problems caused by abuse or negligent care.) American Profiles Co., Inc. CORPORATE OFFICES: 20 Blaine Street Manchester, NH 03102 179 Sheridan Street Portland, ME 04101 American Profiles Co., Inc. 20 Blaine Street Manchester, NH 03102 (603) 623-5518 179 Sheridan Street Portland, Maine 04101 (207) 773-6122 DATE o- / ,? q / C17 SOURCE HOME TEL.(09) U 967S8 WORK T6 THIS AGREEM ma/de entered into between AMERICAN referred to as con r MAIL►NG ADDRESS/STREET Ob V M WA( I CITYIA (% � `• CUSTOM MADE PREMIUM HOME IMPROVEMENTS Installed by Factory Trained Technicians License Numbers: MA 110714 ' Also Licensed in Maine, Vermont, NH Toll Free (800) 639-7902 Fax (603) 641-9640 NH L• r J NC., 20 Blai m r �Fi 6102 hereafter ns u. R P ZIP of hereaftei referred to as owner THE SAID CONTRACTOR hereby �� agrees that it will furnish all labor ana ma�ials�necessary to install the following Qescribed work at premises located at: JOB ADDRESS P� km — I CONTRACTOR agrees to start described work on/or about " >b weeks after all necessary permits are obtained, and complete described work in about working days. CONTRACTOR shall not be h+Ql 10of yyjs due to causes beyond control. YEAR HOME BUILT PLEASE MARK ALL SIZES PATIO SIZE COLORS MOVES PROJ. WIDTH0 T. TAX MAP O.D. SLAB ❑ OLD ROOF: WH//I E ONLY–Pe'-DRYER VENT ! ,1Jr f 1:1NEw BOOK & PAGE NO. TEMO FLOOR r TEMO ROOF S4,LE: 4"4 INCH ❑ CATHEDRAL ~XSTI ne SPIGOT rU ❑ TEARDOWN ❑ WOOD DECK / �.�,� i ❑ EXISTING SLAB ❑ WALLS & I , i "� MICROBLINDS (color) &114 fle U ❑ FOOTING I.f.] / ROOF ' �� SKYLITES - no. ❑ PIERS - no. ❑ DOOR BAY WINDOW ❑ WALLS CAT. # BRICK ORDOOR BLOCK WORK WORK 11❑ TOP TRANSOMS ❑ BOTTOM Front Wall BREAK THRU ❑ SKIRTING Right Pro]. STEPS - no. ❑ ENCLOSURE COLOR: t CUSTOM TRANSOMS ,e`J- ❑ Left Pro]. 2" WALL 4 ❑ SCREENS ONLY ElGLASS & SCREENS El3" WALL [:1SCREENS ONLI9 GLASS & SCREENS ❑ WWII ❑ VINYL ❑ YEL Customer to obtain all necessary permits ❑ We give permission to American Profiles to obtain all necessary permits The following work includes all labor and materials needed to complete your job in a workmanlike manner. WORK NOT TO BE DONE BY AMERICAN PROFILES: Initials: ' / - r�, 9� �(� �J p e y� b rV C� /C THE OWNER SHALL PAY FOR THE WORK p In Cash or Check upon Completion p By MCNISA/Discover TOTAL INVESTMENT: -O WP nrnnncp hprphv to furnish material and labor — comolete in accordance with above specifications for the sum of $ x Y1 5 PAYMENT DOWN PAYMENT UPON JOB START UPON JOB COMPLETION INITIAL AMOUNT ' e0o A 0th U /0, qlr Electrical connections and hook up are the sole responsibility of the Customer. CEMENT AND HEAVY EQUIPMENT RELEASE: It is further acknowledged and understood that American Profiles Co., Inc. and/or its job-related resources will not take responsibility for any damage