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Miscellaneous - 1116 SALEM STREET 4/30/2018
1116 SALEM STREET 210/106.A-0045-0000.0 BUN FILE PO Box 55098 Boston,MA 02205-5098 617-951-0600 : r Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER,MA 01845 NORTH ANDOVER, MA 01845 ' RE: Insured: ANDRE FARAH and KATHLEEN FARAH Property Address: 1116 SALEM ST,NORTH ANDOVER, MA Policy Number: HMA 0009266 Claim Number: BOS00055284 Date of Loss: 2/14/2015 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chanter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. David McDermott Claim Examiner 3/13/2015 Safety Insurance Company Homeowners Claims Unit. P. O. Box 55098 Boston, MA 02205-5098 Phone: (617)951-0600 EXT 3537 Fax: (617) 603-4866 Email: DavidMcDermott@Safetylnsurance.com , 09781 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . �. . !. . . . . . . .'. :C— . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of. . .R 19 .k . . . . . . . . . . . . . . . . . . . at . . . . �� ///�,o 'c��e . . . . .' �"? . . ,North Andover, Mass. ?q3. /A Fee� _". . Lic. No. . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check# o2 e13 ��' 1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY _ Y�',� _1 MA DATE = PERMIT# JOBSITE ADDRESS �� ��'''f 11 OWNER'S NAME POWNER ADDRESS 4�"`''� TEL 011 , 'L04,1FAX TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL © RESIDENTIAL PRINT CLEARLY NEW: QI RENOVATION: REPLACEMENT:Q PLANS SUBMITTED: YES Q NOE] FIXTURES 1 FLOOR-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _( } _____( _} CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER _I __. _ ! _( _ I __ __( ..____.} -_-_._ DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN ? ._.._._( .__._._ ...__.__( .__ _1 ( .__._.__.J __..._..__J _.._.___-_( ______J _.._.__._ -..... ..___.-I } _...__.__.{ INTERCEPTOR(INTERIOR)- E ! .__._._._) _..___._; .___ ! ( .___J _..___-__J -( ._..__..� __.____._! ....__.._ _! _( ------ KITCHEN SINK --! ---- J _.._._J _.__-.f LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET I L.--j ! URINAL WASHING MACHINE CONNECTION WA,JER HEATER ALL TYPES Wk,ER PIPING OTHER .__ _ _ _._ ,( .._I _ ( __-------- ! -------- -- — --- - -- — INSURANCE COVERAGE: 11 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESI NO 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 QI 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 JQI SIGNATURE OF OWNER OR AGENT 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 M and that all plumbing work and installations performed under the permit issued for this application will be in com li a with all Pertint provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ' d t3 /_ __-I LICENSE# SMATURE �ON NIP EJ JP D CORPORATION Q# PARTNERSHIP Q LLC COMPANY �.NAME \�Ud-�P I� �.._..__ i ADDRESS CITY Q I STATE 1 ZIP TEL FAX -I� �— CELL __.._.._..._ _.......__.. EMAIL - �/s'�rl'...... - - - .._ _._...._...- ._ ti. ... . .c�..._....._....._...._. _. ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES G �4a9 - C� The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations kvi 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individua Cil 1^ 1 11" Jl� Address: tl,, �%" City/State/Zip:Z �r 0l( -f V + L C>✓ Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 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.VIA am a sole proprietor or partner- listed on the attached sheet.1 7. ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9, E]Building addition [No workers'comp.insurance 5. El We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ 1 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#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they a're 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. lam 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. Ido hereby cer fy u der thepams andpenalties ofperjury that the information provided above is true and correct. Si ature: �'`f f Date: Phone#: r ! 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#: r , 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 ofpublic 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 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 of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 TO,#617-727-4900 oxt 406 or 1-877:MASSAFE Revised 5-26-05 Fax#617-727-7749 WWW.Mass,govfdia .1 { 71 iI Fold,Then Detach Along All Perforations .17 COMMONWEALTH OF MASSACHUSETTS' Kam IMPORTANT NOTICE BOARD PLUMBERS AND GASFITTERSAND GAS P LICENSED AS A JOURNEYMAN PLUMBER PERMITS s AILLAT ONSLON STATE OWNED OR USED ED ISSUES THE ABOVE LICENSE TO: FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. TYPE ~DANIEL J DOORE _J 68 WOODLAND ST LAWRENCE MA 0184-1-2900 ¢ 176356 `: 24393 05/01/14 176356 �" ' Fold,Then Detach Along All Perforations f Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 1032700.0,0 m $ - $ 1,244.40 Plumbing Fee $ 155.55 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 155.55 Total fees collected $ 1,655.50 1116 Salem Street 137-13 on 8/13/2012 Addition, Kitchen Remodel Date......L:.".�-'. ..! �....... NGpTN -i i � TOWN OF NORTH ANDOVER o 9 PERMIT FOR WIRING r �vier;,- • gB CHU This certifies that�.�...119/. 1 4.2 ...l�v.75 . ............................................. has permission to perform ...:.r�-.'�x.� �� ............................................................................. wiring in the building of................................. ..................�!95. 1. ........:........:............................................. at .....l..�..�...b......�Jr „�'—�.•"•,-./et..............�.is ,North Andover,Mass. . ................ 