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HomeMy WebLinkAboutMiscellaneous - 17 FERNWOOD STREET 4/30/2018 17 FERNWOOD STREET�� / 210/006.0-0036-0000.0 I I Ii IMPORTANT MESSAGE For A.M. Day Time P.M. M Of 17 - Phone —7 FAX Area Code Number Extension MOBILE Area Code Number ,Extension Telephoned Returned your call RUSH Came to see you Please call_ Special attention Wants to see you Will call again Caller on hold Message r n 0 tot O i,s i�0 r r, . Signed universal"48023 LITHO IN U.S.A. GLENWOOD STREET (50 FT. PUBLIC-WIDTH) MAP 6; PARCEL 28 MAP 6, PARCEL 24 MAP 6 PARCEL 29 32 ELMWOOD STREET 28 ELMWOOD STREET h 20 ELMWOOD STREET NAPOLITANO FAMILY TRUST, GIAIMO, SANTO S,LT FINOCCHIARO,CONCETTINA A LT THE MARIA ANNAIAN,TR❑ VITO D&CAROL J NAPOLITANO THOMAS D&ALFRED A FINOCCHIARO BOOK 4680; PAGE 216 BOOK 4799; PAGE 119 BOOK 5295; PAGE 199 150.00' 62' 00 / 11.5' ///% ❑ WOOD "'(IST. POOL c ' 24+_ DECK s 32.0',/ CONCRETE APRON MAP 6,PARCEL 37 2' WALL EXISTING 31 FERNWOOD STREET BUILDING DIMARCA,MARIA A BOOK 1455; PAGE 323 0 I, _ ' �'R �' 2-1/2 STY. o0 o P. 0PO D fl IT N WD.FRM.mu q o A A= 1 - 04S er i 50' .: ,, t fI #17-19 6'WOOD PICKET FENCE tr r,7,,,-�.T, -,_ -, `-,- - _ w 11.0' AV I-', 1 2 2 \1 -01 - 17 FERNWOOD STR] (50 FT. PUBLIC-WIDTH) W OF MASgq� DATE: r r�� Fvks APRIL 6,2001 SCOTT L. GILES g G s N REVISIONS: FRANK S. GILES SURVEYING �� SAND SCALE: 1 INCH=20 FEET o' 20' 40' 50 DEEREMEADOW ROAD APRIL 6 2001 NORTH ANDOVER,MA 01845 TEL: (978)683-2645 DATE THE PURPOSE OF THIS PLAN IS FORA REQUEST�ALLOWED.SPECIALR A PERMIT FOR AN INCREASE OF OVER THE 25% PLAN OF LAND 17-19 FERNWOOD AVENUE NORTH ANDOVER, MA MIN FRONT SETBACK=30 FT.(OR AVE.) BOOK 4498; PAGE 290 ZONING DISTRICT SUBJECT PROPERTY: PAMELA PELUSO-JAEGER RESIDENTIAL 4 17-19 FERNWOOD AVENUE MIN.LOT AREA=12,500 S.F. NORTH ANDOVER,MA 01845 MIN.FRONTAGE 100 FT ASSESSORS MAI' 6 PARCEL 36 MIN. SIDE SETBACK= 15 FT. MIN REAR SETBACK=30 FT. MAX.HEIGHT 35 FT MAX.INCREASE AREA=25% NORTH ANDOVER BOARD OF APPEALS I l I MAP 6, PARCEL 35 9 FERNWOOD STREET WALMSLEY REALTY TRUST I R J&M J WALMSLEY,TRS BOOK 4162;PAGE 324 DATE OF FILING: DATE OF HEARING: DATE OF APPROVAL: THIS IS TO CERTIFY THAT I HAVE CONFORMED REGISTRY OF DEEDS USE ONLY ��' WITH THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS IN PREPARING THIS PLAN THE PROPERTY LINES SHOWN ARE THE LINES DIVIDING EXISTING OWNERSHIPS,AND THE LINES OF STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED,AND NO NEW LINES FOR DIVISION OF EXISTING OWNERSHIP OR NEW WAYS ARE SHOWN. FRANK S. GILES 11,P.L.S. DATE COMMONWEALTH ` w HAROLD STREET AVENUE F o [n �s ST R ET ZONE X y � S ROBINSON �0 STREET ZONE X G ZONE X =Y DANVERS00 STREET ��'� yL E LMWOOD ''°',,,� � STREET . 95 � OQ �` F E RN W O O D STREET ` �� Q` KENWC G LENWOOD �'� 5 STR E STREET SHAWSHEEN AVENUE Q INGLEWOOD : O STREET MARLIN RM4 AVENUE " GREEN STRI ZONE X PRIVATE CORPORATE DRIVE LIMITS J �Q MARGATE STREET HALIFAX SHA WSHEEN °Y � � ; � 'STREET RIVER " xx r fb r DRYAD STREET_ MARENGO STREET ZONE X I i LEGEND SPECIAL FLOOD HAZARD AREAS INUNDATED ZONE X ,, ,;`' BY 100-YEAR FLOOD RFgT ZONE A No base flood elevations determined. { AO ZONE AE Base flood elevations determined. ZONE AH Flood depths of 1 to 3 feet(usually areas of ponding);base flood elevations determined. g 9D90 ZONE AO Flood depths of 1 to 3 feet(usually sheet flow , on sloping terrain); average depths deter- mined. For areas of alluvial fan flooding; velocities also determined, ZONE A99 To be protected from 100-year flood by Federal flood protection system under con- struction; no base flood elevations deter- mined. • 4 �rt' b ZONE V Coastal flood with velocity hazard (wave action);no base flood elevations determined. ZONE VE Coastal flood with velocity hazard (wave ` action);base flood elevations determined. FLOODWAY AREAS IN ZONE AE OTHER FLOOD AREAS ZONE X Areas of 500-year flood; areas of 100-year flood with average depths of less than 1 foot or with drainage areas less than 1 square mile. and areas protected by levees from 100-year flood. OTHER AREAS ZONE X Areas determined to be outside 500-year flood- plain. ZONE D Areas in which flood hazards are undeter- mined. UNDEVELOPED COASTAL BARRIERS Floodplain Boundary Floodway Boundary - Zone D Boundary Boundary Dividing Special Flood Hazard Zones,and Boundary Dividing Areas of Dif- ferent Coastal Base Flood Elevations Within Special Flood Hazard Zones. 