HomeMy WebLinkAboutMiscellaneous - 312 Andover Street (2) 312 ANDOVER ST
2101047._0 0020"0000.0
l
r
i
'I
I
i
{
I
I
i
Location /31 a 4 IN 1D0�77- 'S"M0f7— J
No. 4- 'D Date
„o*, TOWN OF NORTH ANDOVER
V ~ p
♦ i ,+ ;
Certificate of Occupancy $
~ �,sACHUS t� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee`Oew4T�o,j$ So'�
TOTAL $
Check # �1�0
7
1 4 1 v 3 Building Inspector
a
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PE
RMIT NUMBER: DATE ISSUED:
ic
SIGNATURE:
Building Commissiongjng=tor of Buildings Date
SECTION 1-SITE INFORMATION �• O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
o •
Map Number Parce umber
1.3 Zoning Information: 1.4 Property Dimensions:
C
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard `
Required Provide Required Provided Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ Zone outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn
2.1 Owner of Record
Cd/�,�e� �� C�v✓S � oP
Name(Print) Address for Service: (�
Signature
2.2 Owner of Record:
Name Print Address for Service: o
z
M
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES 90
3.1 Lr sed Construction Su rvisor: Not Applicable ❑
Licensed Glonstruction Supervisor: (e `. S^�� 0
y License Number mn
(Address / � —y d
Expiration Date
ignatur Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date A�
Signature Telephone �!
r
SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes.... . No.......❑
SECTION 5 Description of Proposed Work check all applicable)
New Construction ❑ Existing Building ❑ Repair(77 erations(s) ❑ Addition ❑
Accessory Bldg. ❑ DemolitionOther ❑ Specify
Brief Description of Proposed Work:
..� �?/���fps/�✓
- SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be pFF'1CiAI USE ONLY ,:,„
Completed by permit applicant
1. Building 'S =—Wtoa Building==e-
Multiplier
ermit Fee
00
• O
® Multi lie
�- r
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee tel X (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5 Check Number 192
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BU11DING PERMIT
1, as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, /!iU/'�� Y �4'l''j?/Y/� as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belie
Print
ature of O er/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS iST2ND 3KD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
r
NORTiy /►*P: 4-4
Town of over ,>A*= 2>0
D z= L dover, Mass., 'ALA-Lt i Ann
COCKICKEWICK V
oRATED
vv ` BOARD OF HEALTH
PERMIT Td/Kitchen
Se 'c System
UIWING INSPECTO
THIS CERTIFIES THATN&rvto. ...1}orlkXkTLIaD r '.CRi'!4Atp!s!uJ� ...yAJ� .......... Found 'on
has permission on.....ale.../ .i4i ................. Rough
to be occupied as............. 1CQ��. - u�t2l.s S� Chimney
r.. .. ...................�-......... 4 ....................
provided that the person accepting this permit shall in every respect conform to the terms of the application on file i.. Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBGIN ECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
ELECTRIC SPECTOR
S . J.��t., CD W& i$ Rough
............................7............... ................BUILDING INSPECTOR Service
Final
INSPECT
Rough
Display in.a Conspicuous Place on the Premises — Do Not Remove Final
IRE DEPARTMENT
Bu er
cam• ��'� S No.
SEE REVERSE SIDE oke Det.
921E _61111,wal11UEl1CC21 Olv'GCCC;jac2'lUja _
BOARD OF BUILDING REGULATIONS
,License: CONSTRUCTION SUPERVISOR
Number: CS 063515
a Birthdate: 42/16/1967
Expires: 12/16/2000 Tr.no: 5377
Restricted To: 00
RAYMOND Y CORMIER _
15 MEADOW VIEW LN 1.•�.ra .�'i 111
ANDOVER, MA 01810 , Administrator
Town of North Andover NORTH
Building Department �,? g�` 6'6 0
27 Charles Street o
North Andover, Massachusetts 01845
(978) 688-9545 Fax(978) 688-9542
Ib
co
cxwiiwiwcw 1•
0R4TE0 Pp.
