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Home My WebLink AboutBuilding Permit # 3/2/2016 --.............. —------.. ..........................................---- I ORT[I BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0 Perm!tNo#: Date Received �SSH-- CHU Date Issued„ _;2, —----------—-------IMO FAN Applicant must coin lett all itcnis.onthis�)age LOCATION PROPERTY OWNER Print Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes nio -TYPE 0 F E IMPROVEMENT P R 0 V-E-M-EN PROPOSED USE —-------------------- .............. —--------------- Residential Non-Residential to New Building 'One family o Addition F1 Two or more family 0 Industrial 1-1 Alteration No.of units: 0 Commercial .............. . .........--..................... ..... [I Repair,replacement n Assessory Bldg 0 Others: 11 Demolition El Other Se u/ A/ W11 t, g/ '50 W wo. �V; -y' F I o 6 dO lata to AN/ gr g Wi"',NOY DESCRIPTION OF WORK TO BE PERFORMED: SP R1. Coil Identification- Please Type or Print Clearly OWNER: Name: Ie Phone: ' "d- aAa Address: -K, 'Slk,,J-Sot� z Adas4 1VA 61 SU' .......... Contractor Name r Z4 le 'Ir Phone Email: Lzemc ewowezr),�,Qc' Address: ) slwl-41--I,' may, S Supervisor's Construction License:_0 —Exp. Date: Ioae Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ 4 lO,17-S- 496c. hZtZ) —FEE:$t{qZV.<-b Check No.: Receipt No.: NOTE: Per-,sans contracting witliLuill-egisteredeo tractors do not have access to the guarano Signature.-of. jvt6er. ...... 66ilflmad6i' -----------Si6na 1:5�1 Plans Submitted U Plans Waived❑ Certified Plot Plan [I Stamped Plans D TYPE OF SEWERAGE DisposAL Public Sewer p TanniayjMassagc/Body Art ❑ SwirarningP001" 0 Well ❑ Tobacco Sales ❑ Food PackagingfSaleg [I Private{septic tank-,etc. ❑ Permanent Dempster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM PLANNING DEVELOPMENT Reviewed On Signature_'11'14'116'_'_1i1__f_1 T_ COMMEN CONSERVATION Reviewed on c/ 0 Signature COMMENTS HEALTH Reviewed on Signature COMMENT Zoning Board of Appeals:Variance,Petition No: L —Zoning Decisionlreceipt submitted yes Planning Board Decision = Comments-- Conservation Decision: _Comments Water&Sewer ConneGtion/Signature&Dat6__ Driveway Permit 4� 1 y DPW Town Engineer:Signature --c Located 384 Osgood Street FIRE DEPARTMENT -Temp Pumpstek onsite�yes Nz no [,orafpclat 124 Main Street Fire,Department signature COMMENTS Town of2 "�RT"wa L ndover t\A No. 2-o(S° At * �olh ver, Mass, Ar BOARD OF HEALTH Food/Kitchen PERMIT TO ILD Septic System THIS CERTIFIES THAT.,.......�/.. �z........... ..................................................................... BUILDING INSPECTOR Foundation has permission to erect..........................buildings on......./.......,................. ................. Rough to be occupied ILS................7s.fA.._z5r�.