513Base Flood Elevation Line;Elevation in Feet* D D Cross Section Line (EL 987) Base Flood Elevation in Feet Where Uniform Within Zone' RM 7x Elevation Reference Mark 0M1.5 River Mile *Referenced to the National Geodetic Vertical Datum of 1929 NOTES <Y r This map is for use in administering the National Flood Insurance Program;It/ does not necessarily identify all areas subject to flooding,particularly from Irv, draim,ge sources of small size,or all pianimetric features outside Special Floo Hazard Areas.The community map repository should be consulted for possible o- updated flood hazard information prior to use of this map for property purchase or construction purposes. W Coastal base flood elevations apply only landward of 0.0 NGVD,and include the effects of wave action;these elevations may also diffe developed by the National Weather Service for hurrr significantly from those icane evacuation planning. Areas of special flood hazard(100-year flood)include Zones A,AE,AH,AO,A99, t V,and VE. f{ Certain areas not in Special Flood Hazard Areas may be protected by flood r t ' control structures. Boundaries of the floodways were computed at cross sections and interpolated { between cross sections.The floodways were based on hydraulic considerations t with regard to requirements of the Federal Emergency Management Agency. k Floodway widths in some areas may be too narrow to show to scale.Floodway widths are provided in the Flood Insurance Study Report. a �, y widths are provided in the Flood Insyurance Study Report. For adjoin ma panels see separately rimed Ma Index. J'�'r4"�� t 1 g p P P y P P ps r x � Lo0 O MAP REPOSITORY # ? A _J North Andover Town Hall,120 Main Street,North Andover,Massachusetts r � � W Z 01845(Maps available for reference only,not for distribution). IL INITIAL IDENTIFICATION: Z JUNE 28, 1974 r � �7^ FLOOD HAZARD BOUNDARY MAP REVISIONS: MAY 1Q 1977 FLOOD INSURANCE RATE MAP EFFECTIVE: JUNE 15, 1983 FLOOD INSURANCE RATE MAP REVISIONS: June 2, 1993 -to add base flood elevations, to add special flood hazard areas,to change special flood hazard areas,to change zone designations and to update map format. To determine if flood insurance is available in this community,contact your insurance agent or call the National Flood Insurance Program at(800)638-6620. r APPROXIMATE SCALE I 40 n nn0 FEET NATIONAL FLOOD INSURANCE PROGRAM FIRM FLOOD INSURANCE RATE MAP I TOWN OF x NORTH ANDOVER MASSACHUSETTS asp R WM ESSEX COUNTY s etA Pep PANEL 3 OF 15 (SFF MGP INnFy Fnp PAturr c tunr PQmrrcn% APPROXIMATE SCALE an0 FEET 5 ` ? 400 t t 1 { v j NATIONAL FLOOD INSURANCE TPROG!RAM FIRM FLOOD INSURANCE RATE MAP TOWN OF NORTH ANDOVER, MASSACHUSETTS ESSEX COUNTY i PANEL 3 OF 15 (SEE MAP INDEX FOR PANELS NOT PRINTED) 4 �`F , y PANEL LOCATION N G COMMUNITY-PANEL NUMBER ON 250098 0003 C ZONE x POP° MAP REVISED: JUNE 2, 1993 I pyo o� i Federal Emergency Management Agency F- t T � d+� Date '� I . ... .. . . NOFTM Of, o� �` °. TOWN OF NORTH ANDOVER 1- F ' PERMIT FOR GAS INSTALLATION �9SS.f c HUSf'� This certifies that . . . . . . . . . . . . . . . . . . . . . has permission for gas installation P P . . in the buildings of �' ?'`� . .!�'ra:l�Fr<. . . . . . . . . . . . . . . . . . . . at . . .l. .-.7-.1.1: f .:�,h w Pd. . . . . . . .,Nrth Andover, Mass Feed.-'' Lic. No.. . . . . . . . . . . . . . �. . G S INSPECTOR Check#/ 770 r• MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date -/�-'5/� NORTH ANDOVER,MASSACHUSETTS Building Locations l 7`/G /���tn(��n ,L Permit# Amount$ Owner's Name 2_ New❑ Renovation ❑ Replacement Plans Submitted U o F e o x z z o F W � o W Wd + CLQ C W W q F x W W C > W U .a W -� z o x >o x w 3 o C7 Ov a > o p SUB -BASEM ENT BASEMENT I .G 1ST. FLOOR 2ND . FLOOR 3RD.. FLO O R 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR _:,._... - 8.TH . FLOOR (Print or��11' e) / Check one: Certificate Installing Company Name_.b4�-E� f n`P 1i u,t� P,9/yt ❑ Corp. Address [ hALF.�lt' S% dhe�' �� GQ9!