Building Demolition Affidavit 9SSACHUS��,(
DATE 0`/0 _ 0
OWNERS NAME&ADDRESS i22! li 6-4o -G
PROPERTY LOCATION Iv2 �vim`
DESCRIPTION �� � ',S/"!� G-jdU
CONTRACTORS NAME&ADDRESS e 47wiyieysdl
'ant 4�?Z410
DEPARTMENT SIGN-OFFS
D.P.W./WATER ' SE
r L`Z
t�;�GAS
C' ELECTRIC a
J, /TELEPH
� CABLE
TAXES _ �
POLICE
J �
FI
EXTERMINATOR
DUMPSTER-ON/ FF STREE f5 Uevl j' -C. ✓ s�}/G,rt IVIV
a
DIG SAFE NUMBER (fyiY
BLDG. INSPECTOR DATE REC'D w
4r
r
���
f
e
4-
. 1, s r
' /f
/./
�!
`'..
t
rl
G /
' ,, /
r
1
EXTERMINATING - FUMIGATING- TERMITE CONTROL - SANITATION
MAIN OFFICE: 1320 MIDDLESEX STREET,LOWELL,MA 01851-1297
TEL: (978)452-9621 FAX:(978)459-3184 -
® ;I
0,
3
August 30, 2000
I
a
Ray Cormier Construction
59 Chandler Circle
N Andover, MA
Phone: 815-4468
RE: 312 Andover Street l
N Andover, MA
I
To Whom It May Concern:
I
This letter is to certify that BAIN pest control service did perform Rodent Control Prior to j
Demolition on Wednesday August 30, 2000 at the above referenced address.
Sincerely,
BAIN pest control service
Gary Graf
Service Coordinator
{
GG/rb
i
�z BRANCH OFFICES: BO1TON AREAo WOB'RN c9�llu5y78n'^RAnMIN�MuM 87uu8000oFAo.RFueu buccrcjo uf11 HBUpn lon1GiacurnY uN 11u eaa ca lOenr.TER 281-5879-NEWBURYPORT 662-9266
- - ccTco uu iii-nnn ESTABLISHED 1926
AUG-30-2000 09:23 OF-788 (NAM)V1.11 512K 12345678901234567890 P.02i02
'��^ tM ��>..�<, .O.z ��EYRAW
f <Y fxtt .+tri �B/:; f
s x,-. x - f �rVDATE O
.c n 3
a
. >ri
{,....:a.,. : .�. •. '.S. i'.. : ...frt..4k. f<S- ;w k.c:Sc. „ e
v140DUCER 978-458 1865 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAInON
Fred C. Church, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
One Merrimack Plaza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 1865 COMPANIES AFFQRQING COVERAGE
Lowell, MA 01853-1865 COMPANY
A Hartford Insurance Company
IalsuaED
COMPANY
Cormier Andover Const Co B
Catamount Construction COMPANY
59 Chandler Circle C
Andover MA 01810 COMPANY
D
._ :•___.. .::.r-:.;.;:.,.:.,...... ..,.:r.:r.r.;aa.vr:^rF:v ,,,..{a.;.:,,:..:.r.�:�...v;a....rr.....n: ^.r:;-..•'•.:r..;.:•�.:....
��j x.:. i> .; ..-xa ..e.....a,.>:.. !1:::::>:.>:::art:<<�='$•<<k:::?-x:_::->.r..>..>.i.v :. :.t,.}rr'• rr x.f... .:K 1�n <. ..e:..i:.x>r..ax ...i>..,...._... w-tz
f'..��,/.��j-' a:.s« >t .:�:do:<r.:._.x::•:�....._.:,ir.. .x,rr J�v s {r"'�7fk.-ls.x,{a r.�a x-rx-r x i<..ka'�x rt..'<�.xay.. f...:..... -h� 'Y r3 f-r>.e;v„�.�,
:!<�7f �.<:.r.,...t.::. ...::......::..:.......:.r' {.^{r'�?•lg.x f.f ia:{r:n'r<.>rx.xi.i Yv.-9ak�-k:;<o axlc ..w>t.�<.>i'i'< •���> r.,Ix
..,...:,x....a`<-:<...ti..s<F:e:<-.a> >k •.>..av>..;.«..<:.•<..<o'rt> ..>. .,><..x a:.�< 'x>�a-<'xe�..Hr v< ...: xa'`{>i{.;zo r,w..a +vr:,..