—' ................*...........'........ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .................. ............ ................. BUILDING INSPECTOR Final GAS INSPECTOR Occupanev Per Required to Occupy Buildin Rough Display in a Conspicuous Place on the Premises—Do Not Remove Emal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. -t'H� E GLADE t-UT l IS G��ftT Lr��E LANE It �a�f to� A� I3� tai � t1�Li 1[�I i1_i-1-1 i�Il , 'FRO N7 { I EV AT t 0 1 J LOT t5 GREAT lK£LANE NOKN ANDOVEK,MA TK7- LLC c . It " 40"�,a, ocTosER z ,zo�5 �.1 tt.D 49-6 tl-fo @-� K-u tyro }p.fo I'1-o e�_o ?,Ox Gs 4�I+4xt12 3t��4x5� _ 3t jUX�' ea'j�xbs . C1(�I� YO 0 sdlq x6S KITCHEN O � P GREhT Etnot'r+ RenR - 2-t AK GARA6E un�L 0 3ohi"S 38YZx93 % — - �' - FoYr:R Q C ,a LiVlnlfs i f �-• - _ _ __ ! 5�+�2x� 68x65 34+{x2.$ a_p t'o Rc N co 'LZ•b A N 2< 5-e 5'O 2.0 S-� S'o _ FiRsT F�ooR Y��rl �� ti , 15 GReRT L AKS I ANS .3 49- 0 13-o 0 Q E"i1hiN.$�' I_ 1 o ae t>".o 2 0 0 (WIG a x 6 0� ra_o 14-0 - r1 r' pu IR TB - o o ID10 - _ ._ S p Liutcl r B£bRoa L4 @ 0 --- O lJ � x', f u N � n�bgx53 r-1 a 3,0 LA- \s o q-o 55-ro° W-T W , 15 GMXT LAKE �11JE FwoR PLAN, uq-6 i W(d, Hr'RE 6Ax5'� b8x5� �D PoP So IbRaP'Rs artootT Iw I LtKoaT a 0 o � N M 10 0 O 0 M M ^�- 'V wAtL DRop of WtT - (-o y-3 N CI 22.0 g'w wu,"T- '6 �S a to•p Zo la-o 2-p +l3 0 r rouNDhrIolt 81At.i IST y, t5 �R�RT �RkE LAW . 5 I 3Ny"1 3�tf1 1 3d) S 0 0 -n 7V �ra �C Zyi< .tti � sTscnP � zX NEAv�R� >7 j w{ti POLY\soah+��RA'tS '8"socfrr � IJ��J �3vP i wltorrr.ve*n � NoYE S'• 12 ` �� tiBoARb�F1.AStr4. ^3NSULhI-1 oJJ PLS REPoR'j" / \ � 12 A+h'wlvl-L oR v4R��S�y`.1? � '\ a _v�tilt-ATtoU PeR Go9� i � a i 'I !' aoas o 2x 12 D LvL ct �' 10"TNIQ(,% W Cl-yp1WALL 3iN"Pavgisc F,G 3000 fS1,�Z}Y�"�£3niZ o za K Cf�zx 10 PT o (1YQ) 0 3�ir�s(c.tAi1Y 6 di A c SL.Ata y"Pvc SC C d i O?J (T7 P•� DRAM`'/ PG FooT1�6 wlX Tw ty _� 3ry°STONE 3(X10 PS\ LZ)112«fZ�@�R, 8 k GREAT LAKE LAN$ DRIVEWAY WALKWAY �I PROPANETANK C 8183' $ -- 63 8�• LIMIT OF 100' — $ 14'STONE TIOAND SUFFERZONE STONE WALL �P' I tdr A/C CONDENSERS i EXISTING _.1� DRAINAGE EASEMENT FOUNDATION ROP FMD. 190.8') _ 1 LOT 3 LIMIT OF 60' ) W � 4 NO�BUILO ZONE i -� S EXISTING STONE 15 WALL W �Y1 EXISTING CONSERVATION LIMIT OF 25' SIGN PORT(1YP.) N4DISTURB ZONE LOT 5 EDGE OF BORDERING VEGETATEDWETLAND LOT 4 AREA=43,651 S.F. 1 t<9 ad' 51.]q ` \ N NIF KEVIN DOUGHERTYIF TOWN OF NORTH ANDOVER MAP 96 LOT 6 MAP96LOT5 PROPOSED MINOR SITE PLAN REVISION FOR LOT 4 GREAT LAKE LANE IN NORTH ANDOVER,MASS. PREPARED FOR TKZ,LLC 78 GREAT POND ROAD NORTH ANDOVER,MA 01645 DATE:NOVEMBER 25,2015 PROFESSIONAL ENGINEERS&LAND SURVEYORS CHRISTIANSEN&SERGI,INC.180.,IT RAVERRILL,.01830 LM1M1NW.CSI-ENGR.. C�S M.978373-0310 FAX.978-372-SM COPYRIGHT2015 DWG.NO.13114018 mso®®Verizon LTE 11:05 AM 67%. < Ail Inhoxes F- 513' yd90. T 4 f \ f EASEMENT \ 3 50' BVLV 6, l f f SETBACK i 10, EX END EL=UJO 5' y as< R%NoP isq`4 45,2' .