11-7 7?8 Fee... ..5... ...Lic.No. ................. ............................. .. ... ... .............. ELECCEICAL INsp crm I Check# J 1 0: A Commonwealth of Massachusetts Official Use Only Permit No. I / q o 2- Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL) FORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 5 Vo• ' f el Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service ao o Amps 1 / a u V Volts Overhead Er Undgrd❑ No.of Meters j _ New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No:of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Lu,.ri:wires Swimr in6 Fool Above n In- n o.o mergency Lighting b rnd. — rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches 7, No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotalTonsNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: "' """."""'.."'"""""."'."'."""" Detection/Alerting Devices No.of Dishwashers Space/Area Heating.KW Local El Connection E] Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydroma: Mtge Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: S Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Vklue of Electrical Work: (When required by municipal policy.) Work to Start: /-,51,S- 1,3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensed provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURA-NcE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Q Ij I 5-,j 01 PY-j Z fi--- Signature = LIC.NO.:11Z7k/S (If applicable,enter "exempt"in the license number line) Bus.Tel.No.• 9 79:1;/al 1 Address: 7i /- �S� /+� ^'A D/��/c/ Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I a4aare that the Licensee does not have the liability insurance coverage normally required bylamy 'gnature belo ,I waive this requirement. I am the(check one) owner ❑owner's agent. Owner/Agent-11-17y9 PERMIT FEE.$ Signature i ` Telephone No. / r ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule S: In accordance with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§ 32,an a electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall.be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass F?1 Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: '<sc _P , Inspeors Signature: Date: SE CE INSPECTION: P ss Failed 0 Re-Inspection Required($.)❑ In 6tors Comments: Ins ectors Signature: Date: z PAR IAL ROUGH INSPECTION: Pass Fa ? iled Re-Inspection Required($.)❑ Inspect rs Comments: ` 1 C �� rcFlD� 5L d /- -inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comments: L Inspectors Signature: U Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations kvi . 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): C AI "ZA-' Address: jig? CSS City/State/Zip: InA Phone Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ 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.�I am a sole proprietor or partner- 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. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E]Electrical repairs or additions 3.El am a homeowner doing all work - right of exemption per MGL 11.E]Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]r employees. [No workers' 1311 Other comp.insurance required.] *Any applicant that checks box N 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 isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name:. Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as 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. Ido hereby certto under the ams andpenalties ofperjury that the information provided above is true and correct. Signature: Date: /3 Phone#: 9d/21 -55d 9- 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#: �}c 4 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 resented " p p 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 confiimmna,ii n ofiiisuraucc coverage. also be sure to sign and nate 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 ladustdal Accidents Office of Iuvestigatlow 600 Washington.Street Boston.,MA.02111 Tel.#61.7-727-4900 ext 406 or 1-877,7MASSAFB Revised 5-26-05 Fax#617-727-7749 wwwMass,8ov1dia Division of Professional Licensure: License Search Page 1 of 1 y 1 The Official Website of the Office of Consumer Affairs and Business Regulation(OCABR) Division of Professional Licensure Mass.Gov Mass.Gov Home State Agencies A-Z Topics Home>Division of Professional Licensure> ONLINE SERVICES _._ ... ................ ...:........... ....... Check a License Check A Professional License Locate a Licensed Professional By the Division of Professional Licensure Online Address Change __.._ Contact the Agency More... LICENSEE Name:WISTON M. ALMANZAR REFERENCES& METHUEN,MA RELATED INFO NEW SEARCH Disclaimer Regarding -- Website License Searches Licensing Board: ELECTRICIANS Enforcement Process . . _._ I _. Glossary License Type: JOURNEYMAN ELECTRICIAN TYPE CLASS: B Glossary of License Status __. _ . .__. ..._ . ....._ _ . .._... . Codes License Number: 11778 Status: CURRENT More... Expiration Date: .7/31/2.013 Issue Date: 9/6/2006 j Exam Date: 9/6/2006 j School:. OTHER This web site displays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. The page above has been generated by the Division of Professional Licensure web server on Wednesday,February 06,2013 at 8:47:39 AM. ©2007-2011 Commonwealth of Massachusetts Site Policies Contact Us http://license.reg.state.ma.us/public/pubLicenseQ.asp?board_code=EL&type_class=_B&Iic... 2/6/2013 Datelo/,. --. E .- . � TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . .h.` . has permission to perform . ". . . . . . . . . wiring in the building of . . . 5?1N�`---. . . . . . + . . . . . . . . at . . . . . J.a .'^ . 4.