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Home My WebLink AboutBuilding Permit #557-15 - 24 EAST WATER STREET 12/16/2014 BUILDING PERMIT o* r1O0ROR TF/' TOWN OF NORTH ANDOVER 32 y "'t'- APPLICATION FOR PLAN EXAMINATION ` n 4H '1 Permit No#: . Date Received �q"0R„TE, SSACHUS Date Issue I PORTANT:Applicant must complete all items on this page LOCATION � Prit PROPERTY OWNER �C C C _ . Print 100 Year Structure es MAP PARCEL: ZONING DISTRICT: Historic District -- Machine Shop Village*s Sn TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer, DESCRIPTION OF WORK TO BE PERFORMED: S V-cyc L I�Ide tificatign- Pl eType or Print Clearly OWNER: Name: �G Q (� 1U 't�. Phone.1 "-T(pC � Address: Contractor Name: 4 V r4S4hone: � b`l'O(Ob U. � Address: t LS 6V ......... V G� Supervisor's Construction License: Exp.- Date: ! Home Improvement License: _ L 1 J Exp. Date:,- ARCH ITECT/ENG I NEER ate:__ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ' Total Project Cost: $ 0 FEE: $ 65 40 Receipt No.,�V�g 'heck No.: 63 ' NOTE: Persons contracting with unregistered contractors do not have access to ze guaranty fun Pignature of Agent/Owner Signature_of contractor _ cto Location ;a4 - .-1 67 wji, No. '' � Date . - TOWN OF NORTH ANDOVER ' �T LED fas • Certificate of Occupancy $ �.0 Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ I TYPF'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments i Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street FireDepartment signature/date COMMENTS I� pimension 1 Number of Stories: Total square feet of floor area, based on Exterior dimensions. fi otal land area, sq. ft.: I ILLECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No 7m—GL Chapter 166 Section 21A–F and G min.$100-$1000 fine 'NOTES and DATA— (For department use) i f` I� 1. I �I �7 �f i ❑ Notified for pickup Call Email Date Time Contact Name 3 Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Li Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products N TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products N TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE:TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ust be submitted with the building application Doc:Building Permit Revised 2014 E Town 2Andover No. -#- Z oh over, Mass, 14 COCK1c«ewKK y1 S ll BOARD OF HEALTH Food/Kitchen PERMIT T LD I, Septic System THIS CERTIFIES THAT ............... ... .(t .d..........1.� .d. /.n.s.�.l BUILDING INSPECTOR ....... .................. has permission to erect ......... buildings on . ...... 1,�X. ....... , �� Foundation ................. M.a...... ..... Q Rough tobe occupied as .......1�.. ... ........*....... ............. ..... .......................................................... Chimney provided that the person acce ing this permit shall in every respect nform 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 63 - . UNLESS CONSTRUCTIO A Rough Service .................... ......... ... . . - ... ................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Baystate Roofers, Inc. Proposal P.O. Box 189 North Reading,MA 01864 Date Estimate# Tel. 978-664-0668 Fax 978-664-4333 10/16/2014 15699 Name/Address HIC# 137193 Richard Robinson CSSL#99895 24 E.Water St. North Andover,Ma.01845 Bay State Roofers Inc proposes: Remove approximately 1400 square feet of the existing asphalt shingle roof down to the wood decking. Install new ice and water shield along the 6'roof edge, valleys and around all the roof penetrations. Install new 151b felt paper throughout roof area. Install new white aluminum drip edge along the roof perimeter. A new Lifetime GAF Architectural asphalt shingle will be installed over the prepared substrate. A new ridge vent will be installed to ensure the proper roof ventilation. All roof penetrations and flashing will be installed according to manufacturers recommendation, specification and details. Install new pipe flanges. Bay State Roofers will properly dispose of all roof debris in our own waste containers. Any wood decking that needs replacement will be an additional $2.50 per lineal foot. Front main and the section on the driveway only. Add an addtional $200.00 per chimney to install new lead flashing. Add an addtional $3890.00 to include the back lower roof. New Shingle Roof Authorized Signature: Total $5,270.00 Waste containers supplied by Bay State Roofers,Inc. are for sole purpose of roof debris. Under no circumstance is the homeowner to use these containers for personal use. 10 Year Workmanship Warranty on all roofs. (Except Repair Jobs) CONTRACT ACCEPTANCE The specifications,prices,payment schedule are satisfactory and hereby accepted. Date: 3 BAY STATE ROOFERS,INC.is authorized