HomeMy WebLinkAboutBuilding Permit # 8/10/2016 If
BUILDING PERMIT 0. %AORTH
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received
/ -, q TED
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Date Issued: CH
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IMPORTANT: Applicant must complete all items on tllis_page
LOCATION Av
Priqt
PROPERTY OWNER lze:z
MAP PARCEL: _jDQ
Print ,,?
I C", RIC -*ear Structure yes no
ZONING DIS Historic District yes no
T�-
Machine Shop Village yes n o)
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building W_. nefamily
17 Addition 11 Two or more family D Industrial
F1 Alteration No. of units: D Commercial
[I Repair, replacement 11 Assessory Bldg F1 Others:
E Demolition [I Other ----------
DESCRIPTION OF WORK TO BE PERFORMED:
pentification- �kas T�ype or Print Clearly
OWNER: Name: P h o n e:
L1(
Address: 'A
Contractor Name: Phone:
Email:
Address:
(JW �p. '
Supervisor's Construction License: 4x
Dale:
Home"_Improvement License: Exp. Date��- -
ARCH ITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST ABED ON$125.00 PER S.F.
-)Ltm FEE: $
Total Project Cost: $
7?
Check No.: Receipt No
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Plans Submitted ❑ Plans Waived Ll Certified Plot Plan F1 Stamped Plans Ll
TYPE OF SEVfflRAGE DTSPOSAL
Public Sewer Tanning/Massage/BodyAxt El Swimming Pools
❑
Well ❑ Tobacco Sales L1 Food Pacicaging/Sales 11
Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On dlol[ S'ignature
COMMENTS f�lAtrc�
CONSERVATION Reviewed on to Signature
COMMENTS— q--C)
HEALTH Reviewed on Signature.
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decisionlreceipt submitted yes
Planning Board Decision: Comments
,Conservation Decision: Comments
Water & Sewer Connection/signature& Date Driveway Permit
DPW Town Engineer; Signature:
Located 384 Osgood Street
FIRE DEPARfiTMENT Temp �umpser onsite :yes . no _
L -7�
.........................................
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Flreeb"a',. n
signaureldae
0 Q M M P'NTS:'.
t%ORTf q
Town of '} d Andover
No. � ;6 ri " � � l�
o �AKE h ver, Mass,
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BOARD OF HEALTH
PERMIT T., LD Food/Kitchen
/� k�.��7 Septic System
THIS CERTIFIES THAT BUILDING INSPECTOR
.............�iC,►n............... .., ......... ..........Pit
..................... ...
has permission to erect ...............
/ L..1 Foundation
p ....... ............... buildings on .(��..........^!�w..... ..,......................OP �* +':4!5..,. . Rough
to be occupied BS T.. `.�!. .. .v/............."�..�/ ............................ Chimney
p
provided that the person accepting this mit shall in ev respect conform to the terms of the application Final
on fife 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
�± Final
PERMIT EXPIRES I L9 MONTHS ELECTRICAL INSPECTOR
LESS C TR CTI Rough
Service
................ .. .... .....��Pi
.... Final
BUI NG INSCTOR
GAS INSPECTOR
Occupancy Permit Required to Occu,217 Ruildin Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
.......................
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1.600 Osgood Street,Building 20, Suite 2035
�w North Andover, Massachusetts 01945
Telephone(978)688-9545
Gerald A.Brown Fax (978)688-9542
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
BUIDINAG PERMIT APPLICATION
Please print
DATE:
JOB LOCATION: 6A 1VIa /Lot
Number Street Address P
HOMEOWNER + Z �3 f
Name Hoz e Phone Work Phone
I
PRESENT MAILING ADDRESS
9 �
City Town State Zip Code
The ement exemption.for"homeowners"was extended to include owner occupied dwe�tings of ane or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, rod vided
that the owner acts as su ervisor.
DEFINITION OF HOMEOWNER
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-or two-family dwelling, attached or detached structures accessory to such use and/or faun structures.A
person who constructs more than one home ilia two-year period shall not be considered a homeowner. (780 CMR
Section I I0.R5.I.2)
The undersigned"homeowner" assumes responsibility for compliance with State Building Code and other applicable
codes,by-laws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Dep artrrzent
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Devised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 685-9541 CONSERVATION 638-9530 WALTH 683-9540 PLANNING 688-9535
The Commonwealth of Massachusetts
. Department ofIndustrialAceidents
x 1 Congress Street,Suite 100
Roston,MA 02114-2017
wwrt.mass.govtdia
Workers,Compensation insurance,A -fidavit:)Ruildexs/Conixactors/Elpc .rxcaians/i"Xu�bers.