...:... ..:>.ac.w. .v vas.r. ...-<�<.a:.>.>..i<-:al..Y�:tx<{ii.wt>..x�.><.r.:x.x•aiu.e..:2n':.:x:4!.:i'.��::...,.;.... ., .<. ..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ICY WCfqkA'rt
LTTYPE OF IN$yRANCE POUCY NUMBER PDATE OLICY
IMGUm00fYY1 GATE fMMIDO/YYN LIMITS
A GENERAL LIABILITY 08UENBS1390 1127100 1127101 GENERAL AGGREGATE � 7000000
X COMMERCIAL GENERAL LIABILITY PRODVCY$-COMP(OP AGG S 2000000
CLAIMS MADE �OCCUR PERSONAL&ADV INJURY 8 '100009
X OWNER'S b CONTRACTOR'S PROP EACH OCCURRENCE i 1000000
FIRE DAMAGE(AnY One Eitel 3 10 0 00
MEO EXP(Any one person} S.` 10000
AUTOMOBILE UAMUTY
COMBINED SINGLE LIMIT
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS IF*M$Of l S
HIRED AUTOS
BODILY INJURY a
NON•OYYNEO AUTOS Per acc4tno
PROPERTY DAMAGE S
CAIIACE LIABILITY AUTO ONLY•EA ACCIDENT b
ANY AUTO OTHER THAN ALTO ONLY:
EACH ACCIDENT ..><.,...��
AGGREGATE S
EXCESS LUABIUTY EACH OCCVRRENCE S
VM8REGA FORM AGGREGATE i
OTHER THAN UMBRELLA FORM s
A WORKERS COMPENSATION AND OBWEIE8129 14/14/99 10/14/00 we sT MTr Fa "<
EMPLOYERS'U"IUTY
' 0.EACH ACCIDENT $ 100000
THE PROPRATORI INCL EL DISEASE•POLICY LIMIT s $00000
PARTNERS/EXECUTIVE
OFFICER ARE: EXCL K DISEASE•EA EMPLOYEE $ 100000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIMICLE6!SPECIAL ITEMS
JOB AT: 312 ANDOVER ST,NO ANDOVER, MA
...-.... _............ .............:...:.,,�.�., ....:.aw.>.>.w-<.>:<.,>:.>ss.>:<.>.:-..<..:..,a..,.,.....:...y..:. ...... -
{Y.<a-wka.k>.
x.-h{a r<:a� -r i. •r�?: yr >axi_w3:t.:�.
�A,+�-jam r.r.'S;?`%'rl:: t E',f,.x {�� - :i"i. ,•.i+vx.tfo. k•. Y-<!,ol r
.:��.�..�.:r<�.�..�.....'<�25 .x.. ....,...,<.. .. ..F: ..................'.<.>:>kr;...�iy>a;.F:.i.._ ................. .....-....,_....._4a.•r..i;jxL{..ryfJ..'.: h.s ... ...... � .. .>.,
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLEO BEFORE THE
TOWN OF NORTH ANDOVER EXPIRATION OATE THEREOF, THE ISSUING COMPANY VAM ENDEAVOR TO MAIL
NO. ANDOVER, MA 10 DAYS WNTTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT.
BUY FAILURE TO MAM SUCH NOTt"BNALL IMPOSE NO OBLIGATION OR LIABRrTY
OF 49Y KIND UPON THE CkNIPANYp !!!.jA_gWTS OR REPRESENTATIYR:S,
AUT"
T1YE
��. 1i�i.T1�'i':G7Y!�k��"ti:(�r737.♦::..s..:},.'--.:ck..a::.:::v:."..,-.,a....�r....�.s...f.::.f...b,.x,.•..::........v.,.;.....-•:.i.s.±.::-...r........r.:.;.:.:.:.x-Fa•:�.vr<.r-r.w:-r1,v.>:>.:.. s.<a.>�<...x.l>.x.x.�.:<.:.>w..l.ra,s.:�-x.-S�."at�..{)'x.a::•7<.f<�?.:c"E->�Y:-cro:c
! - wt'
-.•{.ia1'�-:�:'.`w.'i..fa...i..:s:'-•r:6s„;:.�r_-x..?`oY:;<x.
•:i ..<...
TOTAL P.02
AUG-30-2000 09:15 12345678901234567890 97% P.02
Town of North Andover a� NORTH qti
6y6 O0L.,
Building Department o
27 Charles Street
North Andover Massachusetts 01845 z h
(978) 688-9545 Fax(978) 688-9542 o� `°`"'w '
SACHUS���h
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 s 54, and a condition of
Building permit# 4S` ,71) the debris resulting from the work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a.