� Partner. usiness a ep one &17 W27- ?0 N y E1 Firm/Co. Name of Licensed Plumber or Gas Fitter 4 coq w 1 I j&&P-J,f INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes a,-- No If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity Bond 13 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 pennit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 0 1 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 Mas setts St a Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title Ej Plumber bowJe� �� f f City/Town Gas Fitter License umber �Vlaster APPROVED(OFF a usF ONLY) Journeyman Y^ The Commonwealth of Massachusetts Department of Industrial Accidents Office of, nrestigations 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pl Aumbers licant Information Please Print Le�ibl Name (Business/Organization/Individual). Addressi C5 milli, City/State/Zip: Phone#: - 7 p Y ox:L❑Are you an employer?Check the appropriate box- LEI I am a em to er with 4. Type of project(required): P Y ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2•❑ 1 am a sole proprietor or partner- listed on the attached sheet t 7• E<emodehng ship and have no employees These sub-contractors have working for me in any capacity. workers' comp.insurance, g' E]Demolition Y [No workers' comp.insurance 5. ❑ We are a corporation and its 9. ❑Building addition required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp, C. 152, §1(4),and we have no insurance required.]t 12.❑Roof repairs q ) employees. [No workers' comp.insurance required] 13.0 Other Any at plieant that check--box#1 must also till out the section below showing_Lar work=T c CmP=s-trCn PChCy f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the.name of the sub-contractors and their workers'coin Policy information. P Po cY' I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: Attach a copy of the workers' City/State/Zip: 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' coverage verification. I do hereby cerV under theains an P andpenalties o , P ofperjury that the information provided above is true and torr � ect Si afore: Date.: Phone#: Official use only. Do not write in this area, to be completed by city or town official Cit, or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person• Phone#: Y, Information an d Instrructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall notbecause of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25CM states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented,to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if ' necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,:are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to si, and date the affidavi t. The affidavit should be returned to the city or town that the application for the pernaitor license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future perinits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank You.in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-72.7-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-72.7-7749 wwu'-mass--gov/dia r . Date..l '�!�b. .. 4 NOFT1y TOWN OF NORTH ANDOVER r PERMIT FOR. GAS INSTALLATION �D --� . 9 . SACHU5 . This certifies that . . . . .:��! .'. ,r?vl-7111 e/( has permission for gas installation . . . .! . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee` . .?�.`... Lic. No.!S.r7.�.Z. . . . . . . . . . . . . . . . . . . . . . . .�,e7 \ GAS INSPECTOR Check# d �� �. 66 8 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ®® GASFiTTING (Prim or Tyrie) -- r /U A66(1e,0FC_ ,lass. hate /.2 20 D&Perrnjt#f Building,Location /7 - /9 ��,fj J6,!J0040` Owner's Name�TC"_v!4 Owner'Tel## Type of OccupancylJ New 11 Renovation 11 Replacement ❑ Plan Submitted: Yes Ll No r] FIXTURES a W V7y to Lijo O F� z H z z o '✓1 Q O W w Z `r W UJ Cl) W Z Q W !Z LZiI W OE_ Q F x to p .1 7 Q w l F F W p w H uV W i- W a W > eu T � '24 2 O O W k5 p uai Ex 6W� O (7 V a l O w SUB-BSMT BASEMENT 'I S' FLOOR 2ND FLOOR 3RD FLOOR 4T"FLOOR T"FLOOR BT" FLOC 7T"FLOOR 8T"FLOOR t Installing Company Name � �LL1W1,,a;4-.• s- 14C-62 (;heck one: Certificate Address r n agl ... st €-Corporation Ab u 0 Partnership — Business Telephortei , ­; (, a t .�--^ L� Firrrl/ o. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes 0— No ❑ If you have checked yes,pl«-ise indicate the type coverage by checking the appropriate box. A liability insurance policy 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 ail 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 the permit issue o athis application wiil be in compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter'942 of the Genf I s. _ 6y � T e of License: E Sign ur f'L9censed Plumber or Gas Fitter Title --Gas fitter � asy r License Number City/Town Journeyman APPROVED(OFFICE USE ONLY) �potrrc� - � rieo M�A� Zoning Bylaw Review Form Town Of North Andover Building Department " SAtH�SE� " 27 Charles St. North Andover, MA. 41845 Phone 978=68&9545 Fax 978-688-9542 Street.,- ... Ma /Lot• G 3 — 3 60 A licant: Gan ifu a, a Re. nest: A- 3 2)LAI t! I-V q v N o �•s a 1�'cs w,i /' Date: please be advised"that after review of your.Application and Plans that your Application is DENIED for-the fllowing Zoning Bylaw-reasons: Zoning Item Notes, Item A Lot Area Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies 3 -Lot Area Complies `1 3 Preexisting-frontage 4 - Insufficient Information 4 Insufficient Information Use . Z. 5 'No access over Frontage 1 AllowedG Contiguous Building Area 2 'Not Allowed- - 1 Insufficient Area 3 Use Preexisting .. 