TO:KE'.`OILED WITJITHP,PElt'If' TING A'UTE[Oi'Ty-
licanf 7nlarmatian Please 1'r9nt Le 'bX
Name,(,Business/Oxganizatiosr/In.dividual): ) ;
Af-dre5s: �
City/ irate/Zip: P
_
t
Areyou an emliloyer2 ClzecIztlse aplixapriaie}aox: Type of pra ect(required);
1.r]I am a employorvrith employecs(full and/or part-time).* 7. New coaistzuctlon
2. I am a sole proprietq or partnership and have no employees working for me in 8. Rentodeliaig
any capacity,LNG workers'comp.insurance required.] Demolition
3.LMlgrn omeownordoingallwoxkmyselfLgoworkers'comp..insurancerequired.lt 10 r ]Buildingadditio�
p p
a homeowner and will be hiring contractors to cmrduct all walk on mY ro ertY I_. 1 will 11. Electrical re airs or additions
e sure that all contractors either have workers'compensation insurance or are sale
prcip'rietora withra a employees, 12.[�Plumbing repairs or additions
5.[]1 am a goneral contractor and!ha-ve hired the sub-contractors listed on the attached sheet. 13.'�(Ro ff ep airs
'These sub-eontractorsliave employees andhavoworkers'comp.insurance.; 14.[1 Othez
6.E]we are a corporation Mrd its of€icers have oxercisedtheir right of exemption per 1v OL c.
152,§1(4),andwehaverao.,e ployees.[Noworkers'comp.insurance required..]
*Any applicautthat chocks box t#1 must also'fdl outthe section below showing theirworkers'compensatiorrpolicy information,
i homeowners vv}io st�iiariif Iris affidavit irrdicatingthey are doing all work and then hire outside contractors must submit a new afadavit indicating swab.
Contractors that checkthis box must•attacAcl an additional sheet showing the name of the sub-contractors and state whothr r arirotthose entities Dave
employees. Iftho sub-contra etor`s kava 6roployees,iliey must providetheir wozkers'comp,policy number.
X arra an eniplayer t7i at spial) ( rag-Wollcers'eompetisation irzsuralzee far rrcy errap ciyees.'Belaiv is"heparicy aid jab site
infarmatioxz. ,
Insuranco Company Name:�.
Policy#or Self ins.Li 0.#:
FxpirationDat-
e; _-
-
e/Gip:City/Stat
Job Site Address:—..---.
Attach _
a copy of the workers' caanpe:p§ation policy decCaration page(showing the policynumber and expiration date).
Fail-ore to secure coverage as rcquixcdunder MG1,c. 152, §25A.is a criminal violation punishable'by a fine tap to$1,500.00
and/or one-,year imprisonment,as well as civil penaltiees in the furan of a STOP WORK ORDER.and.a fine of up to$250-00 a
day against the viola:[or.A copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance
coverage verification.
X cla 1z ere. cerz' y z et't erzaitles afperjzixy tTiat the irzforzatior2 praviclecl a/iav is'tiu arad eoxeci
Date:
Signature:
Phone
Official use only. _V0 riot write in this area,to he corn teteil by city or town afficiaZ
City or Town: -
issuing A-uth o4ty(Circle one): i
1.Board offfealth 2.TsuildingDepartxn.ent 3.CitylTown Clerk 4.Electrical inspector 5.1'Iuz>,bingZnspectoX
6.Other
Contact penow—
361 (30 FT. 1 IN.
TRANSITION CORNER
- Bottom Rail Orange
39" X 9'R X 4 Places
- Inner Stabilizer Purple
37* X 99R X 4 Places
CURVE SIDE
- Bottom Rail Orange 1
49" X 716"R X 10 Places 2
- Inner Stabilizer Orange
TI -
53 1/4* X 7160R X 10 Places
l
Gap between bottom 3
rails in the bottom
plate is 2 1/4*
Strap
4016
(12 Places
r-�Measure rail like this
2 1 1 2
1 2 R9 1 6
(15 FT. 2 IN.)
2 1
DO NOT measure rail like this
Notes:
1. Nall length is 938"
2. The bottom rail is approx 1" X 1" and it
goes on the ground. The pool wall sits on the
groove in the center of this part. STRAIGHT SIDE
3. The Inner Stabilizer is approx 5/8" X 5/8* and is - Inner Stabalizer no color
assembled on top of the pool wall. 8* X 91R X 8 Places
4. The Bottom Rails and the Inner Stabilzers are color
coded on the ends to indicate the radius of the part. STRAIGHT SIDE
5. All dimensions are in inches unless otherwise specified. - Bottom Rail Blue
6. All dimensions are referenced from the wall location. 37 1/2" X 91R X 6 Places
7. Manufacturers tolerances and field condition may result - Inner Stabalizer Pink
in dimensional variations. 33" X 91R X 6 Places
BACKYARD LEISURE eruct POOL FOOTPRINTS
50 Cabot Court, Hauppauge, N.Y. 11788-3716 '1530 0M YARWWW
- --7-.