The debris will be disposed of in/at:
Facil' y location
Si nature ofscant
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers'Compensation Insurance Affidavit
Please Print
Name:
Location: rol,/�` ��✓l�Y�'
City Phone 7&9 0//9
aam a homeowner performing all work myself. '
1 am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
Company name: lr/%�/� U/� cd� s .���.$��/�,✓ �G �o f
Address
City' �-o cd-e Phone
Insurance Co. � �� C �!�✓/G�� Policy
Company name:
Address
City: Phone#:
Insurance Co. Policy#
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00
and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do herby certifyunder rnsenalties "of i ry that the informatio cs d above is true and correct.
Signature Date �d d
Print name �' Phone# or ,
Official use only do not write in this area to be completed by city or town official' Building Dept
❑Check if immediate response is required Building Dept p Licensing Board
p Selectman's Office
Contact person: Phone#: Health Department
Other
FORM WORKMAN'S COMPENSATION
08/31/00 12:03 FAX 7817210047 DIG SAFE SYSTEM INC 10001
I
fAjF
I
DAY: v�
DATE:
ATTN:
011 1F'
COMPANY:
FROM:
# OF PAGES; (including this cover sheet)
S v�
NOTES:
f'f�1 t
DIG SAFE SYSTEM, INC.
331 MONTVALE AV
WOBURN,MA 01801
TEX.,;, 781721-0990
FAX: 781-721-047
WEB: www.diggafl-'.COM
p �I
Ilg�`�
� r3c l�
1 �� �-
. . _ .
08 '30/00 09:38 FAX 7817210047 DIG SAFE SYSTEM INC Q001/002
DATE. Ao/of)
DAY: 1a�
ATTN:
COMPANY: �,prmcer �n�o«e� � sr'vc�te�r
FROM: G
�r
._ •- # OF PAGES: 0--cluding this cover sheet)_c
-------------------
NOTES:
I -
D!G sAFE SYSTEM;INC..
331 MONTVALE AV
WOBURN,MA 01801
TEL: 781-72140990
FAX: 781 721-0Q47
WEB: www.digsafGcouu
AUG-30-2000 09:39 ?817210047 96% P.01
r
� G7"•i
. . ., -
,, _. _,,
•,. , ,.<
,. :...
�'
:-
. ... �. ,.
t .
. ..,.-<.
f
05/30/00 09.:38 FAX 7817210047 DIG SAFE SYSTEM INC "` 10002/002
aJ.
Reof,• _ _ _
N
pyo •�' fi��'1"`T-S��
STREET ADORESS . .ANDOVER ST
NOS 300, 312 ABD 322
ifu
T7 i.
yy .i,t E a..Y:'u `�l:.::r i: ,...,�.,„ �'_ - - _ :,.tiff•..r - .as.: >;,�'+ !.•..,?7'-.•r:a l.; .�.
:'�_� :�� )�y�(S��-�:�,�[y�+�• M r•?.yam{' '�y'�';���::..,ti..Y.•'.�.._..L.`i t.:Y�
-:f. 'r t�,: ..r1'�(,:T..� .�r!.•'�i ,f� I..>.- ..�%.`i'�••,^7�+»r .:.4•. •A. .}AS. tk i.:k:'.I.t.al.:•'�:.I�^:^.�':
: e. ;. ...- r.�V.�$Yj�...• ., taJ" r.EL :',.... �3��y..::':,.,. M.:A:,}A+•,4 dr.7:7`y..�;�... .»_'l^�. �:v_x�. :'��T._ kf ..�.,�f,���'F .
.; -✓:., -_ f e A' - :f w.� :r:. Wit~.-t.:kli"':•:�4r:•.. -:5::��rr: �'.'`i:?��t t
f �>c, ,..-a n �fr'.;:5:-`;'T�ii ..S,ii'�"r.:•ati:.r:M;r'c'!:<r;
CALLER . . . . . .SHAWN TITLE. . .OWNER
PHONE #. . . . .978-373-5354 FAX. . RETURN CALL. .8-5PM
.; - -^'.;-.:.,<':y,:.:�•�Y,' ..ryf: z._.-Ci>Y-..4'i ;.I'� '!�'%�.t i�i,:R -.`�}?:JSA;�: - �'G'._ V>.,t.: �,R•a\
f ,..
