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HomeMy WebLinkAboutMiscellaneous - 1 DANA STREET 4/30/20189 Dear Zoning Board Of Appeals Department: Gerald Brown; Albert P. Manzi, 3rd ESQ; Ellen P. McIntyre; D. Paul Koch, Jr. ESQ; Allan E. Cuscia; Douglas Ludgin; Deney D. Morganthal; Nathan J. Weinreich (.recently sent you a letter in which I pointed out the reasons why the new construction You approved at 11 Dana Street, North andover is a House and not an "In -Law Apartment". I would appreciate a response to the following questions: 1. How does the Zoning Board determine that a given set of plans/drawings is an "in -Law" or a "house" ? 2. Is the size of the House Lot considered? Please note the Lot sizes in this area are extremely small. 3. Has any member(s) of the Zoning Board or the Building Inspector dropped by the 11 Dana Street construction sight? If so, what is your reaction? Is it a "House" or an "In -Law Apartment". 4. Why were not the neighbors, especially the adjacent neighbors, notified that the plans for the "In-law" were changed from the re -furbish of the garage to the present construction? 5. Has the Board noticed the massive equipment, man -power, material needed for this so called "In -Law Apartment"? 6. Has the Board considered the ramifications of these so called "In -Laws" have on the area? In a few years when the present owners move away, the new owners will turn these "In -Laws" into a TWO family. 7. How did a TWO family (across the Street from 11 Dana Street) with a garage "Mysteriously" turn into a THREE family? 8. How is the Zoning Board going to deal with this Monkey See Monkey do mentality that is occurring in this area? Easy, learn to say NO to so called "In- Law Apartments" that are really "Houses" that will become TWO families in the future. Please, Zoning Board do not be an accomplice to down grading / actually destroying the neighborhood. If you do not know how to say NO, then please retire so that someone who does can take your place. Thank you for reading this letter and I encourage your response. Please drop by 11 Dana St. and see what is going on in the neighborhood. Sincerely, Hope ee you 5oonifif J. agaa . D 1 Dan Street, North Andover MA JUL 3 20 BOARD OF APPEALS Date ....... A// TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ....... .......................... has p,,ermission to perform ....... 1 ......... A ... ............................ wirin J -C) // y r, / ,Z in the building of .................................................. / .............................. at ...... .... ....................................... ............ Wrth Andover,,Mass:� Fee.,3 .... JL 0 Lic. No . ............. ............. �� Check # LEMIC NSPECTOR 5d'i 5 \ _ Commwnwealilt of /YlaijaclLuielf3 011icial Use 0111 ", �7 Pm/1No. Occupancy and Fee Checked j- + BOARD OF FIRE PREVENTION REGULATIONS tF; 111991 (Icave blank) APPLICATION FOR PERMIT TO PERFbRb ELECTRICAL WORK All work to be performed in accotd:mce with the Mass3chusms E�"A'l ctric:rl Code (NI EC )7 CN12.00 (PLEASE PRIM -IN INK 01? TYPEALL INFOR,IL17701) c:�City or'Town vf: �/O,e- /w 11�/-9o'r/1< To the Inspector of iles: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 7— Owner Owner or Tenant cJ C7#/rj Owner's Address Telephone No. Y35 Is this permit in conjunction with a building permit'. Y%es J� No ❑ (Check Appropriate Box) Purpose of 13uildiIII, ,� -,E/�/ I�C _ Utility Authorization No. Existing Service Amps / Volts Eherlrc:'d ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of vIeters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion o%rhe to Ito rvii .t tube map be xaived by the Inspector o%IVires. No. of Recessed Fixtures No. of Ccil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Ilot Tubs Generators KVA No. of Lighting Fixtures Above In Swinn.ning Pool ontd. : •❑ rnd. ❑ No. ot Emergency Lighting Battery Units No. of Oil Burners _ FIRE ALA.RNIS`'INo. of "L'ones No. of Recc tacic tliL ii" No. of-Detection No. of Switches No. of Gas B.:rners Iuig Devices No. of Ranges "Total No. of Air Cond. Pons No. of Alerting Devices (-lent Pump Number TonsK_1V No. of Self -Contained No. of Waste Disposers Totals: i Detection/Alerting Devices I N�. of Dishwashers Space/Area