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Miscellaneous - 18 Fernwood Drive
�1 E 1 GCjr7 Date ....l..�I%�.:...... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING lI �+l t I n This certifies that v�-�' fi.....................................nAr- '"'�...........!�.c "..... has permission to perform ...�...... t`��! -..... .t2.u....Se.... .. ................ plumbm, g,ia.the buildings of ...........16�........................................................................ i +P V ........................ North Andover, Mass. Fee.. Lic. No.,Tgn 1..... 4!Y6� ...... :....................................................... PLUMBING INSPECTOR Check # J ,ZIII� l:.t..C.C.➢ej P TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY a�"'� __��� MA DATE Itt- 6�'%*_JI PERMIT# JOBSITE ADDRESSemu, �„mo ' OWNER S NAME OWNER ADDRESS TEL-�____JIFAX OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL D1 NEW: 0 RENOVATION: t, REPLACEMENT: Q RESIDENTIALW PLANS SUBMITTED: YESE9 NOE1 LFIXTURES Z FLOOR BSM 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 1 10 1 11 1 12 1 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTERIO KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET WATER, tAill WATER PIPING M� �� r�r 0-MMMM �•r • F�II� �F�F�li�—F�11�—F�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 [ NO Q r IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY tA, OTHER TYPE OF INDEMNITY 0 BOND M 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 I© SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the be t of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comp) with aH-R�rtinent vision of Me Massachusetts State Plumbing Code and Chapter 142 of the General Laws. \ a,� C ))� PLUMBER'S NAME d � - 0�r ���-VA�LICENSE # �_ e SIGN?ARE IVIP� JPI CORPORATIONQ#I�TfIPARTNERSHIPO# LLC Ek COMPANY NAME ADDRESS CITY STATE rz �� ZIP TEL FAX jl CELL _5�_-11 EMAIL w LL The Commonwealth of Massachusetts - Department of Industritd Accidents Office of Investigations kvi 600 Washington Street .Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/lndividual):_ eA. L Vx-,4L-,� ib+j i,[ ^ r Address: City/State/ZipAav2f1t AL, l g J7 Phone #: � 70-" 3% C Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4. F1 am a general contractor and I 6. F1 New construction ` employees (full and/or part-time). * 2.X_I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. 7• E] Remodeling ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance.g E]Bg addition [No workers' comp. insurance 5. El We are a corporation and its 10.❑Electrical repairs or additions required.] 3111 am a homeowner doing all work officers have exercised their right of exemption per MGL 1 LJ&Plumbing repairs or additions myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs insurance required.] employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i 'Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a 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 information. Insurance Company Policy # or Self -ins. Lie. #: Job Site Address: Expiration Date:_ City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL 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. I do hereby ferto un r t a ains qwd penald perjuiy that the information provided above is true and correct 32c)-23� Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: CRI .0 MMO MMO QN. EALTH_ QF & J BOARD:`p <>:PLUMBER »;> GA`SF.1T;E.R ` .:A:R.V' ISSUES THE FOLLOWING Lt0`ENSE CRI .0 MMO MMO QN. EALTH_ QF & BOARD:`p <>:PLUMBER »;> GA`SF.1T;E.R ` .:A:R.V' ISSUES THE FOLLOWING Lt0`ENSE LICENS -F AS A MgSTER PLUMBER JOSEPFI P HARDIMAN LLh>`>`'STFtE 3 � ET Z H'rA..... L L MA 018 2 - 0 3 3 2'2''" 9 9:7<...... 5YOU :.:::..>:.: 39 t I 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 or 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 dwelling house of another 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 be an employer.." MGL chapter 152, §25C(6) also states that "every state or local licensing 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), address(es) and phone number(s) along with their certificate(s) 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. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of 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 permit/license 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 (ifnecessary) 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 bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for 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: The Commonwealth ofMassachpsPtts Aepat` went of Zndustriai Accidents Office of Investigations 600 Washington. Street Boston, MA. 02111 Tel # 617-72.7,4900 ext 406 or.1-877,MASSAFB Revised 5-26-05 Fax # 617-727-7749 wWWaMass,govfdia Date ..... ��-.:...���...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......................................... 5Z,1,1— C .................................................................... has permission to perform...Q ft l _ c%vQ-e ....(....................................................... wiring in the building of...................................... .O Iia at ...../ ..............rhe J v.............4......................... , North Andover, Mass. 'Fee .. � 05- I ........... Lic. N .................. .. M%� .,,...JLE?C�MaCAL� ................ INSPECTOR ; i... Check # " V 111i = V6. �� Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 0-5 5 7 7 Occupancy and Fee Checked [Rev- 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NM 5 7 MR 12.00 (PLEASE PRINT IN HK OR TYPE ALL INFORMATION) Date: City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives n ce of his or her intention to perform the electrical work described below. Location (Street & Number) Neer\ o � �7 A Owner or Tenant Owner's Address M- Is Is this permit in conjunction with a building permit? Yes L` Purpose of Building � iQ I,� b cKe-IK-e ^'z - Existing Service 2W Amps (10 / %Lto Volts New Service Amps / Volts Telephone No. No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd 1�3— No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion ofthe following tahle may he waived by the fn.cnectnr of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans ~ No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above In- rnd. ❑ rnd. ❑ o. o mergency Lighting Battery 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 Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number " ' " " Tons "'' """"""""" KW """.............. No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of *hires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: 1194 1 y Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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: INSURA-NCE BOND ❑ OTHER ❑ (Specify:) I certify, cinder the pains and penaltif perjury, that the information on this application is true and complete. FHM NAME: es y � ( h �� 7L _ .09,� LIC. NO.: 10 Pi9 Licensee:/ Ponw'J I/ ' - L 1,'�G,n �' Signature LIC. NO.: (If applicable, enter "exempt" in the license number ' e.) Bus. Tel. No.: Address: a IAI ✓r t ��\t 0��30 Alt. Tel. No.- *Per M.G.L c. 147, s. 5 -61, security work requires Department of Public Safety "S" License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required bylaw. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8—Permit/Date Closed: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: . Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: D te: FINAL INSPECTION: Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comm Inspectors Si nature: Date: N DEB WEINHOLD ... TOWN OF MERRIMAC, MA........dweinhold@townofinerrimac.com ML The Commonwealth of 1l2'assachusetts - DepartmentoflndustrialAccidl nts Office of Investigations 600 Washington. Sheet .Boston, MA 02111 www.mass govld'ia Workers' Compensation bsurance Affidavit: Builders/Conti°actors/Electxicianslpliimbers A.ppReant Information Please Print Legibly / If - Name (Business/Oxgani'zaiionlindividt�al): �'� r G �L'� (1 (I tel �— Address: 5i� 4T 4 v i ,Sz-o, City/State/Zip: Il0. l{.- kt44 4W C?5 P Phone #: (Ml Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with 4• ❑ I am a general contractor and I 6. ❑ New construction mployees (frill and/or part-time) * 2. I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. 7• ❑Remodeling ship and'lave, no employees These sub -contractors have 8. [( Demolition working fox me in any capacity. workers' comp. insurance.9. 5. ❑ We are a corporation and its ❑Building addition [No workers' comp. insurance xequired.] officers have exercised.their 10J211ectrical repairs or additions 3. ❑ 1 am a homeowner doing all work right of exemption per MGL 11.[( Plumbingrepairs or additions myself [No workers' comp. c. 152, §1(4), and wehave no 12,0 Roofrepairs iusuranceregt*ed.] t employees. [No workexs' 13.0 Other comp. insurance required.] IAny applicant that checks box*f must also fill out the section below showingtheir Workers' compensation policy information. t -Homeowners who submit this affidavit indicatingthey Ate doing all work and then hire outside contractors must submit a new affidavit indicating such. rContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. am an employer that xs providing workers' compensation insurance for my employees Below is the policy and job site informadon. Insurance Company Policy # or Self ins. Lic. Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fins up to $1,50 0.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a %xne of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA. for insurance coverage verification. I do hereby cert ruder .Riompfi-IrP.' 1 Phone#: I />g I ofperjury that the information provided above its true and correct, nags. %// ,, ,�/ Official use ovfy..Do not Write in this area, to be completed by city or town official: City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. CityHown 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 tri the service of another under any contract ofhim,- express or implied, oral or written." Au employei is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the Foregoing engaged in a j ohit enterprise, and including the legal representatives of a• deceased employer,or the receiver or tnisteo 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 dwelling house of another 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 employes." MGL chapter 152, §25C(6) also states that "every state or local licensing 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 ofpublic 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), address(es) and phone number(s) along with their certdxcate(s) 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, apolicy is. required. Do advised Mat this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. the affidavit should be returned to the city or town that the application for the. permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensationpolicy, 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 par it/license number whieh will be used as a reference number. Iu addition, an. applicant that must submitmultiple permit/license applications is 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 b eon 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. Anew 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 orpermit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any.questions, please do not hesitate to give us a call. The Department's address, telephone aiid faxnumber: The CQmmoumaittlofUassarhv Ptfrt - D-Tartment Qf fndwWal Accident Office o fAvouga-am 6bG Wubl ,gtoa Street BWon, , 02111 TO. # 6IM-27,4.900 eyt 406 Or 1-8777 1 ANAFE Revised 5-26-o5 Fax # 617"72� 749 wwwaaagov/dia Date—'. .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......AP -.F L L.._L .(.......................................................................................... has permission to performVA(6 �L APt e7 It,yviring m the building of...................................................................................... at ... ,1. K......P,rtvc North Andover, Mass. ...................... Fee.....'