•. . . . . . . . ANNh Andover, Mass. Feel.55,L55. . Lic. No24J . . . Mo. . .ELL INSPEC OR Check# _ 11122 CellphrMle IloPI13 -low laU° p. i v y�7 i Gv �S Y/9 1612 7e, l .50 Commonwealth of Massachusetts Official Use Only` Permit No. I Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /D 1 jdL City or Town of. NORTH ANDOVER To the In pec or of Wires: By this application the undersigned gives notice of his or her mtenti to perform the electrical work described below. Location(Street&Number Owner or Tenant _ A Telephone No. Owner's Address 11/6- She 1 M Is this permit in conjunction with a building permit? Yesg No ❑ (Check Appprroprix Purpose g ose of Building Utility Authorization No. J� 4'�J } - Existing Service t Amps /(!""�OVolts Overhead Undgrd❑ No.of Meters .�► New Service Amps /;d /-4C4�Volts Overhead Undgrd ❑ No.of Meters • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Inspector o Wires. e ollowin table m f Com let�on of th f may be waived by the Ins e No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. El No. Units No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS No. of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers HeaTotals t PumNumber. .Tops.........KW...,. No. cSelf-Contained � "�' Detection/Alerting Devices ipal No.of Dishwashers Space/Area Heating KW Local❑ MunicConnection ElOther Heating Appliances KW Security Devic No.of Dryers No.of Devices or E uivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El ctr' al Work: (When required by municipal policy.) Work to Start: pections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that suchcov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:, INSURANCE 2 BOND ❑ OTHER ❑ (Specify:) I certify,under the sins and penves ofperjury,that the information on this application is true and complete �� 77 FIRM NAME: C" DC< _ - LIC.NO.:;`-4-1 y�o� Licensee: �� Signature LIC.NO.. � 3 ro o,• 0-25 3 (If applicable enter exempt zn a license number link. Bus.Tel.N � O Address: Ga eeV' ew ��sw�' h 6Q 0 7 Alt.Tel.No.: *Per M.G.IL c. 147,s.57-61,security wor requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature bel6w,\4 hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent _ '` Signature " ^_ :Telephone No. PERMIT FEE g 4 J v ._ • .+:rJi-Uu1l.r3.J.�*i.'l���J./R�.+u.L�..lf/l'-'�R.���®•���((.l �Y .'•�1�J.�`La.K.R�..l.t.'n+��®..•`��o . �..E40LIY� 7.7.�.L[CJIJ.VJ-fit �• •• � _ or . �'�ssei�.-, �'a�tebt--•� � �e-xnspect�oxtxe�uzz'ecT($a0A0)�X � lispectpxs'commeAts; ns ee-axsy atuxe o it!als � �z xtSz. {� .Y Sn } .. •---• - date a :2.MAL WSPXC�IOW; r �ta •�+'aflec��r )'c ettfis; ( zisiectax 'z xe oto fsdtiaTs) date rT.Le YIPI CD~OMD 3UMICTZON. 'assed-� is Iet - j ate-impeetlop-xepkea($60.00)-[ namotoxs"Comments. [.�nspectoxs��ignatuxe��.o initaTs) ]ate • �, ' WupV,CrkOX--BES,ICE: sseft--j ) a3�ed--fie�nspectionxequixer�($�OAO) j opectbxs'eammepfis; . s ectoxs ,�z aatuxe azo ju�ftials�P Data `e�•--[ � �+:a�.er�•-[ }- '�Le�nsp ecttoxt xec�pixe[�($50.0 OJ.•[ � . ectaxs'COI71J37.�x1tS: _ . asp ectaxs" zgnatuxe xto xnitasJ date n-P rPA O?61a t2&!'A'dl T�T`i �i 77 :fi 73 n1Tr'd t" 7f 6a'Xi RT 8'DY�7�'7�('�i 2 t �i APVi.A'Vd b TIP,M4'7�1Ft'.�'!TED T.9 VNP s• The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le-aibly Name (Business/Organization/Individual): tol ( 14 (-/ Address: �B�✓�/ City/State/Zip: /lreW Phone#: d o 3 S `3 3—el-11 Are you an employer?Check the appropriate box: Type of project(required): 1;.❑ I am a employer with 4. ElI am a general contractor and I 6. employees(full and/or part-time).* have hired the sub-contractors ❑New construction 2.0I am a sole proprietor or partner- listed on the attached sheet. $ 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5• ❑ We are a corporation and its required.] ofcers 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.n 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. T 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 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 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 DIA for insurance coverage verification. I do hereby er in an enal ' per ry that the inform vrded above is true nd correct. 5i nature: Date: Phone#: Official itse 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 li 6.Other Contact Person: Phone#: E I I 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. I 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 4 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 J 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 R 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 of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.goy/dia it 28 �k IEC � �ef 9/L- ul- c4�uu1 • Andre Farah 1116 Salem St North Andover, Ma 01845 To Whom it may concern Please be advised that Red Tail Construction and its associates have been relieved of their duties at 1116 Salem St in North Andover. Due to the shoddy work, electrical and carpentry, I have terminated the contract. The electrician working with Red Tail, and its principal owner Steve McCullough, is Chris Roy out of Nashua NH with a mass license number 2472UR I Sincerely Andre Farah. i l C CA -n V � MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK i t► ' CITY MA DATE _ _I PERMIT# INAMEYc' x Il `' ,IOBSITE ADDRESS _ ,_I Ci'k't I OWNER'S P k OWNERADDRESS _ 4�`�''� _ TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL 0 RESIDENTIAL Q PRINT CLEARLY NEW. 0€ RENOVATION:El REPLACEMENT:® PLANS SUBMITTED: YES NOD FIXTURES 7 FLOOR--+ BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB { CROSS CONNECTION DEVICE —=== DEDICATED SPECIAL WASTE SYSTEM 1 _____.._1 _! _J __._-__J .._ ..� __ _! _.___ __._l ____J .._.. __ ! ! € DEDICATED GASIOILISAND SYSTEM DEDICATED GREASE SYSTEM ___.._l _ ! _..-_ J —! _--1 ! __.._._J _.___1 __ DEDICATED GRAY WATER SYSTEM I _._€ I ____I __J _—._I DEDICATED WATER RECYCLE SYSTEM I ...........I _.___ J __ I .--._.J __.__._1 DISHWASHER _ ._! ._..'__` __- __._ I .._.___€ .___-_J -.__I ._..___J _...._J .___._J _.- DRINKING FOUNTAIN __i ._____.{ __-___J .___.._-I ___..__€ ► --_,-___I _-._ __.__J .____._._f .