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HomeMy WebLinkAboutMiscellaneous - 10 SALEM STREET 4/30/2018This certifies that ..... C9 !;. � � .1 .... P ( � has permission for gas installation ... ............... in the buildings of ... k7kr .. ................... at. A P .... 1S.01 S.k ............. , North Andover, Mass. Fee . Li c. No. . Lo 1.*-! GAS INSPECTOR Check # 11 ell 8570 V 1,'ert A MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY: �_ta T*tA 1_1 MA. DATE: I -11,J1 1 PERMIT # JOBS.ITE ADDRESS: i ST OWNER'S NAME:. r p- +fir 1 �V GOWNER ADDRESS: TEL: FAX: TYPE OR OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL [Er PRINT CLEARLY NEW: ❑ RENOVATION: REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCESI FL00RHj:F= 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCK MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES g NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ❑ BOND ❑ 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 ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in com lance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER/GAS FITTER NAME. STEPHEN C. GALINSKY LICENSE# 103W6 SIGNAT COMPANYNAME: CAi.i►J;i _q PitlMAl#,JG t �457g.1-1t & ADDRESS: P.O. c ox 1701 CITY:- 14 AV E—R_H i L.t, STATE: m A ZIP: O I S 3I FAX: q79 - 5a1 - TEL: 97K- Vt4- 17,q3 CELL: 5,04 - 50q- 6goq EMAIL: wyy w. ml"`plumbt'fC�j MASTER [r JOURNEYMAN ❑ LP INSTALLER ❑ CORPORATION [�# 3 i qb PARTNERSHIP ❑ # LL( 49 0 O C x a 9 b H O z z 0 r� T -I m = m � r «moi. D � b o � r � h � z � rn C Lor) col) � m o o � C CD z ❑o h N � a r b C) H O z z o y r� 09774 Date. . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .... C-,. -, I! -: -.-t? � ( ... has permission to perfon-n ..... Seu. r plumVs in the buildin f g� o .... ........ at ... ....... North Andover, Mass. F "6. &M ee.. PLUMON INSPEA�. Check # 0,�v 7 rem MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY tAo MA. DATE PERMIT # I r JOBSITE ADDRESS kNER'S NAME P OWNER ADDRESS TEL FAX 1? t✓ TYPE OR OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL [L]' PRINT CLEARLY NEW: F1RENOVATION: L REPLACEMENT: ElPLANS SUBMITTED: YES ElNO El FIXTURES 7 FLOOR— BSMT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIL/SAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN DISHWASHER FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK I LAVATORY ( 1 ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET 1 URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liabili insurance policy or its substantial equivalent which, meets the requirements of MGL Ch. 142. Yes & No ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Z OTHER TYPE OF INDEMNITY ❑ 13OND ❑ 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 BOX ONLY: OWNER ❑ AGENT ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws_ PLUMBER NAME STIEPA60 t'._ &RL,Ir.1SKY SIGNATURE 4a�;:Y-2u LIC # I03H S MP [' JP ❑ CORPORATION X# 31916 PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME 6AWOSKY PLUMOJA)b n- RVAnO ADDRESS: P•0- GGX 1%0I CITY HAyCRItiw- STATE rA•A• ZIP 01113L EMAIL Www. ynrpltjMbega-c!!ol, C,om TEL g,7V' 37y- 17,t 3 CELL 5013- 5041 - 5UL4 FAX Q76 -591-413i V ,� t O c r C G� z Ic n 0 z z 0 m = m — cn sfl D D C�n - a z C7 rcnr-. z < o N C7 -o m D z On rnm z 4* O � N -i C CID ❑CD [7 m O z ❑o z a r z b y O z z 0 Date ... I,r. �ko —43 This certifies that . e�.i,,77wD . . ............ has permission to perform. wiring in the building of AA1-77y. 77!� � 7— ............ ........ at-% . ............ No.qh Andover, Mass. ... . ... ... Fee.. ic. No. . . ....... '% ELECTRICAL INSPECTOR Check # 153 2-Z- 11385 .V Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only ` Permit No. Occupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: 1V0t2 l1-,1- 14 G c%�t�_ To the Inspector of Wires: -By this appliciation the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number)—/ 7— Owner Owner or Tenant C EN T"E& f Z Owner's Address PO, O< Q ©X. 9-76 NO Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Sf/Y6L(-;:' i= -4M t LY /-/O CIS-- Utility Authorization No. Existing Service 160 Amps /20 / 2 YQVolts Overhead leLL _. Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters 01YE No. of Meters Location and Nature of Proposed Electrical Work: C 1ff4AjG-,F OLD i p K P, NEL TCS /Vcy!/ Completion of the following table may be waived by the Inspector of Wires. w , No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans r o Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of LuminairesSwimming Pool Above ❑ n- ❑ rnd. rnd. o. o mergency Lighting Battery Units No. of Receptacle Outlets 3S No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches �s" No. of Gas Burners �F o. o Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers p eat Pump Totals: Number I ons o. o el - oEame Detection/Alerting Devices No. of Dishwashers 1 S ace/Area Heating KW p g Local ❑ uniecti El Other Connection No. of Dryers Heating Appliances KW ecNo. of Devices or Equivalent No. of Water KW 0.0 No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications firing: No. of Devices or Equivalent OTHER: tivl N btJ /�Ut1ZN�} GC Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, 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 undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO. A119 8 3 Licensee: T.nUTS ('nNTTNn Signature LIC. NO..V B 7 gg (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.:97 S - 3 63 - 5 4 0 Address: 1 DOW -)VAN LIR JARST NEYABURY-, NA -01 985 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ I r- TOWN OF NORTH ,ANDOVER. ,YASSACHLJSF T5 HISTORIC DISTRICT COMMISSION Application for Certificate of Appropriateness Application is hereby made for the issuance of a CERTIFICATE OF APPROPRIATENESS under Chapter 40C for proposed work as described below and on plans, drawings, or photographs accompanying this application. CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: Type of Building 2. Demolition or Removal of: ( ) New Building ( ) Addition ( ) Alteration ( ) Home ( ) Garage ( ) Commercial ( �/) Other — screevle-A 3. Signs or Billboards: ( ) New Sign ( ) Existing Sign ( ) Other 4. Structure: ( ) Fence ( ) Wall ( ) Other (Type or print legibly) Address of Proposed Work: /D sajem stree--f Date: -7/22/11 Owner: Cem+e✓' Fe LHl ,4 /rkst (CK-�ehe. Ayre1 ,7rLtsiec ) Telephone tt Home Address (if different from above) : f 0. &X NO& -1 Akid oy-e Agent or Contractor: Z9ker f Llohn-P— Telephone ;: Address: ( Allen Sree'fi, A)d►'"fl�- 14m over - Assessor's Map tt: q& Lot T: /2 Detailed Description of Proposed Work: Give all particulars of work to be done (see �8 below), including materials to be used, if specifications do not accompany plans. In case of signs, give locations of existing signs and proposed locations of new signs. (attach additional sheet if necessary.) V)e- COw p1&e- �p�l tc�fto� 50bw►t t%ed '�o 71e .30atrd dl� 4ppe0J:5 /5 a Tackec) 5AOwtk'i!� cle��ea! '2 14 11 -o-F r— f-ear eki+ravice -ftie� tiouse a-�- lD Sa1e� Sfre , Owner (Agent, Contractor) DO NOT ;RITE BELOW THIS LINE RECEIVED FOR HISTORIC DISTIRCT COMMISSION: TIME: DATE: BY: APPLICATION THIS ( ( APPLICATION FOR CERTIFICATE OF APPROPRIATENESS: APPROVED DISAPPROVED Reason for Disapproval: ( ) NO CERTIFICATE OF APPROPRIATENESS REQUIRED A CERTIFICATE OR APPROPRIATENESS is in the application above and attached documents. Chairman: Vice Chairman: Secretary: for work described Received by Town Clerk: r TOWN OF NORTH ANDOVER, MASSACHUSETTS BOARD OF APPEALS APPLICATION FOR RELIEF FROM TIIE REQUIREMENTS OF THE ZONING ORDINANCE /C�� the 114.1 Avr�rett,-Trustee• (TeI,s�GeS-ol�S) / � �/} ��' Applicant Center Pe& r r"S OF %VSA � Address � Sox 111 /VQ� !'� �r�CIVQI� `jl. Application is hereby made: a) For a variance from the requirements of SectionParagraph , 3 j and Table -Z-of the Zoning By Laws b) For a Special Permit under Section Paragraph of the Zoning By Laws. -- -- c) As a Party Aggrieved, for review of a decision made by the Building Inspector or other authority. 