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Miscellaneous - 102 SOUTH BRADFORD STREET 4/30/2018 (2)
a �} c Location •4 No. U Date y dG �Q TOWN OF NORTH ANDOVER �QO �o .t�'s. p Certificate of Occupancy $ fF ling/Frame Permit Fee CO �CT�3 $ 'SSACMUSE� Foundation Permiee $ Other Permit Fee $ "APR 3� 0 %% Connection Fee $ Water Connection Fee $ TOTAL f / $ •�/�/�%�% •a• �//�.f'//tel _ r.../�at"li Building Inspector Div. 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WN/T%/E2 FST. IN N012TI-I ANDOI/E2 ,IK4f S°. SCALE /=L0 FEd. /955 JZa`P11 8. e-rFUrZ �: F. /./,4 t/SS. Mr. Robert Nicetta Building Inspector N. Andover, Mass. Clarence W. Spencer P.O. Box 204 North Andover, MA 01845 Atten. Mr. Walter Cahill: Dear Mr. Nicetta, April 22, 1993 I am applying for a town of North Andover building permit for the purpose of erecting a new utility shed that will replace an existing one. The new shed will be constructed of wood with outside dimensions of 8 ft. W. X 14 ft. L. X 8 ft. 2 in. high. It will be built on a cement block foundation with screened air space below to allow for air circulation, also equipped with air vents in both peaks. The roof will be covered with light gray/red, fireproof shingles to match my house roof. NOTES: 1. This utility shed will not be equipped with electricity, water or gas. 2. The new shed is replacing an existing one, and will be located on the same site. 3. The building permit for the existing shed is number 860, issued April 28, 1969, signed by Mr. Charles Forster. 4. The shed location is 70 feet behind my house at the edge of the lawn/woods dividing line and is located on my property at 102 South Bradford Street, N. Andover: (See sketch #1): I would appreciate your consideration of the request at your convenience. Respectfully submitted, IV. 46r-�� Clarence W. Spencer 3 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: CLARENCE W. SPENCER Phone 682-4784 LOCATION: Subdivision Assessor's Map Number Parcel Lot (s) Street South Bradford street St. Number 102 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved L�V Conservation Administrator Date Rejected Comments `C Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Redeived by Building Inspector 26► Date Approved Date Rejected Date Approved Date Rejected Date Approved z 2 hu Date Rejected Date th ON d o v04 a O C7 A �50 �a� o P4 U G x O 14 U a4 to G w O u W W � 04 > 9. C/) m w F- d '� w W w A co v cn o cn 71 0 L U Z 0 U V J 0 0 v U CD J Q �50 �a� z c E c ca o � C H F- �•.• O lC ts V Z CD RO R OCA C y.r yr — O Z 0 L •Ea co CE >ca Q co cL m m LU z CL c co o CD ~� o CL Aso z O i O `k au� m c E L civ L O, h 3 h v, c Is m. N Ca �a �•O' = c H O H C O O .v E m C.) J -p mo Z C m m c Z m z_ 'moa ccca.c V � V y O O d C •O H Q � � i m C = H m momo 0 ~ N m H m yam.. 'C CO.O L W r•+ L R � ac CAC.Z C �E 2 � CALU Z o Na C3 CM CD t/� CL m 'm C 'O Z cc 0 CL.mi 71 0 L U Z 0 U V J 0 0 v U CD J Q CD O z E L F- ts LU Z CD OCA C — O Z Z LL co O _ >ca Q y �� m m LU z co o CD ~� o CL co O i O CD L civ Ca �a c O -I--O O _ Q C.) J -p Z c Z m z_ V ca LL 0. G Na CD 5 Z � 11365 Date ..... �.1-2- V-15.. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING /-f This certifies that ....... / ..�!.../.......... .................. ... o:.44........................... has permission to perform .... 0e plumbing in the buildings of ........... /4,t6r/o at ...... . ................................................................. W-9 ..z ...... je)�� 69ellb(� Korth Andover, Mass. Fee.67&47n ... L i c. No.-*,;' . ................................................................................. PLUMBING INSPECTOR Check # P,� 1-1 ('s 5 HV- 1 -` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Uyf 4� MA DATE I °I ' 2 l%S �j PERMIT # JOBSITE ADDRESS �Oa Sa/? /1 7L�OWNER'S NAME I ffL0 GOWNER ADDRESS TE �O x_02 TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW[] RENOVATION: El REPLACEMENT: ® PLANS SUBMITTED: YES 0 NO® APPLIANCES -1 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER ... T- �i . _ . ... 1- . -_ �. _ _ .-. I� -I BOOSTER _ CONVERSION BURNER COOK STOVE 15KQ DIRECT VENT HEATER DRYER ._ .— . _ _ .... - FIREPLACE J _ FRYOLATOR_-- -- - FURNACE 1 Lx-1 11 GENERATOR �_--1 == GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVENPOOL HEATER I L ROOM / SPACE HEATER _j _ ROOF TOP UNIT TEST UNIT HEATER �- -- UNVENTED ROOM HEATER WATER HEATER OTHER - ... ... ....... _.. _. _I—JIL — INSURANCE COVERAGE MGL. Ch. 142 YES NO I have a current liability insurance policy or its substantial equivalent which meets the requirements of I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE INDEMNITY Ej BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusep General s, and that rpy signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER E� AGENT 0 S N URE OF,OWER OR AGENT I hereby certify that of the details d information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and i lations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Qom; Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME i k-0 I"G u i�1 LICENSE SSIIGN�A�T�UURE MP El MGF JP 12f JGF LPGI 0 CORPORATION ©# PARTNERSHIP 0#= LLC E1# I COMPANY NAME:ADDRESS CITYLYA/1 STATE D/ V TEL FAX ._-- �_. CELL EMAIL �l �T `) WGon W O z 110 H U-� a t � o a z O y❑ W } � W LLI E-1ILIL z U w �* W X Q w W �+ w C0 a z a a con U F, a a a x w H LL H zz 0 H U a �y The Commonwealth of Massachusetts Department of IndustrialAceidents 1 Congress Street, Suite 100 Boston, MA. 02114-2017 www massgov/dia Workers Compensation Insurance Affidavit- Builders/Contractors/Electricians/1?lumbers. TO BE FILED WITH THE PERNICTT'ING AUTHORTTY. -please Print Le 'bl A '' licant Information Name (Business/Oigariization/Individual): Address: City/State/Zip:_ Are you an employer? Chi the appropriate box: Phone #: 1.Q I am a employer with , . employees (full and/or part-time). 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [Noworkers' comp. insurance required.] 3.Ej I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.❑I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6. Q We are a corporation and its, officers have exercised their right of exemption per MGL c. 152 SIM andwe have no employees: [No workers' comp. insurance required.] Type of project (required): 7. ❑ N6*'d6nstr66tion 8. [] Remodeling 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions Ia.0 P1ulnbing repairs or additions 13%Ro6f repairs 14. [] Other *Any 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 are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this liox mu .. attached an additional sheet showing the name of the sub -contractors and state whether or pot those entities, have employees. If the sub contractors have employees, they must provide their workers' comp. policy number. ' compensation insurance for my employees. Below is the policy and job site X am an employe` that is providing workers information. Insurance Company Policy # or Self -ins. Lic. Expiration Date: City/State/Zip: lob Site Address: Attach a copy of the vc�oxkers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA. for insurance coverage verification. ofperjury that the information provided shave is true and correct I do hereby certify under thepains andpenalties Date: Sinature: in this area, to be completed by city or town official. Official use only. Do not write l. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their em '1i gees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of WO, 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 receivet'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 the grounds or building appurtenant thereto shall not because of such employment b6 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 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'contractor(s) name(s), address(es) and phone number(s) along with their certificates) 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 be returned to the city or town that the application for the permit or license is being requested, not the Department of IndustrialAccident's. 