__----- _-___� --__-.! - :..-__.. FOOD DISPOSER —_1 ......____l .._..-__ FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) _____I ._____1 __._.J __-__-. __._ S i _____1 __--J _-_ 1 __.__.J _-__._I KITCHEN SINK LAVATORY ROOF DRAIN =L J ----------J__ SHOWER STALL ! __.__._J __..J ___.__31_____i _-__ _.-._.J �u12VICE 1 MOP SINK x-_._I --------_I _--_-f IINGMACHINE CONNECTION __( _T—! _-_...._..J __. .__.1 ____ _R HEATER ALL TYPES fi - f ( ..._..____ ER PIPING _ f _ .__ i ! -----.._..a ( ! € ............. fl IER ! -�� - INSURANCE COVERAGE: fhave a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES M NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND Q tOWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the . . t Massachusetts General Laws;and that my signature on this permit application waives this requirement., CHECK ONE ONLY: OWNER _I AGENT SIGNATURE OF OWNER OR AGENT .v 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 knowle0ge and that all plumbing work and installations performed under the permit issued for this application will be in coy,�lji e with all Pertinent provision of the ' �:'' e Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAMELICENSE# _ _ ( G NAT( MP ! JP n CORPORATION E]#=PARTNERSHIPEll _ ! LLC _ _ i COMPANY NAME d �� ��,P P ADDRESS CITY STATE E� ZIP � �.__E TEL — iti � FAX t CELL i EMAIL �;:��____-�'-- ---._..-----.—_.____..__. _. ._ I µ erconstruction cost for fee cal- North Andover Fee Calculation E ,g Construction Cost $ 103,700.00 m $ - $ 1,244.40 Plumbing Fee $ 155.55 Gas Fee 100 comm. $ - 100,00: Electrical Fee $ 155.55 Total fees collected $ 1,655.50 1116 Salem Street 137-13 on 8/13/2012 Addition, Kitchen Remodel 1 North Andover Board of Assessors Public Access Page 1 of 1 gORTIi North Andover Board of Assessors Ot<<N o'e Ati0 h A Y �SSACNUS�� 46property Record Card Parcel ID :210/106.A-0045-0000.0 FY:2011 Community:North Andover '1177-7777777 0 Click on Sketch to Enlarge Click on Photo to Enlarge Click on Photo to Enlarge • Location: +:1116 SALEM STREET Owner Name: ABOU-FARAH,ANDRE J KATHLEEN A FARAH Owner Address: ;1116 SALEM STREET _ City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:6-6Land Area: 0.54 acres Use Code ,101-SN_GL-FAM RES ';Total Finished Area: 1392 sgft Total Value: _ _ 340,400 _ ( 359,900 Building Value_ - 141,700 LL J 161,200 _ Land Value: -1§89700'--- 198,700 Market Land Value: 198,700 Chapter Land Value: Sale Price: ji176,000 !:Sale Date_: '01/13/1995 _ Arms Length Sale Code: Y-YES-VALID Grantor: ~SIDER],WARREN Cert Doc: ;�� _ .,Book: .04197 Page: 0278 http://csc-ma.us/PROPAPP/display.do?linkld=1707726&town=NandoverPubAcc 11/17/2011 Residential Property Record Card PARCEL ID:210/106.A-0045-0000.0 MAP:106.A BLOCK:0045 LOT:0000.0 PARCEL ADDRESS:Ill 6 SALEM STREET FY:2011 PARCEL INFORMATION Uisse-Code: - -101 Sale Price: .176,000 -- Booker 04191 .Road Type:_-T� _Inspect Date: 04/01%2010 Tax Class: T_ Sale Date: 01/13/95 Page_ 0278 Rd Condition: P Meas Date: 04/01/2010 Owner: -- --- - _ _ _ a _ --._ .- - - - -- ABOU-FARAH,ANDRE J Tot Fin Asea X1392 Sale Type_P_- Cert/Doc: Traffic: M_ Entrance: C _ _-_ __ --_ _ _._w_- _-_ KATHLEEN A FARAH Tot Land Area: 0.54___ _ Sale Valid: Y Water Collect Ids v�RRC�- _� - - � ------ - - _--- : �Y - Address: Grantor: -SIDERI,WARREN -�- ` Sewer_ Inspect Reas: C - 1116 SALEM STREET Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: SL Tot Rooms: 5 Main Fn Area: 13.92 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R1 - Story Height: 1.00 Bedrooms: 2 Up Fn Area: - - Bsmt Area: 1336-- � Seg�Type _Code:Method Sq-Ft Acres Influ-Y/N Value Class - -- _ _. . _�... � 1 P 101 -S- --- _._--23586-0.540_ _ - 198,747 Roof: G Full Baths: 2 Add Fn Area: s Fn B'smt Area: 536 Ext Wall: AV Half Baths Unfin Area: Bsmt Grade: VALUATION INFORMATION Masonry Trim; Ext Bath Fix: 1 Tot Fin Area: 1392 Current Total: 340,400 Bldg: 141,700 Land: 198,700 MktLnd: 198,700 Foundation: ST Bath Qual. -T RCNLD: 141683 Prior Total: 359,900 Bldg: 161,200 Land: 198,700 MktLnd: 198,700 Kitch Qual: T Eff Yr Built: 1962 Mkt Adj: Heat Type: -HW ExtKitch: � Year Built: 1931 Sound Valuer _ _ .._ Fuel Type: G _ _ _Grade:- A _Cost Bldg:- 141,700 Fireplace: 0 Bsmt Gar Cap: Condition: A Att Str Val1: - e -- - . - _ -T-,-.-- --_- tt —� Central AC: N Bsmt Gar SF_: Pct Complete: Att Str Val2: Att Gar SF %Good P/F/E/R /100/100/72 Porch Type Porch Area Porch Grade Factor E 460 SKETCH PHOTO- 22 E 18 396 Sq.R 18 22 2=41 1 2 44 Sq.R FM/B 1336 Sq.Ft4 4 q.Ft 34 32 40 Parcel ID:210/106.A-0045-0000.0 as of 11/17/11 Page 1 of 1 North Andover Board of Assessors Public Access Page 1 of 2 NOR7h North Andover Board of Assess®rs MATCHING PARCELS SSACM Click on a column title to sort data by that column 283 items found,displaying 151 to 200. [First/Prev] 1 1 2 1 3 4 1 5 6 [Next/Last] Fiscal Year Parcel ID St.No. Street Owner Name CLARK,GEORGE FRANCIS,JR,BRENDA 862 SALEM STREET 2011 210/065.0-0035-0000.0 ANN CLARK _ 2011 210/065.0-0017-0000.0 871 SALEM STREET MEIKLE,ROBERT D F,AUDREY AMEIKLE 2011 210/065.0-0043-0000.0 874 SALEM STREET TOMBARELLI,STEPHEN D,DONNA J TOMBARELLI 2011 210/065.0-0068-0000.0 886 SALEM STREET EDDY,ROBERT F,CATHLEEN M EDDY 2011 210/065.0-0054-0000.0 895 SALEM STREET CYR,STEPHEN P, 2011 210/065.0-0069-0000.0 898 (S ELA M STREET O'BOYLE,GARY S,O'BOYLE,GAIL A. 2011- 210/065.0-0070-0000.0 910 SALEM STREET ERLER,ALBERT J,C/O IANNAZZI,PAULA 2011 210/065.0-0071-0000.0 922 SALEM STREET CHAN,YOK LIN,TAT WAN CHAN 2011 210/065.0-0072-0000.0 934 SALEM STREET CRABTREE,WILLIAM P,LYDIA M FRITSCHY 2011 210/065.0-0018-0000.0 968 SALEM STREET ROCKWELL,ELEANOR G, 2011 210/065.0-0038-0000.0 971 SALEM STREET CONTI,ARON C,CONTI,DIANA 2011 210/065.0-0019-0000.0 989 SALEM STREET -GRADY,WALTER F,GRADY,ISABELLE M 2011 210/104.D-0061-0000.0 996 