2. a) Prem es affected are land _V and building(s) �numbered� _>AZ Y"1 -------- ----Street . -- b) Premises affected are property with frontage on the North (U-1) South ( ) East ( ) west ( ) side------ erH --- Street, and known as No. Street. c) --------- _--- - c) Pxemises affected are in Zoning District_, and the premises affected have an area of q1�U -square feet and frontage of —_aQ feet . oh Salem eJ, "4 SO -eej on .5yeve+�s S'f . 3. Ownership a) Name and address of owner (if joint ownership, give all names): Cen4er r'qs!_64 Mort_!, Ardover� �,0, (30x_!1 I }LiierqJ ,��lvver Date of Purchase__a7D ____-__Previous OwnerMAry Charles b) If applicant is not owner, check his/her interest in the premises: _-Prospective Purchaser --Lesee Other (explain) 44 Size of proposed building: ?_-front; �'� feet deep; L. " Height 6Me- stories;_(5---feet. SCreejl porch Q -f back em'traAe-e_ a) Approximate date of erection: b) Occupancy or use of each floor: re51p����B�1jTJ(Q1—_ c) Type of construction: (�JW 5. Size of existing building: 3 Q feet front, �Q deep; Height—Ll stories; _fcrr. -Leet. ` a) Approximate date of erection: �85d b) Occupancy or use of each floor: $(vI g c) Type of construction:—_-!.gi2Ua1------_— - 6. Has there been a previou. appeal, under Zoning, on thew: premi::c:? —�Q— If so, when?_----- .1 petition mdersized lot, wi4-4 A' 7 k-' Descri tion of relief sought on this p . a. obs et privacy, ..t ze,_rreemevi orcin UAI( 4/3"4m rear boundary, has litle. pr�sv Pnofec+ed__W_fdQyr space tin pr!pper4y :6.r use AVkVi OPNIoYkeAt by or-cuplow•t, B. Deed recorded in the Registry of Deeds in Book Page SOD Land Court Certificate No. Book Page The principal points upon which I base,my application are as follows: (must be stated in detail) LIST OF PARTIES IN INTEREST USC- A/C)/ 1A I agree to pay the filing fee, advertising in newspaper, and incidental expenses* 4 Signature of Pe -tit I oir r(s) Every application for action by the Board shall be made on a form approved by -the Board. These forms shall be furnished by the Clerk upon request. ;Any communication purporting to be an application shall be treated as mere notice of intention to seek relief until such time -as it is made on the official application form. All information called -for by the form shall The furnished by the applicant in the manner therein:..prescribed. �Every-application shall be submitted with a list of "Parties In Interest" ;which list shall include the petitioner, abutters, owners of land directly .opposite on any public or private street or way, and abutters to the a butters -wi thi n' thr ea hundred feet ( 300' ) of the property line of the petitioner as they appear, on the most recent applicable tax list, notwithstanding that the land of any such owner is located in another city .or town, the Planning Board of the city or town,. and the Planning Board of,• c:.),". :every abutting city or town. '.*Every application shall be submitted with an application charge cost in .the amount -of $25.00. In addition, the petitioner shall be responsible for any and all costs involved in bringing the petition before the Board.: Such shall include mailing and publication, but are not necessarily. -costs limited to these. Every application shall be submitted with a plan of land approved by the Board. No petition will be brought before the Board unless said plan has been submitted. Copies of the hoard's requirements regarding plans are attached hereto or are available from the Board of Appeals upon request. LIST OF PARTIES IN INTEREST USC- A/C)/ 1A LIST OF PARTIES OF INTEREST MTD -4 T)AD('VT 4 77TML TTIN nnnr'c' I �uvv ,.0, l ✓ �' Je -T .J A rvt tJ f, L4A 4,6Ar—A A/ &17 R.AJ A r- 3 szr�"njs st: L� L� Q Q° 5PAL45 SETWO-G k) _---LEF'C' SIQE ELE�/t'.T_LON .. 