:;•%:..-:=.r: � ....,.••d-- ,�`C . ...,,•:.:.�.,;�.;fi.i.-.. .r. -�'.:-. ', :1a`J,.- ,;c".£;.,t::»•r .;£y` -n•���::9e°_T`'f�4`��it. - :`u•'' Lv.
-
•7A
»
�t f
.f fin. 1% +Y'• V.l�:• .1'•
- .v.:.+ -v;.;,::;,:�--.-r.'1.✓,!.�.x r:Y.. S.it�- '['.'J�:. _.y:.•._..,zii.<�:4p.:•. 11:'::,(<a.^.,:.?yii..
-
... �:6 r':::;y :�5• .t';J..�!/•�:�Yr:.• :.,k.:...,,t:..:,:.�.:%.,�r•::�E:,k:.. .J..�.fi... l�
ALN,-30-2000 09:40 781721047 93% P.02
t%ORTH
Town of North Andover of st��D 6,
Building Department .6, o
27 Charles Street °
North Andover Massachusetts 01845
(978)688-9545 Fax(978) 688-9542
4
�.q
Art
DgD I•If�,�S
Building Demolition Affidavit . SS NUS
DATE �d m d
OWNERS NAME&ADDRESS J?W4
PROPERTY LOCATION
DESCRIPTION
f` CONTRACTORS NAME &ADDRESS G
�lr G'�,i,✓���iC /'� Dov /V11 x
DEPARTMENT SIGN-OFFS
D.P.W.I WATER ` S
t
` r
GAS
v ELECTRIC
AL
f! ���' �cC/ • iUU �/ .vim' /�O- �i7�� /,���
G
E DATE RECD
Town of North Andover E N°RT" q
0 . ko
Building Department °�
27 Charles Street °
North Andover,Massachusetts 01845
(978)688-9545 Fax(978) 688-9542
4�AATEof-
' f-
Building Demolition Affidavit "Ss "US��
DATE
9—/0 d
I OWNERS NAME&ADDRESS
PROPERTY LOCATION �� �'��o�'�` �/ • /u` �'��®` � 4
DESCRIPTION 412 Hous
CONTRACTORS NAME&ADDRESS �47ievNr _��? Gvr� �a✓� ,
DEPARTMENT SIGN-OFFS
D.P:W./WATER ' S
r f
1r
GAS
v ELECTRIC
CLEPH
V CABLE - -
( TAXES
POLICE
c G�
F 0X/ �
XTERMINATOR �3UIa-
EJ
DUMPSTER ON/, �STRE
f S tJy ooh /'laC�s S-'.✓� SA/c.., N��
DIG SAFE NUMBER
BLDG INSPECTOR DATE RECD
i
_i
08/31/00 12:03 FAX 7817210047 AIG SAFE SYSTEM INC Zo
;F,
f;.
DATE:
DAY. L�
ATTN;
COWANY:
FROM:
. this cover sheet)
# OF PAGES• (including
NOTES:
DIG SAFE SYSTEK INC.
331 MONTVALE AV
WOBURN,MA 01801
• TEi.:, �817zi-4990
FAX: 781-721-047
wKB: .dlgsafacom
08/30/00 09:38 FAX 7817210047 DIG SAFE SYSTEM INC Q0
A
1{ r r
f.
1
is DATE: DAY:
AT'IN:
:i COMPANY: W � r s cera
FROM:
t
# OF PAGES: (in-cludiug this cover sheet)
i
NOTES:
i.
DIG SAFE SYSTEM;INC.
