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Miscellaneous - 110 RUSSETT LANE 4/30/2018
110 RUSSETT LANE 2101104_A-004000.0 North Andover Board of Assessors Public Access Page 1 of 1 NORTH ■V Orth Andover Board of Assessors 3r e•;r.�... OL � 9 9SSACMUSEt 7zJroperty Record Card Click Seal To Return Parcel ID :21.0/104.A-0046-0000.0 FY:2013 Community :North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales Summary k Residence `' -. Detached Structure Condo 110 RUSSETT LANE Commercial Location: 110 RUSSETT LANE Owner Name: MORRA,JOSEPH P MORRA,BARBARA Owner Address: 110 RUSSETT LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6-6 Land Area: 0.60 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1.248 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 390,000 399,700 Building Value: 194,000 198,500 Land Value: 1.96,000 201,200 Market Land Value: 196,000 Chapter Land Value: LATEST SALE Sale Price: I Sale 06/24/2008 Date: Arms Length Sale F-NO-CONVNIENT Grantor: MORRA,JOSEPH P Code: Cert Doc: Book: 11226 Page: 254 http://csc-ma.us/PROPAPP/display.do?linkld=2256814&town=NandoverPubAce 10/24/2013 Residential Property Record Card PARCEL ID:210/104.A-0046-0000.0 MAP:104.A BLOCK:0046 LOT:0000.0 PARCEL ADDRESS:110 RUSSETT LANE FY:2013 PARCEL INFORMATION Use-Code: 101 Sale Price: 1 Book: 11226 Road Type: T Inspect Date: 11/15/2011 Owner: Tax Class: T Sale Date: 06/24/08 Page: 254 Rd Condition: P Meas Date: 11/15/2011 MORRA,JOSEPH P Tot Fin Area: 1248 Sale Type: P Cert/Doc: Traffic: M Entrance: X MORRA, BARBARA Tot Land Area: 0.60 Sale Valid: F Water: Collect Id: RRC Address: Grantor: MORRA,JOSEPH P Sewer: Inspect Reas: C RUSSETT LANE NO Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open S NORTH ANDOVER MA 01845 P P- B/L% / RESIDENCE INFORMATION LAND INFORMATION x Style: RR Tot Rooms: 7 Main Fn Area: 1248 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R1 Story Height: 1.00 Bedrooms: 4 Up Fn Area: Bsmt Area: 1200 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 1200 1 P 101 S 26240 0.600 195,968 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: DETACHED STRUCTURE INFORMATION Masonry Trim: 24 Ext Bath Fix: 0 Tot Fin Area: 1248 Foundation: CN Bath Qual: T RCNLD: 178357 Str Unit Msr-1 Msr-2 E-YR-Blt Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T Eff Yr Built: 1976 Mkt Adj: SE S 64 0.00 1988 A A ///85 200 Heat Type: HW Ext Kitch: Year Built: 1970 Sound Value: PT S 336 0.00 1988 A A ///85 1,800 Fuel Type: G Grade: AG Cost Bldg: 178,400 PV S 648 0.00 1988 A A 50///50 13,600 Fireplace: 2 Bsmt Gar Cap: Condition: A Att Str Val I: VALUATION INFORMATION Att G Central AC: N Gar SF: Pct Complete: Att Str Val2: Current Total: 390,000 Bldg: 194,000 Land: 196,000 MktLnd: 196,000 Att Gar SF: 440 /oGood P/F/E/R: /100/100/78 Prior Total: 399,700 Bldg: 198,500 Land: 201,200 MktLnd: 201,200 Porch Type Porch Area Porch Grade Factor P 144 W 168 SKETCH PHOTO 14 -;: w •r 12 168 Sq 12 w e 48 __14 u IS 22 440 SgFt 17 FII 1298 SgFt 144 SgFt E 24 j 110 RUSSETT LANE y 4 : L......... �`... Parcel ID:210/104.A-0046-0000.0 as of 10/24/13 Page 1 of 1 I v.......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING L. $sACNUSfc S S This certifies that ..... ................ .............................................................................. ............. .................................... has permission to perform .... ....... . ...... . wiring in the building of......A A at -�North .... . . ) 4USS" // ..... , ...... ... . ............ ............. Adover,Mass. Fee..... ..../..'-....I . Lic.No.-V�34-eA.... 0.�!.. Check# L CTWCAL INSPECTOR 12 '- d1z 5/3 Commonwealth of Massachusetts Off/ficial Use Only � Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ' C), 27 CMR 12.00 � (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Z City or Town of: NORTH ANDOVER To the In ect o Wires: By this application the undersigned gives noticVUS his or herr iintentio to perform the electrical work described below. Location(Street&Number) 1) se, i 1 Owner or Tenant O /{ILC.