11 SLt,,LE: y411-�'-o^ Exlowsc-- -- FLOOR PLAN SCALE I� 0 IIS f�J I� I� U �C-\ O I� ZZ I ,I io �I T Q) �/ Exlowsc-- -- FLOOR PLAN SCALE J �VIA 4 x� x STE- 12 J c C- ZSM HANGF=TZ 11 r o CD P 7 � 2 � V J � P � J Q � J � o 7 � �� Z 14 EJ Qj 0 1AIA a Location -16'-5&Ej4 -5-7 No. I/Y � — Date /-0-- ,LORTN TOWN OF NORTH ANDOVER armiamlI& 'A Certificate of Occupancy $ Building/Frame Permit Fee $ SS CHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ 13y CjjJt:'cat;erICon nect ion Fee $ PAID TOTAL OCT 9 1991 Building- Inspector W. . Div. Public Works /PER -KIT NO. Y VZ APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. 1 J t PAGE 1 MAP d-40. LOT NO. 12 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ZONE) SUB DIV. LOT NO. LOCA ° ' N I�S- PURPOSE OF BUILDING J ,SIZE W 'S NAME NO. OF STORIES PlWNER'S ADDRESS ' •�O Lls� ( n tt( U ��• `Y• BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST ZX6 2ND 3RD UILDER'S NAME�p SPAN -- DISTANCE TO NEAREST BUILDING DIMENSIONS OFSILLS DISTANCE FROM STREET '" POSTS DISTANCE FROM LOT LINES - SIDES A� yLa/"� /Y/ IQJ "' "" GIRDERS AREA OF LOT FRONTAGEJ31 p HEIGHT OF FOUNDATION THICKNESS 7 / 77z( -I e IS BUILDING NEW SIZE OF FOOTING �,rR/ X Y IS BUILDING ADDITION / MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND l<VILL BUILDING CONFORM TO REQUIREMENTS OF CODE yg� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 1- IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING N ATTACHE21GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR IV 1/ATE FILED Iyg/c// OF OWIMM OR AIJl*IORIZED AGENT FEE 2-510-0 PERM92�1- J m�CONTR. TEL-. NZ t,-CONTR. LIC. H 0 Z / 3 x/30/93 3 PROPERTY INFORMATION LAND COST ,E§T. BLDG. COS O" EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE PINE B 1 2 13 CONCRETE BL K. BRICK OR STONE HARDW D _ PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL i4 FIN. B'M'TAREA _ '/, 1/1 '/ FIN. ATTIC AREA _ NO BMT FIRE,, PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS _ B _ 1 2 �_ 3 _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDIN D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ _ BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR POOR ADEQUATE I-1 ONE 5 ROOF 10 PLUMBING ' GABLE I HIP BATH (3 FIX.) TOILET RM. 12 FIX.) WATER CLOSET _ _ _ GAMBREL FLAT MANSARD SHED ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. _ STEAM STEEL BMS. & COLS. HOP W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T;G UNIT HEATERS NO. OF ROOMS GAS. L B'M_ T_ 2nd _ 1t 13rd ELECTRIC NO HEATING s 0 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. Received by Town Clerk: • fes' .r;: , 1 i - TOWN OF NORTH ANDOVER, MASSACHUSETTS BOARD OF APPEALS Tei APPLICATION FOR RELIEF FROM THE REQUIREMENTS OF THE ZONING ORDINANCE P tne_ 14 . AVrel f.�,• Trus?'ee-• (Te%0 (K-014.0 Applicant C2n er iZea1 � T►US 1 OT %V, A , --Add r es s (I6, 8 o 111 �M6 Arelover- v/1. Application is hereby made: a) For a variance from the requirements of Section ' Paragraph 3 and Table -Z- of the Zoning By Laws. b) For a Special Permit under Section__Paragraph of the Zoning By Laws.-- C) As a Party Aggrieved, for review of a decision made by the Building Inspector or other authority. 2. a) Prem es affected are .land V and building(s) �numbered14, i .4 4-&r1'►? ------------ Street. -- b) Premises affected are property with frontage on the North (VI South ( ) East ( ) West ( ) side ------------- Street, and known as No.—ID 21+1 Street. r c) Pxcmises affected are in Zoning District, and the premises affected have an arca of 41leO _square feet and frontage of —gyp _feet. oh GtJem 54, "4 SO 'Feel'Gn S-teVle,,S S -f , 3. Ownership a) Name and address of owner (if joint ownership, give all names): Cenfer 2eat�� Trc��t_of Nary, Ardev_er� 0, 80X 111E}LVertl A�vver 1RDate of Purchase7D ..... --Previous Owner—Airy Charles b) If applicant is not owner, check his/her interest in the premises: —_Prospective Purchaser Lesee Other (explain) 4w Size of proposer] building: ?