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HomeMy WebLinkAboutMiscellaneous - 21 SAWYER ROAD 4/30/2018I NORTH .ANDOVER Buim ATO DEPARTMENT 1600 Osgood Street North Andover Tel: 978-685-9545 Fax: 978-688-9542 .BUSMESSFORM FOR TO WN CLE) DATE: NAME:_ ��✓�� � � We /d re. / c� � � J'Pr �► �� � P ADDRESS: c� % . �'A.Wib ZON1 GI)ISTRITO1. ���3�rvG}t��J ,",�►� TYPE OF BUSINESS. Aud m �;�v r ? ti del ' �r�► P� �r�tr ��,:d. (�� ,��, � � J BUMDINGLAYDTJT PROVIDED: YES NO A7VAILABLEPARKING SPAMS: ZONING BYLAW USAGE: 'SES NO SIGNA.TUPIE 13USMS S FORM FOR TOWN CLERK N 2.40 Home Occupation (1989132) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary *to the use. of the building for living ptuposes. Home occupations shall 'include, "bu't not limited to the following uses; personal services such as funiished by an ar& or instructor, but not occupation involved with motor vehicle repairs, be -u4, parlors, animal ]fennels, or the conduct of retail business, or the manufacturing of goods, which impacts thi 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 ific. owner of thd home occupation and residing in said divelling, 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) percemt of the existing gross floor area of ;the dwelling unit. so used, not to exceed one thousand (1060) square feet, is devoted to 'such use. In conmctionwith 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 dettimmtal 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 objectiomble or detrimental to any residential use within the neighborhood; g. Any such building shall include no features of design_ not cust6mary in buildings for residential fLI" Signature Date v Date../6/ .1........... TOWN OF NORTH ANDOVER PERMIT FOR WIRING I / ) This certifies that .,..,...,Mo/ ..........................nn........................................ has permission to perform�,., ,............. Z..... .................. Lj"g,- 'z-, C-�[.._ wrongin the builldding of......................`.,.�...................................................................................... at ....... / �J �v �� /r h Andover, Mass. ....../....................:....................................... Fee ..:--?............ Lic. No. L %t%, ..... ........... ELECTR CAL INSPECTOR Check # 3171 North Andover MIMAP April 22, 2015 020:0=0034 ,8\ 031.0.-00.49 a� 147 LYMAN1 RD 4-+SAWYER 2.0:0-0035:' RQ 03,1.0-0048 031.0-0_;05.0 031,0=0052 020:0-0065 60 MIDDLESEX,S;_ 8ELYMANhRD' 1091LY11CAN RD 03-10=:005;1. 36, SAWYER,RD .0.20:.0=00'60. 103 LYMAN RD 45':SAWYER4RD �p 032'.0 0036: 021.0=.0.049 020:0=0059' 28 SAWYER.RD 95 LYMAN4 RD' 032:0=0037 3S`tSAWY1ERiRD 032:0-000.3 6 O 21:0=0048 ti0 21.Q-00 20,SAWYER,RD f� .51 ` 032.0;-0038- 0.23.0=00,47' a, i \ 27 SAWYERRD 03-2.0'-00 .:04 12ISAWY;ER-,RD \` 10§,M LIN `ya \ 021.0-.0050 DR 0.4 `,, 211 SAWYERRD 021.0-0040 12 PEMBROOK;RD. �Qti \ .\ � 03 2:0;=0005': 60' / 98. MIFF,__LIN; QR 15 S . WYER,RD. 021:0-0051 X -032:0=0013 moo 02;1.0-0001 . 20aPEMBROOK;RD 032.0-00.0.6: pO \0 C�\ 88 MIFEL•IN OR 2i PEMBROOK,RD 021,0;'=0042 o3a.o,-0,002 2.6, 032:0-0012 REMBROOK,RDi 0� 1 82,MIF.FU Nr,DR' °0 02:1 0-.005;2° 29 PEMBROAKRD, 40P..EMBRO'OK"RD 021.0-.0,054, 021:0-0002. 7.2,MIF,FLIN UR, 032:0-0015; 021.0:-0006' 021.0-0053_ $3IMIEF,LINi,D9, 0,32:0-0031' 032:0=001'_, - - Rail Line': Wetlands Zoning Interstates C Exempt Lands — I Busine G Busine s 1 Dlstrict s 2 District Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, — SR Roads � t Easements C Busine O Busine GGener Planne s 3 District s 4 District 111410111 Business District f ao r q Commercial Dev O�tu �O �. O� �e O Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of North Andover. Additional data provided by the Executive Office of Environmental Affairs/MassGIS. The information depicted on this map is 0 MVPC Boundary Q Municipal Boundary Zoning Oveday :;. Comido Q Corrido O Corrido Induslri Development Dist 3' L Development Dis[ O _ Development Dist 1' 9 1 District # i for planning purposes only. It may not be adequate for legal boundary definition or regulatory g ry interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY 0 Adult Entertainment :.` Induslri G Induslri 12 District a ,# # i 13 District r i OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT Downtown Overlay District © Historic District O Ind Reside i o r y w �, # 1 S District ' ' ce 1 District #l,' pO��r�o v.(°J ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION ® Water Protection Reside ce 2 District SsgCMus�t ❑ Parcels ❑ i ce 3 District C HydrograFeatures phic 1 " = 82 ft d de w .de ce4 District ce 5 Disrict --- Streams de ce 6 District i—ge Reside.al District 'S Commonwealth of Massachusetts / Official Use Only Department of Fire Services Permit No. ? (v Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. V (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: v-) _ t () - i �j City or Town oh 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) 2.1 Sq W ye, j, Q, Owner or Tenant �J �Sh ipgLk I Owner's Address M2 Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building Existing Service .160 Amps i w /7_c4 o Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nat re of Proposed Electrical Work: coo -e- 7rAInACI S,., (Z P— " n" Telephone No. 99.22- y23 96-tgi� No ® (Check Appropriate Box) Utility Authorization No. Overhead ®. Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters 7 - Completion Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above In- El In- ❑ o. o Emergency Lighting rnd. 