to perform work as specified. Payment will be made as previously outlined. Signature All bills over 30 days are subject to 1 1/2%finance charge per month(18% �,� annual). Color PROVISIONS OF THE AGREEMENT PROJECT PROVISIONS e. Damage to Project:Contractor will not be responsible for any a.Guideline:The Project will be constructed in strict conformance damage caused by the Owner. or other causes beyond the control of t the plans and specifications which have been examined and the Contractor.Owner will pay for any restoration work. pproved by the Owner. IV.CONTRACTOR'S RIGHTS AND RESPONSIBILITIES b.Compliance:The Project will be completed in strict compliance with all laws, ordinances, rules and regulations of the applicable a. Delay: Contractor will be excused for any delay beyond his overnment authorities. reasonable control. These delays may include, but are not limited to c. Control:The Agreement plans and specifications are intended Acts of God, labor disputes,inclement weather,acts of public authority, t supplement each other. In case of conflict,the plans will control the acts of the Owner.or other unforeseen contingencies. pecifications and the Agreement provisions will control both. b. Right to Stop Work: If any payment under this Agreement is d.Charge Orders:As directed by the Owner,construction lender, not made when due,the Contractor may suspend work on the job until ublic body or inspector,any alteration or deviation from the specifications such time as all payments due have been.made. Any failure to make at involves extra cost(subcontract, labor, materials)will be executed payment is subject to a claim enforced against the property in my upon the parties entering into a written change order. Expense accordance with the applicable lien laws. i 'curred because of unusual or unanticipated conditions will be paid for c.Substitution of Materials:Contractor may substitute materials y the Owner. without notice to the Owner in order to allow work to proceed, provided e. Allowances: If the Agreement price includes allowances, and that the substituted materials are of no lesser quality than those listed e cost of performing the work is greater or less than this allowance, in the specifications. lLor en the Agreement price will be adjusted accordingly. d.Salvage:All salvage resulting from work under this Agreement FINANCIAL RIGHTS AND RESPONSIBILITIES is to be retained by the Contractor unless other agreements are contained in the written specifications. a. Labor and Material: Contractor will provide and pay for all and materials necessary to complete the Project. Contractor is e. Insurance: Contractor will maintain workers' disability compensation insurance for his employees and comprehensive public eleased from this obligation for expenses incurred when the Owner is arrears in making progress payments. liability insurance policies. b.Permits:Contractor will obtain and pay for all required building V.COMPLETION OF PROJECT ermits and licenses. a. Notice: Owner agrees to sign a Notice of Completion within 5 c.Taxes,Assessments and Charges:Taxes.special assessments days after completion of the project. If project passes final inspection f all descriptions, and charges required by public bodies and utilities and the Owner does not sign the Notice,the Contractor may act as the ill be paid for by the Owner. Owner's agent and sign the Notice. d. Deposit of Payments: Contractor is required to deposit all b. Clean-up: Contractor is responsible for removing debris and ayments received prior to completion in an escrow account. In lieu of surplus material from the property, and leaving the property in a neat uch a deposit,the Contractor may post a bond or contract of indemnity and orderly condition. ith the Owner guaranteeing the return or proper application of such VI.CONFLICT PROVISIONS 'ayments to the purposes of the contract. All advanced funds will be a. Arbitration: Any controversy or claim arising out of this eposited as indicated under Special Provisions. Monies used in Agreement that cannot be resolved, is subject to arbitration, with scrow become the property of the Contractor when they are applied an arbitrator of mutual agreement, and all parties (including cntrat cording to the Agreement payment schedule, when a breach Owner, Contractor, Architect and Sub-Contractors) are bound to ubsct by the Owner occurs, or when the Agreement has beenn this arbitration, If any party does not appear at arbitration ubtantially performed. proceedings, the arbitrator is empowered to decide the controversy e. Bankruptcy: It either party becomes bankrupt. the other party in accordance with whatever evidence is presented by the ihas the right