2- Complies 4 Special Permit Required S 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback , yes !,. H Building Height •1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient � f 2 Complies " 3 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient �r I Building Coverage 6 Preexisting setback(s) Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed ��e S 4 Insufficient Information eS 2 In Watershed Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K -Parking 1 In District review required 1 More Parking Required .eS 2 Not in district 2 Parking Complies 3 Insufficient Information 3 l,, ,19 s,, ufficient Information 4 Pre-existing Parkin Remedy for the above is checked below. Item # Special Permits Plannin Board Item # Variance �- Site Plan Review S ecial Permit Setback Variance Access other than Fronts e S ecial Permit Parking variance, Frontage Exce tion Lot Special Permit Lot Area Variance Common Drivewa Spe cial PemHeight Variance Congregate HOUSin Variance for Sign Continuing Care Retirenpecial Permit Independent ElderlyHousin Special Permit Special Permits Zoning Board S ecial Permit Non-Conformin Use ZBA Lar e-Estate Condo S ecial Permit Planned Develo ment District Special Permit Earth Removal S ecial Permit ZBA S 22!21 Permit Use not Listed but Similar Planned Residential Special Permit R-6 Density Special Permit S ecial Permit for Si n Special permit for preexisting Watershed S ecial Permit nonconformin The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal.explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted c the applicant shall be grounds for his Any to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative°shall be attached hereto and incorporated herein by reference. The building department will retain all,plans and documentation for the'above file.You must file anew permit application form and begin the permitting process. Building Department Official Signatu# Application Received Application Denied Plan Review Narrative The following narrative is provided to further explain the reasons for DENIAL for the APPLICATION for the property indicated on the reverse side: F�s '��."�. ...s3 nc,✓ ,w..r �Fn" MI IS '�'?T f2 —1 AO o N C,C)N 40 Hq 1-��' cS o�r�vc�v� `rA ^ o rig '1 y-A tt 1Pl p.,.,� ry t ti,T S 4C to 9vir�r �o i^ A-m`Z GDiv Q r.u c.�i o %o Oven OZbOa SyvA N,e "In S S 'k,/o d a/S a 'Cof e V SiuV m r Cntie �iv.v a IC . O n MO004-Aj<INri S P,A- �r 5 SWc4'° Iv $� 3 Ca� Ci ) Referred To: Fire Police Health ervation X Zonin Board Cons Cons n Department of Public Works Other. Historical Commission Buildin Department ------------- u TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING feel Q� UEiC BUILDING PERMIT NUMBER. DATE ISSUED: rn ic SIGNATURE: Building Commissioner/12EeEtor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: _0-1 Q &adoodsf- G 1%636 41A 4w"41aA Parcel Number 1.3 Zoning Information: OZ 1.4 Property Dimensions: �5«1���� Coi%--pCme:) 640(15P 150 VT Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 30 rr 1SFr 30PT I o 1.7 Water Simply M.G.L.C.40.154) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public �/ Private 0 Zone Outside Flood Zone 0 Municipal f>/ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record �� / ((1rr r I rS 3ah ahaej Name(P6ht) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number M Address _r Expiration Date z Signature Telephone 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.