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 permit/license number which will be used as a reference number. In addition, an applicant thai 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 burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 wwwrnass.gov/dia a w � BOXFORD CHIMNEY SWEEP P.O. Box 14 • Boxford, MA 01921 508-727-3715 boxfordchimney@comcast.net www.boxfordchimneysweep.com Name: oz Address: City: State: Zip Date: u I Flue Size: ( l ` (2)X)r. CONDITION REPORT HEATING FLUE 1. Height 2. Cap/Screen 3. Crown/Wash 4. Brickwork/Mortar 5. Flashing 6. Gas/Oil Flue Liner 7. Moisture Resistance FIREPLACE FLUE 8. Smoke Chamber 9. Damper 10. Firebox/Grate 11. Ash/Container 12. Spark Screen/Doors 13. Flue Liner FLUE LINER I'0 SMOKE 110 SHELF 1 DAMPER (� C N, LINTEL :BRICK ASH DUMP COMMENTS: NEXT SERVICING SUGGESTED: The National Fire ProtectiVnn Association Stan ates the fire- place and chimney should be inspected rly f an stru ral faults. Chimney Professional's Signature RECEIPT/INVOICE DESCRIPTION PRICE l LA-) 1� I�CYV Y� 1 TOTAL 10814 This certifies that ....�./9<?....,1 r ............................. has permission to perform ......A46a—Alm Date ../..U;l.T . y//.Y. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING plumbing in the buildings at.... ..'+...d.. Fee.-S�.. Lic. No. Check # 0 Andover, Mass. NGINSPECTOR 14 Date ...... 4 ./P./ . It. C./ ............... ........... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... ..... ................................. I ................ has permission for gas installation ....... ......................................... inthe buildings of . ...................................................................................... ............... Nort� Andover, Mass. Fee......... 0 .............. Lic. No.. 3../ l!'fo...... ......... .................................. Check #410 6/GAS INSPE&OR 9608 WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER I—` 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES P_1 " IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY � OTHER TYPE OF INDEMNITY © BOND D.I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General LawA and mt3ny signature on this permit application waives this requirement. SIGNATURE OF ONIn OR AGENT CHECK ONE ONLY: OWNER 0 AGENT J© I hereby certify that all of the details and information I 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 provisi f the AeleAAassachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ✓�r I LICENSE # SIGNATUR IMP© JP CORPORATION RJ #©PARTNERSHIPS#®LLC (# COMPANY NAME4 1ADDRESS .�;F _ { CITY STATE ZIP C7�-j -._-1 TEL FAX CELL[_._. � EMAIL MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I ' if CITY . a MA DATE[ PERMIT # JOBSITE ADDRESS ---__...-_—I S'(�u� tF;G, 1t�f,�Cr rl t -f 11 OWNER'S NAME POWNER ADDRESS TEL[__ FAX f TYPE OR OCCUPANCY TYPE COMMERCIAL © EDUCATIONAL Erl RESIDENTIALt PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: Q PLANS SUBMITTED: YES ® NOEll Z FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB Ei, CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM = DEDICATED GAS/OIL/SAND SYSTEM —E., DEDICATED GREASE SYSTEM_f DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER_E DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREADRAIN _—J_!k INTERCEPTOR (INTERIOR) IOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE /MOP SINK F_7] F-73 I TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER I—` 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES P_1 " IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY � OTHER TYPE OF INDEMNITY © BOND D.I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General LawA and mt3ny signature on this permit application waives this requirement. SIGNATURE OF ONIn OR AGENT CHECK ONE ONLY: OWNER 0 AGENT J© I hereby certify that all of the details and information I 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 provisi f the AeleAAassachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ✓�r I LICENSE # SIGNATUR IMP© JP CORPORATION RJ #©PARTNERSHIPS#®LLC (# COMPANY NAME4 1ADDRESS .�;F _ { CITY STATE ZIP C7�-j -._-1 TEL FAX CELL[_._. � EMAIL H Z O H U W a w o F] z W � W w O W m n Z LLI a Cl) O a W CO o Lil > rx w � a 'LJ p o a w� U J d CL a (1) ui x w F- LJL H O ' H v a t7 a a p� p 'AR6The Commonwealth of Massachusetts - Department ofIntlustrialAccitlents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/ilia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name Address: W0,_ e_F10 W City/State/Zip: { 0 & e4 c,41 ./Phone Are you an employer? Check the appropriate box: LM I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. F1 Electrical repairs or additions 11. W Plumbing repairs or additions 12.0 Roofrepairs MkOther j, *Any applicant that checks box #l. must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they acre doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors 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 N Policy # or Self -ins. Lic. #: Job Site Expiration Date: Attach 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 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. I do hereby certtfy under the pains anoenalties of perjury that the information provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - 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 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 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 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 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 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 be returned to the city or town that the application for the permit 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 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 permit/license 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 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. The Department's address, telephone and fax number: The COMMORWOalthofMassachusetts - Department ofJndustrial Accidents Office o£IavestIgatirons 600 Washington Street Boston, MA. 0211,1 Tel # 617-727-4900 eyt 406 oz 1-877rMA.SSAFE Revised 5-26-05 Fax # 617-727-7749 ww�v.�ass,govfdxa I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK UIPCITYw° r_-_ _ - �_ MA DATE /6 �1 �l - /�/ II PERMIT # JOBSITE ADDRESS OWNER'S NAMET� GOWNER ADDRESS TEq77_ FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONALRESIDENTIAL 13 CLEARLY NEW: Q RENOVATION: REPLACEMENT: ® PLANS SUBMITTED: YES F-1 NO E] APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER 1 .. _ BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATERm(- DRYER j 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 I WATER HEATER OTH—ER �V - - -- - �- _ INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MOL. Ch.142 YES �10 [l I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Z;ar""� OTHER TYPE INDEMNITY [D 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 I 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 pr sion of the Massachusetts State Plumbing Code and Chapter 142 the General Laws. h�of PLUMBER-GASFITTER NAME �W LICENSE # 3 SIGNATUf� MP El MGF Ej JP ( JGF Q LPGI © CORPORATION ©# PARTNERSHIP ®#� LLC,# -. . . -__� COMPANY NAME:I__ 11ADDRESS CITY STATE ZIP © [ TEL G FAX CELL EMAIL ^_ W� F O O� U W y � o Z O y� r W � W LU O U w �* Z w F- � a w 5 O � a w w w U a o a w a U J ' a m a LU s w U- H O H U a 11. The Commonwealth of Massachusetts Department of IndustriglAccidents Office of Invesfigations 600 Washington Street Boston, MA. 02111 www. mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 7,f r,u,,,,,L_ ),e&&r f, Address: 4 J n. �!'C a5,.�s Q_ /)a : City/State/Zip: �; rC 4 s4r?22/ 2 / Phone #: Are you an employer? Check the appropriate box: Type of project (required): .1111 am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* 20I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. E] Remodeling ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 5. El We are a corporation and its 9. E] Building addition [No workers' comp. insurance required.] officers have exercised their 10.❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11. ❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] i employees. [No workers' 13. [i Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they a're doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company N Policy # or Self -ins. Lie. 9: / / Expiration Date: l Job Site Address: fps 2 3� _ 4-� � 2�r.L/ �rr rte/ City/State/Zip: k,. Attach 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 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 DTA for insurance coverage verification. I do hereby certify under the painsaqd penalties ofperjury that the information provided above is true and correct. Phone M k S� 'T 3 33/�- 6 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: VI/ 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 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 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 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 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 be returned to the city or town that the application for the permit 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 Eno. 