HomeMy WebLinkAboutMiscellaneous - 195 BRIDLE PATH 4/30/2018 195 BRIDLE PATH
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' BOARD OF HEALTH �,7
`H"SES NORTH ANDOVER, MASS. o py S
APPLICATION FOR WELL AND PUMP PERMIT
Permit # Date
A permit is requested to: drill a well install a pump
LOCATION: J \�-?� � r� ` Lot #
Owner (�D�'�►�� 1+2LI/-Jt Address tq5 1�('-�t1�� .�P41±�e17 _41 3 - ?O
Well Contrctr Ct 41/l• Q oLiiNS =,jc. Add. (29 6,0cFoP-a ". Tel
Pump Contrctr Add. Tel .
WELLS (To be completed at time of pump test. )
Type of well Use J
Diameter of well Size of casing
Depth of bed rock Depth casing into bedr 40
Seal been tested? Yes (_) No (_) Date of test
Depth of well Water-bearing rock
Depth to water Delivers GPM for
(how long?)
Drawdown feet after pumping hours at GPM
Date of completion J • �
Signature of well contractor
PUMPS (To be filled in before installation. )
Name &size of pump Type
Size of tank Pump delivers GPM
Pipe used in well: Cast iron (_) Galvanized (_) Plastic (_)
Sleeve used to protect pipe? Yves (_) No (_) Type well seal
Date
Signature of pump installer
Date water analysis report submitted to Board of Health
Plumbing inspector Wiring inspector
Board of Health
TOWN OF NORTH ANDOVER of NORTH 1
tsa.tD is '1'
FOj 4`'r a Ta OOp
HEALTH DEPARTMENT
27 CHARLES STREET �e
NORTH ANDOVER, MASSACHUSETTS 01845
SSACHUSEt
Sandra Starr Telephone(978)688-9540
Public Health Director FAX(978)688-9542
June 26, 2001
Robert Ercolini
195 Bridle Path
North Andover, MA 01845
RE: Application for a permit to drill a well
Dear Homeowner:
The Health Department has received an application to drill a new well at 195 Bridle Path, North
Andover. Before a permit can be issued you must submit to the Health Department a site plan
showing your house footprint and location on the lot, any wetlands within 200 feet of the
proposed location for the well and the well location. This must all be to scale.
Please note that you may also be required to file with the Conservation Commission if wetlands
are near to the proposed well and to the Planning Board if you are located in the Watershed.
If you have any questions about the Health Department requirements for the well permit, please
do not hesitate to call me at 978-688-9540.
Sincerely,
,?
Sandra Starr, R.S., C.H.O.
Public Health Director
Cc: Licensed well driller
Conservation Dept.
Planning Dept.
File
f NORT{i
TOWN OF NORTH ANDOVER ° �_�•° -•��
HEALTH DEPARTMENT p
27 CHARLES STREET _ a
NORTH ANDOVER, MASSACHUSETTS 01845
SSACHUSE
Sandra Starr Telephone(978)688-9540
Public Health Director FAX(978)688-9542
MEMORANDUM
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DATE: March 28, 2002
TO: Jackie Byerley, Interim Town Planner
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FROM: Sandy Staq�o
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RE: 195 Bridle Path
Last May the owner of 195 Bridle Path had his well driller apply to the Board of Health
for a landscaping/irrigation well. The well driller was told that a Special Permit from the
Planning Board was necessary before Health could grant him a permit. Can you please tell me if
and when Mr. Ercolini, owner, received his Special Permit? I have had no further dealings with
him on this matter and would like to know the status. Thank you.
I
Town of North Andover cf NORTH
3? a+�+�ao Ysa6��OG
Office of the Planning Department O
Community Development and Services Division
27 Charles StreetArea
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North Andover, Massachusetts 01845 SswcMas��
Telephone(978)688-9535
Fax(978)688-9542
MEMORANDUM
DATE: March 28,2002
TO: Sandy Starr,Health Director
FROM: Jacki Byerley,Interim Assistant Town Planner
RE: 195 Bridle Path
In review of the Planning Department files as of March 28,2002 Mr.Ercolini of 195 Bridle Path has not filed and
application for a Watershed Special Permit. Mr. Ercolini had made inquiries last summer but has not filed.