........... Lic. NoC.�{�... �......................:...d......... ELECTRICAL INSPECTOR1-0 Check It 12107 D6paff-mvid ofFim Sanvfcas ,w Pemim' —_Z�+ of BOARD OF P71PE PREVENTION REGULATIONS 'ITGV Md.-ee 'hfFnk-ri cot�ftac a- f3fd e70,,• f a��Ifc f fe j �`�G"' 1""a (IeGvebla�ic) APPLICATION FOR PERT TO PERFORM ELECTRICAL WORK AL t orlC io bapeziozmed in accoxdance w to the Massabhuseits Electrical Code (?at j, 527 QVM 12.00 (�'T�LSEPRINTiNZtVORI'P1;�� OR 14TXONJ Date: City or T oven of� Ver le o the Ir pecto7' a�"Wi� es: By 7sapplicaiion�iieundertgneclg,Yesnoceofhisoxherinieauort pezio eeleciricaItvoxkdesct�e�beTow ' Lora�on (Stxeet� T Icer) �. CT Omar or Tenagtl<n vh is T'elepFzone No ' : 7� . Qwnex-'sAdrTress 9 D tlzly p erMR in conjuuctlorz 701a hildiug Permit? Yes ❑ No � (£.*b.eck Appropriate Rox) 1'uxpose ofBuriding Uuty lutl'ionzaffon No, .. - Elisaug servim Amps I Volts Overhead [l ' Undgrd D • . xO. of Meters I`2'eitr•5eryice Amps. I Volts Overhead [j tundgxd ❑ No, -of Metors 410L.ILt r W. r eeuers azza.rMpaciv Location. and Nature bf Traposed Electrical Work: , C l� vi1 S f3 1 —� be - - --------F--�---�-•.-•.,.. axrsiurruers--� _ i `�' S�Fo. of Luwhaira OuEleb No. of Hof Tubs Cenezators K7A No, oAbove Iu- o. o mergencyz ting C i Of Luminaires �Swimmingk'ooI �xnd. d, Q Batfe Units - -- -.eo exp Felt {}utIets— - _ �Tne-rt£=Q�=Biers—=•I=A.� -�-c-•moo=o��xt�=----_—.�-.—�— J_ �' M. of;;pitches INo, of•CasBux�zers No, 01JJ66etiOIL and 7niiiatin }}evices NO, of Rang No..ofAir ConcL Total ons No. of A.lertfngDe),ices I No. of WasteDisposexs HeatEump Number Tons KW pNo. ofSeif-Confais�ed } 'Totals„ %�etecfion/AIe Devices No. of Dishwashers aclxeHeang !Catp Couneerion El Oder No. of'Dryers Heaf agrAppltances r Seeuriiy5ystezns:* } Ito. ofDevices or E ivalent No, of Water INo. of i�i0. of Data Whin Headers 5i s 23aIIasts No, ofDe zees or Equivalent - No. HydromassagaPafhnzbs IND. of Motors ToWIT Telecommunications Wiring: j .�... No. ofDevices or i+ 'valent OTTM: • f1ti^ch addz,�onal9� it xY'de ;h,4 or as regv4,e by MF -Inspector of y7jres: 1 EsdmatedYalueofBleciricalWork, ` ? CWhearegaizedby r,mkpaTpoiicy} C�lorkto 'tart �}' i } Xnspections to bezzquesiecCin accorda_M •witb.MEC '11010 _L 70, and up oil cozupledon I INSURANCE C0VEDA.C1r: Ualess waivedby the owner, no pero for the pedozwAxtce oz"elecaical woxknziq issLe tnless the Jiceusee pro'ddes proof bf Eabilify insurance iaclading "completed opemon" coverage or it3substMfW eggivalBuL The I undersigaed ceruses rbat mch covorage is in form, and los e*bitedproof ofs.axo to the pezu..it bsuing offcc. _ CHECK ONR: 19SURLNCE 0 BOND 0 oTIDR (5peciy:) SalfLjsored c�fy,. rr. rider fhepa; za o7idpe-aaUs? ofye2Tury, thrf therrcLqthis ¢ [rc¢ic� is true and co�� tete ' pF p ?�21V{ l�T1s � .- ADT LW DRLI T Securry � LIQ NE�.e C 172 Licensee: 'homael Lee ignature LIC. o, C-172 gapp&able. P- „axamot in the IicE>+ e number IXz J Rus. TaLITo.: Alt Tel, Io.� � ecur ySysLemOo cEorZicenserecpuredfoxthisyrarllr�applicabieenfieripI censeu mberhera� 001.779 �i E' INSUI�AI�CD+ WANED: > am. aware tiatthe Licenseodoes not have the liabiltyiusu a cecovexagenoLL]oLoy reed by Iay , By any siguatu e below, Thereby waive this xequiremsut, .I am. tiro (check one) [( owner ❑ ow_ nex's agent 1 QwierlAgent _ AACk'J C� egeevv int ,`:a•� —_ ,;�'•' — —'�}fit H [C' - - iii' :`�i:i�i'l r k�a� (� - _ q• — SL - x - Y=SrT - - - - - 'er •.:e ,_- - _ .._=�rrc'�•,rr n�r�'•�, ,. ,..- , e'f��='0:2'09_ .._ :�.._ ..- -- ._ ........, ._.'� I i • ,�„ �� Com�on�:aF+l: ni t>r=ssat5usaz'�s ' DepeLmefI of Pgb1ic 5a E!ty t!;i SCc�it,•si•�nee-•st;rrvro - License:-", 41-17,q 4It 1TnzFaza r.': Gotr+rrrissianeT• 05!16!2014• . s• D i. 4; 0 V 600 Wadff MVen Xfrgc a -9510R, 3,m mull ' un Tat I'v -'Op-mass"govAlfia Iverkers' Comrvens-FaVom I, ksuramce A-Mgdava-b- Ion OPFI)m b -e-.rq AL Please Nfnt !m III, ADT Security,�efyices ,Ile ikddyess,, IS Clinton Drive mv-M,m.fv-jzI'n!- Hollis. NH 03049 603-594-5930— "AFLy ftp who -Tcom.-Taerm that cEleck Ibbs box musraw-p0cd gh ndditibnal Rhectdowing thum-me of 00 4 wo I-Aleftfor •nqt illaso talMes. Pave i by Cm - POW r -vrnb,;ir nt, p 'VTL ts ateJUDY10JI fludJobsile 11110'Fruffebm. 111-sur.ane-e c-mr.psiny v Zurich American Insurance Co. 101.1cy9- -01- WIN rl..q, L1,20, Kr. WC509589701MC509589801 10/01/2014 'TobqReAddress.- 01, N-, " ) Fullure to Secure, CPU ggeag -rd,-- M, quir irvv, -Up, to $1,55000.0- 0- and/or Onclear 'Imprimmuent"as Well as civil penah-10-s in., tho tare uf a 5STOP AVORK ORD13M avd. 0. fine of tip to $2,50.00 a day tqTaum! ths Violator. �o.odvi--,,odAral, ft.mpyof.thI Invia-Aflig -cc crageverif-Rca-110m p6ons- ofthe DIA for -k mmmnm v .4 ZOO hemAy cefl(feep parw� f O-Openoftleg o em figg PeOW-F what Me, is foge and correce, gtion-O., 603-594-5_P—G_ -1— e of N'T'Gor, ly. Do 1709 I'mife.Mf' rbk areq, to ke cop d 45Y effy 07 mm 4 tarL 0 (y or ro V,.T pormilixii.mast 0 m R idingDepogiffient 3. CMITIQmm, Clerk 4, Eledviul TIM-spadur 5. 6-.'i ar Pemon Are yum 44 emVioyae? Chec.,li Me upp--f.)Pirlaft tex' ,m a -um a 4p av i f a gench-7almim, do -r anti, I vt & F11 Nei, 0 L �'T'Iredtfira ship ad jum no I L 0110cm 'employce's "Ind -have comp. 511surnn-00 i 9.A ILI insurm"CO "V -u- a -cq.;�orporat! On End itg ML I :isO their .1,n, cum I am a, cebaa ad.�` ip rog �1,03- myself[Mvworkurs'ccmp� r1glit Ok emomp-tion per 12.F Roof mpalfs Pj52,!9I(4-), and V40 hal(0:00. [No workers7 I imurance r=.mEed.I Securitv Svstem "AFLy ftp who -Tcom.-Taerm that cEleck Ibbs box musraw-p0cd gh ndditibnal Rhectdowing thum-me of 00 4 wo I-Aleftfor •nqt illaso talMes. Pave i by Cm - POW r -vrnb,;ir nt, p 'VTL ts ateJUDY10JI fludJobsile 11110'Fruffebm. 111-sur.ane-e c-mr.psiny v Zurich American Insurance Co. 101.1cy9- -01- WIN rl..q, L1,20, Kr. WC509589701MC509589801 10/01/2014 'TobqReAddress.