Heating KW Municipal I Local ❑Coection ❑ Other nn1 '. of Dryers Henfin- .Appliances KW' Security Systems: No. iv Devices E of or ualeut No. of Nater h1V :No. of No. of. i)aia Wiring: kleaters Signs Ballasts No. of Devices or Equivalent No. Hvdromassaoe Bathtubs b No. of Motors Total IIP Telecommunications NViring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by rhe hrspector of Wires. INSURa,`iCE CON:EIZAGE: Unless %Valved by the o%sner, 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 urtdersioncd certifies that such coverage is in force, and has exhilited proof of same to the permit issuing office. CHL -CK ONE: INSURANCE 0,130,14D ❑ OTHER ❑ (Specify:) � d (Expi ation Date) Estimated Value of Electrical Work: (When required by municipal polic)'.) Work to Start: htspections to be requested in accordance with ivlEC Rule 10, and upon completion. certify, tnulrr the pains and penallies of petjrr,)", that the information on this application is tare and complete. 22 Ir1101 NAME: LIC. N0.: r � Licenscc: �q'6F_ / L Q/c C-/� Srgnatw e C �sP ems` LIC. NO.- (ifapplicable, tel* "e.ccmpt" in the license number line.) _ Bus. Tel. No.y:%7 G T 2r- l Jam/ 2 Address: Gtlbolo Z_w;f_1 51' ��Alt. Tel. No.: O\1'NER'S'INSUIZ:wCE NVAIVI IZ: I am aware Ihat the Licensee does not have the liability insurance coverage normally required by law. 13 my si_nature below, 1 hereb}' Waive titin requirement. I am the (check otic) ❑ okNrner ❑ ow'iter s a,rnt. O��'ncr/A��cntI Signature Telephone No. 5"], R W T F- E, S 1 D July 19, 2015 L. :i TO: Albert P. Manzi, III, Esq., Ellen P. McIntyre, D. Paul Foch, Jr., Esq., Allan E. Cuscia, Douglas Ludgin, Deney D. Morganthal, Nathan J. Weinreich BOARD OF APPEALS Dear Members of the Zoning Board of Appeals, I am writing with regard to the house being built at 11 Dana Street. Earlier this year I was asked to sign a letter of support for the property owners, and I was given the impression that an addition was being proposed to the existing structure. If you were to walk or drive down Dana Street now, as I have, you would see that what is being built is no less than a second house on the property. It is my understanding that the Zoning Board of Appeals reviewed the proposed construction project, and gave its approval to the plans as they were submitted to the Board, without requesting any changes. It is also my understanding that the primary role of the Zoning Board of Appeals is to serve as the guardian of the character of the neighborhoods and town of North Andover. I signed the letter of support under the assumption that the proposed construction at 11 Dana Street was to be an in-law apartment or "family suite" (per the wording on the agenda of the April 14 Board meeting). I certainly was not expecting that a second house would be build on the property. I feel that in this particular instance, the Board failed in its mission of protecting the character and property values in the Dana -Dewey -Harold Street neighborhood, and I feel that an unfortunate precedent may have been set. I hope that in the future, the Board will take its role and its mission much more seriously when considering proposed construction projects such as the one going on now at 11 Dana Street. Thank you very much. ;� Ciofolo, Angela From: Leathe, Brian Sent: Thursday, July 23, 2015 3:39 PM To: Ciofolo, Angela Subject: 11 Dana As requested I dropped by 11 Dana Street. The Plans appear to reflect what is being built an approximately 2436 single car garage with an in-law apartment. Brian Leathe Local Building Inspector Town of North Andover 1600 Osgood Street Bldg. 20 Suite 2035 North Andover, MA 01845 Phone 978.688.9545 Fax 978.688.9542 Email bleathe@townofnorthandover.com Web www.TownofNorthAndover.com 1 0 TO: Zoning Board Of Appeals: JUL Iu;� Gerald Brown; Albert P. Manzi,3rd, ESQ; Ellen P. McIntyre; D. Paul Koch, Jr. ESQ; Allan E. Cuscia; Douglas Ludgin; BOW) OF APAEALS Deney D. Morganthal; Nathan J. Weinreich. When does a so called "in -Law Apartment" become a house? How do you tell the difference between building an "In -Law Apartment" and building a house? Let's see if I can help you: 1. When a Breeze -Way separates the existing house and the new construction, RED FLAG, It's a house. 