to cancel this Agreement. party(ies)that do participate. III.OWNER'S RIGHTS AND RESPONSIBILITIES b. Attorney Fees: If either party becomes involved in litigation a. Cancellation: Owner has an unconditional right to cancel the arising out of Agreement, the Court shall award costs/expenses Agreement, without penalty or obligation, until midnight of the third including attorney fees to the party justly entitled to them. usiness day after the Agreement was signed. Cancellation must be c. Limitations: No action related to this Project may be made one in writing. Upon cancellation, any property traded in, any by either party against the other more than,2- years after the payments made under this Agreement, and any negotiated instrument completion of work. executed will be returned within 10 business days following receipt by the Contractor of cancellation notice. VII.GENERAL PROVISIONS b. Property Lines: Owner shall locate and point out property a. Notice:Any notice required or permitted under this,Agreement lines to the Contractor.Contractor may,at his option,require the Owner may be given by certified or registered mail at the addresses contained to provide a licensed land surveyor's map of the property. in the Agreement. c. Liens: Failure to pay persons supplying materials or services b. Prohibition of Assignment: Neither party may assign this according to the terms of this Agreement may result in the filing of Agreement or payment due under this Agreement without the written mechanic's liens on the affected property. Owner has the right to ask consent of the other party. the Contractor for lien waivers from all persons supplying these c.Qualification:This document constitutes the entire agreement materials or services. In the event any mechanic's lien is filed through of the parties. No other agreements exist. This Agreement can be no fault of the Owner, then the Contractor agrees to take all steps modified only by written agreement signed by both parties. necessary for the release and discharge of such lien. d.Insurance:Owner will maintain property damage insurance at d.Governance:This Agreement shall be construed in accordance least equal to the Agreement price. with and governed by, the laws of the state in which the Project is located. A81 FOWLER IN SURzS,hCE CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DD/YYYY) TNA,GER'TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE R IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(Ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such andorsement(s). PRICER CONTACT NAME: IL l'0%VLER ENS LL(' PHONE FAx '00 PARK STRF.FT (AtC,No,Ext): E-MAIL (-}R-I H READIXU.MA 018b l ADDRESS: 'vJbk INSURER(S)AFFORDING COVERAGE NAIC 9 INSURED INSURER A: ,\c.1::L\tt-wt'A�L\:s1:(:,a':cl;+•r):,9P,L�y BAY STATE RUCUFGRS IX(: INSURER B: INSURER C: P0 HON INSURER D: INSURER E: NORTH RFADING.MA 0 186 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY HAT 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 CONTRACTOR 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. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICYNUMBER IMM%DDIYYYY) (MMIDDWYYY) LIMITS GENERALLIANUTY :EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE [—]OCCUR DAMAGE TO RENTED $ REMISES(Ea occurrence) ED EXP(Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER ERSONAL 8 ADV INJURY $ ENERALAGGREGATE $ PCLIGY PROJECT a LOC RODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTC LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIREDAUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE71 $ (Per accident", UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LLAB D CLAIMSMADE AGGREGATE $ DEDUCTIBLE S RETENTION : s A WORK ER'SCOMPENSATIDN AND ___ EMPLOYER'S LIABILITY YIN UB-4669PO62-14 04/12!2014 04/12IA015 NIA E L.EACH ACCIDENT $ 1,000,000 (Mandatoryv.NH) E L DISEASE-EA EMPLOYEE S 1,000.000 " E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICTONS!SPECIAL ITEMS -IH;SILF}'I,AC'FS ANl 111tIUR(- R'T11Ii:A'IY ISM FI)-1'01HF J,IR'11F1t',1"17-'HOT DF.P..tFtF1.1'1\G%VOR}:I'RS 0).\111r r)\•F};;l�rF CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL Bg DELIVEM IN ACCORDANCE WITH THE POLICY PROM :AUTHORIZED REPRESENTATIVE ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACO—RD CORP RA 0 1 embts reserved. cls -P�� ✓Gl� � Office of Consumer Affairs&Business Regulation Of { HOME IMPROVEMENT CONTRACTOR j Registration:x`1.37193 Type: tion Expira :_=10/15/201.6 Supplement 1, �� I BAY STATE ROOFER INO. \ ROBERT O'KEEF' PO BOX 189 N.READING, MA 01 Undersecretary Undersecretary Massachusetts -Department of Public Safety Board of Building Regulations and Standards' Construction Supen-isor Specialt-, License: CSSL-099895 ROBERT E OKEEJ`E 21 FRANCIS STREET NORTH READING M U18 Expiration t 09/29/2015 � Commissioner The cornmonw.eg1th of Massachzesetts - - Department of! ndustr!g1Accidents office of Invesfigailons 600 Washington Street Boston,.MMA 02111 vww.mass.govldia Workers' Compensation Lisurance Affidavit: Builders/Cont ractoxs/Bl c is se Prin>m r A l vanlr Xuformaiion n Name(Business/OrganizationlXndividud): \ Address.. 