- 01, N-, " ) Fullure to Secure, CPU ggeag -rd,-- M, quir irvv, -Up, to $1,55000.0- 0- and/or Onclear 'Imprimmuent"as Well as civil penah-10-s in., tho tare uf a 5STOP AVORK ORD13M avd. 0. fine of tip to $2,50.00 a day tqTaum! ths Violator. �o.odvi--,,odAral, ft.mpyof.thI Invia-Aflig -cc crageverif-Rca-110m p6ons- ofthe DIA for -k mmmnm v .4 ZOO hemAy cefl(feep parw� f O-Openoftleg o em figg PeOW-F what Me, is foge and correce, gtion-O., 603-594-5_P—G_ -1— e of N'T'Gor, ly. Do 1709 I'mife.Mf' rbk areq, to ke cop d 45Y effy 07 mm 4 tarL 0 (y or ro V,.T pormilixii.mast 0 m R idingDepogiffient 3. CMITIQmm, Clerk 4, Eledviul TIM-spadur 5. 6-.'i ar Pemon A Date......'..z. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ........................................................................................ has permission to perform .......... .5V.sc.7cel-I ......... wiring in the building of ...........1// ............................................ at ........... lJ ...... ........... .. orth Andover, Mass. Fee.V5-:�.!—... Lic. No. .2.V.9.6 ............ ELECTRICAL INSPECTOR T Check # Commonwealth of Massachusetts Official Use Only a - Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CodeMEC), 527 CMR 12.00 (PLEASE PRINT INK OR TYPE ALL INFORMATION) Date: '1 0/c) C7 g City o Town f: Nff Ar)�()�JZE To the Insp ctor ofWires: By this application dersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) ,, ill- God 61: Owner or Tenant �(',(,{jn {- }i( uy-, V(,Lo( Telephone No. 66S; 13- - Owner's Address SQA,-CIli - Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building No x BLDG PERMIT # Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install low voltage security system at above location Completion of the following table may be waived by the Inspector of Nlires. No. of Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ rnd. rnd. o. o Emergency Lighting Battery 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 Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Totals Number Tons KW ............ No. of Self -Contained Det ction/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ElMunicipal Other No. of Dryers No. of Water `y Heaters Heating Appliances KW No. of Signs No. Hydromassage Bathtubs INo. of Motors OTHER: KW Systems:' �ystems:1 No. of Devices or E uivalent No. ofin Ballasts No. o eveurvalent Total HP Telecommunications Wiring: No. of Devices or Eauivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work:(When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Brinks Home Security LIC. NO.: Licensee: John Holmes Signatures 9C /4-L, LIC. NO.: 749C (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-657-0443 Address: 155 West Street, Suite 6 Wilmington, MA 01887 Alt. Tel. No.: *Per M.G.E.-c. 147, s. 57-61, security work requires Department of Public Safety "S" License LIC. NO.: SSCO 001163 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 Signature Telephone No. PERMIT FEE: $ , �.a , � 12- 16- t4 6 0 I Location /d No. %rJ' Date D— NORTH TOWN OF NORTH ANDOVER F41 Certificate of Occupancy $ cHusE` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 18447 Building 21nspkfor I 9 I C .TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP AR2!T OR DEMOLISH A ONE OR'TWO FAMILY DWELLING :� r� ,•,�z ;; t '3,��� .� � sir- �' v �� sir .s "�,� `� " ,. 'ter DATE ISSUED: BUILDING PERMIT NUNIBER: SIGNATURE: Building Gomori ° nerJT or of BuildiaM Date SECTION 1 -SITE INFORMATION 1.1 Property Address: 1,2 Assessors Nhp and Parcel Number OR TN �AJ� ll�,�f� Map Number Pared 3amber 1.3 Zmmg Idormatiow Al I.A hgmty Dimeasiaxts: Zonhi District os«t tJae Lot Area Fronts t3 w 1.6 BUILDING SETBACKS ft front Yard Side Yard hear Yard aired Provide ReqWred IProvided Required Provided / f 3 1-7 Witer M.G.Lr— U, . Sd) t.3. Float Z"* h tbrmsiiat: 1.$ - SStiY' System pubis V P&Ma p Z. .w Rd Z.. Muaitipsl On Sift Dis s1 Systasn D SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record M Name (Print) Address for Service: .? .Telephone _ 2°2 Owner of Record: A^•n,,'-/ AA E1.4 -EU X, dQ41-1A.1 print Address for Service: t f Si nature Tel hone SECTION 3 - CONSTRUCTION SERVICES 11 Licensed Construction Supervisor: Not Applicable Licensed Construcllon Supemiwr: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contmetor Not Applicable Cf - Company Name Registration Number Address Expitution Date Si nature Tell hone IN, of SECTION 4 - WORKERS COMPENSATION IM.c.,r_ r. 142 a 1AWsa Workers Compensation insurance affidavit must be completed and Aqbmitted witb;this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Si affidavit Attached Yes—,_0 No.... SECTIONS Desert tlon of Proposed Work tchftkaU licable New Construction Q Existing Building 0 Repair(s) 0 Alteradons(s) 0 Addition Accessory Bldg. 0 Demolition 0 Other la pecify z , Brief Description ofProposed Work: 0Pl/ _ % A< SECTION 6 - ESTIMATED CONSTRUCTION COSTS item Estimated Cost (Dollar) to be _ C2 feted by-permitapplicant 1. Building ©a (a) Building Perzrut Fee Multiplier 2 Electrical 0 (b) Estimated Total Cast of Construction 3 pltimt tjn Building permit fee (c) x tb) 4 Mechanical. HVAC ' Qi 5 Fire Protection ti Total 1+2+3+4+5 3 i Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, l7 ,r C"�'�yt4��r✓ as (hmertAuthotized Agent of subject property Hereby authorize �i � to act on t My behalf, in all matters relative to work authorized by this building permit application, Si ture of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION i, ,� f /� / r✓ / . ( !J �J/�L -�/t,J , as ONvnerlAutliedzed 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 �- f✓ tl 4 print N Si=U.'"r aaent Date NO. OF STORIES S17E BASPMENT OR SLAB SIZE Or FLOOR TIMBERS i 2ND3 SPAN DlIvIENS1ONS Or SILTS DIMENSIONS Or POSTS DiMENSiONS OF GIRDERS PEIGHTOFFOUNDATION TMCXNESS SIZE Or FOOTING x MATERIAL OF CH NMY 1S BUIi.DiNiX ON SOLID OR )LAND IS BUILDING CONNECTED TO NATURAL. GAS LINE FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** o .A APPLICANT LOCATION: Assessor's Map Number SUBDIVISION STREET 97iQ(l'S��r PHONE 97K 4WAV PARCEL LOT (S)_ ST. NUMBER�� ************************************OFFICIAL USE ONLY*********************************** v V uu CONSE VATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER[WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised M7 jm a G U T -W' y7 5 GJdd ,S.c ti /j •e Y I "REDY r.8'Rr1Fr 2V FM FMR 1NSUAOR AND PLOT PIAN m r" BANR rlur r11E D1BI.LINC IS LODArED am IN rRF Or AS SHOW AND Mr IT DOBS cONFDm wim rm;--- Q�'.t�a�,?.