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BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
C' Date. -A A.-A ,
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o� °� TOWN OF NORTH ANDOVER ;
' PERMIT FOR GAS INSTALLATION
y,SSACHUSE�
This certifies that . . �;.�
has permission for gas installation
in the buildings of . .CZ � �. . . �;r<,a� ��... . . . . . . . . . . . . .
at 4. 4-(*^ . . . . . .. North Andover, Mass.
Fee 60:GQ. Lic. No./A 2..6 . . r
GAS[ SPECTOR
Check#
-NL41,iSAa SETTS UNIFORMAPPLICATONFORPEMN,Iff TO DO GAS FITTING
(Type or print) Date
NORTH ND/OVER,MASSACHUSETTS
Building Locations / Permit#
<_ �/
Amount
A
ryy/Owner's Name
New RenovationF1Replacement Plans Submitted
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B A S E M ENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR .
4TH . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . VLOOR
STH . FLOOR
(Print or Che one: Certificate I tailing Company
Name Corp.
Addres — Partner..
BLIs ness Te ephone Firm/Co.-
Name
irm/Co.Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Ch ck o
I have a current liability Insurance policy or it's substantial equivalent. Yes No 0
If you have checked yg�, please i 4 icate the type coverage by checking the appropriate.b .
Liability insurance policy Other type of indemnity Bond
K 1 0 13 1
Owner's Insurance Waiver: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of[tie
:Plass.General Laws:and that my signature on this permit application waives this requirement.
Check one: '
Signature of Owner or Owner's Agent Owner El 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,
hest of m} knowledge and that all plumbing work and installations performed under Permit Issued For this supplication will be in
compliance with all pertinent provisions of the,�fassu usctts. ate G is ode and Ch, • 112 of the General Laws.
By: Signature of Licensed Plumber r Gas Fitter
Title 0 Plumber
City;Totvn Gas Fitter License Qum er
aster
APPROVED(OFFICE USE ONLY) ourneyman
COMMNVI/EA 0 MASSACH'USET`TS
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LICENSED AS A JOURNEYMAN PLUMB
[ ISSUES THE ABOVE LICENSE TO -`
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►osted as requ;rc i
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Date............'. .Zc ...
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°•t``°:•1"° TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
SSAcmUSES
This certifies that ............. .... r".0.
has permission to perform:_ G71 . .....4C
....................................
wiring in-the buildi f... !. .f � .11 � ......................
at......, � /.. ...........�ur� ,North Andover,Mass.
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Fee.` e............ Lic.No..J9.741V�.......... X1.1 f........... ..
ELECTRICAL INSPECTOR U
y Check #
Permit No. g �
Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical CoMdeC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPEALL INFORMATION) Date: 2ZO 4
City or Town of: NORTH ANDOVER To the Inspec or ofWires:
By this application the undersigned gives notice of his or her intention to erform the ele ical work described below.