Tel: (631) 951.9800 -Fax: (631) 951.9170 Dram by:JCR scale:1.50 Data.9-5-93
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LOT I
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LOT 4WOOD FIZME_ ,
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... ( `7 Y E '�.J E 375 COMMON S mr.ET. LAWnCt4CE.MA
TELMIONE 663-5611
Note* 711111 IS NOT A lUITVfv AND!It1ntMD trt UKD fon p"inAatt vninr voila UTrLV.nn HUT Uw4 Orr,,tTs ran r1{TAhLIfHir+4 LOT I.M7l.ran TtH!f nrC-
T1UM Or rrNCrn on Cp1HTniFCTION ruoPOsts.M*t11LT111ifbe sal w"testi THAN aw roar►nafs TIMI ifUUNaA"I 1.11141,IT Is AOVI%*O TO MAKi
SURVfr to vfnlrr tllellt fleAswltnnrlrat
I NT!nrill CrnTI/T THAT I HAV!ef1AM MV Tiff r nr.w$*I„AM)ALL WALIDH#fi1L.VA1I!J`"NTs A"O rRCnOACfII"HT1 A1111LOCAT[ lt
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YER
DRUID CAVAID-h TO THE H 9,5T Esse, �Jf�w4Ga ' A"Y' �? LE'Jls cy
i`(NGI1 AND TITLE INSURERS
ROOK: 1107 u HOLZMAN
rtAGE: MORTGAGE 114SPECT1ON PLAN - No.7817
4O.
+Ln 23 a 5 LOCATED
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UArt 3 Ga TO OF USED FOGS monTGAGE PUnPOSES ONLY
Bk 10838 P�165 -42175-'9
UITCLAR!DEED
1,David V.Lynch,
of North Andover,Essex County,Massachusetts
For consideration paid and in full consideration of Two Hundred Seventy-Five Thouand and
001100 ($275,000.00)Dollars
Grant to Erin Cournoyer,,_ n 7«
of 68 Linden Avenue,North Andover,Essex County,Massachusetts
With QUITCLAIM COVENANTS
A certain parcel of land with the buildings thereon situated in Norht Andover,boring now
numbered 68 Linden Avenue and being shown as Lots 15 and 16 on a plan entitled"Plan-of
Cerdarcrest No.Andover E.W.Greene Owned",made by Horace Hale Smith,Engineer,recorded
with Essex North District Deeds as flan No.237 of 1915,said lots together being bounded and
described as follows:
WESTERLY by said Linden Avenue,one hudnred(100)feet;
NORTHERLY by Lot 14 on said plan,one hundred thirteen(113)feet;
EASTERLY by land now or formerly of Michael Carney;ninety and 101100(90.10)
feet;
SOUTHEASTERLY by Lot 18 on said plan,thirty(30)feet;
SOU'T'HERLY by Lot 17 on said plan,one hundred(100)feet.
Containing 11,865 square feet of land.
Being the same premises conveyd to David A.Lynch and Camilla Lynch by deed of Lena
Thomas dated June 6, 1968 and recorded with the Essex North Registry of Deeds at.Book 1107,
Page 256. The said Camilla Lynch died on See death certificate recorded herewith.
MASSACHUSETTS STATE EXCISE TAX
FxSP:{ NDV O Ree i Sk M4
Date: 67-it-2007 3 02:10nm
MO: 20 Doc'.% 21759
Fee: $IM4.00 Cons: $27540M10
Bk 10888 Pg 166 #21759
Executed as a sealed instrument this japay of JulUDid
V.Lynch
COMMONWEALTH OF MASSACHUSETTS
.F'
On this*y of July,2007,before me,the undersigned notary public,personally appeared David
V.Lynch,
Proved to me through satisfactory evidence of identification,which were copy of licenses,to
be the person whose name is signed on the preceding or attached document,and acknowledged to
me that he/she signed it voluntarily for its stated purpose.
i
WAYNE F VMMON3,3R.
NOTARY PUBUGP b
CjW"W,itrAtTH OF M0SAC',it1$�3 ,
my CflidMlSSli31i WIRES.w121120ti
PROPERTY ADDRESS: 68 Linden Avenue,[north Andover,Massachusetts
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