SALEM STREET ARTIMOVICH,ANDREW N, 2011 1,210/104.D-0030-0000.0 998 SALEM STREET NICHOLAS A.ARTIMOVICH TRUST,C/O MANGIAMELI,JEFFREY H. 2011 �210/104.D-0031-0000.0 1004 SALEM STREET LOPEZ,CARMEN M HENRIQUEZ,LAURO 111111 A RUIZ 2011 1210/104.D-0185-0000.0 1020 SALEM STREET WARREINENTHONY,WARREN, 2011 1210/106.A-0060-0000.0 1044 SALEM STREET MAC DONALD,PATRICIA ANN, 2011 210/104.D-0070-0000.0 1049 SALEM STREET 1049 SALEM STREET REALTY TRUST, 2011 210/104.D-0069-0000.0 1053 SALEM STREET HOLLERAN,ROBERT S,GAIL J HOLLERAN 2011 1210/106.A-0058-0000.0 1060 SALEM STREET WHITEHEAD,KENNETH G,LISA WHITEHEAD 2011 210/106.A-0059-0000.0 1062 SALEM STREET MARCINUK,GLENN S,DENISE M MARCINUK 2011 210/106.A-0048-0000.0 1063 SALEM STREET MURRAY,BRIAN E,LAURIE A MURRAY 2011 210/106.A-0046-0000.0 1070 SALEM STREET CORNBLATT,JEFFREY,LINDAU, MARGOT 2011 210/106.A-0259-0000.0 1075 SALEM STREET SINGH,AMIT K,GEETA SINGH 2011 210/106.A-0057-0000.0 1094 SALEM STREET MILLER,RICHARD,MILLER,SUSAN 2011 210/106.A-0049-0000.0 1099 SALEM STREET DISALVATORE,FRANK R,ROSALIE DISALVATORE 2011 1210/106.A-0056-0000.0 1100 SALEM STREET (NETT,PATRICIA,NETT,JOSEPH 2011 210/106.A-0055-0000.0 1110 W SALEM STREET DOWALIBY,ELLEN M,JOHN F DOWALIBY s 2011 210/106.A-0045-0000.0 1116 SALEM STREET ABOU-FARAH,ANDRE J,KATHLEEN A FARAH 2011 210/106.A-0052-0000.0 1132 SALEM STREET ASPESLAGH,GLEN G.,ORN,SOTHY S. http://csc-ma.us/PROPAPP/newSearch.do?noOwner--027%3B084%3B059%3B 136%3B... 11/17/2011 North Andover Board of Assessors Public Access «�-- Page 2 of 2 2011 210/106.A-0044-0000.0 1135SA ADAMS FAMILY REALTY TRUST C/O JEFFCO,INC. _ 2011 210/106.A-0033-0000.0 1150 SAL T FARR,GEORGE H,FARR,CHRISTINE G I 2011 210/106.A-0050-0000.0 1155 SALEM dREET D'ANTONIO FAMILY TRUST,D.HEHIR& K.HALL,TRUSTEE 2011 210/106.A-0042-0000.0 1160 SALEM STREET HENNESSY,ANDREA J,PATRICK M HENNESSY 2011 210/106.A-0043-0000.0 1187 SALEM STREET WEBSTER,BRIDGET,HURLBURT, DONNA 2011 1210/106.A-0121-0000.0 1190 SALEM STREET LEAHY KATHLEEN M,C/O RYAN P. 2011 1210/106.A-0088-0000.0 1200 SALEM STREET HAJJAR,EDWARD G,KATHLEEN HAJJAR 2011 210/106.A-0181-0000.0 1212 SALEM STREET HANLEY,EDWARD W,DIANE L HANLEY 2011 210/106.A-01 19-0000.0 1213 SALEM STREET LARSON,WILLIS A,GERTRUDE F LARSON 2011 1210/106.A-0182-0000.0 1216 SALEM STREET GUSTENHOVEN,CARL T,KIMBERLY GUSTENHOVEN 2011 210/106.A-0183-0000.0 1220 SALEM STREET GABRIEL,PETER,GABRIEL,MICHELLE - - 2011 1210/106.A-0118-0000.0 1225 SALEM STREET ANDERSON,RICHARD C.,FURTH,MIRA A. u 2011 210/106.A-0184-0000.0 1234 SALEM STREET BONTEMPO,ROBERTO M,NANCY A BONTEMPO 2011 1210/106.A-0185-0000.0 1248 SALEM STREET DI BLASI,JOSEPH P,LAURA DI BLASI 2011-1210/106.A-0 133-0000.0 1253 SALEM STREET BRODETTE,BARRY,BRODETTE,LINDA 2011 210/106.A-0186-0000.0 1260 SALEM STREET CZEREPAK,WILLIAM E.,CZEREPAK, ERICA K. 2011 210/106.A-0187-0000.0 1264 SALEM STREET VESSAL,AHANG,TAHERI,LADAN 2011 210/106.A-0134-0000.0 1265 SALEM STREET HALLECK,ALLISON, 2011 210/106.A-0148-0000.0 1275 SALEM STREET JAMES,STEVEN J,ROSE M JAMES 2011 210/106.A-0 188-0000.0 1276 SALEM STREET MCLAUGHLIN,EDWARD C,TERESA M _ MCLAUGHLIN 283 items found,displaying 151 to 200. First/Prev 1 1 2 1 3 1 4 1 5 1 6 Next/Last http://csc-ma.us/PROPAPP/newSearch.do?noOwner--027%3BO84%3BO59%3B 136%3B... 11/17/2011 I ,,,,- r �._.;� y„.,.r�I,,..,+<: .�,-„K.f,�.�.:-�-.._; :..,.. amu- -�-• 'a Location' ” yNo. 6 1V Date 40RTh TOWN-OFNORTH ANDOVER y: 3?0`, VD Certificate of Occupancy 49 Building/Frame Permit Fee $ cHusEth Foundation Permit Fee $ i Other Permit Fee $ '' . Sewer Connection Fee $ 3 Water Connection Fee $ TOTAL $ d 1 — Y `2 1,23 °`' f:97 I4a47 39. pgt8uildi Inspector Div. Public Works •Location No., 10 Date0,11 NORT" TOWN OF,NORTH ANDOVER _ O? • •• oos � F p Certificate of Occupancy $ * ; ; Building/Frame Permit Fee $ ,SSAONUSEt Foundation Permit Fee $ 1 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $. TOTAL $ � A !t 71Zf97 14:07 39.00AID Building Inspector t i Div. Public Works lb PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE i ,MAP 440. joro OT NO. 0 2 RECORD OF OWNERSHIP DATE BOOK PAGE z ZONE SUB DIV. LOT NO. �' �� I 1 i �COCATION ,�/�/) �// /J ..{��1/e_/� PURPOSE OF BUILDING b'd.�I� �/u� ? JbWNER'S NAME ,d— �n 2 NO. OF STORIES SIZE a �7_ l� 11 WNER'S ADDREKSST/v/'JO�� ��If /� rg� BASEMENT OR SLAB - ARCHITECT'S NAME /1 y'a'LC r' - SIZE OF FLOOR TIMBERS IST 2ND 3RD UILDER'S NAME SPAN ? DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS ., DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING % IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 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 �v EST. BLDG. COST E" PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PERS . FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 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 FIL D A p APPROVED BY BUILDING INSPECTOR FILED ✓ • LDING INSPECTOR ���GNWNER OR AUTHORIZED'AGENT F E E z C) a OWNER TEL. PERMIT GRANTED 7 - CO 'rR.TEL.# 19 _ 17 CONTR.UCJ H.I.C.# Town of North Andover BUILDING DEPARTMENT Homeowner Li�.ense Exemption lease print) )ATE 9 J4 k I JOB LOCATION r(-( - Number, Street Address Section of town IOMEOWNER" 7, BOG!- OR) &FA- 3. I Name Home Phone W o r k Phone PRESENT MAILING ADDRESS 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 in tAnded to be, a one to six family dwell- ing , attached or detached structures accessory t:o 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 . The 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 requirements . . 11110MEOWNER' S SIGNATURE - r APPROVAL OF BUILDING OFFICIAL ate: Three family dwellings 35,000 cubic feet , or larger, will be .iuired to comply with State Building Code Section 127 .0, Construction �:rol . MORTGAGE INSPECTION PLAN .4T 1116 SALEM STREET NORTH ANDOVER, MA. i NO. ESSEX REGI S TR ' OF DEEDS. 