�vovC� Some R3%[JLIZYQN4. RWARA Ms s8re w nwm srR m & wr Lms • 1 nmrmm cc=" wir Alms Dw=m is MOT ./ LOMMD W IM "MJM BLOOD VA*,UW AMU AS DRAD'N FOR S900W ON FFMA ;!Y PANEL # 2SoO9c9 S STaP WS PLAIN FO POSBS - NOT FOR � BaUNDARY DJE'9' BOOMMY INFORMATION MERRIMACK ENGIM'BISRING SERVICINS TAUM FROM !�'X1ST CORDS. 111 66 PARK STREET z -Ar z317 ANDOVRR, VASSACHUSETTS 01810 H W W F- N 0 °o z lx W LL O v U X a0 00 � J m o a 0 @ O � O � O m O Q O O O O O 'CF O O O O O O N A m en 00 0 o0 co OOX�U O U 'aa N co JO pO J c m O Y Y 0 mv� a �cn Ui. 22 o C �0 In !0 C C 0 O o w to N N C p W 0 S 2 Z Q` WU� � } ga z a z1� 08, P o O�5 U.a Qoo r F a o ff ? e t cca cco c Z W -' J. �v� NVQ Zoo >,m° =z :o ON Q o H d — cn ao ` m LL F-c..,,U C Zr:O i m 3 � z� � W p co cc d�H a v Zy LL F t7Q H W g� co LO y'm Q o: U o z} o J - aj (n 0o O W L pp ,.... 3 O m Op ChN 13C Y m 0 E O U W Z. E LL mdU J U 0 0 ��ap a� ZO V CL 0 cc Ha c HH _ V. U O _ m C ~ 2 O m 0 �L.W �a Q LU g z� -� U a on.LL�e 0 � fopp V C3 T C3 *= m O CON i0 o o �- > O CD m m @ y cn(ncncnC9 d m m Q Q — N L L _ L Q y� -J<U- -DM m L L, W OOf� U Em E ZQ jiAm�C LL QmlLm form QC,cc 00 V id L poi r. �. _ ag � �Q'O mi QZ ~N 10 O�lCD i Ofl� r a-�QQ O Om c IL UVii-i E ~ �cc F- W lzlz ®N :.: m LL ni o cQ`Q �Q �'� o En •� v Z L- ctL c mm i6= 0 } c vu=� m @ c,r� W �7)QDF0 W}C9Udo r�i Ln U W $e wy fs O WC C4 V4LU X atin vj LL N .. U CO LL C <O e+i Wp 0 ommmdCY C7 C7 dv y a ui v a o min 0 Q _ .a I Cy C7 3 e a Z �2 o��caxas2x vEi o cn J '� �W F-mtLSWmYW mmQ N W 5 p> 0.ti O Z Q Y 0OZ U�t7LL E i °' z= rn c ZLL m CJS? c 0 � C V -0 Z >. O O X cn 7 m m c. 13 W p Q (A (A 12 W 2 ci 2 ti u. U d co O W D) m a O 0 O 0 C g 0 0 0 0 N W a 4 J r� a2 o w° ani O w ng w° v a U w a w a a o w w a a U w w a w" a°' w aq ° z cn cn ui am z O U U O r2 a� O co ■ �■ L O � w z o. O y Q C I Ccm C.— CA Q M O ■� F mCD ow m � O� '-- 3 O O Q O Boa ca a �a O C d ow c Z s V ca C ■ C y Q uj U) C9 W ce ,,Www Y♦ o m C C C2 =. N O CoO ? art 0 a E to CE �ian E c w� � :.0 M C a: ci :z CD r ' ca cc m m ' L ` L y ch m rt+ o a ^\ y C C,ea m mo r6' V' yC: m O ry:S aSJJ- - 0 m V cccm O 0 CL n 5 N = m mm3 N coAID •v� 'a- n,= v .� LU O n v la g'o QO COD o� .� F- t $ n i m z O U U O r2 a� O co ■ �■ L O � w z o. O y Q C I Ccm C.— CA Q M O ■� F mCD ow m � O� '-- 3 O O Q O Boa ca a �a O C d ow c Z s V ca C ■ C y Q uj U) C9 W ce ,,Www Y♦ Town of North Andover Building Department 400 Osgood Street North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print DATE_ "3 d JOB LOCATION Number Street Address Section of Town "HOMEOWNER���=lw�� =S�E 7 ga-A '77,9- 01 V? Number Home Phone Work Phone PRESENT MAILING ADDRE/SfS� /1AP City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109. 1.1) 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 to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 ara that he/she will comply with said procedures and requirement .. HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. rz w a ' %L �. a N r _ PL ,s n � v � _L x N C�' u1t 1 a L-A A of � C NEW17�j1T'11� V �JTi%7lTjT1TiT1T�t�11Tj7/ ' %L �. a N r _ ,s n � 1 i�.liR>TL��T1T,t7iiT�T�T►rLTL�'l���ilJr7LT� � t V %L �. a N � t r _ ,s z 1 kWh= ° u J CLM o� y O 3� y ma CE s n E a 0 s tscm ti m c E mm � O ' � tq fA y • 3 Nu �� .00 C:yy C re COD Cc IF* : •I: aC= c O m v 'ari Z `o w � C O cm C s 4D 0s C36 p ti H .� a=WC Z W .E 60 *, t� .y O y a •CD C-293 O- d.=.. m U O 0 CD 0 as ■ CD z o. Cl y p C — I Ccm o■— CD p� g mm CD 0 CD CD ?ft CD CD p O ME Ca ca c Cc ca C x CD V y CCL C Cc y p o a a °o LE °. cm o w o c�4 x U w , a o w w W o w q w a�' w r� z cn cn 1 kWh= ° u J CLM o� y O 3� y ma CE s n E a 0 s tscm ti m c E mm � O ' � tq fA y • 3 Nu �� .00 C:yy C re COD Cc IF* : •I: aC= c O m v 'ari Z `o w � C O cm C s 4D 0s C36 p ti H .� a=WC Z W .E 60 *, t� .y O y a •CD C-293 O- d.=.. m U O 0 CD 0 as ■ CD z o. Cl y p C — I Ccm o■— CD p� g mm CD 0 CD CD ?ft CD CD p O ME Ca ca c Cc ca C x CD V y CCL C Cc y p Date../...l 4;�—'�,?.--... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATI This certifies that C-�d.4. !q.'.C1... .......... has permission for gas installation .. tt-.. ................... in the buildings of ... r ".. .� !. ?- ......................... . at .............. . North Andover, Mass. Fee..?..:.. Lic. No../.3/, c.�.... ..... GA'S)NSPECTOR Check # / 1 '1 6 6 MASSACHUSETTS UNIFORM APPUCATiON FOMPS4W TO DO GASFITT1NG. OMM or TTyW_ 4 11 ✓� .Mass. Date / _� Z 2 D- Permit # r Building Location- ✓ �^ /`"�r/✓Lc�©C7 7� Owner: Names 4'WIX-v Type Penc, G New ❑ Renovation: _❑ Plans Submfta& Yesp WEI .. i Business Name of Ucensed Plumber or Gas Fitter Check -awn ate: ❑ corporation - ❑ Pa&4mhtp A Firm/Co. INSURANCE- COVERAGE:. I have a 4 liability •inuuanee Volicy or ft substantial eq;which-meets. the requiremerrts ot:�MGLICN..1 No L-3 If you have-dndosdM&;ftm &A+A a =ee;ge.by, ,the appwpdde. box, A liability insurance policy OowtYpe Lindemc#y l Bond- ❑ OVVNER'S INSURANCE VVAIVER: I arwawere that, the licensee does M101 --have. the irmurance.coverage required by Chapter. 142 of the.-MassaGeMW-iawa, and M*-ffysignature°on-this permit application waWes .this requirement Check one: Signature ot.OwAW.,a- )wws Agent, Ownero Agent -0 I hereby certify that all of the detafa and information 1. have submitted (or entered) in. above � � and rate to.the heat of my knowledge and that All plumbing work and installations-Perlom�ed under the permit �� gill compliance with d Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the GeneraLlnrs. Tvoe of license: ✓ "' '- Title rJourneyman umber nature of um or fitter asfittor City/ToMm Master Ucense Number r 3lGi�. i ��S���e■►.