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction Existing Building V Repair(s) ❑ Alterations(s) Addition Accessory Bldg. ❑ Demolition lr 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 (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 X00,a0d, 00 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I> as Owner/Authorized Agent of subject property Hereby/aorize to act on My beh , all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 ST 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE - 1 �- ly t'�Kly wUv 'NORTH AND ZONING DISTRICT MAP 6; PARCEL 28 MAP 6, PARCEL 24 32 ELMWOOD STREET 28 ELMWOOD STREET �� MAP 6, PARCEL 29 a' � ti 20 ELMWOOD STREET RESIDENTIAL 4 kPOLITANO FAMILY TRUST, GIAIMO, SANTO S,LT �'�v�' FINOCCHIARO, CONCETTINA A LT MIN.LOT AREA= 12,500 S.F. - CHE MARIA ANNAIAN, TRO VITO D& CAROL J NAPOLITANO Oq THOMAS D&ALFRED A FINOCCHIARO MIN.FRONTAGE 100 FT BOOK 4680; PAGE 216 BOOK 4799; PAGE 119 O BOOK 5295; PAGE 199 MIN FRONT SETBACK=30 FT. (OR AVE.) �,4 4ti MIN. SIDE SETBACK= 15 FT. O MIN REAR SETBACK=30 FT. _ MAX.HEIGHT 35 FT 150.00' MAX. INCREASE AREA=25% 11.5' 24'+- -5' •O `" UH MAP 6, PARCEL 37 19 PRa posed EXISTING 1,7-,3 31 FERNWOOD STREET BLUDING t, I S m DIMARCA,MARIAA o � �RcPasec� 1�R°posec� �. C) lacy BOOK 1455; PAGE 323 o r 3,k t� a 2-1/2 STY. o o v WD.FRM. o S'"p o a -, Vl:4.5, it MAP 6, PARCEL 35 #17-19 9 FERNWOOD STREET (V WALMSLEY REALTY TRUST I R J&M J WALMSLEY, TRS 77 T— ` c� wPORCH BOOK 4162; PAGE 324 11.0' 17 t DIEA ' o is; AIt1�TG,a _ - - - - - FERNWOOD STREET THIS IS TO CERTIFY THAT I HAVE CONFORMED (50 FT. PUBLIC-WIDTH) WITH THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS IN PREPARING THIS PLAN THE PROPERTY LINES SHOWN ARE THE LINES DIVIDING EXISTING OWNERSHIPS,AND THE LINES OF STREETS AND WAYS SHOWN 2- ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED,AND NO en V-1 i J I I • K- 'r'I i - _� �t�C - — Q t - bt LZ �1�jw� �tevv tW t -- PON1 ��jj ^a+.t7�•. 6nfNr/1 lvi v�.csdw a ,S I i h - - - - - - - - - - - - - - - - - - - - - - - - - - - , - - - - - - Q :41 - vQ T129L6;lCtl ti,+oo�raC ..�, ,�� • r I I I i I u I I L ' I t-0 g CIS j I yOUT Zoning Bylaw Review Form u • Town Of North Andover Building Department u "'sSaCHus��u 27 Charles St. North Andover, MA. 01845 A9 q�S4Ao�•F1y45 Phone 978-688=9545'Fax 978-688-9542 Street-.- Map/Lot: treet:Ma /Lot• Applicant: Gan i fr,,4,¢ Regnest: A 3 t7 /(1/06 _ .. } Date: Ir- 9_= a 3 please be advised that after review of your,Application and.Plans that your Application is DENIED forahe following Zoning Bylaw-reasons: ,honing r , Item Notes,, Item A , Lot Area Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies S 3 _Lot Area Complies . K 3 Preexistingfrontage 4- Insufficient Information 4 Insufficient Information °- �• �B ' Use 5 'No access over Frontage 1Allowed .G_ Contiguous Building.Area F, v 2 Not Allowed 1 Insufficient Area 3 tJe;Preexisting 2- Complies 4 Special permit Required 3 Preexisting.CBA 5 - ''Insufficirmation 4 Insufficient Information C Setback . H Building Height ° 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information tine S 6 Rear Insufficient I Building Coverage 6 Preexisting setbacks) -R"r- of�tl 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed ��e.S 2 In Watershed 4 Insufficient Information n �3 Lot prior to 10/24/94 Sigi 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 2 1 More Parking Required e� Not in district +�;,e,g 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existingParkin RemedY for the above is checked below. Item # Special Permits Planning Board Item # Variance 3-q' Site Plan Review Special Permit Setback Variance Access other than Fronta e Special Permit Parkin Variance. Frontage Exce tion Lot S ecial Permit Lot Area Variance Common Driveway Special Permit Hei ht Variance Congregate Housing Special Permit Variance for Si n Continuing Care Retirement Special Permit Independent ElderlyHousin Special Permit special Permits Zoning Board S ecial Permit Non-ConformingUse ZBA M6Den Condo S ecial Permit Development District S ecial Permit Earth Removal Special Permit ZBA Special Permit Use not Listed but Similar dential S ecial Permit pecial Permit special Permit for Sign Special permit for preexisting ecial Permit 2!1 nonconformin The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for changes to the information submitted by the applicant shall be gsubsequent rounds for this review Any inaccuracies,misleading voided.at the discretion ng information,or other suu the Building Department.The attached document titled"Plan'Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all.plans and documentation for the above fife.You must file application form and begin the permitting process. a new permit Bullding Department Official Signakfe Application Received Application Denied r Plan Review Narrative ` The following narrative is provided to furtherr explain ther reasons for DENIAL for the APPLICATION for the property indicated on the reverse side: i f P`.