8K. 3,166 PG. 237 PLANS.- N0. 3 20486,229 CER TIF/ED TO.'FIRS T ESSEX SA V/NGS BA;Vk, FSB. S C A L E.' I"- 40' DA TE.' OC TOBER /5, /994 Ex/ST/NG.' B't REOU/RED.'30' t /- [^ 245 { , `V l �/2'X B'MOVABLE WOOD SHED PARCEL 2 v Q j v V' Qo �v PARCEL / l 230'f i i ,sW► v NOTES.' 11A of 4 /J DO NOT USE OFFSETS To ES T ABL/Sh' OR TO ERECT AN. Y STRUCTURE. 2)PROPER T Y LINES ARE DE'ERM,'h'ED P Oy COMP/LED q X35773 INFORMATION TO BE USED FOR :�/ORTGAGE PURPOSES ONLY. '°�FSS,o�"v 3) DWELLING CONFORMS, MOVABLE WOOD SHED DOES NOT. 'SURv ° CERT/FICA TIONS. BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF, i HEREBY CERT/FY THAT THE PERMANENT STRUCTURES INDICATED ARE LOCATED ON THE GRXND APPROXIMATELY AS SHOWN AND ARE (SEENOrE3) CONFORMING TO T,-,'E ZONING SETBACK REC UIREMENT,S OF THE TOWN OF NO.ANDOVER WHEN CONS TRUC TED A�✓D THA T THE S TRUC 7'URE SHOWN IS NOT LOCATED /N A FLOOD HAZARD ZONE 4S PER ti!AP COMMUNITY N0. 250098 EFFECTIVE DATE.' 06-02-93 ZONE.'X JOHN ABAG/S 8 ASSOCIATES, PROFESSIONAL LAND SURVEYORS 137 CHANDLER ROAD, ANDOVER, ,MA. (508) 688- 4899 AH°LICA NT.'FARAH /VO. P2, 138 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments ts 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: 1�NDpg- Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street _ }�.�11� �/ . St. Number 7. 0 *Official Use Only************************ RECOM[EN AT T WN AGENTS _._ Date Approved /2 0) Conservation Administrator Date Rejected Comments Date Approved Town Planner Da e .Rejected. Comments L e- Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date t t... BK 4197 PG 278 We, Warren J. Sideri, Jr. and Sandra A. Sideri, being married, spa of North Andover, Essex County,Maaachusetts in consideration of $176,000.00 0 Sant to Andre J. Abou-Farah and Kathleen A. Farah, husband and wife, as tenants by the entirety, of 1116 Salem Street, North Andover, MA 01845 >tksodaYOnc� with quitclaim cubtuauts ni Mw land in said Ninth Andover,with the buildings -s j thereon,bounded and described as follows:. „•° r I +r, PARCEL,ONE: Commencing at the Southwesterly corner of the prmises on the Easterly side of Salem Road at land now or formerly of one Fish;thence running Easterly by said Fish land,as the wall stmxl%one hundred(100)feet;thence turning and terming Northerly,paranal with said Salem c Road,one hundred(100)feet;thence turning and running Westerly,parallel with the said wall,one hundred(100)fed:thence turning and running Southerly by said Salem Road,one hundred(100) fat to the point of beginning. efs t � , ,, _ ..... . _. PARCEL TWO: The land in said Nath Andover,consisting of that portion of Lot N1 on a plan > of land in Ninth Andover,Massachusetts,dated February 9,1956,C.J.Kitson,Surveyor,known vo as Tarrwood Acres No. 1', said plan being recorded in the Essex Registry of Deeds for the a Northern District as Plan No.3204,beginning at a point at the Northeast corner of land now owned - j « by Low,thence running Easterly 138.26 fedum,mor less.to a point;thence turning at an angle and 64 naming Southerly 100 fed,more or less,to a stone wail at land now or formerly of Kruschwitr, 0 thence turning at an angle and tinning Westerly 138.26 feet,more or less,along said stone wall to 1 , I 4 land now or formerly of Low;thence turning at an angle and mm�ing Northerly by land of said d Low,100 feet,more or less,to the point of beginning. s For our title, we dad dated September 24, 1990 and recorded with the Essex North District � e Registry of Deeds at Book 3166 Page 237. r ;,i• t Executed as a sealed instrument this l2'�A day of anuary 1995 , V1 arr J. ri Jr.In . N � I a I; Sandra A. Sideri moi' i t p Vi the Qlommonfntaltll of Massachuutts Essex, 3. U. January IZ 1995 I • Then penotully appeared the above named •x ` �;t- Warren J. Sideri, Jr. and Sandra A. Sideri 4' and acknowledged the foregoing ,f � Bed instrument to he their {•• r�j , Before me. I �ti Nm.r ASA& ..., ' ATiV. 1/lD M.TMOl1 My commiWon eapirm i 77 N S+TR AN R. MA OtAt^ j ,l• s. It+ �C •yI it ' •b... ,A x U q Q� r� a•�► � �.10RTy ' Town of over No. n * Z dover, Mass. 19 LAKEs w COCMICNEWICK '9 XTE D 04 S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......ArvAit.t.....s......../4.�iU. . .. .. CI4>�0............................. Foundation has permission to erect..... c1. v%C� ►.J.V� buildings on .......I.. ..�a.....f ��.l.[�.m.......s.,.....(NO.T..".R.%xto Rough 1 11 �1 �a� to be occupied as....rWS14�......f 4.A.adoLT�1 cJl .......!..t.�_v%...(Zo(�lYv........... � . ........�� .�Q,.......�..�1�T1�.y r�^^Iw Chimney.. provided that the person accepting this permit shall in every respect conform to the terms of the application on file-in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTIO STARTS ELECTRICAL INSPECTOR Rough ..................... �_........061EDING ....................................... ervice INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough • Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Y Street No. �,�-LR.gyp_'{ Smoke Det. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from i` Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with an a li p y pp cable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT i'C C-A I'A PHONE L [�� LOCATION: Assessor's Map Number 1 O(0 PARCEL L SUBDIVISION LOT(S) STREET ST. NUMBER ********************** ** *** ***OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS s' TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED. COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS ' DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE ,I Revised 9197 jm 4 ql � s r S-0 e e' Town of North Andover ORT Office of the Zoning Board of Appeals g App ti A Community Development and Services Division _ 27 Charles Street " North Andover, Massachusetts 01.845 jL SACHUSE D. Robert Nicetta Telephone(978)688-9541 Building Commissioner _ Fax(978)688-9542 anis is to crrtify that twenty(20)days \ ';ave elapsed from date of decision,filed without filing ofa pi ap e . Any appeal shall be filed Notice of Decision Date � ..