�MIIME®NiiNIMMNMEMO MG .. MEN ENEEMENEE®EENEEN -0000 .. i Business Name of Ucensed Plumber or Gas Fitter Check -awn ate: ❑ corporation - ❑ Pa&4mhtp A Firm/Co. INSURANCE- COVERAGE:. I have a 4 liability •inuuanee Volicy or ft substantial eq;which-meets. the requiremerrts ot:�MGLICN..1 No L-3 If you have-dndosdM&;ftm &A+A a =ee;ge.by, ,the appwpdde. box, A liability insurance policy OowtYpe Lindemc#y l Bond- ❑ OVVNER'S INSURANCE VVAIVER: I arwawere that, the licensee does M101 --have. the irmurance.coverage required by Chapter. 142 of the.-MassaGeMW-iawa, and M*-ffysignature°on-this permit application waWes .this requirement Check one: Signature ot.OwAW.,a- )wws Agent, Ownero Agent -0 I hereby certify that all of the detafa and information 1. have submitted (or entered) in. above � � and rate to.the heat of my knowledge and that All plumbing work and installations-Perlom�ed under the permit �� gill compliance with d Pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the GeneraLlnrs. Tvoe of license: ✓ "' '- Title rJourneyman umber nature of um or fitter asfittor City/ToMm Master Ucense Number r 3lGi�. I O N W O z. .O v O sA Z Z sA sn 1- C O Q d I O N W O v Z 1- >L sA _ O O G W O 5 � ~ V M. CW 16 O O = d C C O O IL 1` 1i = O O W < O ti J d 96 W W d ' I O N W O Date. 7.-. l' - c7 «•° :1"o TOWNOF ORTH ANDOVER p PER;T FOR PLUMBING 40 This certifies that ..!..'. c C ... !................... has permission to perform ....I -X'. 1:7� ......................... plumbing in the buildings of .64 . A 1.t. `. t 1 .................... at . /?. . 7 <!4. �^- �. G �� . , North Andover, Mass. Fee ./. ?r.' ... Lic. No.. � v C .. ...... . PLUMBING INSPECTOR Check 6544 MASSACHUSETTS UNIFORM APPt.1 Type) CATION FOR PERMIT TO DO PLUMBING " (Print or Mass. nate— / Pam" Btnlding Location S7,4 ——� 6 Owners Name c1l� C'yAy�y" TYPO of Occupancy l� New 0 moron .p Fieph nt Plans SubmMe& Yes Q No G FIXTURES Z Check ori ❑ ftrWmship Firffdem I hae Y �urrerrt HaDift pommy or its stAsftK l equWalm" which meets thi �m ;,eems of MGL CIL U2. ff you h�dedced yes. Pease wWX=te the type WvWWe bf► A Gabirity ir�uranoe poi;o),d*dcrn� g the prnte boot. -g Other type of u,demr ft ❑ Bond G owls b""MCE wwvM I am awanethat the by clopw IQ of the Mass. General � and that- a>see does not have tf,e nce ►eQvired �►' on this vem»t aDption waives this ire of owner or OwnWX � Owner M. Check one: AgeM G �. ► CW* that an of the deceits and 7Wmnaron l have 0 h0 0e t ct ► Iviowledge.w+o that an piurrb;ng wow and Ma" n abom bion are true and a=xm to rroe++p6anoernithaN Pas�onsoftht.M� e_ issuediortfasa0p0camen ampteruZot uie General Lass. Si ntm oaf um Type of Lkerme %murneymm C- co co U Y ►�• W ku LLl Jm At jr ¢ su O0 au Z ¢ a ¢Ix O EW ��<i33gzi3Y°D¢��x r- > ►- O t E- O C 2 2 omoi < to t� ii W {ti Co .2 W imo Z .� 0. oc►-1.lao 1.4 f e �., .� Check ori ❑ ftrWmship Firffdem I hae Y �urrerrt HaDift pommy or its stAsftK l equWalm" which meets thi �m ;,eems of MGL CIL U2. ff you h�dedced yes. Pease wWX=te the type WvWWe bf► A Gabirity ir�uranoe poi;o),d*dcrn� g the prnte boot. -g Other type of u,demr ft ❑ Bond G owls b""MCE wwvM I am awanethat the by clopw IQ of the Mass. General � and that- a>see does not have tf,e nce ►eQvired �►' on this vem»t aDption waives this ire of owner or OwnWX � Owner M. Check one: AgeM G �. ► CW* that an of the deceits and 7Wmnaron l have 0 h0 0e t ct ► Iviowledge.w+o that an piurrb;ng wow and Ma" n abom bion are true and a=xm to rroe++p6anoernithaN Pas�onsoftht.M� e_ issuediortfasa0p0camen ampteruZot uie General Lass. Si ntm oaf um Type of Lkerme %murneymm C- Z _d. Z 1 p'. rc O i Z .� Oa _ d_ m Oac 46 e O W IL O: 9L ' V A Y A Location �rr 1-D No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ c Building Inspector Div. Public Works �J:I'T NO.. MAP 4-40. E APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 � LOT NO. �`,j" 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ;ONE SUB DIV. LOT NO. I LOCATIOXr PURPOSE OF BUILDING s� OWNER '&AAME �L J ne-L C c' -P, •�,I" NO. OF STORIES %C/ SIZE OWNER'S ADDRESS �� wf�DJQ% c BASEMENT OR SLAB ARCHITECT'S NAME'g/,�11/U ii HY�[/�i SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEL j -we / C - � SPAN - DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS --- f+' DISTANCE FROM STREET �S POSTS DISTANCE FROM LOT LINES - SIDES REAR 3� % " " GIRDERS AREA OF LOTr&o 0 �• Y�L'T FRONTAGE / R� % HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW 0 SIZE OF FOOTING X IS BUILDING ADDITION %5, V _C ,o � L �ILLJJJ /C MATERIAL OF CHIMNEY IS BUILDING ALTERATION Y � IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM T REQUIREMENTS OF CODE 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 Y PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING I ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR D TE FILED • SIGNATURE OF OWNER R AUTHORIZ AGENT OWNER TEL 0 2 '� F E E 2-©. �-O CONTR. TEL. #- CONTR. LIC. # PERMIT A ED 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST/ U a t 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 FAMILY f I STORIES MULTI. FAMILYOFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE PINE B 1 2 13 CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL '/, 1/1 1/1 FIN. B TAREA FIN. ATTIC AREA. _ _ N_O B -M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 _ _ DROP SIDING CONCRETE WOOD SHINGLES _ .1 EARTH ASPHALT SIDING ASBESTOS SIDING HARDN!J'D COMMON VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME (- CONC. OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I - I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD 11 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 I 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 11NIT HEATERS. " 7 NO. OF ROOMS AS.OIL OIL B'M'T 2nd _ 'at 13rd 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. �� catvzP,riT Sane 5. alh 0/ A./" 4f ��i R �2 02 k � � � � �-/ l � �/ _lea a --- 5 0— P/Z. c✓----G"--c/O/`l II �uS C 5�i�5 f� l J� — — -- e , i _ Ja�Srs In 9 • h y E§ _ O 0 ct Q og o W W e O W .