� •,� "j',of �g'✓S S 1. ! t�'�k,�y�H S�'9�nf`ry�p�,}-fi L.�°��{,���'��� ¢Yt�f/•�: /5 /Z r. C/v t^t CQ S �v J y �. �f- `I'1r n vg u d-0,0.r' A-m D CON6� Nt�CJS/U ✓ e y- eOC CQ r�m 5,.5 t-e/0 b N i-JPW Q a�v o/ d/S Z) E%.0.4.d N S i u m 1� C/^ Al D X4-,0/<I N G S PA- cr 5 �� ��►0 Au $ � 3 Ca) C ,a ) Ci ) Referred To: Fire Police Health Conservation X Zonin Board Plannin De artment of Public Works Other Historical Commission Bundina De artment Zoning Bylaw Review Form Y Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 CAUS qui Phone 978688-9545 Fax 978-688-9542 Map/Lot: G 3 Applicant: nOaReE est: a" 3 �n ��rs_ a =nN►L / -.� 7. o 3 Please be advised that afterre view of your.Application and Plans that your Application is DENIED for the pllowing Zoning Bylaw-'reasons: Zonrng — . .. Item Notes, A Lot Area Item Notes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies 3 Lot Area Complies., `1 3 Preexisting frontage 4 Insufficient Information :iB Use JQ 4 Insufficient Information 5 No 1 Allowed access over Frontage . <� G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use:Preexisting, . 2 Complies 4 Special Perrnlf Re aired S 3 Preexisting:CBA 5 - Insufficientinforritation._ 4 Insufficient Information C Setback Heigh �-5 c, H Buiilding t 1 All setbacks co m.i 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height 4 Right Side Insufficient 4 Insufficient� Information `E`� S 5 Rear Insufficient 'c� ( Building Coverage 6 Preexisting setbacks) or Det) 1 Coverage exceeds maximum 7 Insufficient Information 2 overage.Complies D Watershed C 3 Coverage Preexisting 1 Not in Watershed �e s . `� 4 Insufficient Information e s 2 In Watershed Sign 3 Lot prior to 10/24/94 4 Zone to be Determined 1 Sign not allowed 2 Sign Complies 5 Insufficient Information 3 Insufficient Information -E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district ~- K,e-5 2 Parking Complies S 3 Insufficient Information 3 Insufficient Information 4 Pre-existingParkin Remedy for the above is checked below. Item # Special Permits•Plannin Board Item # variance �- Site Plan Revi11 ew S ecial Permit Setback Variance Access other than Fronts e S ecial Permit Frontage Exception Lot Special Permit Parkin Variance. Common Drivewa S ecial Permit Lot Area Variance Con re ate Housin S ecial Permit Hei ht Variance Conti nuing-CawRetirement Special Permit Variance for Si n Inde endent Efderl Housin S ecial Permit S ecial Permits Zoning Board S ecial Permit Non-Conformin Use ZBA Large(.state Condo S ecial Permit Planned Development District S ecial Permit Earth Removal Special Permit ZBA PS ecial Permit Use not Listed but Similar Planned Residential S ecial Permit R-6 Density Special Permit ecialPermitforSi npecial permit for preexisting Watershed Special Permit nonconformin The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be.voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all,plans and documentation for the above file.You must file a new permit application form and begin the permitting process. Building Department official Sign g Application Received Application Denied Plan Review Narrative The following narrative is provided to further; ~p . I FIC '.r APPLICATION for the property indicated on thereverse s de ons for L7ENIAl.,for the ' "� 3 tell 1�'s�1 Y' ,�f '�` "•^.^"-C l ,_ �"F I�� Y '� r c4-to.ri / 9i o� - +s e toW`F' /Yr► )O-IA-,,A .t/r ArV q' j�D'�.•�'dC n n _/ aFD/� i4 AI C('NQTNur a ' 4 rS'ry G G e d` . (P P.v sS a n. o/ oa/s"Le lu a rD r4.4 C^tie i--A P m v r-G r2/c ti G ee 5 V 4 C % 3: r C , f . A } Referred To: ' f Fire Police Health' X Conservation ZOnlh Board Plannin ne artment of Pubk Woks Other. Historical Commission z z Buildin De artrent sv TOWN OF NORTH ANDOVER BUIT.DING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING , t ,z BUILDING PERMIT NUMBER: DATE ISSUED. SIGNATURE: Building Commissioner for of Buildings Date Z SECTION i-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: doomz Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 1S, ljUO /,5'0 Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide RecjWred Provided Re aired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ownmr�of Record Jr` . fZ SO —1 y, Name(P Address for Service - azo Signature Telephone c, (a- Z PP l()Se') 2.2 Owner of Record: Name Print Address for Service: O z Signature Telephone AAMw SECTION 3-CONSTRUCTION SERVICES 3o 3.1 Licensed Construction Supervisor: Not Applicable ❑ "Wd,k P & Licensed Construction Supervisor: SeLicense �Ve�C� Number� C4 rr ��. �� �/-� c�3ca6'� OT'1 Address Expiration Date ic Signature Telephone rM 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number M Address Expiration Date z Signature Telephone SECTION 4-WORKERS COMPENSATION(M.G.L. C 152,.