2. When the "Footprint" of the new construction is close to one-half or more of the "Footprint" of the existing house, RED FLAG, it's a house. 3. When the new construction roof line is as high or higher than the existing house, RED FLAG, it's a house. 4. When the new building is too large for the existing Lot, Red FLAG, it's a house. 5. When the new construction has a Cathedral Ceiling, Red FLAG, it's a house. The Zoning Board Of Appeals recently approved the building of a structure at 11 Dana Street, North Andover MA, 01845 that includes all 5 items stated above. This area of North Andover is Zoned for one family homes because of the small lot sizes. If and when you are in the area of 11 Dana Street, North Andover located off Waverly Road near the Thomson School, Please view the new construction you approved as an "in -Law apartment", it's a house!!!! When is the Zoning Board Of Appeals going to STOP "rubber stamping" all new construction under the guise of "in -Law Apartments"? Where was the Building Inspector? Doesn't he/she get an opportunity to view the plans? When your friendly next door neighbor is not shown the new construction plans and is out of town when "The Plans" are presented before the "Board Of Appeals", RED FLAG, it's a house!!!! P.S. We love And respect our neighbors at 11 Dana Street, But, it is obvious the feeling is not mutual. P.S. 2 : If you do drop by 11 Dana Street, please stop in at 1 Dana St. and I will show you a REAL In -Law Apartment also, I will show _you a 3 family across the Street you approved. SincerelyKac John J. Fial a, 1 Dana Street, North Andover, MA, 01845 Date. � 1�411.z ........ S TOWN OF NORTH ANDOVER 0 PERMIT FOR GAS INSTALLATION This certifies that 1.7 j� ............... has permission for gas installation a0gle ot in the building of .... 45� 91� .......................... at .... ..................... I North A-hdover -ass Fee. Lic. NoA���... . .4- A Z;�� A Check # IZ6-5 GAS INSPECTOR G TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY��-,-`- MA DATE t� PERMIT # JOBSITE ADDRESS [ �v'1 �''T OWNER'S NAME F to r¢ 6,4 /'0+ OWNER ADDRESS 5 111— e TELr_ _FAX OCCUPANCY TYPE COMMERCIAL Ej EDUCATIONAL NEW: [Q RENOVATION: ❑_J REPLACEMENT: APPLIANCES 7 FLOORS - BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER BSM 1 1 1 2 1 3 1 4 1 5 1 6 1 7 RESIDENTIAL a— PLANS SUBMITTED: YES 0 NOD 8 1 9 1 10 1 11 1 12 1 13 1 14 INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES IffNO El IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [0— OTHER TYPE INDEMNITY ©[ BONDFJj 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 i AGENT SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are and that all plumbing work and installations performed under the permit issued for this application will be in co Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME d F�- LICENSE # �_3__ j and Wcurate to the best of my knowledge nc th all PortinerArovision of the i. ",I SIGNATURE MP MGF [.:]I JP 0 JGF [] LPGI CORPORATION [9# �PARTNERSHIP [---I#= LLC D# COMPANY NAME:ADDRESS 13p��� CITY STATE �hk ZIPd L TEL 7rw FAX .::/= CELL EMAIL----- O z 0 H U W okW o o z a� N Z O N El F- W °z a LU L LU w W o a J a co \ ui x w H LL W F °z 0 H U a rA 4 d �7 C�h The Commonwealth of Massachusetts Department of •industrial Accidents Office ofInvestigations 600 Washington Street Boston, M4 02111 www.mrassgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 3olicant Infnrmnfinn Name (Business/Organization5ndividual): - - - •- Address: - - -- - Qty/State/Zip; Phone #: Are you an employer? Check the appropriate boa: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/orpart-time).' 2. ❑ I am a sole proprietor or have hired the sub -contractors listed partner- on the attached sheet. # ship and have no employees These sub -contractors have worldng for me in any capacity. [No workers' comp. insurance workers' comp, insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing officers have exercised their all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] *Any applicant that checks box M must also RE oat Ehe seciion belor, she:=..;,,R _ -w�,. : 7H - -- Type of project (required):' 6. ❑ New construction 7. ❑ Remodeling S. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.0 Roof repairs 13.❑ Other omeownem who submit this affidavit indicating they are doing a1I work and then hire outside contractors must submitotaa 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. tam an employer that is providing workers' compensation information. insurance for my employees Beloty is the policy and job site Insurance Company Policy # or Self -ins. Lie. #: 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 required under Section 25A ofMGL 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. t do hereby certify under the pains and penalties ofperjurJT that the information provided above is true and correct -wiciat use only: Do not write in this area, to be completed by city or town official City or Town: Per—t-ir. .cense Issuing Authority (circle one): ft L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical 6. Other inspector 5. Plumbing Inspector 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 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 apartrnents 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 uni-il 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 may be submitted.to the Department of Industrial Accidents for confirmation of insurance coverage. .Also be sure to sign and date -the affidavit. The affidavit should er� t i. it" 7^ tShat he F�f=11..4yGL�.lvii for L:SE � 1 5' IyPY x is beingrequested,t beret ia_ • to tie c.E� or tov L y k, mit o_ L ems i b mb not the D_pa_rtment 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 permitlliccnse 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 (if necessary) 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•Iike to thank you in advance f6r your cooperation and should you have any questions, please do nbt-hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Deparrtmentof1'ndua ialAccidents Office ofharestibat ons 600 Washington StFeet Boston, MA 02111 Tel. #- 617-727-4900 ext 406 or 1 -877 -MAS -SAFE Revised 5-26-05 Fax # 6.17-727-7749 Date TOWN OF NORTH ANDOVER PERMITFOR PLUAING us This certifies that ...... ............. ........... has permission to perform ............... plumbing in the buildings ON.. a t . . ........... North Andover, Mass. Fee -Z3 ...... Lic. No.. . . . eJ ............. PLUMBING INSPECTOR Check # tl 7608 .4 1 nstalling Company Name MASSACHUSETTS UNIFORM APPLICATION FOR -PERMIT TO DO PLUMBING (Print or Type) Mass: Datelore 26A�_ Permit Building L catio 0114 G / Owner's ame ` 0 Type of Occupancy New 0 Renovation 0 Replacement kr.*, Plans Submitted: Yes 0 No 0 • C'PiAfFR # FIXTURES kddress lusiness Telephone % (} -f;;' lame of Licensed Plumber or Gas Fitter 1-1 . O`er C— Check ong: Certificate 0 Corporation 00 Partnership I have a current liability insurance policy or Its substantial equivalent, which meets the requirements of MGLCh. 142. Yes If—' No 0 If you have checked es, please indicate the type of coverage by checking the appropriate box. T A liability insurance policy P____ Other type of indemnity 0 Bond 0 OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner 0 Agent 0 tereby certify that all of the details and information I have suhmltted entered} In above application are true and accurate to the best of y knowledge and that all plumbing work a cnd installations perforated nd r the permit iss for this application will be in compliance with pertinent provisions of the Massahusetts State Plumbing Code a t 142 of the � Geral Laws. _ By Title City/Town APPROVED (OFFICE USE ONLY) nature of L'icens'ed llumber Type of License: 'Master OJourneyman License Number__ • • • a e 5������������ • M®MMM ���������5��� mi��.v • . • �v�v�� kddress lusiness Telephone % (} -f;;' lame of Licensed Plumber or Gas Fitter 1-1 . O`er C— Check ong: Certificate 0 Corporation 00 Partnership I have a current liability insurance policy or Its substantial equivalent, which meets the requirements of MGLCh. 