_-front; i� feet deep; Height phe. stories;—L�'__fcet. _Scree1 . bPore-h ex back ewfranc-p_ a) Approximate date of erection: �j,�•w.I�k�q� b) Occupancy or use of each floor: feSlde►�f(G1—_ C) Type of construction: (Nq 5. Size of existing building:_36 feet front; '46 feet deep; Height stories;_ —it stories;2c—_-ECCE. a) Approximate date of erection: �8�d b) Occupancy or use of each floor: c) Type of construction:---bJOrJo�-_---_— - G. Has there been a previous appeal, under zoning, on these^ premises? p — If so, when?_----- tivilersiZed Iofi �-wi'44 'hoose' 7,' Descr tion of r lief sought on this petition loundary, has NVAC ti Vide. ''. %ria M rear' Uffle_ :i Greene or cu.t Yule' � rt �. ro'ftc+e fdWr Tate on �P r ah�1 a �v e+1t occ •!�, 8.:.• Deed recorded in the Registry of Deeds in Book Page d� Land Court Certificate No. Book Page q --- , The principal points upon which I base.my application are as follows: ,; (must be stated in detail) y :. r •S ¢•er [ a6o Vim- `^' .. • . . �. tI agree to pay the filing fee, advertising in newspaper, and incidental • expenses* C% Signature of PetlEiot errs i (Every application for action by the Board shall be made on a form approved ;by•the Board. These forms shall be furnished by the Clerk upon request. jAny communication purporting to be an application shall be treated as mere •as it is.made on the ;notice of' intention to seek relief until such time application form. All informationcalled •for by the form shallbe lofficiaL furnished by the applicant in the manner t,herein,•rprescribed. '• 1Every-application shall be submitted with a list of "I'arties In Interest". :which list shall include .the petitioner, abutters, owners of land directly ;opposite on any public or private street or way, and abutters to the . jabutters ;within' three hundred feet (300') of the property line of the petitioner as they appear on the most recent applicable tax list, ..notwithstanding that the land of any such owner is located in another city..'•.:';;i or town, the Planning Board of the city or town,, and the Planning Board of ; •.,: ..every abutting city or town. '.*Every application shall be submitted with an application charge cost in :the amount' of $25.00. In addition, the petitioner shall be responsible ,for any and all costs involved in bringing the petition before the Board. ,• .?I: .,,,,,,• a..•t`' Such costs shall include mailing and publication, but are not necessarily,."::;;;Its limited to these. ; Every application shall be submitted with a plan of land approved by the Board. No petition will be brought before the Board unless said plan has been submitted. Copies of the Board's requirements regarding plans are attached hereto or are available from the Board of Appeals upon request. 1 LIST OF PAR'T'IES IN INTEREST ,1 V SC A/ >c T �94 ') LIST OF PARTIES OF INTEREST MAP i PAP('PT. $ NIAMP AllnnvcC 11 C11JLi\LlU /''+ 15�J G // �' JAMS t 8A4,dAr-4 14Al R., ZY 9t 7 i c. r �^ S7t-✓LajS f 6 /3 Ceu JLC -u C Yf v rri �., � 'T — t-_ .S': 3G �ol►nsoh 5 t C yy Cerl r ---;qt- c. 60 >Ji ILCAS% )l I� 0 l� Lu - - 0 ICL Ro ova • � EXISTt1�C� - 3� -x-£31---- I -FLOOR PLAN o � y Lo vJ a )j L 1 � Q J�i N vUL,O v) _ o a )j L 1 � Q J�i RECEIVED BY BUILDING INSPECTION Q DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuaiice of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. FORM U. TOWN OF NORTH ANDOVER; i LOT RELEASE FORk1 s is SUBDIVISION %. .ASSESSORS MAP c' E; SUBDIVISION LOT(S) .# PERMANENT ADDRESS (ASSIGNED BY D.P.W. ,STREET I 0 Sim( -Om S'C ' V = : PLICANTy1 j2c� 7ucsT PHONE 6-PA"TE OF APPLICATION 6 1 1 TOWN USE BELOW THIS LINE PLANNING BOARD VYi UA'i'E APPROVED TOWN PLANNER DATE REJECTED CODIRISSION /CONSERVATION v 1eoit DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH DATE APPROVED HEALTH SANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS Iry h19 - FIRE DEPT. / RECEIVED BY BUILDING INSPECTION Q DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuaiice of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. c*5 f -- z U o W o � �X �w W ai CL 0 ao c •C 0 N 6� Z 4. 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