to driveways; sidewalks, fences, landscaping and/or any buried pipes, cables, tiles, or utilities which may occur during The construction process or when entering or exiting the property upon which the job is being built; furthermore, cement is not warrantied. American Profiles Co., Inc. follows standard building construction procedures and exercises the maximum amount of caution requisite to each job. Cement jobs handled through non -American Profiles companies (not part of the American Profiles Co., Inc. agreement form) may cause an additional expense burden to the customer if they do not meet or follow American Profiles standards or are not built to code. American Profiles Co., Inc. does have approved resources for cement jobs. Cement jobs which are part of the American Profiles agreement form are handled by American Profiles personnel. Customer Signature Customer Signature Date You may cancel this agreement if it has been signed by a party thereto at a place other than the address of the seller, which may be his main office or branch thereto, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent, or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellatioorm for an explanation of this right. hz as All material is guaranteed to be as specked. All work to be completed in a workmanlike manner according to Authorized Signaturer standard practices. Any alterations or estimate deviation from above specifications involving extra cost will be executed only upon written orders and will become an extra charge over and above the estimate. All DATE &9 / agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. NOTE: This proposal may be withdrawn if not accepted within days. An interest charge of 1-1/2% per month (18% per year) will be added to any amount Date of Acceptance / unpaid after 30 days from invoice date. Signature In the event of default in payment of this order or any part thereof and the account is referred to an attorney for collection, the purchaser agrees to pay reasonable attorney fees. Signature �- Cl;, _s WE 8 UN�4N sr ' 4P. S.8 o .... s Lot � � f��-rj/ ��s -���'a,!/J � � I� Roder L S�✓ c�ve%c M ' (00 ! ►� �► r a 3h I. _ U I So �v 8092 1- t __ /•o i /.R / P. 850 A 0 0 O (� Clock �+ ("7,7 ria t? i \O rnrn. e J e I l' D 88..3 r � ' •. /00-0 / N x�•��e,�h C 1719417,:7h s' 15ai/ey I PLAN OF LAT �N NORTH ANDOVF.Q, MASS. OWN ED Fay QOBE QT L.;' ACO UV -:L! NE ". Q! L EY .d er p HAQOLD P. f' PQEDA M. BAQQINCTON SCA�� 1 2d' tv 0v. 2, g 53 Th i Plan cdov, no+ requi rQ {hQ 12,6,1 -PH Z,. (B2ASSEUQ,C.E o{' the Plann n�q 6oarCi CA tblz -Town of N (� V F Q !