§ 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this apl lication. Failure to provide this affidavit will result in the denial of the issuance of the building rmit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: / oa17 rAa-f kad 7Z) ExYs4t1L1& I SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to bek '' Mk"0 3 Completed by permit applicant 1. Building (a) Building Permit Fee f�U Multiplier 2 Electrical (b) Estimated Total Cost of O D(� Construction 3 Plumbing O 00 Building Permit fee(a)X(b) 4 Mechanical(HVAC) p 00 5 Fire Protection / ,. 000 6 Total 1+2+3+4+5 J ©OD Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 I, � PCLfK(.�Cc. . _ 0 ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print N e -Z' Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR EMBERS 1 ST2 3 KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE �pnRry Zoning Bylaw Review Form Town. Of North Andover Building Department 27 Charles St. North Andover, NSA. 01845 SACHU Phone 978-688-9545 Fax 978-688-9542 Street: Ma /Lot: 6 —JG A Ilcant• d m'&e a V 6 o Request: 6� '1 X 6-.Q . (J;V Date: –o/ Please be advised that'after review of your"Application and Plans your Application is /DENIED for the following Zoning Bylaw.reasons: Zoning. Item Notes Item A Lot Area Notes F Frontage 1 Lot area.Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies 3 Lot Area Complies <° S 3 Preexisting'frontage 4 Insufficient information 4 Insufficient Information B–, Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required4 eS 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 9e.5 8vibilvi 2 Complies 3 Left Side Insufficient3 Preexisting Height 4 Right Side Insufficient 4 Insufficient Information y 5 Rear Insufficient g eS `:pis % (-Building Coverage 6 Preexisting setbacks 2 S 1 Coverage exceeds maxim um 7 Insufficient Information 2 Coverage Com lies D– Watershed 3 Coverage Preexisting I Not in Watershed: �S 4 Insufficient Information 2 In Watershed Sign 3 Lot prior to 10/24194 1 Sign not allowed A 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information E Historic District 3 Insufficient Information K Parking N 2 N 1 District review required 1 More Parking Required Not in district e-S 2 Parking Com lies 3 Insufficient Information RemedY for the.above is checked below. Item # Special Permits Planning Board. Item# Variance Site Plan Review S ecial Permit Access other than Fronta e S eeial Permit Setback Variance Fronta a Exce tion Lot S ecial Permit Parlun Variance Common drive�ara S .eciai Permit Lot Area Variance Con re ate Mousin .S ecial Permit Hei ht Variance Continuing Care Retirement Special Permit Variance for Si n -Independent Elderl Housin S ecial Permit S eclat Permits Zonln Board FO- e Cando S ecial Permit S ecial Perm"It Use ZBA velo ment.District S ecial..Permit hRemoval S ecial Permit ZBAidential S ecial Permit ecial Permit Use not Listed but Similar S eclat Permit ecial Permit for Si n S ecial Permit Other Su I Additionallnformation The above review and attached explanation of such is based on the plans,request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies,misleading.information,or other subsequent changes to the information submitted bythe.applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plad:Review Narrative"shall be attached hereto and incorporated herein by reference. The buildingdepartment will retain all.plans and documentation for the above file. "Building Department Official Signature —�B � Application Received Application Denied Denial Sent If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons fob the action on the property indicated on the reverse side; XP e e XtS ti U v fU.� ji l�li,U f� rvn�7� 4- ><12 S���iAc1l act //. aC/ r//,Ill / a ,v e y4r S7 ti v �el141 a2i 1rV, �vr r ea l^ S e Referred To: Fire Police Health Conservation Zonin:,Board Plannin De artment of Public Works Other Historical Commission ZoningBylawDenia12000 BUILDING DEPT Location 17 / F I't ° No. /n / Date :2 Z` NaRTh o� TOWN OF NORTH ANDOVER ,...o .�'"c a • • �. Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # r- Z r r 1 15866 U—Building Inspector a ¢ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING 454 BUILDING PERMIT NUMBER. DATE ISSUED: k,2- 0 4 SIGNATURE: Buildin Commissioner/InTector of Buildings Date 22 2 Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: D33- ©© 14 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided v 1.7 Water Supply M.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record Name(Print) WAddress for Service "4,L,L. �'�R,r,_.,__ //// ''7sr — -19 V I 7S—Z Signature Telephone 22 Owner of Record: Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number mn Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number r Address r s Expiration Date z Si nature Telephone Y♦ 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.......❑ SECTION 5 Description of Proposed Work(check all a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify + Brief Description of Proposed Work: An SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIALUSE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC Grd/ 5 Fire Protection 6 Total 1+2+3+4+5 a,/'` $moo _ ®d 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 behal� in all matter relative to by this building permit application. -- 1 Signature of er Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si at ure of Owner/A ent Date NIM iiiiii�illill�m NO.OF STORIES SIZE - BASEMENT OR SLAB SIZE OF FLOOR T12v1BERS OT 2 ND 3 RD SPAN DIlvIENSIONS OF SILLS DIMENSIONS OF POSTS DIIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Norr r►y �,E D Town of ........ .... .. ? LAA - dover, Mass., - COCMIC tom(V %S RATED H BOARD OF HEALTH PER T T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ....... . ..... Foundation has permission to erect........................................ buil ings on ../7!./.?......... .................................... Rough to be occupied as A Chimney provided that the person accepting this permit s in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes an By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION AR S ELECTRICAL INSPECTOR W. /!'/�...!... Rough .. ... ...... Service BUILDING IiIKSP CTOR Final Occupancy Permit Required t0 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 Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE smoke.Det. 1 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.......❑ SECTION 5 Description of Pro oied Workcheck all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) . n I Accessory Bldg. ❑ Demolition ❑ Richard F.Morello Jr- President Brief Description of Proposed Work: a 2� �R terra Construction Co., Inc. } SITEW ORK,SITE UTILITIES EQUIPMENT RENTAL t 4 Tel:(781)246-3121 Railroad Avenue Fax:(781)246-3118 Suite 204 Wakefield,MA 01880 Email:Tierraconstruct@aol.com 1 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to € ( ) 7 �C�� � � � Completed b rnllt fl hcant z �� � nC e isz � ,°B� 1. Building (a) Budding 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 o -- o m Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behal' in all lnatter relative tow uthorized by this building permit application. Si ature of er Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION property As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si attire of Owner/A ent Date BONN NO. OF STORIES SITE BASEMENT OR SLAB SIZE OF FLOOR TIlvIBERS 1 2 ND 3 SPAN DIMENSIONS OF SELLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andovert �`Q } Building Department Q 27 Charles-Street a North Andover, MA. 0184,5 D. Robert Nicetta ' °t<.�a `� 15�'S'fGHtJ��i� Building Commissioner . (978) 688-9545 : 978 688-9542 Fax HOMEOWNER UCENSE EXEMPTION Please print DATE r-- JOe LOCATION /7) $/� f'ea.0- 4 _ � e, 03 3 Number Street Address Ocl r114 Map/lot HOMEOWNER l3 2 ?1 ^ Y Name Home rhon.e Warlc Phone 'RESENT MAILING ADDRESS _Qc :. � City Town 0 TbState Zip Code The current exemption for"homeowners"was eludended to include owner-occupied dwellings of two units or less and to allow such homegwners to engage an individual•fa hire who does. not possess a license,.provided that the owner acts as supervisor. (State Building Code section 108.35.1) iDEFINITION 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 sbuctures ac- ltessory to such use and/or farm structures. A person who oMstr cls tr�ore than one bane c 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 hOshe understands the Town of No_Andover Building Departrnent minimum inspection procedures and requirements and that he/she vatl comply with said procedures and requirements_ HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL