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HomeMy WebLinkAboutMiscellaneous - 90 PUTNAM ROAD 4/30/2018Date. 1�12- . -I . I . I . I , ............. ..... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies ................ ... ........ ......... ... VV\-# A 0-04— has permission for gas tallation ... .................. in the b uildings�of, lio (-,�A at ............................................... North Andover, Mass. Fee:�� ...... Lic. ....... N .. ....................................................... GASINSPECTOR Check ALP C5 rl L -S 3 -7 e .0e �) I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE 5/22/2014 �� PERMIT #Z JOBSITE ADDRESSI 90 Putnam Rd OWNER'S NAME GOWNER ADDRESS I Same 1 TEO 1FAX1 TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL[j PRINT CLEARLY NEW:® RENOVATION: El REPLACEMENT: ® PLANS SUBMITTED: YES® N0[] APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER Replace 1 Gas Meter x INSURANCE COVERAGE °I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES [:] NO IIF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW M LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITYE] BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ® AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in c iance with all Pertinent provision Qfthe Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I Joseph Marino LICENSE # 8736 SI MP 0 MGF ® JP ® JGF ® LPGI [j CORPORATION E]# 3285C PARTNERSHIP®# LLC ®# COMPANY NAME:j RH White Construction Co ADDRESS 41 Central St CITY I Auburn STATE MA ZIPI 01501 TEL(508) 832-3295 FAX 508-926-4347 CELL 508-832-4614 EMAILJMarino@RHWhite.com W F O z z 0 H U W a d z w 0 a z z o N❑ w � ~ w o a LU 3 PLO w rA z N w > p; w 0 w Q W N a dz0 a a a � U x J H a a N di = w H LL H O z � o H N U W a CA C�7 x c� 0 x IN M I .< m CERTIFICATE OF LIABILITY INSURANCE page ti OE 7. L08129120131 DATE 'Mm'DONM THIS CER1IFICATE 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 PolicAes)must be endorsed. If SUUROGATION Is WAIVED, subject to the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this certificate does notconferrights to the certificate holder in lieu of such endorsement(s), willia Of MaesachusottB, Inc. C/o 26 Contuy-y Blvd, P. 0. Box 305191 Nash -ills, TN 37230-5191 R. H. White Conatr-action Company, Inc. 41 Central Street P. 0. Box 257 Auburn, MA 01501 INSURERA.'The ChaxtAr Oak Piro tnsuran o INSURERS.Travo],grB property Casualty Co INSURER C:NatiOMAa Union Piro Xneuranca INSURER D; Travelers Ind&=jty Company INSURER F; P25615 -001. C rP aY of Am 25674-003 y o£ 19445-001 256,58-001 %JVCKAU&zi CERTIFICATE NUMBER! 20187680 REVISION NUMBER, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 16SUC-D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1NQICA7ED. 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. •6 TYPE ,A I GENERAL LIABILITY IMERMAL GENERAL LIABI I.ITY CLAIMS -MADE OCCUR AGGREGATE LIMIT APPLIES PER; B I AUTOMOBILE LIABILITY ANY AUTO AUT48 NEDR'CQA1 AUT08ULE[ HIREDAUTOS NON•OWNE Co DeflAUTOS P Ded VTC20co 977X9948-13 19/3./2013 '9/1/2014 LEACN VTJCAP 977K955.A-13 19/1/20.13 19/1/201.4 CADUMBRELLA 41,$ OCCUR BE8766140 9/1/2013 9/1/2014 X EXCESS LIAR CLAIMS -MADE DED I V. IRETENTIONG 7,0,000 D WORKERS YrRS'LSATION ILIT '�►TRKTJB 820SAI05-13 9/1/207.3 9/l/203,4 AND EMPLOYER8' LIABILITY D ANY PROPRIETOWARTNFR/EJ(ECUTIVE X NIA VTC2XUB 9203A71A-13 9/1/2023 9/1/x014 OFFICERIMEMBRREXCLUDED7 u OF EvXdence of Inmuraace CORD 25 (2010!05) Aeord MED EXP (Any one Breen PERSONAL&ADV INJURY 2,000,000 BODILYINJURY(Perverson) & BODILY INJURY(Peraccldent) OCCU c.L.kAGHACCIDENT s 1,000,000 E•L.DI8EA9E-EAEMPI,CYFE S 1, 000, 000 F-1- DISEASE- P041CYLIMIT S 1,000,000 SHOULD ANY OF TWE ABOVE DESCRIBED POLICIES SE CANCELED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPREaENTATNE 0011:4297604 Tp1s1694012 Cext:20287680 ©1988-2010ACORDCORPORATIO N. All rights reserved, The ACORD name and logo are registered marks of ACORD Date... lA./7J.1. z....... /( IN TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. ,eU�n . !/....()14 ........... p has permission for gas installation .. egt4? .!tom /. in the buildings of .. 44.1- ' IIAC ........................ at ..... ©.,1��o, ................ . North 4ndover, Mass. Fee. .s ov Lic. No.. 3z92-.. ..c�,�r: GAS INSPECTOR Check # 2 (//.S" Date. /vA/// ?- . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ..I.All ..grels.S • . . �. has permission to perform ...��'!x! .��/,9x9 !`�• • • t plumbing in the buildings of .. dv /!r ............ ..... . at .. Y. fiit.' *'? wh... •S./. ............... /-North Andover, Mass. Fee .,..h�.