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HomeMy WebLinkAboutMiscellaneous - 14 GLENNCREST DRIVE 4/30/2018 14 GLENNCREST DRIVE j` 210/104._ q_004Q0000.0 { �..!.4..................... Date..4 40ATh 1 3�; "',;';�•tia�L TOWN OF NORTH ANDOVER n PERMIT FOR WIRING sS�CHUSE This certifies that ...V.U �" . .. ................................................................................................ has permission to perform ..................................................................................................... wiring in the building of..... .6�. �. � .................................................................................. at ......'. ... .�P C D..s. .......North Andover,Mass. .. ....................................... 8C Fee..............................Lic.No.0 1`t ` ELECTRICAL INSPECTOR Check# i sc\ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 121- l0 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(NMC),527 CMR 12.00 a � (PLEASE PRINT ININK OR TYPE ALL.INFORMATION) 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. 1 Location(Street&Number) / L) C t-., f,CX-e 5�- 'D 14-1 Owner or Tenant )�--<l 4,4 ir o /L d, ruff Telephone Na c _ 931&.3 . Owner's Address Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building JtilityAuthorization No. / - Existing Service Amps / doy-�olts Overhead Kr Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity �4 L,u . Locatiand Nature of Proposed ElectriYWypork: Il/ok c 0 ��fycr2 O 'off cr-q c Compl tion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans TransTotal Trsformers KVA i No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergency Lighting Md. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals: '" *' * *""-J------*"" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ 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.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Va ue of Electrical Work: (When required by municipal policy.) ,Work to Sta Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COMAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability in ance including"completed operation"coverage or its substantial equivalent. The um.dersigned certifies that such cover is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) Icertify,under tltepains andpenalties o,,(perjury,tltattlze information on this application is true and complete. FIRM N r'S /7 L (} LIC.NO.:3k3 Licensee: Signatur IC.NO.: (If applica e" xeempt'in the lice se number line.) V Bus.Tel.No.: 7b 3.7 Address: '—"'/ �t RD -�, 4z • 0 1,Q0 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires epartment of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)[]owner ❑owner's agent. Owner/Agent PERMIT FEE: $3 Signature Telephone No. 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: 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. 01 c. 166, §32,an 4 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 Chanter 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. FOR,ile 8—Permit/Date Closed: ***Note:Reapply for new permit❑ mit Extension Act—Permit/Date Closed: Trench Ins ection Pass IN Failed Inspectors Comments: Re-Inspection Required Inspectors Signature: Date: SERVICE CTION: Pass • Failed Re-Inspection Required($.) ❑ Inspectors Comments: . Inspectors Signature: 411Ile� s ,,� u `/ Date: PARTIAL ROUGH INSPECTION: j PasnFailed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: [LOUGH INSPECTION: Pass n Failed Re-Inspection Required($.)❑ Inspectors Comments: I Inspectors Signature: Date: "MAL INSPECTION: j i Pass 0 nspectors Comments: Failed Re-Inspection Required($.) ❑ I _ I i Inspectors Signature: I Date: :B WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com The Commonwealth of.1t2'assachatsePts , - Department oflndastriglAccidents Office oflnvestigations 660 Washington Street Boston,.MA 02111 www.mass.gov1d1a ,Workers' Compensation Insurance Affidavit:Builder°s/Conti°acforslElectrxcxanslPlumbexs i Applicant Xnformatiion Please Print Lea bly Name(Business/Oxganization/Iu(I%vidual): �-�'� � N .Address: Phone 1 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ X am.a employer with 4. 0 I am a general contractor and I 6. []NOW cdnstruction ployees(full and/or part-time).* have nod the sub-contracts 7. El Remodeling 2. l am a sole proprietor or partner listed on the attached sheet. ship and'haveno employees These sub-contractors have 8. []Demolition working for me in.any capacity. workers'comp.insurance. g, ElBuilding addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.[]Electrical repairs or additions required.] officers have exercised.their of exemption per MGL ll.[]Phimbingrepairs or additions 3.❑ 1 am a homeowner doing all work right 52 1(4,and we have no myself.LEO workers comp. ,§ ) 12.❑Roofrepairs insurancerequired.] employees.[No workers' 1311 Other comp.insurance required.] Mny applicautthat checks box#t must also fill outthe section beldw showingtheir Workers'compensationpolicy information. i'Homeowners who submitihis affidavit indicating they 6e doing all work and then hire outside contractors must submit anew affidavit indicating such. TContractors that cheAtbis box must affached an gdditional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compeltsation insurance for my employees Eelow is the policy aracl joi site infon2ation. Insurance Company Name:. Policy#or Self ins.Lic.#: ExpirationDate: Job Site Address; City/State/Zip: Attach a copy o#t�a workers'compensationpoliey declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL o.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. X�herelby cerci under tliepains and enol Ofparlury that the informationprovided alcove is true andcorrect.Sfire• Date: 3 Phone# � 1 / Official use oply. 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 I City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instruction 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 iii the service of another under any contract employees' express or•implied,oral or written:' An employes Is defined as"an individual,partnership,association,corporation or other legal entity,or y two or more an of the i oregoing engaged in a j oint enterprise,and including the legal representatives of a'deceased employer,or the receiver or tmstee of an individual,partnership,association or other legal entity,employing employees. I owevex the owner of a dwelling house leaving not more than three apartments and who resides therein,or the occupant ofthe 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 employes." 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,MOL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political e required.,, ons shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have beenpresented 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,supplysub-contractors)name(s),addresses)and phone numbers)along with the ertificaf (s)of e 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 tbisaffidavit maybe submitted tothe Departmentof Industrial Accidents for conGrmatron 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 axe required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their Self-insurance Incense number on the appropriate line. City or Town Officials Please be,sure thatthe 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 permithicense number which will be used as a reference number. In.addition,an applicant that Must submitmultiple permit/lrcense applications in any given year.,need only submit one affidavit indicating current policy information(ifnecessary)and under"lob Site Address"the applicant should write"all locations in. tov'rh,.A:copy of the affidavit that has been officially stamped or marked by the cit (city or ox town mb applicant as proof that a valid affidavit.ii on file fy may e provided to the or future permits or licenses. Anew affidavit must be fillgd out each Year.More a home owner or citizen is obtaining a license ox permit not related to any business or commercial venture (i.e.ad og license orpermit 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 Depaxttneat's address,telephone and fax number: Tho CQM-MO-Umalth of Mbssadhwtts - DepattMent ofIndmWaX Accidents Qfee of)14Vestfgatjojns. 6.bQ WashjVai� re BOAQn, 02111 TO— 617-727.4900 QA 406 ox 1-877-MAS Revised S 26-05 `ay,9 617-727-7749 1� • t^ COMMONWEALTH OF MASSACHUSETTS ! BOARD OF ELECTRICIANS ISSUES :THE FOLLOWING LICENSE AS A REG JOURNEYMAN 'iLECTRIC AN\ • � l R JOSEPH R L I NO 18 F I SKE' RD a SA000s M.A 01906-3366' 23794 ;>E 07/31:!16 95800 i • . _ .. 4t 1� r I ` y k � A � � ;•� 7y'Me ,fir r � c • r fit 44 tJ , rr � I 8 ` A .rte i , ¢ t'• Date...... c9 ..................... f NOR7M, o?;•tom``°-:•_�."�O� TOWN OF NORTH ANDOVER PERMIT FOR WIRING f SSACHUSEt This certifies that `'s���� t�� T ......................... ..................... ..................................... has permission to perform . L'�E..?:T.hx)� �� ......................... wiring in the building of........ ..................................... .................... .North Andover,Mass. Fee. h... .�. Lic.No. 7..Y �.......... A /^CAL INSPECTOR Check # 814 >' Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. —T Ocupanc BOARD OF FIRE PREVENTION REGULATIONS [Rev.1//07]y and Fee Checked GG?, (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C70 .k 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: � 2, 7 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) L e Owner or Tenant n cc,,- A-7- Telephone No. Owner's Address C-t-.t of I K �v- Is this permit in conjunctio with a building permit? Yes [Z No ❑ (Check Appropriate Box) Purpose of Building -Cl- Utility Authorization No. /k 7-?- Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service ;t vU Amps 11-y / 2 40 Volts Overhead © Undgrd ❑ No.of Meters f Number of Feeders and Ampacity df , Location and Nature of Proposed Electrical Work: C", A"D/-%— -C Completion of the ollowin table may be waived by the Inspector of Wires. No,of Recessed Luminaires of(f No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 7 U No.of Hot Tubs Generators KVA No.of Luminaires —7 Above In- o.oEmergency Lighting ti 1 (� Swimming Pool nd. rnd. ❑ Batte Units No.of Receptacle Outlets L/ No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection InitiDevices No.of Ranges No.of Air Cond. / Total No.of Alerting Devices ' ✓ Tons `7 No.of Waste Disposers HeiTotalsI Number._Tons KW No.of Self-Contained Detection/Alerting Devices J/ No.of Dishwashers Space/Area Heating KW Local❑ unicipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters � KW Signs Ballasts. DataNo.ofitinDevices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: t✓ v (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. ! INSURANCE OVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,.