-1 l (., ►_ Ill A.sS . .1,1 � r- � h And <�• v v r: sip PLANNING BOAl2U UFT"(:> -NN ol= NGtZTN ANWVF(Z p. J. Mc C Q AC K E N /A E -'" U E N MA55. K�e►n der O H o CT to CLO o o CO) CL n m n o Hma0 M Z =rlo y n:CD yo' T .. m a � s = m CD O m y O N O gym' m S = m p CCD to G O ti. Cj : ::&o m C =r y ca o a a m CD c 1 0 CD I CA O d N N CL Cr C c CL H � C � � r^^ 5 � m H m m � y ea CD O c� mCD o ri z =� CD 'O O d dd: a � n n 0 0;, = o o ~" _ C �' d v■ Oz d H o y "M m A' C � ►d r ° m O° � Z w n�d .7 '71a o z It � C C CO) 0 C') O CD n z y 't? R %� CL n� W Cn n 0 c c CD CD ` Cm O �• Cr Im ^* CO o �-I CD O M CD O O C CD y� CL a y to CD I �. y O oc CO o O CD O .CD H' O O H o CT to CLO o o CO) CL n m n o Hma0 M Z =rlo y n:CD yo' T .. m a � s = m CD O m y O N O gym' m S = m p CCD to G O ti. Cj : ::&o m C =r y ca o a a m CD c 1 0 CD I CA O d N N CL Cr C c CL H � C � � r^^ 5 � m H m m � y ea CD O c� mCD o ri z =� CD 'O O d dd: a � n n 0 0;, = o o ~" _ C �' d C o Oz d H o "M m A' ro yn o w' ►d r ° m O° � Z w n�d '71a o z It � C C a a. 7Cto rb d O )mvq 0 9 0 c CD 4 Location 5`6 V d t blv 37 No. Date 7-23- TOWN 2-TOWN OF NORTH ANDOVER pft�•o ,•,$•p � Le C? • p� i ' „ Certificate of Occupancy $ \•"�� ` Building/Frame Permit Fee $ '+ssH�SEt`' Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $-- TOTAL $ =-1 Building Inspector ' R ^�*` Div. Public Works W a a W N � o� Z Q J_ m H LC w W Ir F W _Z J 0 C o O 1� a W Z J N Y 00 w < Z 4 W ZZ N W 1w0 O W � m p J > m N p p O < W f w p W Z N L O Z O _ a � N_ O Z � a i a = N _ 2 � N v `CI � W O � Z 0 j N 1 u 2 0 m N W Z a O~C IW6 0 0 0 p J 7 4 0 N W X m 0 f f 0 O Z V W N at w N 0 w W W N a 4 0 W O J N i Z m N N 0 w I w 1 m O I— < i o O N_ t t W N J_ J yaj p M 4 I x N 0 P a O Z I w k, a7 V d a z Z F �O > � V V o � ` d 0 � x I I Q W N � N Z Q J_ m H LC w W Ir F W _Z J 0 C o O 1� a W Z J N O w < Z W Z N W ZZ N W 1w0 O W � O J > m N p J > m N p p O < W f w p W Z N IL O Z O < Z 4 N Z O Z W Z Q U _ N W z m FI tc a J ZNQ E+ N N j N 1 LL 0 m 0 0 0 OS wI 0 W N w LL Z N N x 0 w I w 1 < i o O N_ N J_ J yaj p 4 4 I x N W a F - z O It 4 Z p Q W N � J I J V: j m I � I m Q J_ m H LC w W Ir F W _Z J 0 w < cc W J 1 U W m O 1� a W Z N O INi J 0 W 0 J Z Z < Z W Z N W ZZ N W 1w0 O W � O J > m N p J > m N p p O < W f w p W Z W f a N 0 Z < Z O N Z r. I� T a W Z Q U N mw W z N W z m FI tc a J ZNQ E+ u N j N 1 0 U 0t m � 0 0 OS wI W a ; W a F - z O It 4 Z p Q W N � J I J V: j m I � I m Q J_ m H LC w W Ir F W _Z J 0 w < cc W J 1 U W m O 1� a W Z N O INi J 0 W 0 J Z Z < Z W Z N W ZZ N W 1w0 O W � O J > m N p J > m N p p O < ■ r` z 01 f U. z �A" Ir W L 0 m L m 8 It 0 z w f K W L U t m r v0 z I 0 Z J I J V: j m I � I m w Z W < ' W Ix 1 0 w < cc W J 1 U W m Z 0 0 N _ N W W al\Oa J z �o u1 i � I I ■ r` I N Z 1 J V � f J W 3'. m 1 0 u N j N 1 Z Z 1 0 0 W W ; N N w I w 1 p o O N J_ J F 4 4 I 0N m W I w W a7 0 I N d 4 I r v0 z I 0 Z J I J V: j m I � I m w Z W < ' W Ix O N LC o L I < 4 p w < cc W J 1 U