• Rv Lic. No. A -129V ......... PLUMBING INSPECTOR Check # /105's MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY I North Andover MA DATE 6/1212012 PERMIT #. JOBSITE ADDRESS 90 Pitman s OWNER'S NAME Ragliffe POWNER ADDRESS 190 Pitman TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL 0 PRINT CLEARLY NEW: 0 RENOVATION: ❑ REPLACEMENT: Q PLANS SUBMITTED: YES ❑ NO[:] FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 1 DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR I AREA DRAIN INTERCEPTOR INTERIOR Y KITCHEN SINK 1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES 1 WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of, MGL Ch. 142. YES[] NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance all 1ertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Mike Capeiess ILICENSE# 15851 ATURE MP❑ JP❑ CORPORATION ❑#PARTNERSHIP❑#�LLC❑#�� COMPANY NAME Boiler GuyMike Capeless ADDRESS 105 tyler St CITY Methuen STATE Ma ZIP 101844 —1 TEL 978-382-1017 FAXI j CELL I EMAIL MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITYQo,�r� (� MA DATE / i PERMIT # JOBSITE ADDRESS9a _�� �t/un� s -II OWNER'S NAME - GOWNER ADDRESS TELFAX TYPE OR OCCUPANCY TYPE COMMERCIAL _.-f EDUCATIONAL PRINT ® RESIDENTIAL CLEARLY NEW: Re RENOVATION: El REPLACEMENT: ® PLANS SUBMITTED: YESE-11 NO APPLIANCES I FLOORS- MM : ■ l-,®^ U, '11 51 1 �L .. AWL+ MtG iL !'■OW,�_ CONVERSION BURNER ..i _'-iW COOK DIRECT VlfNT 'Iry ^��.. I� l��'1j—�� 1E I�,d ■ ■?I1(—��I',�j16Sij,'1j1"k—���1I1.....�M� ��—(jI��1��I��I,IC��.:I �L��{ 'L—�; �r�{� K FIREPLACE ■ 1 11GT.—�',��j'1—�'1W�dIG� it�d'��—�'��''; / • •"IT: ■IF Lp�((��i1.�a-.r„r11��.5�L��b'r—,4low._s�11��3�0-01 'l�L�3�1j.^���j!I��jL��r�j��-�.,..{/ F1—�—ONWS .�-�__ FW—K i ' L'LST"11r—�Ca"''jl—�fL�_'i'lr---0's+t'lr-3f LFL'WT-41 .;c:-,. GENERATOR 'lr—��Il�—j''l�_+.—���+ ^'j—�k�'1r5—��4;'1j—fit _ ..lid �j'If:'t INK INFRARED HEATER ff 510 CKS ■•'•■•WWWWW.W[� X�W—MmMAKEU■,■ UNIT WWW%Wmo—Wm� mygom I dWWF--�WWWWWWWWW WiTLWWWW�-- I[� -•• HEATER ld �WO IW" -•, SPACE HEATER W WWWWTW1 FOW ROOF • ,■1i�kl^"�IIII�'.1�6�—�ti1�.���---��: 1 FW— L�'_�_'^-..�I_ Wl�'�'_�_WSJ.4�.-'ISlLIiLIILIlr z-7--4Lt��--i{1 -�.��] 1 ■ UNIT FM -_ �INO Lfs��t W _.7 moi UNVENTED ROOM HEATER 1 '6::41 �jW�j W , {L���.j �lj���iF HEATER,WATER ..A ���'—�1—I'I�f ���, � �;{1�..�����'• �W,�� lel, Fes— lel�1 IG Im—1 ir1--1�, „F I±R^ 1t':ate. F�--F 1. INSURANCE COVERAGE 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES IF -I NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE INDEMNITY [j BOND E] OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachus s General Laws, and that gnature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ED AGENT SIGNAT OWNER OR AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of y knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance ' h all Pertinent prov o f the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME 4p, -_j LICENSE # 3Z_ S RE MPI MGFI JP [ l'JGF[ �]j LPGI FCORPORATION Q# PARTNERSHIP El#= LLCD_ I# COMPANY NAME: ADDRESS CITY py p� _G1 STATE ZIP 34)33 TEL FAX CELL EMAIL _ H zz 0 H U W a w 4 1 ori O N W >- H W LU O [O+ CL U wVD Z V) WCO 5 a LU O > w w W � W o a a a COD U J F. a a a � w = w E- LL. O \ z z F U W a d C7 Cx7 'w 54 The Commonwealth of Massachusetts Department of industrial Accidents Office ofInvestigations 600 Washington Street Boston, AM 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/C MhCant Tnfnrmafin.. ontractors/Electricians/Plumbers Name (Business/Organization/Individual): - - - .- Address: - - City/State/Zip: ,� ✓ a�®��` Phone #: IW -,967 - Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I - employees (full and/or part-time). 2. 1 am a sole N!� or have hired the sub -contractors listed proprietor partner- on the attached sheet t ship and have no employees These sub_contractors have working for me in any capacity, [No workers' comp. insurance workers' comp, insurance. 5. ❑ We area corporation and its required.) 3. ❑ am a homeowner doing officers have exercised their •I all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employdes. [No workers' comp. insurance required.) * 'kny app icant th-t ch ks bas Yl Mma also fill out fhe t section below Type of project (required):' 6. ❑ New construction 7. [❑ Remodeling 8. .[1 Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other Homeowners who submit this affidavit indicating they are doing all work andthen hire outside contractors must submia new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site Insurance Compiny Name: Policy #,E or Self -ins. Lie. Expiration Date: Job Site Address: CitylState/Zip: - Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine Of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and penti ofperjurJJ that the information provided above is true and correct: vJfzczat use only. Do not write in this area, to be completed by city or town offzciaL City or Town: Permit/License Issuing Authority (circle one): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express 6r implied, oral or written." An employer is defined as "'an individual, partnership, association, corporation or other legal entity, or any two or more of -the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer., or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the — _ _. dweliing•house-of anoiher_who-employs persons to-do.maintenance, .construction or -repair -work_ on such dwelling -house -- -- - - --- or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152,' §25C(6) also states that "every state or local iicensing'agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.,' Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses) and phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with.no employees other than the members or partners,. are not required to carry workers' compensation insurance. If an LLC'or LLP does have employees, a policy is required. Bo advised that this affidavit may be submitted.to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date *the affidavit. The affidavit should �tb rataunG 6o f toR a th=t ih? appliCau� ar the p earl o: t he 9aty o: F in�Y F Q e9 fY 1 4�. t P �op—• !^1Y (: IST Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. the Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pemrit/lice*nse number which will be -used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)" A copy of the affidavit that has been officially stamped or marked by the city or town may be, provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business. or commercial venture (i.e. a dog license or permit to burnleaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would•like to thank you in advance f6r your cooperation and should you have any questions, please do not -hesitate to give us a call. The Department's address, telephone and fax number: `I'.he Commonwealth of Massachusetts Department of Industrial Accidents Of flee of lia estibaflons 600 Washington Street Roston, MA 02111 Tel. ## 617-72.7-4900 ext 406 or 1-8.77 MAS.SARE Revised 5-26-05 Fax # 6.17-727-774.9 Location S'�C ! �J%/!�%�/i✓l / � r No. �_ Date NpRTp TOWN OF NORTH ANDOVER 3? _ • pG igQd1kp Certificate of Occupancy $ * ; • Building/Frame Permit Fee $ Foundation Permit Fee M$ _ sACUs Other Permit Fee $ r Sewer Connection Fee $ I G;% ^ Water Connection Fee $ a' f ` rOTAL A1V Building"Inspector �C" ;. Div. Public Works PERMIT NO. 60 IF r APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. V PAGE 1 MAP 00. LOT NO. I 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE (ZONE SUB DIV. LOT NO.—I LOCATION PURPOSE OF BUILDING ; OWNER'S NAME i ��, C y �` 1 7 L 1 C1 1 L [L� 1 C NO. OF STORIES SIZE o N f OWNER'S ADDRESS �� OWP - �v u-rp.�a-w� 0-0,A& BASEMENT OR SLAB ARCHITECT'S NAME _ SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Lo Ge ] p cL SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS f, W DISTANCE FROM STREET POSTS -� DISTANCE FROM LOT LINES - SIDES REAR "' i V GIRDERS AREA OF LOT FRONTAGE F FOUNDATION THICKNESS IS BUILDING NEW .+� SIZE OF FOOTING 1 X IS BUILDING ADDITION , I� I L/ MATERIAL OF CHIMNEY IS BUILDING ALTERATION .� `I IS BUILDING ON SOLID OR FILLED LAND V WILL BUILDING CONFORM TO REQUIREME TS OF CODE -/� -I IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL 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 APPROVED BY BUILDING INSPECTOR DATE P LE1 S RE OF OWNER OR A D AGENT F E 5 n PERMIT RANT 19/ OWNER TEL. QTR. ILC CONTR. LIC. 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST , EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYSTORIES MULTI. FAMILY OFFICES APARTMENTS __ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE a 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDWD PIERS PLASTER a DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M TAREA _ 114 1/2 '/ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS II 9 FLOORS CLAPBOARDS CONCRETE B _ 1 2 3 _ _ DROP SIDING WOOD SHINGLES EARTH HARDW D COMMON ASPH. TILE ASPHALT SIDING ASBESTOS SIDING _ VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORPOOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD I A HIP BATH (3 FIX.) TOILET RM. (2 FIX.( _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST V PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. _ STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING ' RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M_I 2nd I_ tt 3rd ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 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