- i (),p0,eA6r1je5 Telephone No. Owner's Address r7 14 / cUe H S Is this permit in conjunction with a building rmit? Yes No F-1 (CheckAppropriate Box) Purpose of Building 7c% l e' G Utility Authorization No. Existing Service Amps / Volts a Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ . No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 60-11S `4 CX Al Com letion of the followin table m y be waived by the Aspector of Wires. of No.of Recessed Luminaires No.of Ceil: TranSusp.(Paddle)Fans s Total Trsformers KVA , No.of Luminaire Outlets No.of Hot Tubs Generators KVA 3 No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o mergency ig ting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons TotNo.of Alerting Devices �— No.of Waste Dis posers Heat Pump Number Tons KW_ No.of Self-Contained P Totals: Detection/Alerting Devices No.of Dishwashers / S ace/Area Heating KW Local❑ Municipal g 11 Other P Connection No.of Dryers Heating Appliances KW Security Systems:* � Y No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: i Heaters Signs Ballasts No.of Devices or Equivalent ' No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or—Equivalent OTHER: ,� 3D c(r C, ll r lv -- Attach additiona detail if desired, or as required by the Inspector of Wires.= Estimated Value of E c 'cal Work: ""� (When required by municipal policy.) Work to Start: // Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E AGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability i urance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover e is in force,and has exhibited proof ofs e t the pit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER F1 (Specify:) �/ I certify,cinder the pains&Mdpgnalties of rjury,-thhajt the inform tion o tis application is true and complete � FIRM NAME: . d rj� �!i I t'!t C LIC.NO.: �f, S Licensee: .�j�phek? vb4 Signature LIC.NO.: (If applicable,ente "ezem t"j' t�e lice a number lin Bus.Tel.No.: Address: ,,r C'n t&kenm 4 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work r quires Department of Public Safety"S"License: Lie.No. T OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. N Owner/Agent PERMIT FEE: $ -7 Signature Telephone No. r • Re r Yuspetox'coments: •�� ocsm -inspeefzon xecuized'($�0.00) 7-2, (Xnspectore szgnatuxe-Xo knivals) date jeasse -[ afSec7--[ } e nspecfzox�xer uixec�($ 0.40)"[ Ynspectaz-s'commenfs: ------------------- ( isliectors'gzgnature•-no ka fials) v� / date Passed—j ailed- [ ate-rsts ectZonxec uirec ($ 0.40)"[ Easpecfoxs'comments: �lnspectoxs',�ignatuxe-ao?nitals} ]ate . t assed -j wiled-- Pe-iuspeedon required($50.40)" !s�pectbxs'eo7mm.eptfs: �' 06asp ectoxs'Siguatuxe-io Mtials) Data ' NBPF,CTI:ON"o ra:' rs ed•--(' � �'azSer�--•( ]. 'ate�nsp ectzon req�ixed($5Q•Q 0}"[ � pectoxs'cozamellb: • S ' �rusp eetox ' igxtatuxe nonifials} ,date �d'l'D��A rrr�r b i7'G�rsTn 7?'u-�'�rr.7'�r►�il7i�r A•�Ys►•x•�'rn�r*,t-t,•r�Y�rr�n�•nc�frux+ A'U'c��. �.("►'FZ'£i 7A7�+'t3'�A7�'��r�1ar��r µ b The Commonwealth of Massachusetts Department of IndustrialAccidihts Office of Investigations 600 Washington Street Boston,MA 02111 UV www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C) 4 Ole A/C Address: City/State/Zip Phone#: AVaim an employer?Check the appropriate box: Type of project(required): 1. a 4 employer with . ❑ lam a general d I contractor an �_ 6. ❑Ne construction employees(full and/or part-time).* have Hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• emodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers'comp.insurance. Y p tY• 9. E]Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3111 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.[]Roofrepairs insurance required.]t employees.[No workers' 13.❑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 aie doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is provi�lln workers'co pensation insurance for my employees. Below is the policy and job site information. � f Insurance Company Name:. ` GG., (,, C Policy#or Self-ins.Lic.