�it�. i13 within(20)days after the Year 2003 Joyce y a A;BrOaMaw i date of filing of this notice l t� in the office of the Town Clerk. Property at: 1116 Salem Street 11 NAME: Andre&Kathleen Farah HEARING(S): 2/11,4/16,6/10 &9/9/03 ADDRESS: 1116 Salem Street PETITI^N• 2003-005 North Andover,MA 01845 TYPING DATE: 9/15/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,the 9`h of September,2003 at 7:30 PM in the North Andover Midelc School Auditorium,495 Main Street,North Andover upon the application of Andre&Kathleen Farah,1116 Salem Street,North Andover requesting a Variance from Section 7,Paragraph 7.3 and Table 2 for,for relief of side setbacks;and a Special Permit from Section 9,Paragraph 9.2 in order to construct an addition to a.pre-existing structure on a pre-existing non-'l conforming lot. The.said premise affected is property with frontage on the East side of Salem Street within! x the R-1 zoning district. The following members were present: William J. Sullivan,Walter F. Soule,John M.Pallone,Ellen P. McIntyre,Joseph D.LaGrasse,and Joe Edward Smith. g 2nd Upon a motion by Joseph D.LaGrasse and by John M.Pallone,the Board voted to GRANT a dimensional Variance from Section 7,Paragraph 7.3 and Table 2 for relief of 23'south side setback;and f u1 GRANT a Special Permit from Section 9,Paragraph 9.2 in order to construct a deck,family room and garage to a pre-existing structure on a pre-existing non-conforming lot per Plot Plan of Land,location 1116 Salem Street,North Andover,MA,prepared for Andre&Kathleen Farah,date:December 4,2002,revisions: August 25,2003,Frank S. Giles II,P.L.S.#45493, Scott L.Giles,Frank S.Giles Surveying,50 Deermeadow Road,No.Andover,MA 01845 and Plans for Farah residence, 1116 Salem Street,North Andover,MA. [5 pgs] ; Voting in favor: Walter F. Soule,John M.Pallone,Joseph D.LaGrasse,and Joe Edward Smith. Voting 7 against: Ellen P.McIntyre. 4 a The Board finds that the applicant has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of this Variance will not adversely affect the neighborhood or derogate from the intent:and purpose of the Zoning Bylaw, and satisfied the provisions of Section 9,Paragraph 9.2 of the Zoning Bylaw that such change,extension, or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. i Page 1 of 2 A M'_ Copy :i own Clerk Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9510 Planning 978-688-9535 i Town of North Andover NORTH Office of the Zoning Board of Appeals _ °p Community Development and Services Division 27 Charles Street ` + tir North Andover,Massachusetts 01845 'SSwcHuBEt D. Robert-Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Furthermore,if the rights authorized by the Variance are not exercised within one(1)year of the date of the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,it shall lapse and may be re-established only after notice,and a new hearing. Town of North Andover. Board of Appeals, JL William I S van,Chairman Decision 2003-005.. M106AP45 Page 2 of 2 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 s ESSEX NORTH REFI TR Off' � EDS LAWR 9CE, MAss. C� ;+ A TRUE COPY: A'7'79ST: f NOHTFi . Of�tUo e�'aH Zoning Bylaw Denial Town Of North Andover Building Department �'sACHUSE'' 27 Charles St. North Andover, MA. 01845 Phone;978-688-9545 Fax 97$-688-9542 Street: Ma /Lot: J©G 19 AA Zi Applicant: Re nest: ..2 X Y-3 V- is N. G arZ /h(3ap�M a Date: Please be advised that after review of your Application and Plans that your Application is DENIED for the following;Zoning Bylaw-reasons: Zoning R —o'�_ 43S6c) - Iso Item Notes Item A Lot Area Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting S 2 Frontage Complies 3 Lot Area Complies 3 Preexisting frontage ��S 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed �►e S G Contiguous Building g AreaN � 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required S 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient +e s(eA4i� 3 Preexisting Height 4 Right Side Insufficient Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexisting setback(s) 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed 4 Insufficient Information 2 In Watershed Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required A q 1 Mgre Parking Required 2 Not in district 5 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pr'e-existin Parkin Remedy for the above is checked below. Item # I Special Permits Planning Board Item # Variance Site Plan Review S eciaMermit C 3-9 Setback Variance Access other than Frontage Special Permit Harking Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway S ecial Permit Her ht Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special PermiF S ecial Permits Zoning Board Inde endent Elderly Housing Special Permit S ecial Permit Non-Conformin Use ZBA Large Estate Condo Special Permit Earth Removal S ecial Permit ZBA Planned Development District-Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit S ectal Permit for Si n R-6 Density S ecial Permit 13 S ecial Permit reexistin non Watershed Special Permit conformin The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the diserebon,.pf the Building Department. The attached document titled"Plan Review Narrative"shall be attached hereto 00noorooraw'herein by reference. The building department will retain all plans and documentation for the above file.You must file a new building permit application form and begin the permitting process. C) _ L — t3uilding Department fficial Si nature 9 Application Received . Application Denied Denial Sent If Faxed Phone Number/Date: i Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: �+�' �,yµ�y� yy+��`}Xy y� L. /.iIT�YiWIML}�H"` �A�.��r"�t.V^y+�isYty�i."VV�.tf�,r 4nv,��'�A �����.�K Nom' `�.�,r F"��� •a *jG r Y.,�,v �,��n°2 'tr ryn�t �iN{i� •,-F z' srWA i i o+�;Yi'i 4, // 61 A—I 02 N `,^-t e SIS /'Lc /]jON cCi,v�r�Iiti-c U i`5 lJA IC 1A N C S / We -e-I1 o0 AO O's.lecl� J MW! J70.J Referred To: Fire Health Police Conservation Zonin Board Department of Public Works Otter PlanningHistorical Commission Other BUILDING DEPT TOWN OF N W-M ANDOVER BUILDING DEPARTMENT e^.� APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: m SIGNATURE: .iro Building Commissioner/Inspector of Buildings Date v Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and] Number: p Qr7 N � oi�y9 Map Number Parcel Number ��- rl�- 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District ]r--Posed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided Q 1.7 Water SupplyM.GL.C.40. 34) 1.3. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record I Name(Print) Address for Service zt .10 wle . C 2, Aq Stg Telephone 2.2 Owner of Record: Name Print Address for Service: O z _ m Signature Tele hone ' SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address Expiration Date Signature Telephone �. 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address aa® Expiration Date Signature Telephone SECTION 4- COMPENSATION(M.G.L. C 152 § 25c(6) Workers Comnce affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial oMim an J6f the building rmit. Signed affidavit Attac Yes.......0 No.......❑ SECTION 5 Descri tion of Proposed Work(check all applicable) New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory.Bldg. ❑ Demolition -0 Other 11 Specify Brief Description of Proposed Work: . /. ,� � �9Gf.S Awn /!!i�b� �D►/��H f Jc'�i�r�,�u SECTION 6-ESTIMATED CONSTRUCTION COSTS v CIALUSENL � Item Estimated Cost(Dollar)to be Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGE-NTT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,_o �i✓il R� '� /MatL• Fi t/ 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. n 't--nature of Owner Ah Date SECTION 7b O N R/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 Si ature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2ND 3 RD SPAN DRv ENSIONS OF SILLS DIMENSIONS OF POSTS DiNNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i f I r 7 i Town of North Andover , pORT#f Office of the Zoning Board of Appealsro 3? •':' �;• Community Development and Services Division 27 Charles Street �. ,Area North Andover,Massachusetts 01845 cMuSEt D. Robert Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Any appeal shall be filed Notice of Decision within(20)days after the Year 2003 date of filing of this notice in the office of the Town Clerk. Property at: 1116 Salem Street NAME: Andre&Kathleen Farah HEARING(S): 2/11,4/16,6/10 &9/9/03 ADDRESS: 1116 Salem Street PETITION: 2003-005 North Andover,MA 01845 TYPING DATE: 9/15/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,the 9`h of September,2003 at 7:30 PM in the North Andover Middle School Auditorium,495 Main Street,North Andover upon the application of Andre&Kathleen Farah,1116 Salem Street,North Andover requesting a Variance from Section 7,Paragraph 7.3 and Table 2 for,for relief of side setbacks;and a Special Permit from Section 9,Paragraph 9.2 in order to construct an addition to a pre-existing structure on a pre-existing non- conforming lot. The said premise affected is property with frontage on the East side of Salem Street within the R-1 zoning district. The following members were present: William J. Sullivan,Walter F. Soule,John M.Pallone,Ellen P. McIntyre,Joseph D.LaGrasse,and Joe Edward Smith. Upon a motion by Joseph D.LaGrasse and 2nd by John M.Pallone,the Board voted to GRANT a dimensional Variance from Section 7,Paragraph 7.3 and Table 2 for relief of 23'•south side setback;and GRANT a Special Permit from Section 9,Paragraph 9.2 in order to construct a deck,family room and garage to a pre-existing structure on a pre-existing non-conforming lot per Plot Plan of Land,location 1116 Salem Street,North Andover,MA,prepared for Andre&Kathleen Farah,date:December 4,2002,revisions: August 25,2003,Frank S.Giles II,P.L.S.#45493,Scott L.Giles,Frank S.Giles Surveying,50 Deermeadow Road,No.Andover,MA 01845 and Plans for Farah residence, 1116 Salem Street,North Andover,MA. [5 pgsj Voting in favor: Walter F. Soule,John M.Pallone,Joseph D.LaGrasse,and Joe Edward Smith. Voting against: Ellen P.McIntyre. The Board finds that the applicant has satisfied the provisions of Section 10,paragraph 10.4 of the Zoning Bylaw and that the granting of this Variance will not adversely affect the neighborhood S g y or deco ate,from the g intent and purpose of the Zoning Bylaw,and satisfied the provisions of Section 9,Paragraph 9.2 of the Zoning Bylaw that such change,extension,or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. Page 1 of 2 Board of Appeals 978-688-9541 Building 978.688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 Town of North Andover NuerN Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 AMUS D. Robert Nicetta Telephone(978)688-9541 Building Commissioner Fax(978)688-9542 Furthermore,if the rights authorized by the Variance are not exercised within one(1)year( )y of the date of the grant,it shall lapse,and may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2)year period from the date on which the Special Permit was granted unless substantial use or construction has commenced,it shall lapse and may be re-established only after notice,and a new hearing. Town of North Andover Board of Appeals, William I S 4Chairman Decision 2003-005.. M106AP45 Page 2 of 2 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535