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 permit/license 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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department ofzndustrial Accidents Office of Intvestigatioyts 600 Washington. Street Boston} MA 02111 `f`e1, # 617-727-4900 ext 406 or 1-877:MASS.AFF, Revised 5-26-05 Fax # 617-727-7749 wwaass,govfdia 4144 Date../ 0 ..... o �.t,TOWN OF NORTH ANDOVER ,(, � A PERMIT FOR WIRING r— ISG( ai f FCf-i? 1 . This certifies that .......... . ..0.......... }�............- ... .........................f.............. has permission to perform ..........! `.. l..��. �!..Y ......�1 wiring in the building of ............1.....x.1.. �U/ .......................................... at ......... U �i U f .'l. l 0,.c. l / v� 1 ,North Andove , MSS Fee.r...�S...� Lic. No.. ./..3U.�% ... ......... ..... .�2.1�.... . i ELECTRICAL INS 11 Chc-�,k # � S �`� THEC0MM0NWFEALTH0FM4SS4CHUSE77S q e Use only DEPAR MEATOFPUX1CS4FETY BOAROOFFIREPREVEAWONRWAYAHONS527CMR12.-M Permit No. Occupancy & Fees Checked APPLUARONFOR PERMIT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /5 - - O L .Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 10Z 506TI.1 (3(14coll- Owner or Tenant Owner's Address? t Is this permit in conjunction with a building permit: Yes /�No (Check Appropriate Box) Purpose of Building � <- FA, -%1 (-- Utility Authorization No. Existing Service 2-64-, Amps 70 /7 go Volts Overhead Underground� No. of Meters New Service Amps / Volts Overhead � Under found No. of Meters g Number of Feeders and Ampacity ------ Location ands Nature of Proposed Electrical Work k , j C k t 1� No. of Lighting Outlet=o-.iof ot Tubs No. of Transformers Total No. of LightAg Fixtureng Pool Above Below KVA Generators KVAround roundNo. of Receptacle Outleil Burners No. of Emergency Lighting Battery UnitsNo. of Switch Outletsas Burners No. of Rangesr Cond. Total FIRE ALARMSNo. of Zones Tons No. of DisposalsHeat Total Total No. of Detection and Pum s Tons InitiatingDevices No. of Dishwashers Space Area Heating W No. of Sounding Devices No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local Municipal Other No. of Water Hdbters gW Connections No. of No. of Si ns Bailasis No. Hydro Massage Tubs No. of Motors Total HP ]I OTHER nst==Coverage Putst ttothelegtlrtanaysofMaSsa lseltsGalerallaws haveaamei tLiabl7it llsm=pb yu CmPlete CoNrageortsstlbb legLuvalait YES ©'/O haveatminedvandproofofsametotbeOffce. YES j FywhavedmkodYES plea9 mxbc&thetypeofwwrageby hxkirigthe box/ Lj / p 14SURANCE a- BOND 01IRR [:3 (Plem-* y) _ Lr lit l lT 1kDunder�iePe<taitiesofpaju6tXZ i1 hpt lDaleRegd ! RMNAW SCktAa/- �I i Rmffi Estimated Vahaeo E1xfiical Wolk $ 7 -Soo, e o Fmal Signal= �� �i;7,-1't ri/nA t 73 > _ Li ermNo. _LixweNo l 3 v 7,4 Bt Tel.No. 1kdGl«_ I -q l—NILl '`SIL ,/11,0 CA C / At'Te1No. %7F� %,�- 31 A7'URSINSURANCFWANFR,Iamawaletha&lioensedoesnothavetheir>umxcowrageor8wbstaMepvalataslegtzWbyMa%achusemst;ffnalLam 3thatmysignattueon thispeunitapplirafion waivEsthislequr<emetu lease check one) Owner � Agent M i ) Telephone No. PERMIT FEE Signature ot Uwner or Agent N2 1754 Date........ 717119.... t TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING C u U This certifies that ....... Q.Q. ...... � 1.: .... 5.!?.QA..vx . ............................... �. has permission to perform ... ..!R ....... .......... I ch wiringof ..... ift ....... in the building t ................................... I'R air .... I.. a a ...S.0 ......... ......... North Andover, M,..gw, FJ/7 ... Lic. No. ........... ................ 9�EC�rZICA'L*INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer I MMOl� L1H0FM4,MCHV:S= Office Us'ee 00%nly MAP DFP4RTA=0FPUBLICS4F= Permit No. OFFIREPR0111 70NREGULATION552 112.00 i%� Occupancy & Fees Checked PARCEL ()�- PERNfIT TO PERFORM ELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 ^ (PLEASE PRINT NI INK OR TYPE ALL INFORMATION) Date (' Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. FORWARD "7 Location (Street & Number) DZ S a. tar Fat�Gf Owner or Tenant S�A7 j'' 72 j 4z)T Owner's Address Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box) Purpose of Building Is, - `S � L_ l -1 Utility Authorization No. Existing Service Z o U Ampsiz- / Z VDVolts Overhead!� Undereround No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work R_e4J1Rc 5ecwnd flaolX, D%bAli- Ak km l , 'icgrtr Y, No. of Lighting Outlets C No. of Hot Tubs No. of Transformers Total J KVA No. ,f Lighnng Fixtures Swimming Pool Above Below Generators KVA / ground 1:1eround No. of Receptacle Outlets v No. of Oil Bumers No. of Emergency Lighting Battery Units N0. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No.'df Heat Total Total Pumas Tons KW hosting Devices No. of Sounding Devices No. of Dishwashers Space Arca Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. oF�Water Heaters KW No. of No. of Sims Bailasis No. Hydro Massage Tubs r No. of Motors Total HP OTHER • •t: 4:f I J - �•1 t •1 h1 • • :f �- �•: d• �• •• : r • IA • ••'�.' :141 :•: IMESA • '- WIN .11 .t1• •i'i_ Wa3c ;o sw 7— b - Irsi ecut I�te Rte Signed ta�t'he Pa>alties oFpe'jtay: � GQ^ A RT/ % �I�Cf2! L FIRM NAME Lica I�rQ n, Q L (� S Cy1 A rt/� siotae dIc 2C( Vah& i Wale S Raig, 0 -It coo- 11 Final _ Rt :ss -V�5Z1 Z vvA OWTvEZ'S 1TtEL7RA7` Cc WANEt 1 am aware tt theLie z not t the amrori>s atai rmt, ire i ty� Cu�rai Laws �d thatmysig�at;mti� pemar v�,es this \ (Please check one) Owner Agent Telephone No, PER,'47 FEE S a2 SERS rcco Z W¢ O WP, Z Q- 0 , a o� xaz2�,C 7C rw V�� QWQQWLL co o L vi �W 0a=u.Q �. v 02ZQ0� QUj wWZ ZzQo¢p3 �LQcQ w ��o~Cco rz VQI 044Z ,r 0 U.- � Q: k z U�cq 4 Z LL 4°v0icQ) a! ., i. � O OR Cc cc T y�� WW LuLuUj I1 a < XA �/ � s'� xq /, j ieh a�o�s � • LU 4 w Z u ?)lw a I O �` P� '77 << M (1 4/ tii kt VN ° / �- �M'�� � � �� ��O , - � � � •,� � J � ons �Na 60.6 C 4 goo 0� LU i/am auolS %'� ~ Z CO F- LU N y / D' N co° y � w°� 00 4Z q ¢=$; o° Om Q Z Q o �.a JCo a� 1% Q� Z,% Tz �. W .t co cn I— O �U ��i�Z oF�u;o J o Wocoz Z4 z °m o cc QZ 4 N Q WWS WW UU LL O COO a 1=, o. O W L o Z o 4 HANCOCK Environmental Consultants # 9627 May 2, 2002 Barbara Talbot 102 South Bradford Street North Andover, MA 01845 RE: Wetland delineation and regulatory issues 102 South Bradford Street Dear Mrs. Talbot: O 235 Newbury Street This narrative is prepared to accompany a sketch showing eleven blue surveyor's flags placed this morning along the Northerly perimeter of your yard at 102 South Bradford Street. I obtained the `As -built Plan of land' dated 11/09/99 from Julie Parrino at the Conservation Commission offices, marked the flags in their approximate locations, and left her a copy. The attached copies are for your use and to assist Mr. Giles in the location of the flags. Please be advised that Hancock can also perform the survey if you want a second estimate, or Mr. Giles cannot get to the job in a hurry. For what it is worth, Julie believes that the 75 foot conservation line shown on the 1999 plan is inappropriate, as the dwelling is `grandfathered', having been built before the watershed zoning district was created. You may want to pursue this matter with the Building Inspector, as it is not exactly Julie's specialty. Flag A-7 lies approximately sixty (60) feet from the left rear corner of the garage, about fifteen (15) feet behind the rear range line of the garage. The jurisdictional buffer zone established by the state regulations intersects the proposed addition, but the activity is categorically exempt from state regulation as a `minor project'. [See 310 CMR 10.02 (2) and 10.58 (6) (b), excerpts attached.] I believe that the local bylaw and/or the watershed zoning compels local review, but the Department of Environmental Protection is out of the loop, so to speak. I would expect the Conservation Commission to be concerned largely with construction -related impacts, such as management of debris and minimization of soil disturbance. Note that the state regulations presume that a silt fence will be installed — I