331 MONTVALE AV
WOBURN,MA 01801
3Ex,:
FAX: 7$1 721-0047
WEB: wv►w.diggufe-CM
�i
AUG-30-2000 09:39 7817210047 96% P.01
08/30/00 09:38 FAX 7817210047 DIG SAFE SYSTEM INC X002/002
099—FG*SSTAAS —MF* —SF* —71*
�i13A1�:C:YP1��L�:tF:�;. _<s,_ Nt5'�'fi+l�-.Q"�173f?4I:F,k':r�y�t��>�'�;•P`k:(I:I�S�1`'`T� ': tl � Y i <���`
STREET ADORESS . .ANDOVER ST
NOS 300 , 312 ABD 322
- �{�/ 1' y"'! y�c�.(•y�i�:I.y •f�•l- y.. lir.r "T;t'• y,t �i•,�`t1-��„yam_ -a�crh F,. rt ..+.1`+.r.y.' ..��'W'.:.:.1' `.r.Y: �
h� `"y,14•1'. 14� 4P"►T^�•�S� ����-�y'(1.bf•..� .c�C ��4'" 7r`L^��.d�' .��'y{}y�::.a i�P:,iV,': r`P.•'}a.�t��{F .f�,rr`1Vs.'.-t•A.>'�.;>1k`i} 'TFk,.:i { ."1.L^d„
�.,.� �.�.. �.'r t.. ;S!:��,F-Ti" ..,S�irL 1. .l��y. �.'.. T•j;,y��t�'� I".-•4,,.4 :i Z, �h .�j„51..��'t��,i 'Y{1. •3'a�/� .
•:i'r,-y• i:, I.t.: rrl. y ..[ , :-ry�l� � .-�w.<!��t.,:�•;�,Y.�i'�f. -�j•Ia..F,x� ..�i•w
:'3 •Lty .-1 T:'1+, r - r 2.;. .:ik„f..,'r:_:t-Y�:-t�=.=::t : '.�:: „�.�'.tyfir':'� r�:_ �I
CALLER . . . . . .SHAWN TITLE. . .OWNER
PHONE # . . . . . 978-373-5354 FAX. . RETURN CALL. . B-5PM `
=+J'^ i �'Ti ll. Z 1:^h'r:;.F;:., .. ..t:^�:• "::d:i.[f�- ni!;a;{'r`P�F �'�`
//{{y�y� _ ��. .` x:Y.-V.t.i::.1�.�J.,, •�:.., !l.. tv .t,.:Z r�.l l''��:.4�
:.'R{: ��� :��'i Y(�'"��tit. ��.�,:��'qq'' Y;y�}.{p� �/�' ~'�' �_; i.,(,r•.!jktti-f" ��..... k,a l`r.:
K.��... .� .fr.• ''Yr�::.L:.F:.T,«���,....��J',`w'•�;1..St'F�'_i."^.' '�•1���: v.r.'.a:J. .,SS"w"r4'in�`:<,:.
i• 'y��T�
'..ter_•- r-:�'_::'..'..'•lr.r:ae:....�.'.;.'::::: i:• _ ,Xs .M1 .�yi. s,:
..v: ''�'� i'Y....„t:a?i�.3C'�, .N Y.; 1a',v�s'��. .• �•tirr.':..•}�,r�;,a<^".,,,i'•:c;,:i��.
.1-�.f�,�.S,�:'��, >;."�J1�;1 y;q.t4.✓g �j�t�j�('•'3 y�j ,r;r ;,+1 �;r'• _.>.ti.',' ,,�',�{`:;:. ;.:�,,,.., _ r�i .t;;'. ^',^:� �P,g':'',1:.•: _a.
Yl1?.;v. .771? , .:,'.l7`C�y•}-�fl�:�„•f> .1,\'Va ,:2�: ./� �.ir,t� �!{L°:w�1.[l":ek^:'1 :.: v\�5::.
- . ..rn...... ;:`t...-..•y; ..r..<...__l.. v� e:4•'..:,n: _ �•1::.•N 4'?.�'i.k.:' f.:: ''e�.! i
:Ti, _'t�, :.:J�'.�%:•r r'=)':. �r..Y�fl�' ';C... •,:J,: r'1:'��.i.t a,1n..,, .
^":._... `...r-,•,. r,r'...:_v�:,:_• '� 1.-. :`1:'=r'. At{..e;.: i... _ ;:,lc..
.e� r.L. �''• !Y.: _wJ•'{:.e'''�^�- _a:� �i..�.; _ tib .a.::.. .�.. :.r,•, t` t.�•.���.
-ti F.E. !.:rti.'.� ,y. �i�:. •:'{'-:i; �"f;'v ?'.x�: e
-'-� •r.r,.,-.,:�{J:::��.:F _. n• �.•....' .Y._. .lie. 2.. �� ���`"t- Ci.�;.' e.!
ALIG-30-2000 09:40 ?81?21004? 93% P.02
fay,'
_ H
• - APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAG1; 1
Fir RIIIT NO.