�2 MICHAEL C-"%'[ 306 e c ={' �a t � F S . SGI i Wvo.S.aj, F9ygye'� GREAT LAKE LN. FOUNDATION LOCATION I C_FTIFY-IAT TfiE PR±F"K RI TRUCTURlT F.I'iH CONFORkiS iC+ ppm THE 111.E p,iL G BY-LAWS S,EFFEETITS OE RIE SIN APPLIC_RTI ICATIO DOI'SH T ENSIDE.HEHCOHSTRUCTED. CLIENT: tf /' i HI F TTIFIC�TC ❑ S`IQTC O\SIJ R1VPC FR CLIENT.TKZ,LLC RETRCTIONS SUCH AS COVENANTSN -ANDSEASEENTS, ORDERS H,CONOIUONSFTF.ITV "JRAFNNO SHU-NOTBE USED THIS CERTIFICATION IS NIANE AND Liki TE TO THe ABHVF LIE�NT Rt`THE<GiFNT FQR tiY PORP-OSE OTI1E:?THAN Tl.kT OUTLIIEQ LOCATION:NORTH ANDOVER,MASS. AHOVEEXIEPT WTn+T;I'WRITTEN PEMISS.ON cF CHRISnANSeFl &5FPGI ING FQ'RTHERMCRE THS O—ING IS THE GOPYRIGf TED DATE:/1122115 SCALE;1"n50' ERTY GF CHRISTI NSEN A EEGI Inns.AND ANY NN —S,"'USE 15 PkQ EITIN EITIOUTA,ISEN 3-1—TARES NO`FE5-ECRSEELITY FEN THE UTAUTFU RVEO USE OF THIS S NNG SINN OR ANY INFORMATION CONTAINED HEREON PROFESSIONAL ENGINEERS&LAND SURVEYORS CHRISTI 1, INC 160 SUMMER STREET, HAVERHILL.MASSACHUSETTS 01830 WWW.CSI-ENGR.COM TEL.978-373-0310 FAX,978-372-3960 DWG.N0.:13114.001.014 Home Energy Rat=in- Certificate wrq 5—d-1 -MW wm - d- ut:m.ta A-1 U--gy Ust HEM MMv 57 7012 17117 On=�vvl 10010,01- TIT: Ui,'A,-d Appift.—F-t.,- NOTICE z NOTICE TOTO EMPLOYEES a tit ea` EMPLOYEES .ort* The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street,Suite 100,Boston,Massachusetts 02114-2017 617-727-4900 As required by Massachusetts General Law,Chapter 152,Sections 21,22,&30,this will give you notice that I(we)have provided payment to our injured employees under the above mentioned chapter by insuring with: Associated Employers Insurance Company NAME OF INSURANCE COMPANY P.O.Box 4070 Burlington,MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC-500-5006517-2015A 10/01/2015-10/01/2016 POLICY NUMBER EFFECTIVE DATES 1060 Osgood Street M P Roberts Insurance Agency North Andover,MA 01845 (978)683-8073 NAME OF INSURANCE AGENT ADDRESS PHONE TKZ LLC 78 Great Pond Road North Andover,MA 01845 EMPLOYER ADDRESS 08/12/2015 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act.A copy of the First Report of Injury must be given to the injured employee.The employee may select his or her own physician.The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER %oz/SO/4o , SVST0 VW'anopuV 41,19 peog puod VWD SL -� ollinloyaz a sewogz L64SS0-SD .