Location(Street&Number) 11715 �i ,AO,
Owner or Tenant Z 16 Telephone No. j
Owner's Address c i�-31I/1
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building ��j�E,�}c'_cam Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: %2),67W//r-
Completion 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
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- E] No.of Emergency Lighting
rnd. grnd. Battery Units
No.of Receptacle OutletsNo.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches �� No.of Gas Burners No. InDetection and
Initiatin Devices j
No.of Ranges l No.of Air Cond. Tons TotNo.of Alerting Devices
No.of Waste Disposers Heat Pump Number ns ToKW No.of Self-Contained
p 2 Totals: .......... Detection/Alerting Devices
No. of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other
p g Connection
No.of Dryers 7 Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of WaterKW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: r ��® / (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 cover is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:
I certify,under the ains an enalties of perjury,that the informatio oz this applic do is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Lu1Z'(' -G`~� � Signature
(If applicable,enter "exempt"in the license umber line.) us.Tel No.:.®lSZ %
Address: '�t? lAlt.Tel.No.:-j 7& - ?�/3�
*Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: 1 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
Owner/Agent
Signature Telephone No. PERMIT FEE. $
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston MA 02111
a� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): � —` � g_9
Address: (Q J) 0 C—TH �F_A _
�I �n �
City/State/Zip i� �, Phone#: i
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Are yo 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. E]New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7. 21 emodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
y working for me in any capacity. workers' comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
� officers have exercised their 10.[:]Electrical repairs or additions
required.] o
3.❑ I am a homeowner doing all work right of exemption per MGL 11.F1 Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs
insurance required.]i employees. [No workers' 13.0 Other
comp.insurance required.]
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*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providin workers'compensation insurance for my employees. Below is the policy and job site
information. f
Insurance Company Name: <
Policy#or Self-ins.Lic. Expiration Date:
Job Site Address: 1�_ , C a'� l�'Cf—F 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 insuran coverage verification.
Ido hereby cer y under ce ns, nd penalties o -that the information provided above is true and correct
Signature: Date: '` _7b-7
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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NORTH ANDOVER BUILDING DEPARTMENT
7' DRATiD� �ty 1600 Osgood Street
�ssacwus��
North Andover
Tel: 978-688-9545
Fax: 978-688-9542
BUSINESS FORM FOR TOWN CLERK
DATE: t d `i 2 0 l 0
NAME: • AL ssoo,+
ADDRESS: �( S �%J—q#
ZONING DISTRICT:
TYPE OF BUSINESS:
0 J! (k< 4tw ti U ce
BUILDING LAYOUT PROVIDED: YES NO
AVAILABLE PARKING SPACES: 'N O C co 6pml- -'T m{ �w con
ZONING BYLAW USAGE: YES NO
BUILDING INSPECTOR SIGNATURE
BUSINESS FORM FOR TOWN CLERK
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2.40 Home Occupation(1989/32)
An accessory use conducted within a dwelling by a resident who resides in the dwelling as hisp rincipal
address, which is clearly secondary to the use of the building.for living purposes. Home occupations shall
include, but not limited to the following uses; personal services such as furnished by an artist or instructor,
but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or the conduct of
retail business,or the manufacturing of goods,which impacts the residential nature of the neighborhood.
4. For use of a dwelling in any residential district or multi-family district for a home occupation, the
following conditions shall apply:
a. Not more than a total of three (3) people may be employed in the home occupation, one of
whom shall be the owner of the home occupation and residing in said dwelling;
b. The use is carried on strictly within the principal building;
c. There shall be no exterior alterations, accessory buildings, or display which are not customary
with residential buildings;
d. Not more than twenty-five (25) percent of the existing gross floor area of the dwelling unit.
so used, not to exceed one thousand (1000) square feet, is devoted to such use. In
connection with
such use, there is to be kept no stock in trade, commodities or products which occupy space
beyond these limits;
e. There will be no display of goods or wares visible from the street;
f. The building or premises occupied shall not be rendered objectionable or detrimental to the
residential character of the neighborhood due to the exterior appearance, emission of odor,
gas, smoke, dust, noise, disturbance, or in any other way become objectionable or
detrimental to any residential use within the neighborhood;
g. Any such building shall include no features of design not customary in buildings for residential
use.
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Signature Date
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2 Silver Ledge Road, Newbury, MA 01951
Office: 978-462-4331 • Cell: 978-973-2366 • Fax: 978-462-5528 • email: jfix@comcast.net `
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4
August 16, 2010
Inspector of Buildings—Town of North Andover
1600 Osgood Street
North Andover, MA 01845
Re: Residential construction at 195 Bridle Path,North Andover, MA
Dear Building Inspector:
On August 16, 2010, I visited the residence at 195 Bridle Path in North Andover to
observe the new construction. During my site visit I observed that the structural framing,
which was substantially complete,had been constructed in general accordance with—or
met the intent of—the structural drawings which I stamped.