W m Z 0 0 N _ N W W al\Oa J z �o i 9 ■ r` J J V � f J W 3'. o 0 u v x I � 0 u I W I d I N z I 0 Z J I J V: j m I � I m w Z W < ' W Ix O N LC o L I < 4 p w < cc W J 1 U W m Z 0 0 N _ N W W al\Oa J W aC w Z N ti G N y A A 1 N D T O O Iw 8 T 0o Vi O A Di 0= y> r V1 p�A p Ap,mpD mm OC) N ~ D O_ O A x N D Z 2 N n� ti T 0 r N Z 0 0O � vmimDv +Oi N p a p IIIT�_IIIIIIIIII12; ADOmmv ; Ni 0: y;:E aD D O O T O Dp pA-i Am mmOD n<� >m Dnp' m�vSDmmSO D A m y A -�C +Z-! pN DOzxczonANm pA x OOTOmN< ;TT x o 0 D Z A y C� z 0. xz<n.1O C m N Xz A Z m ti ' .0 w n w 0znnCcpm=0o> m w o<> D* p n A m Z- 0• D W T p ti 0 O O N 0 y N 0 Iv M 3 D c T Z D D 000 ZAZZOO C v`^NxvA Z 7C O� < < T TZ�ogz�o D Dnx CA OpDAO 3 n s ;T OAZZ TT m c0 T:2 Z{DDZi /y� W %9 C n y T? n O 0 v S Z m p A Z m p T N p m Z` m N m LC Z H w n A0O A n n N D; N DcIZ I I I_ ~ T p ti T ti I T 3 T T m m T Z D D ti C Z 7C C < < T N D Dnx CA OpDAO 0 n to lO ;T OAZZ TT m c0 T:2 Z{DDZi /y� W %9 C n y n 0 0 Cl o N m m u,Cu► Zm mN0 . DO Z Cox �X-i D n 0�0 UI p mim • mX -IzD X00 N0",Z MN3 HOZ mW0 NCZ r rr-°_o �c)r vog r z�z ° =o 04 �D �z 20 mm mm C' M LLLJ I I I I I_ Ll� I J_1.1 I I 0 _ D Dnx CA OpDAO n to lO ;T OAZZ TT m c0 T:2 Z{DDZi /y� W %9 C ON TO y n ; = y v S Z m p A v D m T N p m Z` m m LC Z D p ^^ r Z p x m n; p z 0 T S II 6 Z O Z I A 1111111 IIIIIN Cl o N m m u,Cu► Zm mN0 . DO Z Cox �X-i D n 0�0 UI p mim • mX -IzD X00 N0",Z MN3 HOZ mW0 NCZ r rr-°_o �c)r vog r z�z ° =o 04 �D �z 20 mm mm C' M v Cfl 'a C � CO! Cl) 10 0 CD n Z y O n� r C O � C CO)CM CD O p co o CD CD O CD C CDCD y 0 N1 O I tC CD � v CA O 10 Z CD O � • CD O CD 0 I� N M 9 FY V J 0 z cn c? o e a S O —• y 0 a y C m CA a m O CD C•) C2 m "�•� C2 CD Z m a=,m = m m p m y O CA N o m m: m D •o o : 13 -� O C y Ci CD C CA CD CD y CD c a 0 m CD y d a ^f c :b G Z CA < N y = 1=0 m d y a O mCA O :� m; CD y o m dm: oma: a'fl n23 om: C42 O � O oma: won -moo I d rt o Gyw ���yy I' n 1' co n GO O � � O O o, � C �•' to C/)tz (rtD 7' Gi O 1 N W 0 c CDol t r� TOWN of NORTH ANDOVER AFFIDAVIT .•n- nI• • on a•Gxitractx law •• .Ila•• r• .nn • •• ✓.1■ • a• 1 r :1 / •�•• � s• ■ •/ r�•:I■ •/ � ••:I■ •/ a•:1 II••:.•/1 �1■ • •• SwY • I11• • alla Iall• •.11• ■ • IWO Wroo - •• ■ •1 •' .. / ••/ ■ •/ /• • �• ■1 • • ••• •1 �• • I • • :..Y •a •- • • 1 41 •' •• - • .•J �• a. �• ••/ICK •Ir•w 1 / •� Y.t a.•a•AL ■ • . • 1 / •'/ a• 1 all - Type of Work: Address of Work QA) Owner Name: 1 Gv✓r /� !� �/�-� �+CaC� Date of Permit Application: Est. Cost I hereby certify that: Registration is not required for the following reason(s): For office Use ably Work excluded by law lit ND. Job under $1,000 Dire Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby given that: Sh u hies of perjtry: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above proper t Dat& Owner Name