#: �5 0 Z Y/U✓/ Expiration Date: -` J/0 j Job Site Address: 1/o leisseff W,t !e City/State/Zip: , ) X Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A 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 cert! nde a pa s d penalties ofperjury that the information provided a ove i true and correct. Signature: Date: lIZ41 L/ Phone#: 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#: P r A Information and InstrnctionS 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 producedacceptable 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 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 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 of Industrial.Accidents Office of Investigations 600 Washington Street Boston.,MA.02111 Tel,#617-727-4900 ext 406 or 1-877rMASSAFB Revised 5-26-05 FaY,#61.7-727-7749 www.mass.goV1dza L t { t - 555 .s Eft 3 KOMiH AII.WWR RA .0184"09 Fold,Then Detach Along All Perforations COM1V10�1W"ft" l�AOSAACHUSE T� . • - • • UA C T A�tS 5'�'EP�ER:?R dUB� 11 1 555 5 A T`t 5T :3 # .. Date..... .......... f-, 71- L i i j i TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that... .....7AA Cj .. ................................................... (� c.`.... ............................... has permission to perform.... ....... plumbing in the buildings of ....................... ....................... 110 SSS p - at................. North Andover, Mass. Fee...9.1.......Lic. No. b .. ... ..................................................................... ............... PLUMBING INSPECTOR Check# 32 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK UV 4 1 1�7 -,-\ CITY _J MA DATE L II PERMIT# 10 7 JOBSITE ADDRESS 1 b OWNER'S NAME POWNER ADDRESS TEL _ FAX TYPE TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL © RESIDENTIAL "' PRINT CLEARLY NEW: RENOVATION:� REPLACEMENT:�_ PLANS SUBMITTED: YES® NOD FIXTURES Z FLOOR--> BSM 1 2 3 1 4 5 6 7 1 8 1 9 10 11 12 13 14 BATHTUB _-ji I ___ CROSS CONNECTION DEVICEyl DEDICATED SPECIAL WASTE SYSTEM ---I DEDICATED GASIOILISAND SYSTEM ) -_.. _J ___.I ._.. ( _ __- I I _ I F—::! _ I ___ I DEDICATED GREASE SYSTEM _,_! ___ __—J .—..__.i _ ____..! _-__ _._._ -----_J DEDICATED GRAY WATER SYSTEM ( 1 ! DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER AL: FLOOR/AREA DRAIN I __JI =L_ 1 _J __.J ____-.. .__,.._._k __J .__J INTERCEPTOR(INTERIOR) _k __.__,J ___._ _I .-_.__._I KITCHEN SINK LAVATORY ___._-_.I ROOF DRAIN 1_.._..I .........J . -__ I _�_� -_-J __.._._! _� I _ SHOWER STALL SERVICE/MOP SINK TOILET WASHING MACHINE CONNECTION _ I k J _ _I ._.___..� --_-___S __-..._� _� _-.__.� .__.___� _.___! ___._J __...-_ J _____..{ � URINAL t ,__..___k ._-_- __._- i --_- I __—! E _. I WA ER HEATER ALL TYPES _I I ___ I k J _____ ( ____. I ._.. WATER PIPING _ J ._. I _ _--_l — J �_.J ..._... I I i J OT,ER ----- _-____! INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES JXNO �! C IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW -� LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY Q 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 Q 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 provision of the Massachusetts State Plumbing Code and Cha ter 142 of the General Laws. c _ PLUMBER'S NAME ",,,,..,.,,. f LICENSE# 2b 6 I SIGNATURE IMP© JP 0, CORPORATION F_1J# PARTNERSHIP 01 I LLC z _f COMPANY NAME ADDRESS I CITY _...__. ._._._. ... )STATE ZIP © � $ .� �'� TEL FAX CELL MAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION TES Yes No S- THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 4 C4 /i a The Commonwealth of Massachusetts - " Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance,Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print UAW Name(Business/Organization/Individual): iz!WMUV1_CP , Address: 9 City/State/Zip: _ cam-. Phone#: Are you an employer?Check the appropriate box: Type of project(required): -LEI I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2, am a sole proprietor or partner- listed on the attached sheet,t 7• ❑Remodeling ship and'have no employees These sub-contractors have S. E]Demolition working for me in any capacity. workers'comp.insurance. 9, ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.F1 Electrical repairs or additions required.] officers have exercised their 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.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:- Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as 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 certify under the pains andpenalties ofperjury that the information provided above is true and correct. Simiature• Date: Phone#: 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.PIumbing 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 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 shallnot 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(ifnecessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the 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 Commonwealth of Massachusetts Department ofZndustrial Accidents off oe of Investigations 600 Washington Street Boston}MA 02111 TO,#617-727-4900 ext 406 or 1-877:MASSAFB Revised 5-26-05 Fax#617"727;7749 `w W-Mass,govaa i y� COMMONWEALTH OF MASSACHUSETTS P► UMBERS AN[? GASFI`T T ERS LICENSW AS A JOURNEYMAN PLUM -1 ISSUES THE ABOVE LICENSE TO: RAIMUNP Ic "HECK � 9 BIRMWOD TFRR GROVELAN11- MA 01834- 1607 � 20666 05."11/14 168236 PERMIT NO l APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. � PAGE 1 MAP h40. /c;� ��1 I LOT NO. j),4, ` L/ 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE- ZONE SUB DIV. LOT NO. l LOCATION '/ �1 vs�-rz: �a�C PURPOSE OF BUILDING OWNER'S NAME '� t a rJ �^`A NO. OF STORIES SIZE y )K/ OWNER'S ADDRESS �, ��ss r� I-�A�11 t BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN IC} DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS L/ x 41 DISTANCE FROM LOT LINES-SIDES REAR GIRDERS 7 AREA OF LOT `1tJ G., FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW d Z SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION �/��+ IS BUILDING ON SOLID OR FILLED LAND '�b t r 1 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �� �� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ��y PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR CTE ILED '�� /v// BUILDING INSPECTOR 81 AT E OF iOWNER OR AUTHORIZED AGENT FEE � OWNER TEL.# PERMIT GRANTED OX RIlk� CONTR.TEL.# 19 1�4(A)*AD CONTR.LIC.# H.I.C.# APR 161997 of b 1 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S.OkIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BUK. PINE BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 114 1/2 1/. FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS 8 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVI D _ ASBESTOS SIDING _ COMIACN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I---I POOR ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE__ HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. )2OILET RM. FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF.ROOMS° GAS OIL B'M'T 2nd T-711 ELECTRIC { 1st 13rd NO HEATING 1 PER111T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 7-40. LOTNO. L� f 2 RECORD OF OWNERSHIP IDATE BOOK iPAGE' �a.-" 7 ZONE SUB DIV. LOT NO. �I LOCATION // O , CS :: ��� PURPOSE OF BUILDING {.� t d _ �Q OWNER'S NAME '�d..S-Q ;3 O /J` NO. OF STORIES "') SIZE OWNER'S ADDRESS j IQT J-r�� 1 �a� L BASEMENT OR SLAB •L q_ 'X ARCHITECT'S NAME / I` SIZE OF FLOOR TIMBERS` 1ST 2ND 3RD BUILDER'S NAME '11 \h' /1 SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET " POSTS (�x 7�../ DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT \C, FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND Flo`Ij L L'_5 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE _;1 IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. SLOG. COST /'zr. :� PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS I - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 9"E-FILED ^ � BUILDING INBPECTOR BIC;NATId E OF OWNER OR AUTHORIZED AGENT (/ F E E OWNER TEL X ^A' a ' G PERMIT GRANTED CONTR.TEL X tti &j o 'D CONTR.LIC.# H.I.C.N APR 161997 - - - NORT �---� Town over .0 No. 3� 7 --_ . _ * 19 9 * Z �( dover, Mass., ' O LAKEy1 �P- � T '9 COCMICHEWICK '9I BOARD OF HEALTH I Food/Kitchen i PERMI Septic System BUILDING INSPECTOR j ..... Foundation THIS CERTIFIES THAT. ... � on �.(..0...........�.K.�..��..�•,�.�.-�-...... Rough has permission to erect........... '��•• L....... . �.. �.. . ........ . ' ........................... li ati n on.f....... chicon y to be occupied as......................................................all i. .. rovided that the person accepting this permit shall in every relattirespo to they nspe t on, Alterat on and Construction of le in Final this office, and to the provisions of the Codes and By-Laws 9 FRoughh ING INSPB(`TOR Buildings in the Town of North Andover.VIOLATIONof the Zoning or BuildingRegulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS Rough ....... service i B DING INSPECTOR Final Permit Required to Occupy Building GAS INSPECTOR • Occupa�' Rough a in a Conspicuous Place on the Premises — Do Not Remove Final Display P No Lathing or Dry Wall To Be Done FIRE DEPARTMENT • Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. EL r• I f CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MAS. SCALE--l"=60' DATE.-6116197 JUN 3 O Scott L. Giles R.P.L.S. 50 Deer Meadow Road - North Andover, Mass. D.H.FND- j I 1397? Q.H.FND. L / �s - 00 NX O ZF c9 S1 LOT#10 ti LOT#9 ao 44,134 S.F. PLAN#5145 N.E.R.D. 'SNS s5 , s LOT#8 S8s 00 %K � SO 00 I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING BY LAWS OF CONFORMITY OR NON-CONFORMITY NORTH ANDOVER WHEN BUILT WHEN CONSTRUCTED. �a - Jlc; NORTH o { Of t��ao is 14, Town Of North Andover 0 Plan ' Building Department Review 508-688-9545 � C FIUSEt�y 146 Main St. Town Hall Annex/�sbeCode APPLICANT. Po '' DATE:Zoning District : Title of Plans and Documents: Request : ,5--'G/C Please be advised that after review of your building permit and or zoning review has been DENIED for the following reasons: o 'no l"ng Use not allowed in District Not in conformance with P I fitent ' Violation of Height Limitations Sign exceeds requirements Violation of Setback Front Side Rear Insufficient Lot Area Insufficient Parking Violation Contiguous Building Area Insufficient Open Space Insufficient Lot Frontage Sign requires permits prior to Building Permit Form U not complete by other departments Not in conformance with Growth By-Law Use requires permits prior to Building Permit Other Other Remed for the above is checked below. Dimensional Sign Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign-offs Copy of Recorded Variance Information indicating Non-conforming status Copy of Recorded Special Permit Variance for Sin Other Plan RevleW The plans and documentation submitted have the following inadequacies : 1.Information Is not provided,2.Requires additional information,3.Information requires more clarification, 4. Information is incorrect. 5.All of the above. # # IF"oundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure Construction Plans 127 Affidavit Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details Framing Plan Fire Sprinkler and Alarm Plan Roofing Footing Plan Plans to scale Utilities . Site Plan Water Supply Sewage Disposal Waste Disposal Other ADA and or AAB requirements Other Administration The documentation submitted has the following inadequacies : 1.Information Is not provided,2.Requires additional information,3.Information requires more clarification, 4. Information is incorrect. 