If you have any questions,please feel free to contact me.
I
Sincerely,
vi of dt
JOSEPH P. „
FIX
STRUCTURAL
oseph P. Fix,P.E. No.34051
stet �
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Date ,/.`"
"O Rr"1� TOWN OF NORTH ANDOVER
PERMIT FOR PLUJiMING
k' ,SSACMUSE�
pp C
This certifies that . . . �.�?G.'.!9 . . .�. . (.l' .��. �.`... . . . . . . . . .
has permission to perform ...... . . . . . . . . . . . . .
plumbing in the buildings of ..'. . . . . . . . . . . . . . . . . . . .
at . . . ��? �� 1? ��. . �. h.{l . . . . . . ., North Andover, Mass.
Fee. .?.).-. . .Lic. . . . . . . . . . .,n Y - , . . . . . . . . .
PLUMBING INSPECTOR
Check #
86 .7
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
Date
BuildingLocation Owners Name �� Permit#
Amount
Type of Occupancy
New Renovation Replacement Plans Submitted Yes No
FIXTURES
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W x a U a
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H x x p *4 04 w O
a x A A x as
SUMM
sASE"M
NES
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4MHAOM
5M It"
sMHAOM
7MHi"
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(Print or type) Chec one: Cicate
Installing Company Name -�' - Corp.
Address Partner.
Business Telephone Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indica the ype 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 of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I'have su mitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work d tions performed un e e t Issued for this application will be in
compliance with all pertinent provisio�as-ef assach e s State Plumbi g hapter 142 he General Laws.
BY gnature-37-Licensea Fluwoer
TXpe of lumbing License
Title
City/Town License Numoer Master ❑ Journeyman
APPROVED(OFFICE USE ONLY ;E
Date. l `./�!� . .... . . ..
Of HpRTM
o� °' ° TOWN OF NORTH ANDOVER
' PERMIT FOR GAS INSTALLATION
• p9 �
SAC14 5ES
This certifies that . . . . /?� a7 !'-• ? /� .? '�C ` �„
has permission for.gas installation� �.a--z,�!` . . . . . . . . . .
in the buildings of . . . `. . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . .I.G. . . . . . .. North Andover, Mass.
Fee. ° .`. Lic. No.21. . . . . . . . . . .
GAS INSPECT6R
Check# / 76
7254
MASSACHUSErI'I'S UNIFORM APPLICATON FOR PERMPT TO DO GAS FITTING
(Type or print) Date
NORTH ANDOVER,MASSACHUSETTS /
Building Locations/ Permit#
Amount$
Owner's Name
New❑ Renovation Replacement ❑ Plans Submitted ❑
WC6 E-4
W a+ p U
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W Er W p a.
Gw w w z a a W W W U a
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O x a A C7 UO 0 9 > A Oa F O
SUB -BASEM ENT
p BASEMENT
1ST. FLOOR
k2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
STH . FLOOR
(Print or he one: Certificate Installi Company
Name ' Corp.
ce ❑ress Partner.
Add
Busyness Telephone
❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Che k o
I have a current liability Insurance olicy or it's substantial equivalent. Yes No❑
If you have checked yes,please i dicate the type coverage by checking the appropriate ❑
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:
Signature of Owner or Owner's Agent 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 installati s performedunder Pe it Is ued for this application will be in
compliance with all pertinent provi s ate Gas Code and 1 - of the Ge Laws.
i
Signature of Licensed Plumber Or Gas Fitter
Title ❑ Plumber
Tit
City/Town Gas Fitter License Number
Master
J
APPROVED(OFFICE USE ONLY) ourneyman