142. Yes If—' No 0 If you have checked es, please indicate the type of coverage by checking the appropriate box. T A liability insurance policy P____ Other type of indemnity 0 Bond 0 OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner 0 Agent 0 tereby certify that all of the details and information I have suhmltted entered} In above application are true and accurate to the best of y knowledge and that all plumbing work a cnd installations perforated nd r the permit iss for this application will be in compliance with pertinent provisions of the Massahusetts State Plumbing Code a t 142 of the � Geral Laws. _ By Title City/Town APPROVED (OFFICE USE ONLY) nature of L'icens'ed llumber Type of License: 'Master OJourneyman License Number__ 14 *47 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that t ....... ............. has permission to perform ................... plumbing in the buildings of ................ at .... /. . . ......... :;�� North Andover, Mass. &10 .... P 12 - - Fee. Z,/.1.... Lic. NoIT�71... .1 ....... —:'� ........... PLUMBINGASPECTOR Check# // 5L/ u 8 MASSACHUSETTS UNIFORM (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location of 1►1 PLCATION FOR PERMIT TO DO PLUMBING e Date 0A, AJ r K� /� ! f Permit # f Y Amount ov New 1:1 Renovation IT Replacement El Plans Submitted Yes 1:1 No 0 FXT-JRES mmmm (Print or type) Check one: Certificate Installing Company Name J 0 � XV f R— /iky /1✓ e— ❑ Corp. Address 9 co S � 1:1 Partner. .5I;Aeln a//1 036 7 Business Te ep one ;;m/Co. Name of Licensed Plumber: &A'),j r 13 W 61 P0q/1) e Insurance Coverage: Indicates the tt of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond 10-1 Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance ignature IOwner ❑ Agent M I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and ' stall tions pe rmed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa use s State mbing C de an Ch ter 142 of the General Laws. By: i n re o icense m er— ype of Plumbing License Title City/Town icer e u er Master ❑ Journeyman APPROVED (OFFICE USE ONLY LLd f, ,�. . ,'? 3 - 0 Y Date .... ............. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that Q ............. ........... ..... ..... has permission for gas installation ............... in the buildings of ... ........................ at ........... North Andover, Mass. Fee�.��.��. Lic. No./.�,7�.. C�A-i INE�-�Q ......... Check # //.;� ��- 4642 MASSACHUSETTS UNIFORM APF (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations t`>N A S� Alb It r'!'� ii 111� A 114 Owner's Name New Renovation Replacement Ee PEIMI' TO DO GAS FfrMG Date r Plans Submitted El Permit # 1116t1P- Amount $ 20. (Print or type) ( l Check one: Certificate Installing Company Name �w h A� ��^i /V t P0 Mid � � Corp. Address F �fe / v Partner. n 0,347 Business Telephone Irm/Co. Name of Licensed Plumber or Gas Fitter 3 C'W l ,\ l9 116 11--+9 lv`'- INSURANCE COVERAGE Check one - have have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity M Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfor ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusgtts S�iate Gas i ode and Chapte`42 of the General Laws. tle Ci ty/Town IAPPROVED (OFFICE USE ONLY) V11 -nature of Licensed Plum`�er Or 6as'Atter Plumber /2972 79% Gas Fitter License Number W u x z W W 9 O U W F x x Cq C9 Z H F Z Z O E W z C4 O Pa rn W F Q O �:) O z W F. Gv� z U x g W a U C7 W F V1 z rr F z x F z W F F y a o z a o o w a H o a x w o a o a U A SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4 T H. F L O O R 15T H. F L O O R 6 T H. F L O O R 7 T H. F L O O R S T H. F L O O R (Print or type) ( l Check one: Certificate Installing Company Name �w h A� ��^i /V t P0 Mid � � Corp. Address F �fe / v Partner. n 0,347 Business Telephone Irm/Co. Name of Licensed Plumber or Gas Fitter 3 C'W l ,\ l9 116 11--+9 lv`'- INSURANCE COVERAGE Check one - have have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity M Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfor ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusgtts S�iate Gas i ode and Chapte`42 of the General Laws. tle Ci ty/Town IAPPROVED (OFFICE USE ONLY) V11 -nature of Licensed Plum`�er Or 6as'Atter Plumber /2972 79% Gas Fitter License Number Location No. / 7-),A /L) A A� 19 Cf S 4— Date --) 5 10 0 1 40*Th TOWN OF NORTH ANDOVER Certificate of Occupancy $ o 5 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (.A I q- 17 L 4 7 ( Building Inspector 1.1 Property Address: 1.2 Assessors Map and Parcel �! Map Number Number: Parcel Number 1� o 