�tzh.at the information on this application is true and complete. FIRM NAME: 7.c jS);e.e- LG</f-/`[� tip C� LIC.NO.: Zr Licensee: Ql-, 1 1 ,1'S/=Pv Signature / LIC.NO.: (-'1,G �/S (If applicable, enter "exempt"in the lice nsg number line.) Bus.Tel.No.: yd'�I S 8,q 9 J Address: o F`v ev- G�, % ( _� P `� ri/mss<J Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ ( I i s f f Y J f •� The COnzMonwela ltsoDepa�yne� f Msach iusett sofInd' raACCide z�wi"sgov/dia nsf0ce ofnveti600 Wasfg in n Street Workers, Bostoft, MA02111 lipeaawwwcantfo m$doItsetraaca4ffdavif: i Builders/ Name Bganiusinessior Builders/Con zation/tndividuat). crans/Plunlbers Address: �� �� �ei-., Please Priat Legibl t3'/State/zP; " C E Are you ane 1. employer?Check the Phone#: . I am a employe,with appropriate box: I a Ptoyees(full and/or p----Z- 2.[j4. Q l am a m a.sole Part-time)* have hired the s tractor and I general con TYWNprejec t{r proprietor or Partner- ship and have no a lis 6. e<tuired): working for employees ted on the attached ss ew constructs me.in any These su 7. No workemo comp PacitY. workers, h-contractors have Q Remodeling required:) Insurance 3.D I am 5. Q We are cOMA insurance. 8' Q Demolition s hofiep e a corporation and its myself. �0mg all work Okers have exercised then a Q Building addition [No'workers'comp, right of exe ins urate"required. t c mPtion Per k l Q Electrical r ] t5Z §101 and we GL 11, "pairs oradditions i 'Any a employees. have no ❑Plurnbin iHon,PPiiaBnr that cheeses bo e*l [No workers' g repairs Or additions IC �`�"m who sub comp. ins 12•Q Roof repairs mit this aMdavit Inds fill out the secti �rditce re9uired) I3.Q Mors that shcci�this box °n below showier must cattng they art dein B their workers' er attached an additions!Is gall worse and th conilt"afiori I stn employer th crshowi en hire outside co Policy info information, at providing wor/� the name o fthe sub"n nuactors must submr "tion Insurancecorrtpe on ' traftm and their worke,neW affidavit indican Com �w'ancefor �`ccmP•Policy info49 such. Company Name: 'emlif0 enation. Policy#or ��� G u Belo rs.the pot' Self-ins.Lic.#; ky and job site Job SiteC �U Address: Attach a copy of the e eu > xpiration Date: �S Failure wO fine to secure coveragecompensation Polis City/state/z. Y declaration up to$1,500.00 Cequlred under pa r: and/or one- (showing of upup $250.00 a da. Year ire Section 25A of MGL c. 1 S2 g the polic Investigations Y agatt Prison can lead to the tm Y number and ex of the the violator. Bed as well as civil penalties ' Prration date). DIA for ins advised that a in the form of position of criminal 'ranee coverage verification.copy of this state a STpp WORK Aertalties of Ido hereby cert! meet may forwarded 3'under thepai tZ+'ardedthe and a fine Si tore: and pens nfper.0 Office°f l ry that the infortioir Phone#: � _ Provrdedabove ' is true and co : rrect Date o "icial use only, Do Z } nor write in ic � m'e4 to be co City or Town; Chmplet&'Ifby d&or town o Issuing Authorf ffcfal 1. Board of (eircle one): Permit/License# 6.other Health 2. Building De par'tment 3.City/Town Clerk 4. Electrical Contact person: inspector 5• Plumping inspector Phone#: i v • d instructions on a� ensation for their employees. • V I.nf or m ati rovide workers cOmP contract of hire, all employers top another under any 152 requires K Person in the service of •� General Laws chapter every P Massachusetts an enrpiDyee is defined as or arty two or more pursuant to this stat o'i or writterL„ oration or other legal entity+ ,OT the express or implied, d employer partnership,assooiation,coc'rP resentatives of a deceased .}-}oweverthe "an individual,partn d including the lege P toying employees.ant of the !v er is defined as Dint enterprise,an al entity, P or the Occup house p'n emp Y Din eng g . ership,association or other leg Vbo resides therein, of they foreg g a ed in a j eats and air work on such dwelling g oyer„ Of an individual,parfi construction or rep to be an P not more than three martin receiver or trustee house having Persons t0 d0 maintenance, ent be dttmed owner.of a dwelling to s p of such employm house of another who employs thereto shall not because issuance or dwelling rounds or building app a envy shall withhold the or on the g K state or focal licensing g in the commoswea th for any States that every ae required" 25C(6)also sta a business or to construct buildings nce'coverav shall 1,dGL chapter 152,§ compliance with the insu o�political subdivisions e or permit to operate compliance with the insurance produced acceptable evideaCe of comp onwealth nor any renewal of a license. 25C(7)states"1`leither the cornuble evidence of comp SO who has not Wr 152,§ until anew MGL chap ance of public work ctir► authoTin, Additionally, contract for the perform d the contracting enter into.any ter have been presence �qr ents of this chap YO situation and,if tel by checking the boxes theapply ficate(s)of Appiin� davit comple Y+ along w to ees their other than the the workers' compensatiorn affidavit es and phone number(s) LLp)with no emp Y have s name(s),address( A Liability partnerships( LLP does ha • please fill s� ly sub-contractor() LLC)or►rim Ce. if an LLC or necessary, uPP Companies( ens6on insurance d to the Depa ,,a of Indusmal Limited Liability to cam,workers cArnP be submitte The affidavit should, I insurance. attners,are not Tequrred at this affidav t may and date the a{'�idavit. wtment of members or p , Be advised ti os,.be sure to sign re vested,not the Dep licy is Teo iced to obtain a workers employees°apo unit or license is being q for confinnafion of insurance coverage. on for the Permit law or if you.are sego anies should enter their Accidents or town that the app ding SeIf.-irsured comp ed to the city. ou have any questions regar' be listed below. be returnShould y at the nun► Industrial Accidents. lease call the Department tion po1}cy,P ro ria te lire. coMpensa a number on the a p P nce jicens at the bottom self-insura went has Provided a spacethe applicant. or Town Officials The Dep contact you Tending applicant City }ete and printed legibly. tions has to In addition,an PP t affidavit is comp Ce of Irlves used as a reference nurt►ber. please be sure that the fill out in the event the office vtt indicating(ccity r vit for you t0 which will be used need only submit one affidavit of the affida ermitnicense numbero in any given year, "all locations m---- please be sure to fill in the P a licati „the applicant should write be provided to the r""tfl d derp"Job Site Addr'es or marker by the city or town may that must submit multiple Pe davit must be fi}]ed out each information(if necessary) officially stern on fermits or licenses. A new affiercial venture policy" of the affidavit that has been to any business or m town)• A c a license or perms not related complete this affida vit Ile roof that a valid affidavr15 obta Hing r futm e. usred to COmp applicant asp er or citizen is NOT req you have any questions, ere a home own leaves etc.)said person d should y • year.VJh Perm to bum for your�Peration an . (ire.a dog license or p k you in advance The Office of investigations would like to than Y . to ive us a call. y please do not hesitate g d fax number: Massachusetts entIs address,telephone and _ of e arm OTI�'e&lth 81 ACCidents The D P )ep�tnent Of Industrial of ftCe of Inveshbations 600 W�ngton street aoston,MA 02111 Tel.# 617-72? - 400 Ext 406 or 1-877-MA.SsAFE Fax##617-727-7744 ww"ass.govldia Revised 5-26-05 Date. . ... ... . MONTH O TOWN OF NQRTH ANd VER S 1 / • PERMIT FOR GAS jwSTALLATION y,SSACHUSEtt This certifies that has permission for gas installation in the buildings of . . . . . . . . . . . . . . . . . . . . . . . at ./.`�. /,./:r:f:(.Orr �!:7. . . . . . . . . . . .. North Andover, Mass. Fee. Lic. No./. . . . . . . ISINSPECT4' Check# L/ i 6517 MASSACHUSETTS UNN ORM APPUCATON FOR PERMiT'TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,/MASSACHUSETTS 7 Building Locations / `'f lam _ _ _ ln,co`U�`/�S� �— ^) Permit# .' � 3� Owner's Name - � �V`" �l Amount$ New Renovation D Replacement Plans Submitted � a , U a �; Z. a w m F x vaj z - ' c x F F �• � � Z , Z u W x v, p a w w v' e x x a w a� w F A F dzd W > W n" F F" Y V� M Z Q Z L�- S UB-BASEMENT OVrr C a F BASEM ENT 1ST. FLOOR i 2ND . FLOGR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR E 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) Check one: Certificate Installing Company Name d- 9jjLzh,, 0 Corp. Address �r p Cyt12 0 0j Partner. usmess a ep one Firm/Co. Name of Licensed Plumbeior Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance,policy or it's substantial equivalent. If you have checked es Yes please in ' ate the type coverage by checking the appropriate box. No� Liability insurance policy Other type of indemnity 13 Bond 1 Owner's Insurance Waiver: I Arn aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner13Agent D t hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts S G Co and C er 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title JPlumber3 City/Town; D License Gas Fitter J l 7 e um er Enaster _ APPROVED(OFFICE USE ONLY) Journeyman i Date. f NORTH . 4,, TOWN OF NORTH;AV-O--�VER PERMIT FO`R P� BING �• .....rat... �'+ ,SSACHUS� This certifies that . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . ,k.r. .. . . . . . . . . . . . . . . . . plumbing in the buildings of . C..` �?!. ./ �� . . . . . . . . . . . . . . . . . at . . . . . . . . . . . ., North Andover, Mass. Fee. Lic. No.. . . q- . . . . . . . . . . PLUMBING Check # 7825 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS � �r / �d�S Date Z Q Building Location �T f ld/;1�'/�1(�,{'G�-�- 51—owners Name ��� Pernut# y T e of Occu anc Amount T4 � New RenovationReplacement Plans Submitted Yes No El FIXTURES Cr O rA � xccc7 01.2 A w )40VEW f M L`fM I 3M rl.),J1.al 41HRfM SM CR 6i F O�FLl�.CIR 7M Rft gm Hfm (Print or type) Check one: Certificate Installing Company Name J (( ❑ Corp. Address - J n"(— ❑ Partner. usmess a ephone T Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the-typ of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond Insurance Waiver. I, the undersigned,have been made aware that the licensee three insurance of this application does not have any one of the above Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse t Pl bing Co�hapter 142 of the General Laws. By: �gnaL&re o kens u er Title Type of Plumbing License 31-74 City/Town i Anse um er Master APPROVED(OFFICE USE ONLY journeyman ❑ i Sub-contractor replacement Letter To whom it may concern, I Jeremy Robitaille of T.C.M Building LLC here by remove all remaining work to be completed at 14 Glencrest road, North Andover, Massachaussetts from Royal Flush and am giving the remainder of the plumbing and gas work to Mike Harris plumbing and heating. Work to be completed consists of water meter hook up, sewer line hook up, all plumbing fixtures in bathroom and kitchen and water heater. Also need to complete propane connection to gas fireplace and gas cooktop. Jeremy Robitaille /VI/ 6 _Ien LY V Mike Harris / , � /3/7 ' I I COMMONWEALTH OF MASSACHUSETTS e • , R LICENSED AS A MASTER PLUMB R' SI. ISSUES THIS LICENSE T6 o s� MICHAEL P HARRIS SR 671 SECOND CROWN PT RD n . STRAFFORD NH 03884-62 13174 05/01/10 464911 " `) J i 1 i 1 ` V Date. TM Of aNOR11' 3�r` TOWN OF NORTH ANDOVER O 9 • PERMIT FOR GAS INSTALLATION �,SSACHUSEt 9 This certifies that . .`. . . . . . . has permission forgas installation �,. in the buildings.of � . . . . . . . . . . . . . . . . . . . . . . . . . at � �:=� �`���. . . . .. North Andover, Mass. Lic. No.. .�. _ . >,: �... . . . . . . . . . . GAS IN.� GATOR Check# 6557 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER 1' 9/16 2008 Permit# S,/ ' ,Mass. Date '' r, Building Location 14 GLENCREST DR Owner's Name FRANK CORDIMA Owner Tel# 978 794 9363-978 944 0751 Type of Occupancy RESIDENTIAL New W1 RenovationF] Replacement Plan Submitted: Yet NOD FIXTURES rA 30.50 U w a p brssi Lu w a o A H x x z J W�W H H >. z z o H °� Q m H W p A O z H W w ¢ x H o a x > Q z U) W rn w z Q x 94 a W w w H x x .a z QHQ uj J_ H F > v� OW z O z O w z W Q W > A ¢ P; ¢ Q OO W O W H x O 1 CD I x w ✓ 3 GQ C7 a U cx > A a H O w SUB-BSMT BASEMENT 1ST FLOOR 1 2"D FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Eastern Propane & Oil, Inc Check one: Certificate Address 131 Water Street Corporation Danvers, MA 01923 Partnership Business Telephone# 800-322-6628 Firm/Co. Name of Licensed Plumber or Gas Fitter John Lij2inski • INSURANCE COVERAGE: I have a cures liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. ye sl ✓ I No ❑ If you have c ecked rimes,please indicate the type coverage by checking the appropriate box. A liability insurance policy ✓R Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above application ar e a curate to the best of my knowledge and that all plumbing work and installations performed under the permit issued f tis applic i n compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General a By Type of License: lumber Signature o Li nsed P ber or Gas Fitter Title tAGas fitter729 • -Master License Number City/Town •-Journeyman APPROVED(OFFICE USE ONLY) Location //-/ No. y.� Date C0 r �ORTM TOWN OF NORTH ANDOVER 3: OL � . a Ito ` Certificate of Occupancy $'' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # C1 / Building Inspector CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER TEMPORARY PERMIT Permit# 437( 12/19/07) Date: August 27, 2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON_ 14 GLENCREST DRIVE MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: FRANK CARDIMA 14 GLENCREST ROAD NORTH ANDOVER MA 01845 a D Building Inspector Cie^ Ge-Jr Ar. a K$V 1 t4A— rA; �s f r !`G,(��►s,f o� bra 6 / No TN Hu APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Building Permit# q3 ADDRESS/LOCATION OF PROPERTY : Map Parcel Lot Number SUBDIVISION N w DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS$20.00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. Permit Issued to: w Address SIGNED RO TIN CONSERVATION PLANNING D DPW-WATER METER SEWER/WATER CONNECTION NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF�THE OCCUPANCY/INSPECTION REQUEST DPW 49-6 6)a� Signature Fife: Application for OC form revised Jan 2007 NO TN !. 1 � CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER # 3 9 Permit 4 7 f 12/1 /0 7) Date: October 17,,_.2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON 14 GLENCREST DRIVE MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: FRANK CARDIMA 1.4 GLENCREST ROAD NORTH ANDOVER MA 01845 1 Building Inspector MO TM Ah w 1 • seNu CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit# 437 ( 12/19/07) Date: October 17, 2008 THIS CERTIFIES THAT THE BUILDING LOCATED ON 14 GLENCREST DRIVE MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: FRANK CARDIMA 14 GLENCREST ROAD NORTH ANDOVER MA 01845 1 Building Inspector Town o Andover No. _ / - }y.C�1ldover, Mass., �9.. �a COCriIC YE LV IC IK \ �'.� ;fif I Y' BOARD OF HEALTH DPERMIT T.. Food/Kitchen Septic System THIS CERTIFIES THAT................. BUILDING INSPECTOR ... ........................................................ -J........................................................ Foundation has permission to erect........................................ buildings on ./ Rough �--' to be occupied as........... ... ........' ..............C��1�� .... . ........... . .. 'v.......................................... .... Chimney �•o provided that the person accepting thi ermit shall in res ct conform to the terms of the application on file in Fin this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of /A, Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 7 c` /1 �y LoM- 6 O1-1-,`i ELECTRIC C OR Lq ............................................................. .. ........... .. .... . .r BUILDING INSPE R "" inal equ ?"£'d to _ r? ?<` SAS INSPECTOR Display '$ —.._._._..__.__.. Rough pI ay in a Conspicuous Place on the Premises Do Not Remove Final No Lathing or Dry wall To Be Done FIRE DEPARTMENT. Until Inspected and Approved by the Building Inspector. Burner r Street No. LLSEE REVERSE SIDE Smoke Det. ovm 0 6Andover 0 t;%% No. 17Z 4k , k_ 11or �'" over, Mass., x' e LAK. dq � COC rIIC FIE Y',�IC Kn n C`\� 'qsE L) BOARD OF HEALTH T LD PERMIT . Food/Kitchen Septic System BUILDING.INSPECTOR THISCERTIFIES THAT.................... ................................................................. .................................................................... Foundation has permission to erect........................................ buildings on. .. .... ..... ........... ........................................... Rough to be occupied as........... � Chimney � ....... . .... ................. ........��re�s� .............. ..................................................................... provided that the person accepting thi ermit shall in eveconform to the terms of the application on file in Fin this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of o. Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit, �W�91 '7 ELECTRIC ] C OR _ g rA olk S .. ......... BUILDING INSPE 3 >ij Required to O cGAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina, No Lathing or Dry Wall To Be Done FIRE DEPARTMENT II Until Inspected and Approved by the Building Inspector. Burner Street No. �:= Smoke Det. SEE REVERSE SID 1. Efficient Communication. a. Signs should not display 1 nationally distributed pro( the floor or lot on the prei other processing of that sl b. Premises chiefly identifie auto brand) should devot( also displaying the identit c. Signs should not contain not an integral part of the enterprise. d. Sign content normally she (40%) of the sign backgre element. e. Signs should be simple, n contents can be quickly a: 2. Environmental Relationship { NORTH CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER I Permit# -437 ( 12/19/07) _ Date: October 17, 2008 i THIS CERTIFIES THAT THE BUILDING LOCATED ON 14 GLENCUST DRIVE MAY BE OCCUPIED AS ' SINGLE FAMILY DWELLING ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: FRANK CARDIM 14 GLENCREST ROAD NORTH ANDOVER MA 01845 Building Inspector ToVM Of And 0ver in No. 171 -v s 7 4 i R North Andover, Mass., x w BOARD OF HEALTH PERMIT To BUILD Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................... (2 .............................................................:... ......;............................................................. Foundation . has permission to erect........................................ buildings on ,*.: :... ............... Rough ' `---- to be occupied as........... .... .... .. .....it.........✓ ............ Chimney �7;�o o ' provided that the person accepting thi ermshall in every resl9r.1 conform to the terms of the application on file in Fin 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. ELECTRIC C OR ��7 R ugh`';, 1"�;,, 3_.'�' .�'"► � ,�`''+�% ................... :........... ` .....".::...:....................... . . .. ... BUILDING INSPEC R "{ final t� 9-2- GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. t SEE REVERSE SIDE Smoke Det. > Live Search i- w G ,Sle [C rho �� Es akmarks. ] Flcicked I lia . ,,out Lick T t�uk `ill Sendtow , i lav%,rencedeeds Settings- BRO'A'Ntech document Management Systems � W [�7 � Pa ��Tools itj ec .4ar�/� Irl Oran on M .'_:t auarrarr ra1� - e ■urarrnar ■Orr^.. e�, _ . [i,� ;[� pion. .Select the nest actiooi you want to perlorni. "; x derive my titis to the preriarer diked of Paul, G. daft d rud When dobe viewing, click o�� Gyral!', fOrwrlY known as"9691lyn deftnde, dated ftbruary 8, 1l7i r the <Previous button below. y '. and rocozded at said Registry of Doodo, seek tSbd, pave 9id# a rg icn Vievic(Prioit(Add to Cart3 }? alleo by 40" of Paul 4- 4420040 and �T&Awa F. dogmdo dated Pg B 191 VievilPrintlAdd to Cart _ RepEeiher 3, 1987 rigid recorded apt Said Registry of Doode 2608, F Pam RSB, 9" a1wo ftRoade +a. deRotlde, dirosce, secran,a s i:0'"ty BuPsri, CauFt tar the Stats c! !fw p�opattlrs, b 1 9�7d mmammsma anOa `: - i , runrrrwmr assn. nrrrrnn mnwk x41R, A lrtat ?an7 fi. dr110ttde, alsae�c CountyFoliate Cert !t!f• wsrorl 9 0 100661 mea rasuaaa runsu rmwa O k = �r Whoss■ d i"l tut! 3 f.�gtt8. fay ot-�i�Fab, 3Slt•' ■rarrrrar m� +m . • Orr■ aw ■ r rnrr all Oranrrnrmannm■aaa ; 'Y 1taFii (' arav444raa ■rrraaam■r 0K sun raarr ■ aria z yt6 �". 1301 [14�d rruura lar ,y ■11114■ nma f l mmmmmrmerwwm '� , �. armrrrm Pamaalr �, wMk 4w 1 L1MIt!'!`l as aaw 1111 r� _ _ rrgaseous aar n ror rrarr 4arr ` m°r�mm m�me mma w� �i �O not Mama a 1994 ! r ■nr an rr us ■irarmrrrrs ar�sr ur a124M, arraumra Uan abtCYvliR9tldri 1# . 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OwDidaration of two hundred twl" thous"d live hundred aed ;t P 0011001 ($212,500.06) dollars gsaxit to lxaoais �� t5ordiw and r :� Pg 190 Vie�+wiPrintfAdd to Cart 14 ,t *� a d I Pg 291 ViewlPrintlAdd to Cart A «rdifsa, htubrnd and rilEa#arjwcjz , 4eth l IRaraaahuaatt*P as tenants 'by the antlrsty, wm 'Q1G220AIN IeONSili"S' the Ian d With the buildings thereon situated ■rru\urrrru ■\ o.Riu■r.■r•r .shwa, in H4Rth t11d0Vs'i, aeesx Cgiilty, 'hpssaschusatts and being . I ooroiru\ \rr a�� - � sin !sI I: on■urr■.a rr saran iR■■■\r\■■rl;■aS�i■\m..,,. LOC 016 on plse of Land entitled •Oslieitiwa plan '41a�►neiraat I ■Rr\rras\riao r ■yo-•. .arfr\r■■ao■gulsi`■r- uuuuifur ■ Rive, Hor'tb Andover, "940.,,a 4wried by Sidney C�. and Adaih Z. 8la, :� • e. iuurur.tuur ■a�� dapr. w R. IRa a 9 iri\f\\■■r\■far• IRE', q Y •, En ine4r, dated January �, 1951, raapsdad with � F ufaruurs r■r a- 882ex '.north Dl■trLot X"istry of Deeds, plan #424'1 and inner + r\\a\orrul;�■�.=��s fit. . ■ouoaraa r �. crocus errs rQi�a..: .� unaaa\�r=oa vouuoae o -. . umuuursa • � r- bOtidd94 and described as goiio+aei ' HOUR ■•ur r ■r■f ■ - F ru\un uorW ■■roorruur s�iiii.•iiiea ■W- � NOA'P'HUCEd'.CEA]t+! 4Y IG19ntMCe+eat 'Dz'iMeyt by two curved 11:nas one - oavourr a •r=■��' vouowa ■ � \■ a�. ■ruu.ura R=r clear. hund1r0d eiShty-sir. and 33/100 (186,.33) test IA' t ■usssR�r��■��ra�r�� .` +� urur\ r ■ • ■ � ?J � - uasru�u ouur ■ � and !iltl►-=iOU! and SQ/11O0 1154.96) feet2t ■uuo fir a\■ uu.rrlerR�torrl� ... "� �• .. ■u.aussr NRr ■ a m\\\\rr■1:• ■ la�u.: � � roa atival .00rur� � • ° 1='1'liBALY by 'Winter street west sixty and $21100 + rruoor ■ ■r uusour • ■ oouur ■ r . \i■sun �ira.a�ir\\ r�• .. (¢0•6$1 iss#i ■rirurwwarrrR r i.auvu.r ■ m� a ' RLY Lot 017 an said plan threw.hundred tots- - - - r\\rfaa\Nr■f■•■ - R - ■rra.a■arrrrr�rria��eaaT � - - uric■■■ru\rrviur�. - - vuruu \rr�r�s■• - four and 81/300 1324,84) foot, 4 , ioi.■i�ljii�i'■is iiG�ewi� rriuruurr rs r.. rrrn\ao\• rr r ®t>u'i ntr ru••u•r a��i�ll by :wait Of Lot #IS an said plan awe huidirod er•ur\\ra\ a: u■u■o■ �■i i ;R ; inety-oi ght and '33/.100 (198.331 lest j =sair�■�iZ�S ��ii. vo■urCar\■ r r■r�:. ( -�1h}•�l ntePnefi I + 2o6% v- 1 .start Inbox-Microsoft... TO -Merrimac Co... Derision draft,200... 1 db:i:-Database i Projects:Table BRaViNked,Docu... « � +'7Vff #:i PM ; c) Annual certification demonstrating continuing compliance with the standards of the Federal Communications Commission, Federal Aviation Administration and the American National Standards Institute shall be filed with the SPGA by the Special Permit holder. 12)Term of Special Permit. a) A Special Permit issued for any wireless service facility shall be valid for three (3) years. The special permit may be renewed under the same criteria as the original special permit, provided that the application for renewal of the special permit is made prior to the expiration date of the original or any renewed special permit. Additional measures governing the administration of the special permit are found in Section 10.3 of this Zoning Bylaw (1998/36). 13)Exempt Facilities: Municipal Emergency Wireless Service Facility a) Wireless service facilities necessary to provide and ensure adequate town-wide coverage for public safety communications to include Police, Fire, Ambulance, Emergency Medical Services, and Emergency Management shall be exempt from the provisions of this bylaw. Commercial or private wireless service facilities, unless they are under contract with the Town of North Andover to provide public safety communication, shall not co-locate on or utilize a municipal emergency wireless service facility and shall not be exempt under this section. Further, if said municipal emergency wireless service facility is to be located on private property, the Town must obtain the permission of the landowner. (12-5-2005 Article 6) Section 8.10 Lot/Slope Requirements 1. Lot/Slope Requirements: In the residential zoning districts the following provisions of this Section 8.10 shall apply: a. Purpose: The purpose of this bylaw is to preserve and enhance the landscape by encouraging the maximum retention of na-Lurai topographic features, such as drainage swales, streams, slopes, ridge lines, rock outcroppings, vistas, natural plant formations and trees; to minimize water runoff and soil-erosion problems incurred in grading of steep slopes; to encourage innovative architectural, landscaping, circulation and site design. For the purposes of this subsection, the term "natural" shall be defined as the condition of the ground surface as it exists at the time a subdivision or development is proposed including any man-made alterations such as grading, excavation or filling which may have occurred prior to the time such subdivision or development is submitted. No land intended for subdivision or development may be regraded or filled in such manner as to circumvent this bylaw b. Provisions: The provisions of this Subsection 8.10 shall not apply to building lots in a definitive subdivision plan submitted in accordance with M.G.L. Chapter 41 in order to obtain the protections afforded by M.G.L. Chapter 40A, Section 6. c. Defining the Slope: The slope of land at any point, stated as a percentage, shall be defined as the change in elevation over a horizontal distance measured perpendicular to the contours divided by the distance over which the change occurs multiplied by 100. The slope of land at any point, may be stated as a ratio (2:1, 3:1, 4:1, etc.). The first number of the ration indicates the horizontal distance and the second number indicates the vertical rise. d. Undisturbed Slopes: All natural slopes exceeding 33% (3:1) over a horizontal distance of 30 feet as measured perpendicular to the contour on a tract or parcel of land intended or proposed for subdivision or on a building lot are protected and shall remain undisturbed. e. Slope Exclusion n for Minimum Lot Area Calculation: All areas with natural slopes exceeding 33% (3:1) over a horizontal distance of 30 feet as measured perpendicular to the contour on a tract or parcel of land intended or proposed for subdivision or development, or ori a lot intended for building purposes, shall be excluded from the calculation of the minimum lot area required for the applicable pp e zoning district. 112 f. The Planning Board may grant a special permit for exemption from the provisions of this section if, in the Board's opinion, the proposal satisfies the purposes of Subsection 8.10.La (F"" above. In cases where the proposal includes disturbing or creating slopes exceeding 33%, the request for special permit must be accompanied by: i) A geotechnical report prepared by a registered professional civil engineer in the Commonwealth of Massachusetts that recommends methods for slope stabilization. ii) A commitment from the applicant to fund construction inspection services of a geotechnical engineer. 113 1998/37 2.65 Special Permit Granting Authority 1998/42 8.3 Site Plan Review 1999/18 4.133.6 Industrial 2 District 1999/20 2.27 Building Height 2000/17 4.136(8) Est.Watershed Waiver 2000/30 7.1.2 Amend Lot Width '2000/21 8.9(3) Amend setbacks 2001/27 8.8(2) Amend location 2001/29 8.7 Extend expiration 2001/301 8.10 Lot/Slope Requirements 2002/12 10.4 Variance and Appeals 2002/13 6.6 Temporary Signs 2002/31 8.7 Growth Management 2002/32 9.3 Non-conforming uses 2004/38 4.2 Amend Phased Development 2004/39 8.7 Delete Growth Management 2004/40 4.122.14 Amend R4 District 2004/41 9.3 Amend Non-Conforming Uses 2004/42 4.3 Add Residential Adaptive Re-Use SP 2004/43 4.137 Amend Flood Plain District 2004/45 ,15 Add Planned Com.Development District 2004/46 3.1 & Add PCD district&Amend Tables 1 &2 2005/43 4.2 Amend Section 1 Intent&Purpose& Section 9 Expiration 2005/44 8.8.7 Application information, ad Section e 2005/46 6.6B2&6.6.G1 Sign bylaw 2005/47 4.133 Recreational uses 2005/48 8.5.6.G PRD/Calculation of Allowable Residential 2006/4 2.30 Def. of a Drive-through facility F 2006/5 16 Creation of new zoning district CDD1 2006/6 16 Creation of new zoning district CDD2 2006/38 4.122(14)(B)(b) Demolition of residential homes and construction of new multi-family residences in R-4 2006/41 4.136 Modify uses within Non-Disturbance Zone 9 780 CMR 54.00 FOUNDATIONS 780 CMR 5401 GENERAL characteristics at a particular location. This test shall 5401.1 Application. The provisions of 780 CMR be made by an approved agency using an approved • 54.00 shall control the design and construction of the method. foundation and foundation spaces for all one-and 5401.4.1 Geotechnical Evaluation. In lieu of a two family detached dwellings and accessory complete geotechnical evaluation, the buildings. Wood foundations shall be designed and load-bearing values in 780 CMR Table 5401.4.1 installed in accordance with AF&PA Report No.7. shall be assumed for the design of foundations. Exceptions: TABLE 5401A I PRGSUNII'TIVE 1. The provisions of 780 CMR 54.00 shall be LOAD-BEARING VALUES OF permitted to be used for wood foundations only FOUNDATION MATERiAi S' in the following situations: LOAD-BEARING PRESSURE 1.1. In buildings that have no more than two (pounds per square floors and a roof. CLASS OF MATERIAL foot 1.2. When interior basement and foundation Crystalline bedrock 12,000 walls are provided at intervals not exceeding Sedimentary and foliated rock 4,000 50 feet. Sandy gravel and/or gravel 3,000 2. In addition to the provisions of 780 CMR (GW and GP) 54.00, the design and construction of Sand,silty sand,clayey sand,silty foundations in areas prone to flooding as gravel and clayey gravel 2,000 established by the community's Flood (SW,SP,SM,SC,GM and GC) Insurance Rate Map(FIRM)publishedby the Clay,sandy clay,silty clay,clayey Federal Emergency Management Agency silt,silt and sandy silt 1,5006 CL,ML,MH and C shall meet the provisions of 780 CMR 5323. For SI: 1 pound per square foot=0.0479 kN/mZ. r 5401.2 Requirements. Foundation construction a. When soil tests are required by 780 CMR 5401.4,the shall be capable of accommodating all loads allowable bearing capacities of the soil shall be part of according to 780 CMR R301 and of transmitting the the recommendations. resulting loads to the supporting soil. Fill soils that b. Where the building official determines that in—place soils with an allowable bearing capacity of less than support footings and foundations shall be designed, 1,500 psf are likely to be present at the site, the installed and tested in accordance with accepted allowable bearing capacity shall be determined by a engineering practice and 780 CMR 5401.6. Gravel soils investigation. fill used as footings for wood and precast concrete c. Also refer to 780 CMR Appendix 120.R for foundations shall comply with 780 CMR 5403. additional guidance. 5401.3 Drainage. Surface drainage shall be diverted 5401.5 Compressible or Shifting Soil. When top to a storm sewer conveyance or other approved point or subsoils are compressible or shifting, such soils of collection so as to not create a hazard. Lots shall shall be removed to a depth and width sufficient to be graded so as to drain surface water away from assure stable moisture content in each active zone foundation walls. The grade away from foundation and shall not be used as fill or stabilized within each walls shall fall a minimum of six inches(152 mm) active zone by chemical, dewatering, or pre- within the first ten feet(3048 mm). Temporary and saturation. finished grading shall be such that surface water runoff, either during or after completion of 5401.6 Engineered Fill Used to Support construction, shall not be directed to, nor create Foundations. Where footings or foundations are flooding or damage to adjacent property. supported on compacted fill material the compacted fill shall comply with the specifications Exception:Where lot lines,walls,slopes or other prepared by a registered professional engineer. physical barriers prohibit six inches(152 mm)of The specifications shall be detailed in a report fall within ten feet(3048 mm), drains or swales which shall be submitted to and approved by the shall be provided to ensure drainage away from building official prior to commencement of work. the structure. The report, as a minimum, shall contain the 5401.4 Soil Tests. In areas likely to have expansive, .following: compressible, shifting or other unknown soil 1. Specifications for the preparation of the site characteristics,the building official shall determine prior to the placement of the compacted fill whether to require a soil test to determine the soil's material. 3/23/07 (Effective 4/1/07) 780 CMR-Seventh Edition 571 Residential Property Record Card PARCEL_ID:210/104.A-0040-0000.0 MAP:104.A BLOCK:0040 LOT:0000.0 PARCEL ADDRESS:14 GLENNCREST DRIVE FY:2008 PARCEL INFORMATION Use-Code: 101 Sale Price: 212,500 Book: 03999 Road Type: T Inspect Date: 05/23/2004 Tax Class: T Sale Date: 03/09/94 Page: 0190 Rd Condition: P Meas Date: 05/23/2004 Owner: Tot Fin Area 1456 Sale Type: P Cert/Doc'. Traffic: M Entrance: X CORDIMA, FRANCIS J Tot Land Area: 1.12 Sale Valid: Y Water: Collect Id: RRC EILEEN M CORDIMA Address: Grantor: BELANGER, MARILYN Sewer: Inspect Reas: M 14 GLENNCREST DRIVE Exempt-B/L% / Resid-B/L% 100/100 Comm-13/12/0 Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION 1 Style: RR Tot Rooms: 6 Main Fn Area: 1456 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R1 Story Height: 1.00 Bedrooms: 3 Up Fn Area: Bsmt Area: 1404 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 392 1 P 101 S 43560 1.000 208,652 Ext Wall: WS Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0 0.120 912 Masonry Trim: Ext Bath Fix: 0 Tot Fin Area: 1456 DETACHED STRUCTURE INFORMATION Foundation: CN Bath Qual: T RCNLD: 185882 Str Unit Msr-1 Msr-2 E-YR-BIt Grade Cond%Good P/FIE/R Cost Class Kitch Qual: T Eff Yr Built: 1965 Mkt Adj: Heat Type: HW Ext Kitnh• guilt: 1962 Sound Value: PT S 234 0.00 1988 A A ///89 1,300 AG Cost Bldg: 185,900 SE S 288 0.00 1999 A A ///96 3,900 1 0 z rn E F11 Z 0= 'V :ion: A Att Str Val 1: PA S 452 0.00 2000 A A /50//48 3,500 1 implete: Att Str Val2: VALUATION INFORMATION = m n to cn m -n Mo p d PIF/E/R: 1100/100/77 Current Total: 404,200 Bldg: 194,600 Land: 209,600 MktLnd: 209,600 z Prior Total: 428,700 Bldg: 196,900 Land: 231,800 MktLnd: 231,800 M Porch Grade Factor D >> PHOTO 0M D r� { 9 f 9 j m 26 12 132 SqF12 T� < wa` ❑ M = D O � m D� m 14 GLENNCREST DRIVE { ❑ Z N ❑ U1 Page 1 of 1 c) Annual certification demonstrating continuing compliance with the standards of the Federal Communications Commission, Federal Aviation Administration and the American National Standards Institute shall be filed with the SPGA by the Special Permit holder. - 12)Term of Special Permit. S J r�/O� �a) A Special Permit issued for any wireless service facility shall be valid for three (3) years. The special permit may be renewed under the same criteria as the original special permit, provided that the application for renewal of the special permit is made prior to the expiration date of the original or any renewed special permit. Additipnal measures governing the administration of the special permit are found in Section 10.3 of this Zoning Bylaw (1998/36). 13)Exempt Facilities: Municipal Emergency Wireless Service Facility a) Wireless service facilities necessary to provide and ensure adequate town-wide coverage for public safety communications to include Police, Fire, Ambulance, Emergency Medical Services, and Emergency Management shall be exempt from the provisions of this bylaw. Commercial or private wireless service facilities, unless they are under contract with the Town of North Andover to provide public safety communication, shall not co-locate on or utilize a municipal emergency wireless service facility and shall not be exempt under this section. Further, if said municipal emergency wireless service facility is to be located on private property, the Town must obtain the permission of the landowner. (12-5-2005 Article 6) Section 8.10 Lot/Slope Requirements 1. Lot/Slope Requirements: In the residential zoning districts the following provisions of this Section 8.10 shall apply: a. Purpose: The purpose of this bylaw is to preserve and enhance the landscape by encouraging the maximum retention of natural topographic features, such as drainage swales, streams, r slopes, ridge lines, rock outcroppings, vistas, natural plant formations and trees; to minimize water runoff and soil-erosion problems incurred in grading of steep slopes; to encourage innovative architectural, landscaping, circulation and site design. For the purposes of this subsection, the term "natural" shall be defined as the condition of the ground surface as it exists at the time a subdivision or development is proposed including any man-made alterations such as grading, excavation or filling which may have occurred prior to the time such subdivision or development is submitted. No land intended for subdivision or development may be regraded or filled in such manner as to circumvent this bylaw b. Provisions: The provisions of this Subsection 8.10 shall not apply to building lots in a definitive subdivision plan submitted in accordance with M.G.L. Chapter 41 in order to obtain the protections afforded by M.G.L. Chapter 40A, Section 6. c. Defining the Slope: The slope of land at any point, stated as a percentage, shall be defined as the change in elevation over a horizontal distance measured perpendicular to the contours divided by the distance over which the change occurs multiplied by 100. The slope of land at any point, may be stated as a ratio (2:1, 3:1, 4:1, etc.). The first number of the ration indicates the horizontal distance and the second number indicates the vertical rise. d. Undisturbed Slopes:.All natural slopes exceeding 33% (3:1) over a horizontal distance of 30 feet as measured perpendicular to the contour on a tract or parcel of land intended or proposed for subdivision or on a building lot are protected and shall remain undisturbed. e. Slope Exclusion for Minimum Lot Area Calculation: All areas with natural slopes exceeding 33% (3:1) over a horizontal distance of 30 feet as measured perpendicular to the contour on a tract or parcel of land intended or proposed for subdivision or development, or or a lot intended for building purposes, shall be excluded from the calculation of the minimum lot area required for the applicable zoning district. 112 NORTH i c Town 0 6 over No. 17137 dover, Mass., COCMICKEWICK �ADRATED qS BOARD OF HEALTH PERMIT T D Food/.Kitchen Septic System �• BUILDING INSPECTOR THIS CERTIFIES THAT............ ' ......................................................................... / / Foundation has permission to erect........................................ buildings on .1.. ..........�T,CWCA.-00.7 ..... ............. Rough to be occupied as........ n.. ..�'t.... I..�..'.�...P11 �/..... ..... ...... ....................... ..... ............ .... .. Chimney rovided that the arson ain this ermit shall ihaes act conforrlf'fo thetermsofthea lication on file inP P Pt 9 P P PP 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR O T TS Rough ....... .... ....... ................ ...................... .. .................. Service BUILD SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. �.' TCM BuildiNq, LLC Should any dispute arise relative to the performance of this contract that the parties cannot resolve, the dispute shall be referred to a single arbitrator acceptable to the builder and the buyer. If the builder and the buyer cannot agree upon an arbitrator, the dispute shall be referred to the American Arbitration Association for resolution. All attorney fees that shall be incurred in the resolution of disputes shall be the responsibility of the party not prevailing in the dispute. XVI.The Governing Law and Assignment This contract will be construed, interpreted, and applied according to the law of the state where the property is located. This contract shall not be assigned without the written consent of all parties. XVII. Effective Date and Signature This contract shall become effective on the date it is signed by both parties. TCM BUILDING.LLC 10 PICADILLY CT,MANCHESTER,NH 03104 TEL/FAX:603-624-8844 WWW.I'CMBUII-DING.COM TCM BuildiNq, LLC If the buyer enters the property during the course of construction without the permission of the builder, he does so at his own risk, and the buyer hereby releases the builder and does hereby hold the builder harmless from any and all claims for injury or damage to his person or property, and to the person or property of any person accompanying the buyer. XIII. Inspection,Acceptance, Final Payment and Possession At the final inspection, the buyer will give the builder a signed and dated list that identifies any alleged deficiencies in the quality of the work or materials. The builder shall correct any items on the buyer's list that are, in the good faith judgment of the builder, deficient in the quality of the work and/or materials according to the standards of construction in the area in which the house is built. The builder shall correct those defects within a reasonable period of time. After the defects have been corrected according to the standards of construction in the area in which the house is built, the buyer shall sign a certificate of acceptance acknowledging that the defects on the buyer's list have been corrected according to the standards of this contract. The builder shall provide the buyer with an affidavit stating that all materials and services for which a lien could be filed have been paid, or an affidavit identifying what services and materials for which a lien could be filed have not been paid, and swearing that such amounts will be paid from the proceeds of the final payment. Occupancy will be granted to the buyer when the buyer makes a final inspection of the home, signs a certificate of acceptance, and makes the final payment. XIV.Warranties All warranties are limited to the implied warranties of habitability and workmanlike construction and are limited to a period of one year from the date of the issuance of a certificate of occupancy by the local building code enforcement authority. This limited warranty is the only express warranty provided by the builder. XV. Disputes TCM BUILDING,LLC 10 PICADILLY CT,MANCHESTER,NH 03104 TEUFAX:603-624-8844 W W W.TCMBLJILDING.COM r• TCM BuildiNci, LLC of any additional cost, and the additional number of days to be added to the contract completion date. Any of the buyers may sign the change order and that signature will be binding upon all of the buyers. The buyers hereby agree to make all requests for change orders to the builder, and not to issue instructions to, or otherwise negotiate for additional or changed work specifications with, the builder's employees or subcontractors. All change orders are issued at cost+ 16% profit and 5%administrative fee. Payment is due upon signing of change order. XI. Insurance and Risk Management The builder shall obtain all workers'compensation, commercial general liability insurance and comprehensive liability insurance necessary to protect builder from claims for damages due to bodily injury, including death, and for damages to property that may arise out of and during operations under this contract. The buyer shall purchase his own builders risk insurance including fire and casualty insurance to the full insurable value of the house and shall name the builder as an additional insured. Each party shall issue a certificate of insurance to the other prior to the commencement of construction. XII.Access to the Property Site The buyer shall have access to the property and the right to inspect the work in the presence of the builder. TCM BUILDING,LLC 10 PICADILLY CT,MANCHESTER.NH 03104 TEL/FAX:603-624-8844 WWW.TCMBUILDING.COM �' TCM BuildiNq, LLC If the buyer fails to pay the builder within seven days of the date the payment Is due, through no fault of the builder, the builder may stop work and may keep the job idle until such time as payments that are due to the builder are paid. If the builder chooses not to stop work after a payment delay, this is not to be construed as a waiver of his rights to stop work if future payments are delayed. All attorney fees incurred by the builder to collect sums owed by the buyer shall be paid by the buyer, together with interest at the rate of 12%anum. IX. Permits and Surveys The buyer shall obtain and furnish all necessary surveys describing the physical characteristics of the property, the location of all utilities, and the location of all easements to the building that are necessary to allow the builder to complete his performance. If additional easements are necessary to complete the work, the buyer shall obtain those easements promptly. If no soil report is available, the buyer shall provide one at his own expense. The builder shall obtain building permits, licenses, building inspections and approvals required by local law. The costs of these permits are the responsibility of the owner. If a covenant or architectural review committee requires the approval of plans and specifications, the buyer shall be responsible for obtaining these approvals and paying for any fees connected with them. X.Change Orders The buyer may order changes in the work within the terms of this contract, but only by a prior written order and agreement with the builder that states the changes to the contract, the amount TCM BUILDING,LLC 10 PICADILLY CT,MANCHESTER,NH 03104 TEL/FAX:603-624-8844 WWW.TCMBUILDING.COM TCM BuildiNq, LLC The buyer agrees to pay a total price of$275,685.00 dollars. for construction of the house, and the builder agrees to provide all the labor, materials, equipment, tools, and other services necessary to construct the house. Upon the signing of this contract, the buyer agrees to pay 5%of the contract to the builder as a deposit. This will be credited against the first draw request. The buyer will make the following interim payments: 1. 5% Deposit 2. 30% Upon Completion of a Weather Tight Building: Frame, Roof,Windows,and Doors 3. 15% Upon Completion Siding, Rough Mechanicals,Garage Doors 4. 20% Upon Completion of Insulation,Drywall,and Flooring 5. 20% Upon Completion of Kitchen,Trim,and Paint 6. 10%Upon Completion of Finishes and Obtaining a Certificate of Occupancy The buyer agrees to make a final payment within 5 days of the buyer's final inspection and acceptance of the property. The buyer is not entitled to possession until after final payment. VII.Allowance Items Upon signing this contract, the buyer shall be given the selection guide that is incorporated by reference into paragraph II. Contract Documents to help the buyer select allowance items, materials, and colors that will be required during the construction process. Exterior selections must be made within 15 days of signing this contract. Interior selections must be made upon completion of roughs. Vlll. Late Payments Payments not made in a timely fashion shall incur daily interest at the rate of 3%from the day the payment is due. TCM BUILDING.LLC 10 PICADILLY CT,MANCHESTER,NH 03104 "CEL/FAX:603-624-8844 WWW.TCMBUILDING.COM F TCM Bui [diNq, LLC IV.Completion Time Assuming all conditions are satisfied and weather permits, the work to be performed under the contract shall be substantially completed no later than 160 days after the work commences.The work shall commence after site work has been performed. The buyer shall have supplied the builder with a correct statement of the recorded legal title of the property and the buyer's interest in the property. Any time lost by reason of changes to the contract or changes in plans by the buyer, other acts of the buyer, strikes,weather conditions not reasonably anticipated, or any other condition not within the builder's control shall be added to the specified time for completion. For any delays which are not the builder's responsibility, the contract price shall increase by any increase in the builder's costs caused by the delay. A claim for an increase in time for the performance of the contract, or an increase in the contract cost shall be made within 5 days after the builder first recognizes the condition giving rise to the claim. V. Financing This contract is contingent upon the buyer obtaining a construction loan in the amount of $275,685.00 dollars. All fees and expenses of obtaining a loan shall be borne by the buyer. The builder is not required to begin construction until the buyer provides the builder with written notice from the lender confirming the loan. VI.Contract Price FIXED PRICE CONTRACT WITH ALLOWANCES TCM BUILDING,LLC 10 PICADILLY CT.MANCHESTER,NH 03104 TEL/FAX:603-624-8844 WWW.TCMBUILDING.COM �. TCM BuildiNc, LLC CONTRACT TO BUILD A HOUSE AT 14 Glencrest drive, North Andover, MA I. Contract Parties The Builder, TCM Building, LLC of Manchester, NH and the Buyer, Frank Cordima of North Andover, MA hereby agree to build a house on property located at 14 Glencrest drive, North Andover, MA II.Contract Documents The terms of this contract include all the documents specifically listed below, and constitute the entire terms of the agreement between the parties. The terms of this contract shall prevail over any conflicting provision in the documents incorporated by reference. 1.Architectural Plans and Drawings dated November 8,2007 with 8 numbers of pages is hereby incorporated into this document. III. Building Plans FIRST OPTION: USE WHEN THE PLANS ARE SUPPLIED BY THE BUYERS The builder agrees to construct the home in accordance with the plans, including specifications and drawings, supplied by the buyer and incorporated by reference into paragraph 11. Contract Documents. The builder assumes no responsibility or liability for defects in the design or engineering in these plans. The buyer represents to the builder that the buyer is the sole owner of the plans or has the legal right to use the plans. The buyer agrees to indemnify and hold the builder harmless for any copyright action which may be asserted as a result of the use of the plans. The buyer warrants that the plans are adequate and that the builder can rely on them. The buyer will be liable for any damages caused by defects in the plans, including, but not limited to, additional material costs, additional labor costs, pro rata overhead and profit. 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L y J 'rcti1IN -�11 '3^ g'`€t; ,"^-�'h F,}j 'µ4,^1�r�'r Sy am a r �� kr i > 3�mi } Z S t xsr sY K ? 14"^� } iF sy{ u It a r ,.z'w'ti>dna+mss b^L 'qf'1 txt,.w U i s x.- ..�X, 5,2' Y', s� g"i � . y 'I`e��,riN'e� �� V fn d a „ s 3.y 3c p t � ®y W F 'S W Y 1Y r TCM BuildiNq, LLC We, the undersigned, have read, understood, and agree to each of the provisions of this contract and hereby acknowledge receipt of a copy of this contract. By: on behalf of -7 �zIrl`k.Il TCM Building, LLC Title: Date: By: r1r� l/h�f'O�^-'�' Date: Frank Cordima Attached Contract Documents: 1. Final Contract (Rev. 12-02) Forms ContractorCity.com TCM BUILDING.LLC 10 PICADILLY CT,MANCHESTER,NH 03104 TEUFAX:603-624-8844 www.TCMBUILDING.COM E The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations ' a`w 600 Washington Street .-� Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ormat><on Please Print Legibly �. Name (Business/Organization/In �. dividual): 1-G 1 Address: City/State/Zip: ✓NAc., IJH 03V I Phone #: 03 L/ 60C 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 employees(full and/or part-time).* have hired the sub-contractors 6. ern construction 2.Ell am a sole proprietor or partner- listed on the attached sheet. 7. ❑ emodeling ship and have no employees These sub-contractors have 8. ADertiolition working for me in any capacity. employees and have workers' 9. E] Building addition [No workers' comp. insurance mp. insurance.'t required.] 5. We are a corporation and its 10.0 Electrical repairs or additions q ] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself o work ' right of exemption per MGL y � workers' comp. 12.❑ Roof repairs insurance required.] T c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also till out the section below showing tile m eir workers'compensation policy inforation. 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 state whether or not those entities have employees. I f the sub-contractors have employees,they must provide their workers'comp.policy number. 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 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 certify under thepains andpenalties of perjury that the information provided above is true and correct. Signature: Date: /oZ 3—0-=i-- Phone#: &0 G 9 y 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 Cleric 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Date..../ ........ 16f TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SSACHUS This certifies that ..... ........ ` ..................................... has permission to perform ...... .......... . ..................... wiringin the building of...............................................I................................... at. ..7...... ...:T- North Andover,Mass. ..... ... Fee.16Lic.No."A .............. ....... ....... .. . &TRIC L NSP�E�CR v.. Check # 7660 a.v�uuivnw�dlzn Or massachusetts Official Use Only , Department of Fire Services Permit No. 7F�Fa _ BOARD OF FIRE PREVENTION REGULATIONS [ Occupancy and Fee Checked Rev. 1/071 eaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C 12.00 WORK RK (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: Z City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her in tion to perform the electrical work described below. Location(Street&Number) ItY C `, Owner's Address J f � Owner or Tenant �/- �, Ccs �� L, Telephone No. ��Y53 00, ,.y�, -e Is this permit in conjunction with a building permit? Yes 'M No ❑ (Check Appropriate Bog) Purpose of Building A9P �N-•C� Utility Authorization No.� Existing Service Amps / Volts Overhead Und d No.of Meters �� /� h ❑ ❑ New Service i* " Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 'p Tom'/�-,� r,C, Completion of the folloi4fin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans °•of Total Transformers KVA No,of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- o.o mergency ig g d• ❑ d• ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No. of Gas Burners o.of etection an No.of Ranges No.of Air Cond. °tal Initiating Devices Tons No,of Alerting Devices No.of Waste Disposers eat ump Number Tons � p Totals: "......'-'.....'."---..- o.of a -Contained -._. - Detection/Alertinty Devices No.of Dishwashers Space/Area Heating KWMunicipal Local L] Connection [I Other No.of Dryers Heating Appliances KW Security Systems:* No.of water No.of No.of Devices or Equi alent . Heaters KWNoof Data Wiring: Sips Ballasts . No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: • OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I ce?Wfy,under the pains andpenaides ofperjury,that the information on this application is true and complete. FIRM NAME: �/'Q '�'e Thr L -1 t i,C LIC.NO.: f 7 Licensee: ,q Ll A? J J G a✓ Signature ._.. (If applicable, enter"exempt"in the license number line.) '" ��-'�' LIC.NO.: F Z 6 ff IS Address: h,, ,,I �L/G Bus.Tel.No47 - •_X31 *Per M.G.L c. 147,s.5f--6 li',security work requires Department of Public afety"S" License: Alt Licl.No. q7�'��rL-Z s C OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: The Common wealth of Massachusem kf ! Department of Industrial Accidents • Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/piwnbers Applicant Information Please Print Le-affilv Name(Business/Organization/[ndividusl): �G' f5/ er Address: C-" vt?rr— o�► J City/State/ZipZ64"'C Z6 Dry, U f S(J Phone 1:7F- Are ,Yoan employer?Check the appropriate•box: 1.❑ 1 am a employer with 4, Type of Project(required): ❑ 1 am a general contractor and i employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.[] I am.asole proprietor or partner- Iisted on the attached sheet i 7• ❑Remodeling ship and have no employees These sub-contractors have 8. Q Demolition working for me in any capacity. workers' comp.insurance. ticers'comp,, insurance 5. 9• Q Building addition [No wo ❑ We are a corporation and its required.] officers have exercised their 10•0 Electrical repairs or additions 3.Q I am a homeowner doing all work right of exemption per MGL 11.Q Plumbing repairs or additions myself.[No•workers'comp, c. 152, §1(4),'andwe have no insurance required.]-. •employees. [No workers' 12.Q Roof repairs comp. insurance required.) 1.1n Other *Any applicant that checks bore#l must also fill out the section below showing their wo&art'aompensatioo pot icy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside oantractors moat submit a new affidavit indicating such ;Contractors that check this box mustatt abed an additional shear showing the name of the sub-contractors and their workers'con p.policy information information.ant an employer that es provideitg workers'compensadon insurance for my employee.L Below is-Me policy and job site i Insurance Company Name: ' Policy 4 or Self-ins. Lie.#: Eicpiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' COM pensation 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 againstthe.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 cert under the pairfc a penalties of perjury that the information provided above is true and correct Si titre: Date. I ?A 7 Phone#: [Contact cio!use only. Do not write in this areq to be completed by city or town aa� or Town: Permit/License# s a Authority fy(circle one): 11 ard of Hearth 2 Building Depatnent 3.City/Town Clerk 4. Electrical inspector 5.Plumbing Inspector her Person: Phone#: Information and Instructions i 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 eM=prise,and including the legal representatives of a deceased employer,or the receiver ortnistee 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 tate 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 bean 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 requ=ments 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 numbers)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or.Ltmited Liability Partnerships(LLP)with,.no employees other than the members or partners,are not mquired.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.. Aliso 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 insurancelicense number on the-appropriate Tine. 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 permitnicrose number which will be used as a reference number. In addition,an applicant that must submit multiple permiVlicense 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 shouid 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 Offiee of Eavestigations 600 Washington Street Boston, MA 02111 Tel.#617-7274900 ext 406 or 1-977-MASSAFE Fax#617-727-7744 Revised 5-26-05 www.mass.gov/dia i N° 2358 Date.... s ��7..0... NORTF� w °f<�``°:•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING S�cMu This certifies that ..... .....:... has permission to perform ...... ........................................... wiring in the building of...... .t1.t% .` ................................................... ......1?............. .North Andover,Mass. Fee.l S.... Lic.No 2S.y ........... ..... .........11.`.......................... j ELECTRICAL INSPECTOR Check # ` 3-3 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer TIMCOMMOA7V ALTHOFMASYAOIUS`E' IS Office Use o3S7 7 DEPARTA1EW0FPUBL[C&4= Permit No. O a BOARDOFFB?EPREVENI7ONREGUTA770NNS27CMR12.00 Occupancy&Fees Checked APPLICA 77ONFOR PEI?AlffT TO PERFORMELE(=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perforin the electrical work described below. MAP 70 PARCEL 440 Location(Street&Number) 6Ytkc iqy Ale, R act.-*- /0-4 Owner or Tenant tryp t i fL Owner's Address le `V lVor 4Wo(r Is this permit in conjunction with a building permit: n Yes� No (Check Appropriate Box) Purpose of Building F)�©t- (,*, v� Pep f Utility Authorization No. Existing Service Amps / Volts Overhead E] Underground No.of Meters New Service Amps / Volts Overhead M Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units 4 No.of Switch Outlets No.of Gas Bumcm No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other ED Conncctiorm No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP ,OTHER- 4 fiwar=Co%�Rr=uvotheragt�oflvmdagsCaX1alLaws IhaveaalaartLialaldyhstuarnePbltiyurhr3rclgCorr>plebCawraWorflssubsfarr5alag>iva)t YES LaJ NO Ihaw%fiT&dwWpmfofsmwtotheOfiec YES rV1 NO IfyntrlmedviodYFS,pleases>dcalolhetypecfwwraWbyduia%the INSURANCE � BOND F-1OMER F1 ( > Estrrn*dValueof0xtcalWc&$ � Wcklosrmt hpocfioriDa1eRe4rstad Rough Final sgndundxTrPtmkcsofpqjuy S 'Fly.""„ BusirmTeLNo. u p Alt,Tel Na OWI,,S1NSURANCEWAIVER;Iamavamd-attheLioa�edoesnnthavethe' eauaWcritsstalBbnbalec rAcritasr gzWbyMassada.>s&Cmuallaws ardfliatmysi@-Eb cntlwpmntapiicabmw&%cst mragartanat (Please c1Xck one) Owner 191 Agent -3S� Telephone No. " 3 -� PERMIT FEE$ tgna e o Uwner or Agent Location �` �Y In Cr?`�°St U/? - G No. _ �a -7 Date ( !� NORTH TOWN OF NORTH ANDOVER f? • • O9 Certificate of Occupancy $ + Building/Frame Permit Fee $ 2S^ dC� • ��y� a �'�s'•• E<� Foundation Permit Fee $ s�cNus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Buil nInspector 120/ 11 12110/9�8,j13:32 25.00 PAID C (T�° Div. Public Works 1 1"FRMIT NO. / APPLICATION ICOR PERMIT TO I3UI1.0********N01ZT'll ANDOVFR, IIIA nl\I'Nfl: OI.NO. Z. RL( UHU OFT)\1'NI HS1111• -- DATE BOOK ------- PAGE ----- /Dht: SUBMV. Lt Y1 N(1. �1 I ION "1 01, x ��, �y��- �. PNHIIOSI1 1 t w IM DIN6 o �� C - OWNER'S NAME 0"NN�'tt- NO. Of S I(NiIES !%Gx- SILT- a v O\VNER'S ADDRESS / /�C, �1 �Y� �jBASF-ME NI OR SLAB AR(I Ill E(-I'S NAME v i SILE Of FL CX>f2 TIMBERS 1 ST 2 ND 3 RD lit Ill DEN'S NAME SPAN )ISIANCEl'ONLARESI BUILDING DIMENSIONS 01:SII_LS DIS DANCEFROM SIRLE I DIMENSIONS 01:POSTS DISTANCE FROM LOf LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE IIEIGI IT Of:F(A)NDATION THICKNESS IS BUILDING NEW SIZE O(-I(X)I ING X 1SBI11LDINGADDIIION MAIERIAI.OFC111MNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OKFII I ED LAND W11.1.BUILDING CONFORM TO RECKIIREMENIS OF CODE IS BUILDING CONNECTED-10 TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECT EO 10 TOWN SEWER IS BUILDING CONNECT ED TO NAI URAL GAS LINE INSI U('TIONS 3. PROPERTI'INFORMATION LANDCOSI' ES 1. BL1X;. COS f PAGE I FII.I.OITf SECTIONS 1-3 EST. BLDG. COS T PER SQ. FT. EST. BI DG-COSI PER ROOM EI ECTRIC I.4E'I'ERS F1US 1 BE ON otrrs DE of BUILDING SEPTIC PEItn11 I NO. IL .A I-I ACI IED GARAGES NIIIST C(NJFoRt,t TOS FATE FIRE RE(;UI.A IlONS a. .-kPPItovvi)Bl': L. PIANS MUST BE FILED AND APPROVED 13Y BUILDING INSPECT(N2 / BUILDING INSI'FCIOR DATE 1:11 I'D �l� � � � OWNERSfEl.l1- ('(NJTR l l l ry �,IGNAII)HI:0I OWNI1R t1R 1 )Rl ZI:DAGI N1 Illit I 1'I Rnlll tilt-\NII 19 TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work:_�5;U � /w Est. CA—'z, Address of Work Owner Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. S- 1 I Job under $1,000 Date 0�- Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the'above property: MAP Date Owner Name 1 MORTGA GE /NSPEC TIO N PL A N NO. /4 GL ENCREST DR. IN N. ANDO VER MA SS. MIDDLESEX SURVEY INC. LAND SURVEYORS /3 / PARK ST. N. READ/NG , MASS . SCALE.' I It = 80 ' DA TE.' FEB. 18 , /994 CERTIFIED TO.' WAKEFIELD CO-OPERA T/VE BANK t� 32 a4 3 tri LO 48, b; x.35 G g/.42 �FS'T NOTES.' I OFFSE TS ARE NO T T 0 B E USED TO ESTABLISH PROPERT YL/NES. ' 2)L OT LINES ARE COMPILED INFORMATION T/ TL E REFERENCE W REGISTRY OF DEED37sx l DEED.' BOOK 2698 PA� 5 I HEREBY CER T/FY BASED D MY KNOWLEDGE /NFORMA TION AND BEL IFF THAT THE STRUCTURES ONTH/S ;dL AN ARE L OCA TED ON THE GROUND APPROX/MA TEL YEASZSHOWN. SE BACRIVING Q/U REMENTS AT HE TIME OF CONSTRUCTION AND THE PARCEL IS NOTIN A FLOOD HAZARD AREA AS SHOWN ON F. E. M. A MAP COMMUNITY NO. 250098C ZONE.* X EFFECTIVE DATE.'6- 2 -93 594 Poser/aNlq-) jq9Fi#NK Cok)rM4 N0. P8205 (&d13o Setbuks) N04 T40RT Town of t _ 4Andover No. * _ dover, Mass., 19 s LAKE '9 COC MrIC M E W ICK q AD ATED P S BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D• � � �. a THIS CERTIFIES THAT.......... . ....... ................... .. ... ....................................................... BUILDING INSPECTORFoundation has permission to erect....... .. .. ............ buildings on .. A...V..*v.............:XQ CV-- .. .9 Rough • tobe occupied as..... �y . .......... ,�_� .�.. ....... . . .......................................................................... Chimney provided that the porn accepting this permit shall in ev respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-La s 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONTS Rough _.!� ..... ..... .................... Service BUI DING 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Location / C_�/p����'�� 'A� No. �''�/ Date 4 NORTIy TOWN OF NORTH ANDOVER Certificate of Occupancy $ Eck' Building/Frame Permit Fee $ swcHas Foundation Permit Fee $ _ Other Permit Fee /��� $ S' TOTAL $ S' Check # �✓ r� 13 7 . 5 r Building Inspector � _ . TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER• DATE ISSUED: _. 02 *3X3'-2 3 - X SIGNATURE: A Al Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION Z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Ske c(s�t �hlle_ I®� y-p Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: �4(�46�_, ZoningDistrict Proposed UseLot Area Fronta e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided RNWred Provided 1.7 Water Supply M.G.LC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT q M 2.1 Owner of Record cc AJO, As�V - eAO Name(Print) Address for Service00 : Q y54- n43 •v Signature Telephone 1 2.2 Owner of Record: d Name Print Address for Service: O z Si nature Telephone M SECTION 3-CONSTRUCTION SERVICES Qo 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construct' n Supervisor: License Number Address Signature Tel Expiration Date K Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name Registration Number M Address rM Expiration Date ' Si nature Telephone f SECTION 4-WORKERS COMPENSATION(M G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check au applicable) New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building ; Q© (a) Building Permit Fee / Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1. 1 � f�'> (!S 6kill l� 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 ri,t If Print Name 4JY 3AA-40 .rw Signature of Owner/A I ent Date NO. OF STORIES SIZE BASEMENT OR SLAB STND RD SIZE OF FLOOR T MBERS 1 2 3 SPAN DM ENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIIv1NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i 't pORYH� Town of North Andover ° "`° '••"� � ' Building Department 27 Charles Street North Andover, MA. 01845 '�,s••TM° '�;g. D. Robert Nicetta Building Commissioner (978) 688-9545 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION 6-(ese& /"O, #A'40w° — NI/� �d Number Streef Address Map/lot e "HOMEOWNER4 13P3 8)" Name Home Phon4 Work Phone PRESENT MAILING ADDRESS G to OL Ij /Va. R'j►�av� J4 A City Town State Zip Code The current exemption for"homeowners"was extended to include owner-ccupied dwellings of two 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 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two family dwelling,attached or detached structures ac- cessory to 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. 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 No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE 'S APPROVAL OF BUILDING OFFICIAL FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT 65khtf,f 4C t'Q04y PHONE ASSESSORS MAP NUMBER ! O�1 LOT NUMBER `f o SUBDIVISION ,,��// LOT NUMBER STREET cm(eac4 ye STREET NUMBER J OFFICIAL USE ONLY RECOMA4ENDATIONS OF TOWN AGENTS IPSi& I o`2 4' 12Nc� A��e Go v� i......■ ■...................................■.............................lw �-eQ l t Cl�n �11& DATE APPROVED CONSERVATION ADMINISTRATOR rr / DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMIyIENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE MORTGA GE /NSPEC r10 N PL A N F NO. 14 GL EN CRES T DR. /N N. ANDOVER MASS. MIDDLESEX SURVEY INC. LAND SURVEYORS 131 PARK ST. N. READING , MASS . E. It = SCALE,* I 80 ' DA TE.' FEB. 18 , /994 CERTIFIED TO.' WAKEFIELD CO-OPERATIVE BANK k W c� LO 16 48, 832 S.-F. �ry ; iry $ O 3�� Z � 549 ..: "", ..i CF�c� NOTES.' ` / OFFSETS ARENOT TO BE USED TO >� ESTABLISH PROPERT YL/NES. 2)L 0T L /NES ARE COMPIL ED INFORMATION TITLE REFERENCE REGIS TRY 0 PA� S X DEED.' BOOK 2698 I HEREBY CERT/FY BASED OINY KNOWLEDGE INFORMATION AND BELIEF THAT THE STRUCTURES ONTH/S ALAN ARE LOCATED ON THE GROUND APPROXIMATEL YEASZSHO/WN. SETBACK REQUIREMENTS AT HE TIME OF CONSTRUCTION AND THE PARCEL /S NOTIN A FLOOD HAZARD AREA AS SHOWN ON F. E. M. A MAP COMMUNITY NO. 250098C ZONE.' X EFFECTIVE DATE.'6-2 -93 NO. P6205 NORTH Town of _ R Andover 0 O +- LA E o dover, Mass., a3 an COCHICHEWICK ADRATED iPa��S S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.. r.�!N.�:�. ..........C.o.r.A.I..WI.A.......................................... .................................... Foundation has permission to erect..... .y........................ buildings on .... .'1...... 1. .�.r'.+�.5..........�.R.............. Rough to be occupied as... V � v a..... h V w� 44M.1. Chimney ............... ....... ....lN....Nr... A.. .. 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 Const r ction of Buildings in the Town of North Andover. M 10 4 P L4 �� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STAELECTRICAL INSPECTOR T Rough ...............t.................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Dec. Location No. Date y ,.ORTq TOWN OF NORTH ANDOVER 3?0�,•`•O ,•,MSL n Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ sACMUs Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building frspector 12910C `t�, ! /T t Div. ublic works i I'l_12MIT NO. S APPLICATION POR I'LRMI1' "1 0 13UIL.0********NOR"1.11 ANDOVIAZ, MA M v N(1. 1 l)l.Nl). 2. RE(()KU OF (J\1'Nk 1(SIIIP DA'I E BOOK —- -- pAG F. -- -- /1)NL SUB 1)1V. LOI-N(1. n�, n I'UI,IVISE(N=BI)II1)ING .\ 1(x �IRJN / �°ftCYll� Y�Y� �}`h6 G/�c'l A7 ��fil/ 6r/n 2/l•' — u\1NER'SNAt1E NO. (N SIINNIES SILK {�/YL OWNER'S ADDRESS /�, ) BASFtiIENI OR SIA13 AK('1 lll'EC"I'S NAME ST SIZI:(V FI(Xx2 TIMBERS f 2 3 131 III DER'S NAME SPAN DISI ANCE:TONEARESI BUILDING DIMENSIONS OF Sit S DIS I ANCE I ROM SIRES I DIMLNSINJS OF POS IS DIS I ANCE FROM LOT LINES-SIDES REAR DIMENSI(NJS OF GIRDERS AREA OF LOT FRONI AGE I IEIGIIT OF FIXJNDATI(NJ THICKNESS IS BI ItLDINGNEW 51ZLOFI(XYIING _ - - X I S BI l I LDI NG ADDI IIOJ MA)ERI AI.OF CI II MNE Y IS BUILDING ALTERATION IS BUILDING ON SOLID(Null LED LAND WILL BUILDING CONFORM TO RFQUIREMEN'IS OF CODE IS BUILDING CONNECI ED 10 10"WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECT ED 10 TOWN SEWER IS BUILDING CONNECIED TO NATURAL GAS LINE INSI'U(PIONS 3. PI2OPERTI"INFnR�L1IlON LAND COSI ESI. BLDG. COSF DU� PAGE I FILL OITT SECTIONS 1-3 EST. BIIXG. COS I PER SQ. FT. ESI. BI I)G. ('O51 1'LRROOM EI ECTRIC KIEI LRS MUS F BE ON(NI'ISIDE OF BUILDING SETT IC PLRMI I NO. AI-1ACI IED GARAGES MUS-IC(NJFoRmTOSTATEFIREREG1ILA IIONS a. API'RWYk:DBY: _ PLAN,j MUST BE FILED AND APPROVED 13Y TIMLDING INSPECRN2 Bl III.Di (.IN$PEC TOR DA I E 1 11 ED tl OWNERS TELN.- '� �� / �i "7 CI NJI R A I I b ' CcNJIRJ.I<'b SIGN.\I IIRI{(SI OWNI It,t)I AIIIIIt RI It 1)Al;1-NI J\ �� I III.( I'I IU,11 1 (MAN 11.1) - i 1 � T Town of 10 -1 ►OR_ eAndover No. _ * dover, Mass., 19 %0 O s LAKE .m T 'D COCNICMEWICN V OA T E D PPG '� BOARD OF HEALTH �i Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... . ........ .. .... .......................................................... Foundation has permission to erect. R .�. .1..�... buildings on ., .� . cs................. ..C41.a Rough to be occupied as........5.t . .:.......C ►► ... Chimney provided that the person acce ng this permit shall in ev ry 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC ARTS IF Rough ...................... . . .... ........ . ...... Service BUILDING SPECTOR Final ' Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. R,�,� 4&4:ti0 Smoke Det. r MORrGA GE /NSPEC r10 N PL A N NO. /4 GL ENCREST DR. IN N. ANDOVER MASS. MIDDLESEX SURVEY INC. LAND SURVEYORS /3/ PARK ST. N. READ/NG , MASS . E. SCAL ' / 1.4 = 80 ' DA TE.' FEB. 18 , /994 CERTIFIED TO.* WAKEFIELD CO-OPERATIVE BANK - _ Cry LO 48, F. m �i 91.42 C 16 Ccl ' I NOTES.' i / OFFSETS ARENOT TO BE USED TO ESTABLISH PROPERTYL/NES. 2)L OT L /NES ARE COMP/L ED INFORMATION '� < T/ TL E REFERENCE '";W` REGIS TRY OF EF S X ) DEED.' BOOK 2698 PA � ,5 I HEREBY CERT/FY BASED 0 MY KNOWLEDGE INFORMATION AND BEL /EF THAT THE STRUCTURES ONTH/S;dL AN ARE L OCATEDON THE GROUND APPROX/MATEL Y ASZSHOWN. SETBACK REQUIREMENTS AT THE TIME O CONSTRUCTION AND THE PARCEL IS NOT/N A FLOOD HAZARD AREA AS SHOWN ON F. E. M. A MAP COMMUNITY NO. 250098C ZONE .' X EFFECTIVE DATE.'6- 2 -R3 5t(i) POP TI-00 l�� /q� F0XK Cc0M4 N0. P8205 ,� l Y� &UoveAKsl' A Lw/30 '.ift uks) TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Y L?e� Est. Cost_ Address of Work d- �'lG'' ' ©' � ; X19 Owner Name: > /� �D�i� Date of Permit Application: l�// /1 I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No.'S _ IZK Job under $1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name Date.6/-. ,� - 3992 NORTH TOWN OF NORTH ANDOVER O� t�•0 1./r Y� PERMIT FOR PLUMBING CHUS�� This certifies that .� . .4/.-r.Mo. .c�. . .SG!ti . . . . . . . . . . . . . . . has permission to perform . . Re.-tL"a.4 A/I .`. . . . . . . . . . . . . . . plumbing in the buildings of . . .Q./?.C. S. . . . . . . . . . . . . . . . . . . . . . . at. . .P/ . .if len. ,c t?PS, T,`:r , , , , , , , , ., North Andover, Mass. Fee. }�s,.' . .Lic. No.. . . . . . . . . LUMBING INSPECTOR 04/06/99 11:04 35. RID WHITE: Applicant 40 CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DPLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS DO Date �— �" ` 1 Building Location� 'fi! wn� e� Permit#—j a �f 2 Amount Ln Type of Occupancy New Renovation Replacement Plans Submitted Yes No FIXTURES z x w Ln w z Ln a �" x a � z aw Cra F- x a a a w o a � a A x A w a w O z x a 0 d Q w C x w F■ F„ O Cn Z O O > .. W O U d 0 O o SLB-E&VM 114salm 19E l ern� llDat ani lomat 5M FLOCR 6Hi FIDat 7M FLOCIR sIx moat (Print or type) nn �/ Check one: Certificate A Installing Company Name c P 'e TYL Q S�.0 [] Corp. Address 53 A o d,'(4 5 A U5 ® Partner. (/ro o S^ Business Telephone ,2 2!� V q// Firm/Co. Name of Licensed Plumber: SXw A 1'9,r—T(L 0 Insurance Coverage: Indicate the insurance coverage by checking the appropriate box: Liability insurance policy r7Ill, Other type of indemnity Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent I hereby certify that all of the details and information I have submitted(or entered)in abovea lication are true and accurate to the best of my knowledge and that all plumbing work and instal i s performed un rmit s e this application will be in compliance with all pertinent provisions of the Massachus tate mbina p e General Laws. By: Signature oT Licenseaum r Type of Plumbing License Title <9 ls'6 City/Town inns um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY MORrGA GE /NSPEC r10 N PL A N NO. 14 GL EN CRES T DR. IN N. ANDOVER MASS. MIDDLESEX SURVEY INC. LAND SURVEYORS 131 PARK ST. N. READING , MASS . E. SCAL ' / " = 80 ' DA TE.' FEB. /8 , /994 CERTIFIED TO.* WAKEFIELD CO-OPERATIVE BANK ",0/ /- 32 '84 L� 48, x'35 I 6`4 r (VOTES ' '' / OFFSETS ARENOT TO BE USED TO ESTABLISH PROPERT YL/NES. 2)L0T L /NES ARE COMPILED INFORMATION T/TL E REFEREN REGISTRY O X ) DEED.' BOOK 2698 PA5 ,5' 55 I HEREBY CERT/FY BASED O MY KNOWLEDGE /NFORMAT/ON AND BEL /EF THAT THE STRUCTURES ONTH/S AL AN ARE LOCA TED ON THE GROUND APPROX/MATEL YEASZSHOWN. SETBACK REQUIREMENTS AT HE TIME OF CONSTRUCT/ON AND THE PARCEL /S NOTIN A FLOOD HAZARD AREA AS SHOWN ON F. E. M. A MAP COMMUNITY NO. 250098C ZONE.' X EFFECTIVE DATE.'6-2 -93 ,SP0C04046 N0. P8205 i