have added a proposed location for such a fence to the enclosed sketch. Division of Hancock Survey Associates. Inc. Route 1 North Danvers, MA 01923 (978) 777-3050 REc,ely (978) 352-7590 E� (978) 283-2200 (781)6629659 JUN 2 8 Z002FAX (978) 774-7816 ........................... CONSER ❑ 12 Farnsworth Street Boston, MA 02210 AT pN DOVER COMMISSION (617) 350-7906 This narrative is prepared to accompany a sketch showing eleven blue surveyor's flags placed this morning along the Northerly perimeter of your yard at 102 South Bradford Street. I obtained the `As -built Plan of land' dated 11/09/99 from Julie Parrino at the Conservation Commission offices, marked the flags in their approximate locations, and left her a copy. The attached copies are for your use and to assist Mr. Giles in the location of the flags. Please be advised that Hancock can also perform the survey if you want a second estimate, or Mr. Giles cannot get to the job in a hurry. For what it is worth, Julie believes that the 75 foot conservation line shown on the 1999 plan is inappropriate, as the dwelling is `grandfathered', having been built before the watershed zoning district was created. You may want to pursue this matter with the Building Inspector, as it is not exactly Julie's specialty. Flag A-7 lies approximately sixty (60) feet from the left rear corner of the garage, about fifteen (15) feet behind the rear range line of the garage. The jurisdictional buffer zone established by the state regulations intersects the proposed addition, but the activity is categorically exempt from state regulation as a `minor project'. [See 310 CMR 10.02 (2) and 10.58 (6) (b), excerpts attached.] I believe that the local bylaw and/or the watershed zoning compels local review, but the Department of Environmental Protection is out of the loop, so to speak. I would expect the Conservation Commission to be concerned largely with construction -related impacts, such as management of debris and minimization of soil disturbance. Note that the state regulations presume that a silt fence will be installed — I have added a proposed location for such a fence to the enclosed sketch. Division of Hancock Survey Associates. Inc. I also attach a locus map, which you will need to file a Notice of Intent, and is not normally something folks have lying around the house. As with the survey and site plan, we can assist you with the filing in any way necessary. Another bit of information pertinent to a Notice of Intent is wildlife habitat. I have reviewed the South Groveland quadrangle of the Massachusetts Natural Heritage and Endangered Species Program atlas. There are no certified vernal pools or estimated habitat shown in your area on the current atlas, which is dated 1999-2001. (The Program has been unable, to date, to issue updated atlases — I checked at the Conservation Commission offices, and saw nothing to contradict my findings. You are not in an Area of Critical Environmental Concern, nor is there any Wetland Restriction Order outstanding for your area. Your assessor's map and lot number and deed reference are shown on the 1999 plan. These data also must be included in a Notice of Intent — having it all in one place renders the paperwork a little less daunting. Julie Parrino can assist you with any other questions, if you wish to prepare your filing. She can be reached at (978) 688-9530 during usual business hours. Her office is at 27 Charles Street (but call ahead — she does a good deal of fieldwork). Thank you for the work. Please contact Rich Albano or me if you have any questions. Sincerely, Hancock Environmental Consultants t_Dick, P.L.S. Wan cien is Attachments: As -built Plan (annotated) Locus Map (1987 USGS Lawrence quadrangle) 2 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 10.01: Introduction and Purpose (1) Introduction 310 CMR 10.00 is promulgated by the Commissioner of the Massachusetts Department of Environmental Protection pursuant to the authority granted under The Wetlands Protection Act, M.G.L. c. 131, • 40. 310 CMR 10.00 shall complement M.G.L. c. 131, • 40, and shall have the force of law. 310 CMR 10.01 through 10.10 provide definitions and procedures. 310 CMR 10.01 through 10.10 pertains to both inland and coastal areas subject to protection under M.G.L. c. 131, • 40. 310 CMR 10.21 through 10.60 provide standards for work within those areas. 310 CMR 10.21 through 10.37 pertains only to coastal areas and 310 CMR 10.51 through 10.60 pertains only to inland areas. A project may be subject to regulation under 310 CMR 10.00 in which case compliance with all applicable regulations is required. (2) Purpose. M.G.L. c. 131, • 40 sets forth a public review and decision-making process by which activities affecting Areas Subject to Protection Under M.G.L. c. 131, • 40 are to be regulated in order to contribute to the following interests: -protection of public and private water supply -protection of ground water supply -flood control -storm damage prevention -prevention of pollution -protection of land containing shellfish -protection of fisheries -protection of wildlife habitat The purpose of 310 CMR 10.00 is to define and clarify that process by establishing standard definitions and uniform procedures by which conservation commissions and the Department may carry out their responsibilities under M.G.L. c. 131, • 40. Applicants and issuing authorities shall use forms provided by the Department to implement 310 CMR 10.00. 310 CMR 10.00 is intended solely for use in administering M.G.L. c. 131, • 40; nothing contained herein should be construed as preempting or precluding more stringent protection of wetlands or other natural resource areas by local by-law, ordinance or regulation. 10.02: Statement of Jurisdiction (1) Areas Subject to Protection Under M.G.L. c. 131. • 40. under M.G.L. c. 131, • 40: (a) Any bank, any freshwater wetland, any coastal wetland, any beach, bordering any dune, on any flat, any marsh, or any swamp (b) Land under airy ofthe water bodies listed above (c) Land subject to tidal action (d) Land subject to coastal storm flowage (e) Land subject to flooding (fl Riverfront area The following areas are subject to protection the ocean any estuary any creek any river any stream any pond or any lake (2) Activities Subject to Regulation Under M.G.L. c. 131, • 40. (a) Activities Within the Areas Subject to Protection Under M.G.L. c. 131 • 40. Except for minor activities within the riverfront area meeting the requirements of 310 CMR 10.58(6)(b), any activity proposed or undertaken within an area specified in 310 CMR 10.02(1) which will remove, fill, dredge or alter that area is su' I 113 un IN r 1 Q and requires a filing of a Notice of — _ (b) Activities Within the Buffer Zone. A y activity other than minor activities ident 10 CMR 10.58(6)(b) proposed or undertaken within 100 feet of an area specified in 310 CMR 10. a) (hereinafter called the Buffer Zone) which, in the judgement of the issuing authority, wv71 alter an Area Subject to Protection Under M.G.L. c. 131, • 40 is subject to regulation under M.G.L. c. 131, • 40 and requires the filing of a Notice of Intent. [ See also 6/26/98 310 CMR - 324 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 310 CMR 10.05(3)(a)2.1 The areas subject to jurisdiction identified in 310 CMR 10.02(l)(b) to (f) & not have a buffer zone. Minor activities within the buffer zone meeting the requirements of 310 CMR 10.58(6)(b) are not subject to regulation under M.G.L. c. 131, • 40. 6/26/98 310 CMR - 324.1 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 10.58: continued (f) When an applicant proposes restoration on-site of degraded riverfront area, alteration may be allowed notwithstanding the criteria of 310 CMR 10.58(5)(c), (d), and (e) ata ratio in square feet of at least 1:1 of restored area to area of alteration not conforming to the criteria. Areas immediately along the river shall be selected for restoration. Alteration not conforming to the criteria shad begin at the riverfront area boundary. Restoration shad include: 1. removal of all debris, but retaining any trees or other mature vegetation; 2. grading to a topography which reduces runoff and increases infiltration; 3. coverage by topsoil at a depth consistent with natural conditions at the site; and 4. seeding and planting with an erosion control seed mixture, followed by plantings of herbaceous and woody species appropriate to the site; (g) When an applicant proposes mitigation either on-site or in the river&ont area within the same general area of the river basin, alteration may be allowed notwithstanding the criteria of 310 CMR 10.58(5xc), (d), or (e) at a ratio in square feet of at least 2:1 of mitigation area to area of alteration not conforming to the criteria or an equivalent level of environmental protection where square footage is not a relevant measure. Alteration not conforming to the criteria shad begin at the riverfront area boundary. Mitigation may include off-site restoration of riverfront areas, conservation restrictions under MG.L. c. 184, • • 31 to 33 to preserve undisturbed riverfront areas that could be otherwise altered under 310 CMR 10.00, the purchase of development rights within the riverfront area, the restoration of bordering vegetated wetland, projects to remedy an existing adverse impact on the interests identified in M.G.L. c. 131, • 40 for which the applicant is not legally responsible, or similar activities undertaken voluntarily by the applicant which well support a determination by the issuing authority of no significant adverse impact. Preference shad be given to potential mitigation projects, if any, identified it a River Basin Plan approved by the Secretary ofthe Executive Office ofEnvironmental Affairs. (h) The issuing authority shall include a continuing condition in the Certificate of Compliance for projects under 310 CMR 10.58(5)(0 or (g) prohibiting further alteration within the restoration or mitigation area, except as may be required-to_maintain the area in its restored or mitigated condition. Prior_to 7equesting the issuance of the Certificate of Compliance, the applicant shad demonstrate the --restoration or mitigation has Been successfully completed for at least two growing sextons._. (6) Notwithstanding the provisions of 310 CMR 10.58(1) through (5) certain activities or areas e grandfathered or exempted from requirements for the riverfront area: (a) Any excavation, structure, road, clearing, driveway, landscaping, utility line, rad line, airport ��. owned a political subdivision, marine cargo terminal owved by a political subdivision"bsidg"V& two males long, septic system, or parking tofwW3fiir—the riverfront-a ea-ht-eYistenceCon August 7, 1996. Maintenance of such structures or areas is allowed (including any activity which maintains a structure, roads (limited to repairs, resurfacing, repaving, but not enlargement), clearing, landscaping, etc. in its existing condition) without the i7ng of a Notice of Intent for work within the riverfront area, but not when such work is within other resource areas or their buffer zones except as provided in 310 CMR 10.58(6)(b). Changes in existing conditions which will remove, fill, dredge or alter the riverfront area are subject to 310 CMR 10.58, except that the replacement within the same footprint of structures destroyed by fie or other casualty is not subject to 310 CMR 10.58. (b) Certain minor activities, provided the activity is not within any other resource area: 1. Unpaved pedestrian walkways for private use; 2. Fencing, provided it will not constitute a barrier to wildlife movement; stonewalls; stacks of cordwood; 3. Vista pruning, provided the activity is located more than 50 feet from the mean annual high water line within a riverfiont area or from bordering vegetated wetlarnd, whichever is farther. (Pruning of landscaped areas isnot subject to jnuisdiction-tm&-r3i0 CMR40:00.);_ 4. Plantings of native species of trees, shrubs, or groundcover, but excluding turf lawns, �� 6/26/98 310 CMR - 401 10.58: continued 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 5. The conversion of lawn family houses uses accessory to existing single fahouses m existence on August 7, 1996, such as decks, sheds, patios, and pools, provided the activity is located more than 50 feet from the mean annual high-water line within the riverfront area or from bordering vegetated wetland whichever is farther, and erosion and sedimentation controls are implemented during construction The conversion of such uses accessory to existing single fiunily houses to lawn is also allowed. (Mowing of lawns is not subject to jurisdiction under 310 CMR 10.00); The conversion of impervious to vegetated surfaces, provided erosion and sedimentation 7. Activities that are temporary in nature, have negligible impacts, and are necessary for planning and design purposes (e.g., installation of monitoring wells, exploratory borings, sediment sampling and surveying). Activities not meeting the requirements of 310 CMR 10.58(6)(b) may be allowed through a Determination of Applicability or a Notice of Intent. If resource area boundaries are uncertain, a Request for Determination of Applicability or Notice of Intent should be Sled. (c) On-site sewage disposal systems in existence on August 7, 1996 and the repair or upgrade of existing systems in compliance with 310 CMR 15.000. New construction of a system under 310 CMR 15.000 must comply with 310 CMR 10.58, subject to the presumption for the siting of systems in 310 CMR 10.03. (d) The expansion of structures, airports, and marine cargo terminals, provided they are owned by a political subdivision and the expansion activity was physically begun on or before November 1, 1996. (e) Projects for which a draft environmental impact report was prepared and submitted pursuant to M.G.L. c. 30, • 6213, on or before November 1, 1996, or as extended by the Department for just cause but no later than December 31, 1996. (f) Projects for which a building permit conforming to local requirements was Sled on or before October 1, 1996 and granted on or before April 1, 1997, or as extended by the conservation commission for just cause by no more than 60 days. (g) The road and infrastructure shown on a definitive subdivision plan approved or endorsed under M.G.L. c. 41, • 81U, on or before August 1, 1996. Activities on the subdivided lots are subject to 310 CMR 10.58 unless they received a building permit under 310 CMR 10.58(6)(f). (h) Construction, expansion, repair, restoration, alteration, replacement, operation and maintenance of public or private local or regional wastewater treatment plants and their related structures, conveyance systems, and facilities, including utility limes. (r) Structures and activities subject to a M.G.L. c. 91 waterways license or permit, or authorized prior to 1973 by a special act, are exempt, provided the structure or activity is subject to jurisdiction and obtains a license, permit, or authorization under 310 CMR 9.00. 6) Activities within riverfront areas subject to a protective order under M.G.L. c. 21, • 1713, the Scenic Rivers Act. (k) Activities on land occupied by historic mill complexes. 10.59: Estimated Habitats ofRare Wildlife (for inland wetlands) If project is within estimated habitat which is indicated on the most recent Estimated Habitat Map of State -Listed Rare Wetlands Wildlife (if any) published by the Natural Heritage and Endangered Species Program (hereinafter referred to as the Program), a fully completed copy of the Notice of Intent (including all plans, reports, and other materials required under 310 CMR 10.05(4)(a) & (b)) for such project shall be sent to the Program via the U.S. Postal Service by express or priority mail (or otherwise sent in a manner that guarantees delivery within two days). Such copy shall be sent no later than the date of the filing of the Notice of Intent with the issuing authority. Proof of timely mailing or other delivery to the Program of the copy of such Notice of Intent shall be included in the Notice of Intent which is submitted to the issuing authority and sent to the Department's regional office. Estimated Habitat Maps shall be based on the estimated geographical extent of the habitats of all state -listed vertebrate and invertebrate animal species for which a reported occurrence within the last 25 years has been accepted by the Program and incorporated into its official data base. 6/26/98 310 CMR - 402 Y Printed from TOPO! QIPW W>ldf ower Prodactins (www.topo.coo Town of North Andover Office of the Conservation Department Community Development and Services Division f" Julie Parrino Conservation Administrator July 16, 2002 Scott & Barbara Talbot 102 South Bradford Street North Andover, MA 01845 27 Charles Street North Andover, Massachusetts 01845 RE: Addition to Existing House Dear Mr. & Mrs. Talbot: Telephone (978) 688-9530 Fax (978) 688-9542 This letter is in regard to your proposed addition to be located to the rear of the house, adjacent to the garage. I have reviewed the Plan of Land, dated July 8, 2002, prepared by Scott L. Giles and Frank S. Giles Surveying. The addition will be located within the 100 foot buffer zone to bordering vegetated wetlands located within the Lake Cochichewick Watershed Protection District. Considering the addition is within the 100 foot buffer zone to bordering vegetated wetland, I recommend you file a Request for a Determination of Applicability (RDA) with the North Andover Conservation Commission. The RDA is a smaller permit application than the Notice of Intent. Attached is a copy of the application. The next available hearing is August 14, 2002 and the filing deadline is August 2, 2002. If you have any questions pertaining to the filing procedures, please feel free to contact me. Thank you. CC: NACC Planning Department BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Location No. /ba r SD 801AASl /a3 Date NORTH TOWN OF NORTH ANDOVER O h + s Certificate Occupancy $ + I ; , of �+CNus <�' Building/Frame Permit Fee $ 11 50 Foundation Permit Fee $ Other Permit Fee $ l S TOTAL $ 48 /( Check # 15835 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING � _ BUILDING PERMIT NUMBER: DATE ISSUED: �r SIGNATURE: r Building Commissioner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: �1 ZoningDistrid Pr osed Use 1.4 Property Dimensions: t` Lot Areas Fronts e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R redProvided Required Provided S R7 ' L410 1Za. 1.7 Water Sup1y M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record N (Print) Address for Service Signature Telephone c --I Z ? A��� L 2.2 Owner of Record: Name Print Address for Service: t Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Construction Supervisor: R . — l . `�S�o (� Addres9 W �� 9-71d Signature Telephone Not Applicable ❑ ILA �Licensetl License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 —fir Company Name (D Address '` ` V ` l J w ` Registration Number Expiration Date Signature Telephone M rn X Z O v rn 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 ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ I Demolition A I Other ❑ Specify Brief Description of Proposed Work: 'r I SECTION 6 - FSTIMATRn rnNCT1RITCT1nN rnCTC 1 Item Estimated Cost (Dollar) to be Completed b ermit applicant OFFICIAL USE 0.NLY 1. Building (a) Building Permit Fee Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbinZ Building Permit fee (a) x (b) ----- / 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number or.�111v1'4 is %JVV1'4r1( AV 1nV1(11,A11U1V 1V nh LUMYLEIEV WHEIN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING 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 SECTIDN 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject prop A 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 ! et / 14 V;. % Si ature of Owner/Agent Date NO. OF STORIES Z SIZE p BASEMENT OR SLAB Q .}- S17 -E OF FLOOR TIMBERS 1 2 ND 3 FD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS I[EIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE �. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Depdrtments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT—. LOCATION: Assessor's Map Number. SUBDIVISION STREET ly �REC WIVIE ID IONS OF C6NS1= ATION A MINI COMMENTS,4/ 1/--/' 4� TOWN PLANN COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS PHONE PARCEL LOT (S) ST. NUMBER_Zo_,:� AL USE ONLY*********************************** AGENTS—FF- - APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 im TE 2u c� --f D rn tj m � 7o z < C 2 ((� iF Im�7:iA'd:n ay m x m o \\I o A C) IM � -0 � tp 3 m m 1y rn Vf d 1 A �"'� "U 2 L S 1yT Q H C r O ... W v yi40, r cn Z O D D 3 D m A C7 3 w C = ►+ d 'r O ►+ Z p`� r N !� 07 rn y z < d a 3 33 Jo � n 1 m a;o 0 -0 tp 3 �1 m rn w a -, `D m Z.0CA -� w to m -r d 1 C) r+ r o r-• w v ?i r cn A c7 3 i m --4 m a' � Z Z t 'nn nom:; i N a Z m a m N a o 0 N N a O � fJf YI ''.. H• N N A y O Hr B O G � 0 0 � O d o. � o � o m A O z x o a OU W cn :1c ro c O W a�' is w O W W v' Uto W 7 G V � c w O U cr,z rL c w W CLIw Q cc U) cn e� a c 0 QPa, cc ami �C9 N � Eco Q C Cl 0 0 4 me &S E :mom co to o zN� y c N � O • �' M E E C"., cgyp 5 a co cmc rno � C N Q = c ca y O i t� .; �► p cc ® C7f a o ao = m cx L id O y C • t co LL. AR ca 40 oc E 40N o c _ {yp N •� �- s a= c a N C) 0 c® m CD co ci>-. ® o O Im— g1 ©- cm C cv c® J � O ' CD z y C 0 U) W W crW 161 Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT Director (978)688-9531 X N March 23, 1999 Mr. Peter Davies 102 So Bradford St. North Andover, MA 01845 Dear Mr. Davies: Fax(978)688-9542 Please be advised that it has come to the attention of this department that an inground pool has been installed at this address without the benefit of a building permit. This is also in violation of the zoning ordinance of the Town of North Andover as all construction, additions and accessory structures in: the watershed district require approval from the Planning Board. Please be aware that the pool is in violation of section 4.136 of the Town of North Andover zoning ordinance watershed protection district. Be further advised that under section 10.1.3 penalty for violation states that "whoever continues to violate the provisions of this bylaw after written notice from the building inspector demanding an abatement of a zoning violation within a reasonable time shall be subject to a fine of three hundred ($300) dollars and that each day such violation continues shall be considered a separate offense". Please contact me so that we may begin the process to rectify this situation. Respectfully, Michael McGuire ` Local Building Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 N° 1 563 Date. �.J�..7e .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that :4 ....^".... .�4 "1�,�%..��. v U has permission to perform..� �<�....:. ............................ >viring in the building of--..Z=' f ......................................... ....................................... at . _.Ie— . , North Andover, Mass. "Fee....... Lic. Nag % :tp; Cc, �............. t ELECTRICAL INSPECTOR 03/26/99 08:39 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer - _- The Commonwealth of Massachusetts Oltice Use0.1y Nmit No. /6-7113 = Department of Public Safety J�ov' = Occupancy S Fee Checked BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 (lease blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE /I�NFFORMATION) Date 3 - 43 - T 7 City or Town of Wo_ �t"t'V\d Fy e -ye To the Inspector of Wires: The undersigned applies for a permit torform the electrical Work described below. stqvi-esLocation (Street & Number) Pe_+tdt Owner or Tenant / 0 21 Owner's Address Is this permit in conjunction with a building permit: (Check Appropriate Box) Purpose of Building Utility Authorization NO Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No. of Meters No. of Meters Location and Nature of Proposed Electrical Work S t,,t)I VA wA ti t OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liab lity Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 21 -NO ❑ .I have submitted valid proof of same to this office. YES 0--90 ❑ If you have checked YES, -please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Electrical Work $ Work to Startl�,3'ZZ — / f Inspection Date Requested: Rough /►� Final Signed under the penalties of perjury: FIRM NAME VJi i �• /�'�N %4 1-_L l LIC. NO. Liccnseell�� �� fq�� a- �Ri't^V�14L' ,Signature LIC. NO. Address ?17 ti VrrQ-t'e S S / • p,Tk Aele Bus. No. %� - & J -73 .0 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. Signature of Owner or Agent PERMIT FEE $ CA, -1,1--p W 0t ltilCD r J b ! W} /. l G� bi-t C cANY�-e-eJ No. of Lighting Outlets g g No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency LightingBattery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local 1:1 Municipal ❑Other Connection No. of Ranges No. of Air Cond. Total tonsInitiating No. of Disposals No. of pumps Total Total Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Y Heating Devices KW g No. of Water Heaters KW No, of No. o Si ns Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liab lity Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 21 -NO ❑ .I have submitted valid proof of same to this office. YES 0--90 ❑ If you have checked YES, -please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Electrical Work $ Work to Startl�,3'ZZ — / f Inspection Date Requested: Rough /►� Final Signed under the penalties of perjury: FIRM NAME VJi i �• /�'�N %4 1-_L l LIC. NO. Liccnseell�� �� fq�� a- �Ri't^V�14L' ,Signature LIC. NO. Address ?17 ti VrrQ-t'e S S / • p,Tk Aele Bus. No. %� - & J -73 .0 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. Signature of Owner or Agent PERMIT FEE $ CA, -1,1--p REMARKS BY ELECTRICIAN: 1 IV m in E 4 Z N w •E y a E E O U REMARKS BY ELECTRICIAN: 1 IV Date /4/- 4080 TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING ,SSACIM4 �............