2,�6 V 4 '°1 V to/Zi � #' i City/Sta p. Phone Are you an employer?Check the appropriate box: Type of project(required): � 1.I-LYam�aemployerwith 4. ❑ I am a general contractor and I 6. New construction F _� havebiredthesub-contractors employees(full and/or pati lime)* hate,).on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or Partner- ship and'have no employees These sub-contractors have 8. ❑Demolition working forme in any capacity. workers'comp.insurance. g, [l Building addition [To workers' comp.insurance 5. ❑ We are a corporation and its 10❑Electrical repairs or additions required.] officers have exercised their f exemption per MGL 11.❑Plumbing or additions El o 3. X am a homeowner doing all work Roof repairs myself.[No workers' comp. c• 152, a§1(4),and have no 12,E] insurance required.]i employees.PToworkers' ME]Other comp.insurance required.] Mny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they Y're doing aliworlc and then hire outside contractors must submit anew affidavit indicating such. ?Contractors that checkthis 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 Name:. J Policy#or Self-ins.Lic.#: v �('0C 2-' Expiration Date:_ I? C1 City/Stat Job site Address- �� e/Zip: 43 V Attac,h 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 o.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 uo$250.00 a day against the violator. Beadvised that a copy of this statement maybe forwarded to the Office-of p t Investigations of tho D Afor insurance coverage verification. I do liereby ce t der a pal an a s rjury t at the information provide,)above is true and correct. Si ature• Date• Phone#- official use only. Do not write in this area,to be completer)by city or town official. City or Town: Permit/License# Issuing Authority(circle(Me): X.Board of Health 2.Building Department 3.City/Town Clerk d.Electrical Inspector 5.Plumbing faspector 6.Other Contact:Person: -'hone#: Information and 1[nStructions . . Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...everyperson in the service of another under any contract ofhiro,- express ori replied,oral orwritten:, I An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two ormore of the foregoing engaged in a joint enterprise,and including the legal representatives of wdeceased 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 tho grounds or building appurtenant thereto shall not because of such employment bo deemed to be an employes." MGL chapter 152,§25C(6)also states that"every state or looal licensing agency shall withhold the issuance or renewal of a license or p ermit to op erate 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 notrequired to carry workers'compensation insurance. If an LLC or LLP does have employees,apolicy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents fo;confirmation ofiasurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retained to the city or town that the application for thepennit 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 Ofdelals Please be sure that the affidavit is complete andprinted legibly. The Depaxtmenthas provided a space atthe 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 whichwill 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 iapplicant as proof that a valid affidavit is on file for future p ermits or licenses. Anew affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license oz permit not related to any business or commercial venture Q.e.a dog license or permit 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. he Department's address,telephone anal fax number: . Tho ConuAonwaltIL of W_amarhuSettq Department of IndwWal Aaoidwta' Off ee of Javestfigationa 6bQ V1 ask»gta. Stied Boston,lam.02111 Tel,#617-7-27_49.00 ext 406 ox X`8,77-MASSAFE 12e iced 5-26-05 NX#617-727-7749 wwwawa,gov/dia 0ORT11 Zoning Bylaw Denial Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 Phone 978488-9545 Fax 978-688-9542 Street: Map/Lot: jo a el Applicant: R I C h a r a+l- J9 A tuc._ 1....o.. So,%) Request: Acickition Date: r1- 1 a -Qoo Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning Item Notes Item A Lot Area Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient e S 2 Lot Area Preexisting Ll e Ca 2 Frontage Complies 3 Lot Area Complies 1`1 e S 3 Preexisting