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Name Print Address for Service: i Front Yard Side Yard Signature Telephone Rear Yard Iteored Provide Reored Provided Reqttired Provided Not Applicable ❑ D 70 License Number Address ✓ � `� �S`633-;W 0 1.7 Water SupplyM.GL.C.Q. 54) Public ❑ Private ❑ Zone 1.5. Flood Zane intion: Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHMAUTHORIZED AGENT 2.1 Owner of Record / %� ` / DANA / Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: r~ Name Print Address for Service: i Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: 441,, ''e- �y /l. 6--ve/'f i,A, Licensed Construction Supervisor: 36 A / A- e r / / Not Applicable ❑ D 70 License Number Address ✓ � `� �S`633-;W 0 d o ignature Telephone Exp' ation Daie 3.2 Registered Home Improvement Contractor Not Applicable ❑ / 7 y ompany N./e— 1 %o/ 3/77. Registration Number �/lI o/oz �K�0 ExpX tion Dat i nature Telephone Ma M �o z O V 0 M O z M 90 O r _rM z 0 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(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: C e/� � A" L L IV e sA? A? e r 7 G ES SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by pertnit applicant ,. OFFICIA]F USE'ClNLY „, .......... 1. Building' d s d (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 SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner/Authorized Agent of subject property Hereby authorize to act on My if in all m�ttersae4fi e to work thorized by this building permit application. d( 6 Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,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 belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3RD SPAN DEV ENSIONS 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: L�111- , \ i,; C, P % r i "''k, Location: City Phone / 7�" 6 0 3 71) 0 aam a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity 1011 7 c re% • e I am an employer providing, workers' compensation for my employees working on this job. ComDanv name: Address City: Phone # Insurance Co. 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. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under pains and �penalties of perjury that the information provided above is true and correct , , \ Date :2- — Print name �� % e - L e r Phone # ! 7 Y V ` 7110 Official use only do not write in this area to be completed by city or town official' E] Building Dept El Check if immediate response is required Building Dept ❑ Licensing Board F1 Selectman's ice Contact person: Phone #. 0 Health Department 0 Other FORM WORKMAN'S COMPENSATION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall -be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: w © 5 S (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector -------- ---- -- invoice -------------- Andy R. Guertin (mr'Ilrr.•;! cmlltr..1enir ►.,�__J`�. 36 Pine St., Methuen, MA 01844 * Phone: 978-683-7110 * Email: wolffish@comcast.net License No. 040151 * Since 1968 * Fully Insured Date- 2-4-04 MR. JOHN FRAGALA 1 DANA ST. NO. ANDOVER MA. TEL -978-683-5054 Description I Stock I Amount INSTALL NEW CABINETS. INSTALL NEW WINDOW SAME SIZE. I TILE BATH WALLS. TILE BATH FLOOR. I I I I LABOR ONLY 1$11800.00 1 1 Subtotal Balance Due I $1,800.00 Authorized Signature 4 ✓lte�onri�ra,uveallir �f; llaaxx�/zudell6 [ 1 Board of Building Regulations and Standards t HOME IMPROVEMENT CONTRACTOR C` •, Registration: 121799 Expiration: 6113/04 Type: Individual ANDREW R. GUERTIN ANDREW GUERTIN 36 PINE ST.��✓ METHUEN, MA 01844 Administrator+ J/ce G4�n�nan+ueall� a�'✓6Prra,,.uj�;� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 040151 Birthdate: 06/30/1951 a Expires: 06/30/2004 Tr. no: 27049 Restricted: 00 ANDREW R GUERTIN 36 PINE ST METHUEN, MA 01844 Administrator W O z I rA W co as u41 o r ° C�U a ) O U -0 C w° coo G U w O a c�° w O W w a°' U) ca a W '�°° o co W w w w z Q o c o o O H CJ CJ CL= ccc s o r :oma C43CD E CD r m o CL h :.o m s ` ate. E • mo � a _m o y O O E.00 _R �J1cm co ' :_= O O) +� c o a act m 11.2� VH O C Z ld ` cm C d0 C Q � IA m C p _ :map N mL r •ca dt C Z W E vZ v�ti O CM C42 5 CD O CD Z Cl 0 � I H CDCA CD Q CL So z v Q fx e_v CO3 v h � v O cc C 0. COD Q w co CLCOD C O CM C CD D "c m m Q co ev �` 3,0 O 0 0 o - a cm< 0"c G Z cc CD CLy C