`..� ......... This certifies that has permission to perform .......................... plumbing in the buildings of ..................... 1-y-, North Andover, Mass. Feo/ Lic. N*6'71 ....... .."jM.t'-N-z-�P -EC TO . R ....... 07/16/99 14:22 I20-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer P�2cct► J4� Z16//03, 0- 6037--.0000-6 MASSACHUSETTS UNIFORM APPLICATION FOR P RMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date -7j 12j -q Y___ Building Location �6 Z Soafll S� Owners Name SCd Tra-� b0 f ' Permit v Amount /ZO TypeofOccupancy New Renovation ❑ Replacement Plans Submitted Yes No (Print or type) Check one: Certificate Installing Company Name �. �. S-54kM <0P ��S "� 44, 0 Corp. Address 23 L2 4 ew o o Z O nA V -e. El Partner. Ufa ►ti rJ a.. Business Telephone Firm/Co. Name of Licensed Plumber: . SCA.&JS o rJ Insurance Coverage: Indicate the tvpe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 Bond 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 Signature Owner 0 Agent 0 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By:Stdf Eicensea Flumoer Type of Plumbing License Title _ City/Town tcense Um' er Master ® Journeyman ❑ APPROVED (OFFICE USE ONLY c ` C is I ..�-..--.-.�------------- i■nnnnnnnnosnn�nnnnnnnnnnn ,.,n�©nnn�nnn�nnnnon�n�n��n� ,.., ., �n�nn�nnnnn■�n�n��n�nnnnnn . � , nnnnnnnnnnnnn�nnnnnnnnnnn ��. � � : nnnnnnnnnnnnnnn�nnnnnnnnn �. � �_,�nnnnn�n�■n�n■�n�n�nnnnn�nn� (Print or type) Check one: Certificate Installing Company Name �. �. S-54kM <0P ��S "� 44, 0 Corp. Address 23 L2 4 ew o o Z O nA V -e. El Partner. Ufa ►ti rJ a.. Business Telephone Firm/Co. Name of Licensed Plumber: . SCA.&JS o rJ Insurance Coverage: Indicate the tvpe of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 Bond 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 Signature Owner 0 Agent 0 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By:Stdf Eicensea Flumoer Type of Plumbing License Title _ City/Town tcense Um' er Master ® Journeyman ❑ APPROVED (OFFICE USE ONLY 7812290566 ZOLL s q Scott Talbot 90A Kodcweii � f I A71- s. A - MI -- To: Michael McGuire Fax: 97&688-85`+2- phone 97&658-9545 ft-: 102 So. Bradford 0 Oroent H for Retieew Uj pease Q please RBPb C1 pwase ReCYG:C F-582 T-950 P-001 FEB 04 199 10:58 From; Scott Talbot pages: 3 Date: 02/04/99 CC: (C[iCk here of ld type Mr. McGuire, a Au the plot plan and another map of the 01",t Per our phone conversation l am �.�.ae�� Y end the applicatwA to you shQ�� wit) got the letter frOm the pressene • L4zrne owr TMnks again, A&� Scott Talbot 7812290566 L OCRrcRezz)zcti AT NO. 53 ZOLL F-582 T-950 P-0_02 FEB 04 199 10:58 .a ,, . � • J r ! `moi �� , t s 7812290566 ZOLL no:55a aveLI-T999 2:6+ 4 F-582 T-950 P-003 IFJLTY Ago FEB 04 199 10:59 Wi HT37TOT. ir "O;m -k*- f tv. Arc. VR cr s Iq rCAL, E 740 Location 1 !3 No. d.5� Date d NORT1y TOWN OF NORTH ANDOVER A Certificate of Occupancy $ Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ ` TOTAL $ ' 3 �� 7 Building Inspector r �I (f,f27l99 14:54 520.44 PAID Div. Public Works SI i9 �J J N C I (5-4 i A T V P _ N 1 .J t O O 46 A i R z J JI x s ac s W 7 N •G ♦7 X _ l� J1 _ s W! i = y y. u a uj o z 'jj WA VA ;ft C I (5-4 i A T P _ N 1 .J t O A z J s 7 N s y uj o z r < ;ft W � = :. n V 40 W t`r � 1. us 0 XX 2 ac C I (5-4 i Tk T _ N 1 .J t Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES WILLIAM J. SCOTT Director (978)688-9531 Mr. Scott Talbot 90 A Rockwell Street Malden, MA 02148 27 Charles Street North Andover, Massachusetts 01845 Re: Building Permit 120 South Bradford Street North Andover MA 01845 Dear Mr. Talbot: O'tt�ac ,s`N X25` SOL O A �9SSACEHUS�t�y Fax (978) 688-9542 May 26, 1999 I have been advised that your petition (s) before the ZBA on May 11`n and the Planning Board on May 18`n were heard and approved without opposition. Both petitions were approved by the respective Boards and filed with the Town Clerk on May 20`n (ZBA) and May 21s' (Planning Board). The twenty (20) day appeal period for both will then expire on June 10`n In order not to jeopardize your construction loan you have requested a building permit prior to the expiration of the appeal period. It is doubtful due to lack of opposition at the hearings that an appeal of the decision (s) is forth coming. A permit will be issued according to 780 CMR Section 110.13 which states in part "the holder of such permit for a building or structure shall Proceed at the holder's own risk with the building operation and without the assurance that a permit for the entire building or structure will be Granted". The risk in this case will be if the decision of the ZBA and the Planning Board are appealed within the twenty day period, then all construction must cease and the Town will not be held responsible for any action. If you require any other assistance in this matter, please call my office at 978-688-9545. Very truly yours, D. Robert Nicetta, Building Commissioner DRN:jm Cc: William J. Scott, Director File: Talbot/South Bradford St. Note: Please sign and date receipt of this document Notary Public: My Commission Expires: IA- ////,A J BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 W w a O cu v aG L"0 cn . Q. C4 w a4P z z Q W G sC7 ro w° t L ry U cb w ° w 7w 47 cd w a O u � W W 00 cL . U cn _ w a O U w z ~ .%0 :3 c°�i f z w Q W a fa, y cn ° 2 cn v (� -� ° V) coA C L C-4 w v •ate tmm m c Q o&� m ter' EQ , A6.i 0 a N m �..� o 0 m m�L L NAV m o'— Vca XLaCM0 cN o - :M cam_ o� m N C = QQ CL m C. o � 0 r N m r co C o.=..�_ O C r LL 'N O m m CL= C W Eca .0 v •N C-3 mL c m c coo 2 m �-v''� F- s yo., d_.. m o� 9 Y 1 N C2qj Cc Cc CD c O w E CD moo i�O A 1L v CLI) O. 0 47 IW w` ^^ cm3 C y � o.— n® .MM C4 •E co co cc i CL CD CD CL c,ct b C2qj Cc Cc d O w CD V y c a ca _o CCw LU Irw 0 a QQ u -=Q. wo � 1.. Co Q LU OLLti WC6c) �SETIS �0 ZOO IZ—CLvtjcoZZ Z � �y gp0✓b�p L QWQQWLLI QS CO co co i I-- Uj =oQ. �� ZCO)�uj U�O� W"WO QO-UCO O-2° 2 CUCtco aOyyQco= O 15� =W HOZ=CZct uc i-Qozo V I / I I / , 106 �Z � l rrey a CO l � m� l l cors o Q `oW 1 W W I ,Z off. o , Q % �,s►. U h cc , CIO , Or C7 /o oo, Asx y. a\` I °CN o, ►�,/ zoo 6 W O ui � ao I/ GUM 0 WO� 01 133815 O S<< �� - o; y i 00 a � wC� � p m~W co C U Q O moa a �z a W O� Q �m�Z,aco OCL W 2 �� LLI Ixq� QQ x rt CI) coop z 0 Z o v� imN o Z a QQZ N Q c QJ W W S= tui,. L O coOa F— O O W Q FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from - Boards and Departments having jurisdiction have been obtained. This does not relieve: the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION- APPLICANT ECTION APPLICANT �� ��1b�� PHONE -18 2 1=2 LOCATION: Assessors Map Number PARCEL -32 SUBDIVISION LOT (S) T STREET S�41�� �y 0.c • �ST. NUMBER �8Z OFFICIAL USE ONL � RECOMMENDATION OF TOWN AGENTS: iaA 4- Pla^O N t^'s %wJ4l�tw�_,.oZc� c7 a.( ►41��rAl.._..a►b��ss 1 , _. A ID / . CONSERVATION ADMINISTRATOR DATE APPROVED DATE- REJECTED- TOWN PLANNtK 1� t COMMENTS UAI C P4rrKUVCU DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT Q FIRE DEPARTMENT 6 �G r �r �� r RECEIVED BY BUILDING INSPECTOR DATE MI d 1e L � � e. H = W QJ 1V•� O� � O O -� 1•-1 .O-+ O� W pC O m N t {ip O W y v N =_ W • V i V OC 00 H MI m M 00 CD CC C* CY) CO Ni cc -.4O cc -.4 dM _j 4vN OC 3c to W Ww LAJ• 4D . -9-- cb Lj cr Y Ie cl, oc m M I I I I I I I I i I I I I I 15'10 T71 97 F It L 9 0 L to Q5 3'11- L411 97-�I 14'6 'F 3(Y- 93 0 11'6 9'3�I wl G�N 1 ^ 1 C Q V V 1 D D 1 1 i m m Form - L Departmental Referral Form To: Building Inspector_ Open Space Committee Director of Community Development Director, Public Works, Jim Rand Fire Chief Health Agent Police Chief From: Town Planner and / or Planning Secretary, Planning Office Re: Preliminary Plan Definitive Subdivision Special Permit Site Plan Review Date: /P(g A Public Hearing has been scheduled for p.m. on `Cjy IS' lqc�-j to discuss the plans checked above. (Preliminary plans do not require public hearings.) The Technical Review Committee Meeting is scheduled for: Thank You. v a o m rn rn ° °_ rn o N Nm� G) to Z w00 o OoZ�vo', Z 0 O co p o ° o C) Z v '0 �Dr- �m ib y$ ��m��m z Do p D � co 0%y N STREET /.