frontage 4 e-S 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed 4 e S G Contiguous Building Area N 2 Not Allowed 1 Insufficient Area 3 1 Use Preexisting .2 Complies 4 Special Permit Required 4 e g 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient E S 2 Complies 3 Left Side Insufficient ti e-S 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information e- 5 Rear Insufficient I Building Coverage NIA 6 Preexisting setbacks) eS 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed Li es 4 Insufficient Information 2 In Watershed Sign A 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required —1--re Parking Required 2 Not in district 2 Parking Complies 3 Insufficient Information 3 Insufficient Information qe_ S 4 Pre-existin Parkin Remedy for the above is checked below. Item # Special Permits Planning Board Item # Variance Site Plan Review Special Permit -a{3 Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Con re ate Housing Special Permit Variance for Si n Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Si n R-6 Density Special Permit Special Permit preexistin nonconformin Watershed S ecial Permit The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to:the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file.You must file a new building permit application form and begin the permitting process. �- 7// Bu9�pment Official Signature Application Received Application Application Denied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the application% permit for the property indicated on the reverse side: lt .l`c,�-."' 'pu [pd� y( a �'4 s t �c..�� ' '... W d {*I;F_- :'�:`'.: Ki.•._7�S ��s';,y 'k101-111,71 ' -� ` n/� O n9'-CO nl IG/'[tr!a IS c,&J&[`-e c7 V c4 � 1' l v TSPS J/4- /UGllf �GOv�!'lylltit 1` DD � `� hy- Referred To: Fire Health Police Zoning Board Conservation De artment of Public Works Plannin Historical Commission Other BUILDING DEPT f 1 t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING W9, t`7T BUILDING PERMIT NUMBER: DATE ISSUED. SIGNATURE: Building Commissioner/1for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number 1.3 Zoning Information: 1.4 Property Dimensions: a Zoning DistrictPr osed Use Lot Areas frontagek-) 4, AO% 1.6 BUILDING SETBACKS 00 . Front Yard Side Yard Rear Ya d Re red Provide Required Provided Recpired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1K,C,W-J of Record tj T- k NA" . P06,19 am (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licens6dConstruction Supervisor: License Number mn Address Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number Address rM Expiration Date z Signature Telephone Q SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) f, 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.......0 No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: �r PT i�(Ytt� 1.1 d��.�`D AIJ ��I(,iSTt ►� `�, M) gddl rou F � � � � w SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be -0, ,TJSEN{} ,y X j Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number i SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH DING 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 I, as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date 109 ENE= NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TflVMERS 1 ST 2 3 SPAN DMENSIONS 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 MORTGAGE INSPECTION PLOT PLAN owl . f NORTHERN ASSOCIATES, INC. 630 TURNPIKE STREET N.ANDOVER MA ( 508 )975-7117 MORTGAGOR: RICHARD T. G NANCY C. ROBINSON DEED REF. 1485 . 231 LOCATION.• 24 EAST RATER STREET PLAN REF. 59.19 CITY. STATE.• N. ANDOVER MA SCALE: 1- 40' DA TE.' 9 / 4 / 92 JOB 4* 9212262 70.DO' LOT 3 4 - qOr eq{ LOT 4 a v1c T, l Kr OL :i1T sHED — - _ LOT 5 Y s/2 STOR 1/000 74.000 • EAST WA TEA STgEET CERTrFSED TO.• METHUEN CO—OPERA TI VE BANK NOTE: This mortgageI FURTHER STATE THAT IN MY PROFESSIONAL Inspection was prepared OPINION the principle structurals and accessory sped tally for mortgage purposes and is not to be relied vpon as a survey. Northem Associates, Inc. accepts no OF CONFOR Zsponsibility for damages resulting from said reliance d Its as$ With requirements local of the toning In vone other than the sold mortgagee financin said ordinances,and that there aro no encroachments of major rection with Its proposed mortgage Magor. g TOV mo erty fa ments either way across prop" except u N0.X M ALSO: ,rtgage inspection was prepared in 0 Property is not In a Flood Hazard Area. Technic2.P Technical Standards for Mortgage ropsrV Is In a Flood Hazard Area. as adopted by the Massachusetts As tion O 3.Information Is InsuffKWt to determine Flood Hazard. vvors and Civil Encineen.Inc. Flood Hazard determined from latest Federal Flood