5.All of the above. Water Fee State Builders License Sewer Fee Workman's Compensation Buildinq Permit Fee Homeowners Improvement Registration Building Permit Application Homeowners Exemption Form Other Other The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice,by the Building Department,shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL.Any inaccuracies, misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Revi Narrative"shall be attached hereto and incorporated herei b erence. The building departm Fit will etain all plans and d ument for the above file.You must file buil irf�ermit application form and or r t for an review to receive pproval. Building De menOfficial ignature Inf ati Received Died z 4 O 3iJ If Faxed Denial Sent If you require assistance please call the above number and we will be able to guide toward meeting the necessary requirements. Please understand that many of the reason for denial are related to the code requirements that must be met to ensure public safety.Requirements for detailed plans are necessary to ensure that there is enough information through plans and specifications to show that code requirements will be met. i Plan Review Narrative The following narrative is provided to further explain the reasons for denial forithe building permit and or request for plan review for the property indicated on the reverse side: Po, 8 MWE ANN,ire" L %6d .1;§ .,NO Referral recommended : Fire Health Police Zoning Board Conservation Department of Public Works Historic Commission Planning Other Other !, -P JUN 3 0 1997 1 , to ,fir. F/ ,5�,.ed ct J Dec-k+ RouSi— i �a.�l luytif >39 yXy„Posts J-1 JcreP.TOrck /TOUJG r/Or- Ki It S+air ,j, ,,f-- Sin�Lc aX8 . _. - Nailed -- - T N .. .. // Xy�posfs. n/q, %a� ,� , %�crecJs 4--$oX 3aNx _ . ee���XS_ xq &4A End - - C7A�✓. , II arcs T _ AidDo, 66L iwr%_ j S� ram DO/I $,Xe �yy ;-;' LG JJ q eG. gX i ho0� w a7� t>. ,O; 4 �!o✓ X �o1G - ;,q-ocr byf —. c Qf Ot ^, ,,,5 " 0 V 0 / 1 U p Z `� � � �•��-��� � �� �Pie R S k SCr2u� 07 ��GC. 'acs .- C I 17 r^cam ,✓a,l Beck SyxG„ Decklny (70,(U. l:o rr1G( B,,I+.1(2) o .11 -I'8 Y7 '4I"tJ 0 v f7 S�aJ7s r/ T� IT 71` b�< 1661 0 C Nnr m SENDER: I also wish to receive the ,v_ ■Complete items 1 and/or 2 for additional services. rn ■Complete items 3,4a,and 4b. following services(for an d ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. kli ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address. Z permit. d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N r ■The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. 0 -a 3.Article Addressed to: 4a.Pcle Number air i3c�,rLv S f G q I OL cc E 4b.Service Type F G ae !-.00 Registered Certified CO ❑ Express Mail ❑ Insured S LU cc �5e� �, ❑ Return Receipt for Merchandise ❑ COD t 7.Date of Delivery w ¢ 5.Received By: (Print Name) 18.Addressee's Address(Only if requested and fee is paid) s ¢ F- 6.Signatu (Addresse or Agent) PS Form 3811, December 1994 102595-97-B-0179 Domestic Return Receipt 11" 1•dFi -Ast-Class Mail UNITED STATES POSTAL SERVICE r t`i. Postage&Fees Paid V USPS y 1 Permit No.G-10 • Print your name,address,/and ZIP Code in this box • I /VO. /A/4)v✓crZ. 14AID60: C- 0 01e�5 ttt,,,,,•,tit„t„t„t,t,t,,,t,t,�„t„tt„t„t,t„t,tt„t,t„t NORTH ?04`,t♦�D Town Of North Andover ;� Plan Building Department �� , : Review 508-688-9545s'411 AC 0Et `y 146 Main St. Town Hall Annex //� e a s S E7r APPLICANT: Mc) q k i DATE: 4 Zoning District : Use Code Title of Plans and Documents: Request : Please be advised that after review of your building permit and or zoning review has been DENIED for the following reasons: Zoning Use not allowed in District Not in conformance with Phased Development Violation of Height Limitations Sign exceeds requirements Violation of Setback Front Side Rear Insufficient Lot Area Insufficient Parking Violation Contiguous Building Area Insufficient Open Space Insufficient Lot Frontage Sign requires permits,prior to Building Permit Form U not complete b other departments Not in conformance with Growth By-Law Use requires permits prior to Building Permit Other Other Remedy for the above is checked below. Dimensional Sign Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign-offs Copy of Recorded Variance Information indicating Non-conforming status Copy of Recorded Special Permit Variance for Sin Other Plan RevleW The plans and documentation submitted have the following inadequacies 1.Information Is not provided,2.Requires additional information,3.Information requires more clarification, 4. Information is incorrect. 