� W. Z Z ? W W O z j H o LU _u � ca Z 0 v ? 09 KG m y Ix *00 L6 o T . o m m L C O) E -a L d. O) � L V W CD L p► L m C Y 'O L C 'O C 7 �. C O y O c0 O C ` O U ii OC ii ¢ co U. Q ii m to .` •C O o H e O u � .� C r O H O O U C _u � ca C °a 0 C y W y Ix *00 V . et � C 6� a CL a W r C u c � y au+ -y-ww W _ CL d ar • � O W V� � h a 3 p� m .= .= c E6. y a ° s y c y C H u Z = W cl ag U .E u y u rA ° "a o F r ° a .` O Z H .� i. a a C 0 C *00 C CL a W C C c Z Z) •. CL � O W V� Q W p� m .= .= c O Z p north 800 east along Boxford''St eet 245 fe t to pipe at point of begin - 'Ing. The grantee accepts t s conveyance s bject.to 1936 taxes.Thes dieing the same premises -co eyed to me by Henr Lambert on May 17,191 , +;and yrecorded with the No th°Essex Registry'of Dee s book 353,page 465. Fxaiatis L: Lambert wif�of said grantor, release toXaid grantee all '4-ri9hts of DOWER and OMEST+",D and other interests the in. WITNESS a� Our handand seal hi's 30th, day of April 1936. . Te`Commonwealt of Massachusetts. •)George M. Lambert (seal) r. ,,.",,,Essex ss. A. it 30, 1936. Then ,,)Hattie L. Lambert (seal) 3t personally appeared the above named George M. Lambert and ack owledge the fore'oing instrument to be his free act and deed, before m Elto '. St ens, Notary Public. My commission expires January 17, 193 . s.s x ss. Received May 1,1936 a# 12m past 3P.M. Recorded and Exami ed. 'A Vire, Ralph W. Bevington, Benjamin R. Bradley and Henry A. Schaake, Trus TrTste sof the"Qngue Bev, nton•Trust."un.dsr, trut,�,ind�tdated Decem . 'Fong e. .. - �; bex 3191928, recorded with North Essex Registry of Deeds, book 546, Be ing on page 12, by the power conferred by said indenture, and every other po Tru t IN CONSIDERATION OF one dollar and other valuable considerations to �? k`,pa'd, grant, to9f1i`lliam A. Boyle and Mary C. Boyle,husband and wife,as 3oyl (� :joint, tenants, and not as tenants in common both of North Andover Es -1. t u tCoyt• Massachusetts, a tract of land situated in said North And i /�.:x. . ;'A0ver, .being Lot numbered forty seven (47) on plan entitled "Waverly 9 2 iy/ ti' r�S -Ve6t Park", recorded with said Registry of Deeds, Plan No. 463, and 18(JUNDEDt ~Northwesterly fifty feet by Fernwood Street; northeasterly + jl�}one hundred feet by Lot numbered forty six (46), as shown on said plan;- ---r- E( !+;'southeasterly fifty .feet by Ldt numbered sixty eight (68),as shown on ,4?�:'i•se:'id plan;`•and southwesterly one hundred feet by Lot numbered forty tlgh.t (48),;. as shown on said plan. Being a portion of the ninth parte M ' a + ' ge'NO."Lambert" of.'Lawrence, Essex County; Massachusett , being_ amb rtro )tiedj, for consideration paid, grant to Claudia Roberge, f Lawrence to lobe ssaehuse ts, with QUITCLAIM covenants the land •in No h Andover, ge r, 4esachusetts, containing 9 4/5 acres, more or less, d more particu ;..Iarly•described a follows: Beginning at a pipe on the south side of *** *** ** Street, Nort Andover,at northeast corner of land of said Lam U. I. S. R. ��,r'r}t....• `- t ,• a. - 4:iy� thenee� roceedTn"" rsu`t i ` 10° �u�est 19 " 'feet to r i° a "Ai a"stones S amp *yy V Can ell d* l'tbence south 450 30' east 69 feet to a pipe • .thence south 49° 301wes _470,feet part of this last c urse being a ng a stone wall; thence A:<< "A.,.br,th 590 west 336 feet to a di t h;thenc northwest by ditch 215 feet Ef%gnce•northwest by ditch 400 feet,'th nee northeast by ditch 319 fee 1' to'corner•of stone wall to said Box f d Street; thence south 771 east !''by:stone wall along Boxford Stree. 474 et to end of wall; thence p north 800 east along Boxford''St eet 245 fe t to pipe at point of begin - 'Ing. The grantee accepts t s conveyance s bject.to 1936 taxes.Thes dieing the same premises -co eyed to me by Henr Lambert on May 17,191 , +;and yrecorded with the No th°Essex Registry'of Dee s book 353,page 465. Fxaiatis L: Lambert wif�of said grantor, release toXaid grantee all '4-ri9hts of DOWER and OMEST+",D and other interests the in. WITNESS a� Our handand seal hi's 30th, day of April 1936. . Te`Commonwealt of Massachusetts. •)George M. Lambert (seal) r. ,,.",,,Essex ss. A. it 30, 1936. Then ,,)Hattie L. Lambert (seal) 3t personally appeared the above named George M. Lambert and ack owledge the fore'oing instrument to be his free act and deed, before m Elto '. St ens, Notary Public. My commission expires January 17, 193 . s.s x ss. Received May 1,1936 a# 12m past 3P.M. Recorded and Exami ed. 'A Vire, Ralph W. Bevington, Benjamin R. Bradley and Henry A. Schaake, Trus TrTste sof the"Qngue Bev, nton•Trust."un.dsr, trut,�,ind�tdated Decem . 'Fong e. .. - �; bex 3191928, recorded with North Essex Registry of Deeds, book 546, Be ing on page 12, by the power conferred by said indenture, and every other po Tru t IN CONSIDERATION OF one dollar and other valuable considerations to �? k`,pa'd, grant, to9f1i`lliam A. Boyle and Mary C. Boyle,husband and wife,as 3oyl (� :joint, tenants, and not as tenants in common both of North Andover Es -1. t u tCoyt• Massachusetts, a tract of land situated in said North And i /�.:x. . ;'A0ver, .being Lot numbered forty seven (47) on plan entitled "Waverly 9 2 iy/ ti' r�S -Ve6t Park", recorded with said Registry of Deeds, Plan No. 463, and 18(JUNDEDt ~Northwesterly fifty feet by Fernwood Street; northeasterly + jl�}one hundred feet by Lot numbered forty six (46), as shown on said plan;- ---r- E( !+;'southeasterly fifty .feet by Ldt numbered sixty eight (68),as shown on ,4?�:'i•se:'id plan;`•and southwesterly one hundred feet by Lot numbered forty tlgh.t (48),;. as shown on said plan. Being a portion of the ninth parte M 4N , described in deed from Melinda B. Tongue et al, Trustees,to the grant- ' ors, dated December 310 1928, recorded with said Registry of Deeds,boo t 546, page a e 12. This conveyance is made subject to the taxes for the current year, which the grantees herein assume and agree 'to pay, and also to the following restrictions. 1. That no dwelling house shall, U. * I. be erected thereon to cost less than $4000., if for one family, and * Sta p * $.5 $8000., if for two families. No dwelling house to be erected thereon *Cance led ► * to be occupied by more than two families. 2. That no building or (` part of any building shall be erected thereon within ten feet of G, streets whereon said premises are bounded.' 3. Th.ut no building shall e2 be erected or maintained thereon except dwelling houses, private gar-' is ages and other buildings usually appurtenant to dwelling houses, pro- vided, however, that such private garages and other buildings shall be so constructed and used as not to be justly'offensive to the occupants of the surrounding buildings: 4.i That. no building' or part of any building on said premises shall bet.used for�any mechanical or manufac- turing purposes. WITNESS our hands 'and`• seals' this twelfth day of Noy vember, 1935. .y,)Henry, A. ,.Schaake Commonwealth of Massachusetts.' .Es-, )Benjamin'R.--Bradley `, sex ss. Nov. 12th 1935. 'Then )Ralph W.' Bevingtonfj personally a � p y ppear.ed the .above nam- )Trustees of the Tongue Bevington ed Benjamin It. Bradley,.Trustee as )Trust as_*aforesaidji , aforesaidt and acknowledged the foregoing instrument to-be-his free act and deed, before me, Mary McDonnell,Notary Public. (Notarial- Seal) . I Essex ss.Received May.1,1936'at. 50m past 3P.M.Recorded-and Examined. £' a, k q� Trus ees of , Ralph W. Bevington, Benjamin R. Bradley and Henry A.•Scha►ke, y To gue Trus es of the Tongue Bevington Trust,.under trust indenture ed Bevin t n December , 1928, recorded with North Essex Registry of D ds, book Tri1st 546, page 12, the power conferred by said indentur , , and every oth o er ower, IN CONSI TION OF one dollar and oth valuable considera- I Le tions paid., grant to M1 ael M. Lane, of Nor Andovero Essex Count '. (+ setts a tract of 1 d situated said North Andover,•,being t` t Massachusetts, ***** *** * numbered forty six (46) : on a la entitled "Waverly West Park",-- Lot * i U. S. *� I. R. * recorded with said Registry of eds Plan No. 463, and BOUNDED:North- *Stamp *�$ *IU * westerly fifty feet by Fern od Street, shown on said plan;. north- *Cane Ile * t= * j * easterly one hundred fe ..by Lot numbered fv y flue (45�,p as k ow Qn said plan; southeas erly fifty feet VY-Lot numb ed sixty nine` as shown on sa plan; and .southwesterly one hundre feet by Lot num- bered fort seven (47), as shown on said plan. Being a' ortion of the,-. );�`F ip ninth reel described in deed from Melinda B. Tongue et al, Trustees '�� Ri, to he grantors, dated December 31, . 1928, recorded with said Re stry� on 4j at r� u x t-+ Q� 0 b 0 z a� 3'+ b 0 3 at w r` 4j 0 a .. ♦ raw ... .t.r•. u. .. A.. k...!0.�:.�H+.34<1.••M. .Yi "''. 7. tiGr..: ..., .t . I, Mary C. Boyle, being unmarried Of 10 Fernwood Street, North Andover, Essex in consideration of one dollar ($1.00) • <"`^ i`.W..R�Yy(;�Fj Si�W��YIM W4:�.4.a• �...w •..•i.+W.u.JYM!'+ii:Y.:..1 . 1_Y 1. County, Massachusetts grant to Michael J. McQuade and Kimberly A. Skelian as joint tenants Of Lot 47 Fernwood Street, North Andover with cJui#Clutttt rni><euttnts the land situated in said North Andover, being Lot numbered , forty-seven (47) on a plan entitled "Waverly West Park", recorded with said Registry of Deeds, Plan No: 463, and bounded: Northwesterly fifty feet by Fernwood Street; Northeasterly one hundred feet by Lot numbered forty-six (46), as shown on said plan; Southeasterly fifty feet by Lot numbered sixty-eight (68), as shown on said plan; and Southwesterly one hundred feet by Lot numbered forty-eight (48), as shown on said plan. Beiny the same premises conveyed to the grantor and William A. Boyle by deed of Ralph W. Bevington, Benjamin R. Bradley and Henry A. Schaake, Trustees of the Tongue-Bevington Trust dated November 12, 1935 and recorded in North Essex Registry of Deeds Book 598 Page 181. William A. Boyle died June°17, 1986. Executed as a sealed instrument this /142— day of November 1986 Mary C BcW.e� k Zile (gontmoufveal#h of Pazsar4uze##$ MIDDLESEX ss` November Then personally appeared the above named Mary C. Boyle i`) A, / and acknowledged the fmcgoing instrument to be her free ct a d e , Before ►ne, W Char A. Per ins; Yr. My commission expires July , Recorded Dec.16,1986 at 9:28AM 742064 +r - t 1) 19 86 Notary Public 1989 i 8 •'�"+`e..s..—e•�w n ..'nam I 18 000 =Taeez �— a P, flan 0 50' 1 LOT 47 5.000 SF t 1 EXISTING o DWELLING o 50' 12'f 15 FEQNVVOOD STREET FOR MORTGAGE PURPOSES ONLY Not to be used for Building Permits, Zoning Variances 8 Special Permits- DESMARAIS 9rmits- DESMARAIS ASSOCIATES, INC. Setbacks shown on eased on my knowledge, Information, and belief, 1 certify that this plan are for the the building Is located approximately as shown and conforms to RAYMOND F. DESMARAIS determination of I. the zoning laws dimensional requirements regarding setbacks Registered Professional Land Surveyor from streets and lot lines In the clty/t not DAVID B. DESMARAIS ing requirements only. NOTE: NO . ANDO ER when constructed. 566 RoRors Str"t - lowoll, MA 01852 Phone: 459-9860 FAX: 937-0690 This is a tape survey sY based on the location of survey markers of REGIS EREO PROFESSIONAL LAND SURVEYOR 1 hereby certify that the dwelling shown on this plan Is not others and is not in- ESSEX County located within a special flood hazard area as shown on Federal Emergency Management Agency/Federal Insurance Adminis- tended to be a prop - �i �4`!S ` arty line survey. This \ �cy�` tration Maps. plan was drawn for Deed Reference Community Number 250 098 0 0 0 5 B mortgage purposes % RAYMOND only. Not to be rec- Book 2378 Page 315 a Identification Date JUNE %3,1983 orded. [DESMARAIS n No. 291,96 O; scale: 1 "=2 0 ' Plan Reference EClSTE� By(:4__ "is date. 4-24-91 ,c?�AI S .RED PROFESSIONAL LAND SURVEYOR Book Plan LAN'� KEVIN,*MURPHY