MAP NO. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE
ZONE I SUB DIV. LOT NO. L— (—
LOCATION c igw/Z 0�9,%I� �,sE t'T�L7al' PURPOSE OF BUILDING
OWNER'S NAME 7"f�0��d,S / �L G NO. OF STORIES r SIZE EE a o x G7 6
OWNER'S ADDRESSc�•T.4_462 r SLAB
ARCHITECT'S NAME �.�G SIZE OF FLOOR TIMBERS IST 2ND /2 ` 3RD
BUILDER'S NAME �iEfr� SPAN CJD 0 .1.1
DISTANCE TO NEAREST BUILDING �/ /40 /1 DIMENSIONS OF SILLS C/
DISTANCE FROM STREET /28 / POSTS
DISTANCE FROM LOT LINES-SIDES ",q " REAR ' GIRDERS
AREA OF LOT � �Lreo7S FRONTAGE /1�J tVo I HEIGHT OF FOUNDATION rte( - THICKNESS Q 114,IS BUILDING NEW `/�� G SIZE OF FOOTING Af X .61
IS BUILDING ADDITION J MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND S'QG1,0
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yes IS BUILDING CONNECTED TO TOWN WATER I,D
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IVIG
IS BUILDING CONNECTED TO NATURAL GAS LINE /YO
3 PROPERTY INFORMATION
INSTRUCTIONS
LAND COST
SEE BOTH SIDES EST. BLDG. COST 1700 fj d
EST. BLDG. COST PER SQ. FT.
PAGE I FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER ROOM
PAGE 2 FILL OUT SECTIONS I - 12
SEPTIC PERMIT NO.
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND,APPROVED BY
`BUILDING INSPECTOR
DATE FILED /J 71
��/✓� //�/
rC / BOARD OF HEALTH
SIGNATUROF OWNER OR AUTHORIZED ENT
C
r
F E E
PLANNING BOARD
PERMIT G AN ED
l
19 J/
BOARD OF SELECTMEN
BUILaG INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
! 2 FOUNDATION $ INTERIOR FINISH
CONCRETE d 1 2 I3_. `
CONCRETE BL'K. PINE
BRICK OR STONE HARDW'D
PIERS PLASTER _
DRY WALL
UNFIN._
3 BASEMENT I '
AREA FULL FIN. B'M'TAREA _
v, '/z 14 FIN. ATTIC AREA _
NO B'M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDNJ'D _
ASBESTOS SIDING -COMMON
VERT. SIDING ASPH.TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STIRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK. _
STONE ON MASONRY WIRING !
STONE ON FRAME _
SUPERIORI� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
Ili GABLE HIP BATH (3 FIX.) _
GAMBREL MANSARD 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 1
6 FRAMING II 11 HEATING
WOOD JOIST PIPELESS FURNACE '
_ FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. HOT W'T'R OR VAPOR I�
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
Ist 13rd I NO HEATING
�I
r
FORM - U - LOT RELEASF FORM
INSTRUCTIONS: This form is used to verifi/that all-necessary approval permits from j
Boards ard Departments havirg jurisdiction have been obtained. This does not relieve.the
applicant and or landowner-1-om compliance with :any applicable requirements.
APPLICANT �ul �'PA Q �`ep �e Q U LCS PHONE
ASSESSORS MAP NUMBER qQ LOT NUMBER t;2 ®
SUBDIVISION LOT NUMBER
STREET AAgd, D(,-e R. 4-
STREET NUMBER
OFFICIAL USE ONLY
RECOMMENDATIONS OF TOWN AGENTS f
??''✓�(Lv� �'`(_T S _ DATE APPROVED C<47,10 Q 0
CONSERVATION ADMR41STRATOR
DATE REJECTED—
COMMENTS 1`�
DATE APPROVED
TO R
DATE REJECTED _
C,yyiiolEiJ'1 S
DATE APPROVED
FOOD INSPECTOR-HEALTH DATE REJECTED
DATE APPROVED �!
SEPTIC INSPECTOR-HEALTH
DATE REJECTED
COMMENTS
f�
PUBLIC WORKS-SEWER/WATER CO TIONS
DRIVEWAY PERMIT-- -�x�� - --._-- -- -_— -
DATE APPROVED v v
FIRE DEPA&MfENT
DATE REJECTED
CONBAENTS
RECEIVED BY BUILDING INSPECTOR DATE
i �