5.All of the above. oundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure Construction Plans 127 Affidavit . Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details Framing Plan Fire Sprinkler and Alarm Plan Roofing Footing Plan Plans to scale Utilities . Site Plan Water Supply Sewa a Disposal Waste Disposal Other ADA and or AA8 requirements Other Administration The documentation submitted has the following inadequacies : 1.Information Is not provided,2.Requires additional information,3.Information requires more clarification, 4. Information is incorrect. 5.All of the above. # # Water Fee State Builders License Sewer Fee Workman's Compensation Building Permit Fee Homeowners Improvement Registration Building Permit Application Homeowners Exemption Form Other Other The above revlew and attached explanation of such is based on the plans and information submitted. No definitive review and or advice,by the Building Department,shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL.Any inaccuracies, misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan R Narrative"shall be attached hereto and incorporated hard b erence. The building depart nt will etain all plans and d ument for the above file.You must file buil i�ermit application form and or r t for an review to receive pproval. Building De men OIcial ignature InfotyfiatiReceived DhKied T Z 9 3"'30If Faxed : Denial Sent If you require assistance please call the above number and we will be able to guide toward meeting the necessary requirements. Please understand that many of the reason for denial are related to the code requirements that must be met to ensure public safety.Requirements for detailed plans are necessary to ensure that there is enough information through plans and specifications to show that code requirements will be met. f PEaatrr xo. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP x.10. I LOT NO. 2 RECORD OF OWNERSHIP (DATE • � �` ` � � BOOK ;PAGE — ZONE SUB DIV. LOT NO. I LOCATION } ! I [PURPOSE OF BUILDING OWNERS NAME NO OF STORIES SIZE OWNERS ADDRESS1-/ ��S i`_f 4- �a� F BASEMENT OR SLAB ARCHITECTS NAME SIZE OF FLOOR TIMBERS 1ST 2ND 3RD BUILDER'S NAME O t SPAN I fI AA DISTANCE TO NEAREST BUILDING ---L-�. DIMENSIONS OF SILLS DISTANCE FROM STREET DISTANCE FROM LOT LINES-SIDES REAR POSTS 7 GIRDERS AREA OF LOT `�1 ^u C FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x IS BUILDING ADDITION MATER:AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 'r�`1 _ IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY ' IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS a PROPERTY INFORMATION SEE BOTH BIDES LAND COST EST. BLDG. COST /1C PAGE f FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4 APPROVED BY PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR EILED � SIG�NATIO E OF OWNER OR AUTHORIZED AGENT BYILDINO INIPECTpR (/ FEE OWNER TEL.X PERMIT GRANTED CONTR.TEL 8 19 CONTR.UC.x H.I.C.# APR 16 %7 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: a e cy.( (� Phone LOCATION: Assessor's Map Number -/C) Jq Parcel q&- �o Subdivision Lot(s) Street f 1 �� S rc ���� St. Number ************************Official Use Only************************ RECO TIONS OF TOWN AGENTS: v Date Approved Conserv tion Administrator Date Rejected Comments V(� Date Approved Cly Town Planner Date Rejected Comments FoodDate Approved Date Ins t -Health Date Rejected l/ Date ApprovedS `� 7 f 'Se is Inspector-Health Date Rejected Comments Public Works - sewer/water connections driveway permit Fire Department Received by Building Inspector Date APR 16 1997 'GILBERT REA ,7pg__ 44 Rea St. SHEET NO.._..__._._.-- -__,---- OF- NO. ANDOVER, MA 01845. �.CALCULATED ev — DATE_—_ -_ Phone 682-9864 ' CHECKED BY DATE SCALE I ,......,.... -� -- o _ ' X A77 I C) L4 I } I I I � ' ............ 