� _ 94.40' Stone-Wall� " F�� ys@ � 0O 9 1 /� a�. X09 aU o j /4 F.risr Aoo/ /0� y l x asp D 0 lb 60, (61 m m r1l 'o O C - .90, `'90, =��cncrni�5rn CO�0 D v �moorn, cC) Co 00�0'n2M Tri %OST"IyOm� vvrni� rn -<w r Z tj M �ocrnn0yZo' yin dcoMyo J3aaoao� ��� W Rowmzoo mQm��rnn gym ycot:) ZZo �ooti q 000 oym 'n °sins o"' ��o Arno z 2 O D 0 a m m o° 0 X corny o Z T N zOD Nto CO) coo 0 a �� om; a o co �a z ti co oo O v rt 8 w C D y y O Z p 0)0� v E ar ° OIn c C �7 R1 0y o r c "� �7 � a `� y 0 co 0��, yLulio A ,o.04 STREET st s9 , REET a�Ai 94.40' / CO Z y /-'' Stone Wall l < �. NSz 5 .09 09 y x 2U0� S _ o '. /O\y � r I p/. C D ZI - a :70 a �X co 4 �o / x w y . 3.9 - 0, , oz���iz� o� oto 13 r nz,o_o Amo a O C� l' =ti cn cn m amovm nco T�omz� orm vi Z CO my� 0jr-ngz rjZ� ' cn rn • Z vy Zm� azaoao= Doy�000 mea Cl) ZZp Odl Jto ti FORM U .- LOT RELEASE FORM*$- �c INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. - " �►rrL1c;ANT FILLS OUT THIS SECTION******************** APPLICANT PHONE 7�-7aS—Ce S ' LOCATION: Assessor's Map Number � PARCEL � o� SUBDIVISIO �/�� /� LOT (S) -----_ -�� STREET ST. NUMBER__ C7� OFFICIAL USE ONLY************************** ** RECOMMENDATIONS TOWN AGENTS: e CONSERVATION ADMINISTRA OR D, DA4 T, WN PLA R TE APPROVEQ DA . REJECTED_ COMMENTS _ ..f FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVES DATE REJECTI� DATE APPROVED DATE REJECTED G PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9197 jm TOWN OF NORTH ANDOVER BUI]LDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING W-9- 4 T c j ox Jj' r address CC i, L. ¢ bx f a, S Q — ignature � �( jyl0. Telephone WILDING PERMIT NUMBER: DATE ISSUED: ;IGNATURE: Building Commissioner/I for of Buildings Date )n%. 11v1V 1- A11k uvrvtUV1A11V1N I 1.1 Property Address: Not Applicable ❑ 03 V '7/1 G 3171P° 1.2 Assessors Map and Parcel Number: W-9- 4 T c j ox Jj' r address CC i, L. ¢ bx f a, S Q — ignature � �( jyl0. Telephone M E M r" z ice' �c Expira 'on D e j69 Not Applicable ❑ Q s Map Number Parcel Number -/694;�`�� ��1 'rG Firm D e ignatureTelephone 1.3 Zoning Information: A�j Z S`I 1.4 Property Dimensions: 00, oo7 ,oning District Proposed Use Lot Area s Frontage ft .6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Regaired I Provided Required Provided 8 78' L 90' .7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: ublic Private 0 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ 'ECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT .l Owner of Record ' s_a'1i 116 t, oa & AVI BrA J -For tame (Print) Address for Service : -ign Telephone .2 Owner of Record: f�nrbflc-P Tv-�Ibc3 r sfi NPrint a: k Address for Service: ( &&jQ 6A..J. tt� O i re Telephone ;ECTION 3 - CONSTRUCTION SERVICES I T M M z .1 Licensed Construction Supervisor. � ( .icensed Construction Supervisor: Not Applicable ❑ 03 V '7/1 G 3171P° J W-9- 4 T c j ox Jj' r address CC i, L. ¢ bx f a, S Q — ignature � �( jyl0. Telephone M E M r" z License Number Expira 'on D e .2 egister o e mprovemdrit Contractor cc V1 `�-T C-jk V? Not Applicable ❑ Q s :ompany Name Piet r i Registration Number Actress Firm D e ignatureTelephone 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 it. -Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Pro osed Work check ail avvhcable New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: X-190 mn ll i? Q�� -ex ".S4'✓'r o� CCL(' GIX�'�P W I l0CZ� �c bc�J - . o0e ' fn "Sik-d ot1JS C,-� c.— C—J I SECTION 6 - FSTTMATRT) CONSTRUCTTON VORTC I Item Estimated Cost Dollar to be (Dollar) Completed b permit a licant1 �xx a CLAM. mak, or�x r spa fa ' 4f 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 70 a U Check Number SECTION 7a OWNER AUTHOKIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR j APPLIES FOR BUILDING PERMIT .4— , 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 1, ,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 Si ature of Owner/Agent Date 211 � 11 1111 NO. OF STORIES SIZE 3 7 0 BASEMENT OR SLAB _05 SIZE OF FLOOR T OERS 1 2 ND 3 SPAN DIMENSIONS OF SILLS DUENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH114NEY IS BUILDING ON SOLID OR FILLED LAND S c IS BUILDING CONNECTED TO NATURAL GAS LINE t'1 6 AVE W '] las 4 ill o� L4'11 8'3� 3- 1.� 132 k 1210 A W2 2'1 O1 2-i 4'— co �3 w r� �o 0o a A m � � - m z Oz 3'9 ............. -- O N m A w 170 m a i� „ tv nn o 1� m � J © A nWS 4'S A 4' 8'5 4'9 14'4 31,6 i Z I� W= a Z Z W o SETIS o� O LL � = C$ Q. O (X Q LL.1 x ! Z O wc7 51fpw VOO` ct QWQQLu uj yo =JQC oOZ(xcnO�- �i� Cl- 20QOQZQ ¢�? 0zF4000 Z°� W�w�wc?3 �Z° Zwm>.•?w Q - �°o°z �Wp �Ov�j��QC�Y O IIi--=p�ZjU-4 COC) Lij V(Xco gS;COCoQuj2 10 Lu 0: T cnti� Lu co wZww CIL ozo J 106. M Q)I Cl) ' T l l `L ' ��� Q W w � ' � �; ne 0, �z u Q v % 'mss► z, 'W Ct CC LU qz /oo 96 C d ;rsx o \off0./ 6 y• d 04 w uj uj co euo;s Cl) W �xx v�' J Q� U- 338 -LS 1�o Obi i c(i Ot.9 Q I Q C I-. of p w o �i o y w a' M �u tiJ Q ao .,j y V � Q LL p� Q° rya aoo 00 Q Q �co o �iLIJ Q)CL _ ° O•- � cp.� dap- �� Q)jamu`. W) Z �CnLLi A Q Wesco� a Z-- 4 O00 mN o I i W Q Q°Z N i iz = W WW W O 0 W cr) o a w ti ~ Q o Z i y a FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANTPHON0 ':V?9 Z �; ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION \\ LOT NUMBER r� STREET O��h �D' SOI` STREET NUMBER OFFICIAL US ONLY RECOIWAENDA NS OF TOWN AGENTS ..... .. .... ............................................................ DATE APPROVED ,C ERVATIO ADMINISTRATOR DATE REJECTED D DATE APPROVED 2--oz- DATE --pZ FOOD INSPECTOR - HEALTH DATE REJECTED { �i SEPTIC INSPECTOR -HEALTH DATE APPROVEDw DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE so( a-zsm TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, REN OVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING N BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: (� Z�r� 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: w p`nq QS S �e Zoning Distrii t Proposed Use 1.4 Property Dimensions: ' Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Ril Provided Regiured. Provided 2-18" L Sc.' 12s IF 1.7 Water Supply M.G.1-CA0. 54) 1.5. blood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ l.'F Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSE IP/AUTHORIZED AGENT 2.1 Owner of Record Name Tint) Address for Service Signature Telephone .2.2 Owner of ecord: I Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 ICGr 4, C.I Licensed Construction Supervisor: 3 C.f ` ' License Number Address v C08 `t33 ^ J � Gi Z Expiration Date Signature Telephone 3.2 R istered Home Improvement Contractor Not Applicable ❑ cQ n��h Company Name l 1� l� Registration Number Address W 1111111 lc�--? � 7 l Z I Expiration Date • SECTION 4 - WORKERS COMPENSATION (MG.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 aII a ble New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ` ackk Kl e✓1 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item 1. Building Estimated Cost (Dollar) to be Completed b rmita licant v« (a) Building Permit Fee Multiplier a•...,. 4, 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical AC 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 BUIIAING PERMIT I, as Owner/Authorized Agent of subject property Herebyauthorize 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 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 'Z SIZE BASEMENT OR SLAB SIZE OF FLOOR TMMERS 1 2 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DRvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHI b NEY ; C IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I Z w=a Z LU USEITS rti� WQ LU Op� W=a2 ZO �tl, b\ Zc) W�yWQZ—= o LUrev Wp �'' V�� ��>-QOc�W WLyu ¢z3N=BSc \ Q�W zc) 3oaZ c) NZ Z OOZCcapO>. —04•2pICC 0QZQ CI)cn LLJ ZO Z�Wm>-sW �WLU p �OcoLcccr. WJLL �ZU.0 LL �p WOOWZj QtoCL a Q tiW 0 055.2cc W 0 O p~� CL CO i.''W = co=� WWWW u IZ-3a I= - �tiQOZO J � Z , 106. 141 0,�LLj � m uit Iicc LL Y / %98 i�0 0, ol �, s /O� fall AZ a LLJ o W>- YxB� o j/eM auo4s ,, CI) w v ,Ob'ti6 � C6,LL 13-981,3 s p�� , 0&,0 ypb� ev, O%P o O W b C6 p vy W W J JW m Q co � o •..•i o Q- U- 0 0 m U- OL Q �0$� a.00 poo OZ O �'o C) �O Qg Qoo CO 4)Q QQ 4 ¢? z CL Co 004 0 O CO o Z Z o Z 2000 z c_( CE CO Q3 IQu LU N W O c W j 2 LL W C',oa f- o OLLJ o ~ o Z 0 O O O SID