1 I I i i I II 770=2417Ne i;O 1a.Gam M.,01471 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: I ,dA C Phone LOCATION: Assessor's Map Number lcjy Parcel q& Subdivision Lot(s) r' Street 1 a I�` s` �,�a ��ti St. Number ************************Official Use Only************************ RECOMME TIONS OF TOWN AGENTS: �t�-OQ�b ffll:�&' Date Approved n ISA q 7 Conserv tion Administrator Date Rejected Comments (� Date Approved Town Planner Date Rejected Comments Food Ins t -Health Date ApprovedDate Rejected Date Approved y /S 2 ".--'Se is Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date APR 16 1997 1 g�va $ - - - -S�( r}r 3c7/t? p�/oS�°�X q ^cQ ___� ld ax�°t�j9"OC 03.00; L I+SiY3 - CJ Jia � wa r - - k of � T� •'-�., ��y�• 777 1 C _ . �1T�S .;9,, 9I GILBERT REA JOe-Tin 44 Rea St. SHEET NO..... NO. ANDOVER, MA 01845 CALCULATED BY Phone 6829864 -- CHECKED BY DATE-. K'.. SCALE .. n O _ ( ................... �. I T . X . ..... fill i i 4J1 5 6-N . �o 1 � i � � 1 1 I 1 APR t 61997 � - - - - - - - - - - - - - -- - - - - - - p , PMKINRI CNcCu IK.Grotm Mass 01471 Town of North Andover OFFICE OF o •• . ~o COMMUNITY DEVELOPMEN . ND SERVICES 146 Main Streit �, -�..,,,• �; KENNETH R.MAHONY North Andover, 'Massachusetts 0184 �SS•cHustit Director (508) 688-91-33 Please pr'-rfi. n JOB LOCA8 TION /l 6 , SSF " .U'.' Number St:eec addressSection of tower ,.I.o��Eo�v�-ER•• Sr Tame H.-=e prone 'Afork phone . PRESEN+i 'N AILING ADDRESS- ¢ CitylTowr_ ;_ State Zip code The curent exe^Notion for "homeowaers" tvas z:c:e�aed to include owner-occupied.dwellings of six units or less and to allow s,:c_ hcmec:vners to engage an individual for hire who does not possess a license. provided that the owner acs as supervisor. (State Building Code Sec- tion,109.1.1)' _ IDE, OF HOV1E04Vv : Person(s) who owns a parcel or- lana en :viuca he:sae resides or ince.ds to reside. on which U''iere is, or is intended to be, a one to si.Y fa yil;= a;calliag,. attached or detached strictures ac- cessorr to such use and/or farm s--c^.:ras. A. oe:scr- who cons—tucts more than one home in a t-vo-year period shall not-be considered a homeowner . Such "homeowner' shall submit to the Building Official. on a for= acceptable to the 3uilding Official. that he/she shall be responsible for all such work per"ormed under.the building permit. (Section 109.1.1) T,he undersi-ned "hdmeowner•• ascsa=es respons Miirt :Cr com-iliance with the Slate Building odes. b;- a7 vs. rules "a .e—lat:ons. Code and other applicable c The undersigned "homeowner"°ce.Z_es that ne:'Sze understands the Tcwn of Vo, Andover Building Deparunent minimum-is spe_#= procad•.:.res and requirements and that Aeishe will comply with said procedures and :�ui_-s^ents.. - HOMEOWNER'S SIGNATURE .A.DPR04Ai OF BC3ILI)RiG OFFT-CLAi. AM 0 0 1997 'dote: Three family dwellings 33,0G0 cubic feet, or larger, :will be required to comply with State Building Code Section =70. Coas—a :ctioa Control. BOARD OF APP�A.LS 688-9541 BUMDtNG 688.9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Perrino D.Robert.\'m== Mkbad Howard Sandra Starr Kathleen Bradley Calweil Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption !,Please print) DATE JOB LOCATION /( o �J S5- r Number Street Address . Section of town „HOMEOWNER" dsV N Ma-&(fin- a - lid s Name Home Phone Work Phone PRESENT MAILING ADDRESS S,o City Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor. (State Building Code, Section 109 . 1 . 1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is infended to be, a one to six family dwell- ing , attached or detached structures accessory Lo such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109. 1 . 1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . 'he undersigned "homeowner" certifies that he/she understands the Town of ;.North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and ,.equirements . .'.IEOWNER' S SIGNATURE O� _,?ROVAL OF BUILDING OFFICIAL ,ote : Three family dwellings 35 ,000 cubic feet , or larger , will be quired to comply with State Building Code Section 127 .0, Construction ,ntrol . AM 16 1997