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 Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number .............................................................. Tons KW No. of Self -Contained Totals: 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: T, Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: —1000 t (When required by municipal policy.) Work to Start: 10 - I \ 1 y 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 certify, under the ptr�nsland penalties of per'ury, that the information on this application is true and complete FIRM NAME; . Mft,-, N.\A t L LIC. NO.:� � Licensee: t pyla e \,)� Signatu LIC. NO.: (If applicable, enter "exempt" in the license number line)Bus. Tel. No. -�� Address: Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Sa ety "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/AgentPERMIT FEE. $ 1J' — 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. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall.be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: ***Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass F?1 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: " Y Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass F?1 Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass Failed 0 Re- Inspection Required ($.) ❑ 3 Inspectors Comments: r Inspectors Signature: Date: FINAL INSPECTION: Pass 0 Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: ate: V DEB WEINHOLD ... TOWN OF MERRIMAC, MA. .......dweinhold@townofinerrimac.com 1 The Commonwealth of.Massachusetts Department of IndustriglAccidats Office of Investigations 600 Washington Street .Boston, MA 0.111 www.massgov/dia 'workers' Compensation Insurance Affidavit: Builders/Contract Name (Busyness/Organization&dividual):. 22 lf�, fXc; City/State/Zip:, Phone #: `.� 2 " .�16 re bu an employer? Check the appropriate box: 'Type of project (required): I'S4J.am a employer with 4• ❑ I am a general contractor and I ` 6, ❑New construction employees (fall and/or part-time,).* have Med the sub -contractors 2. [l I am a sole proprietor or partner- listed on the attached sheet. 7• [1 Remodeling ship and'haveno.employees These sub -contractors have 8. F1 Demolition working forme in any capacity. workers' comp. insurance. g, F1 Building addition [No workers' comp. insurance 5. [l We are a corporation and its 10.[1 Electrical repairs or additions required.] officers have exercised.their 3111 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.Roofrepairs insurancere ed. employees. [No workers' a 13.❑ Other comp, insurance required.] xAny applicant that checks box01 must also fill out the section below showingtheir workers' compensation policy information. i -Homeowners who subm itihis affidavit indicating they go doing all wont and then hire outside contractors must submit anew affidavit indicating such. TContractors that cheoktbis box must attached an additional sheet showing the name of the sub -contractors andtheir workers' comp. policy information. I am are employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. 1.t Insurance Company Policy # or Self ias.Lie. #: 1 b we � I/v��l y ExpirationDate: (o°'Z�"' � y Job Site Address: 1 `� lu'�/Q ) City/State/Zip:g An 6Uv(e_ M oil) 3 Attach a copy of 0e workers' compensationpoliey declaration page (showing the policy number and expiration date). Failure to secure coverage as requitedunder Section 25A ofMGL o.152 can lead to the imposition of criminal penalties of a flue 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 tine of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for ffi#ance coverage verification. I do Izereby trim tree information provided above is true and correct. Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing.A.uthority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone Information and Instrnctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an 01ployee is defined as "...every person iA the service of another under any conlxact o1 hire, express orimplied, 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 trostee of an individual, partnersbip, association or other legal entity, employing employees. Ifowever the owner of a dwelling house having not snore than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction, or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean 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, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' arycompensation affidavit completely, by checking the boxes that apply to your situation and, if necess, supplysub-contractors) name(s), address(es) and phonenumber(s) along with their certiticate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members ox partners, are not required to carry workers' compensation insurance. If an LL C or LLP does have employees affidavit Be advised thattbisaffidavitmaybesubmitted tothe Department of Industrial Accidents for confrmation 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 thepermit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the affidavit fox 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. iu addition, an applicant that must submit multiple permit/Ecense applications in any given year, need only submit one affidavit indicating current policy information (ifnecessary) and under "Job Site Address" the applicant should write "all locations in . (city or town) " A copy of the affidavit that has been officially stamped or marked by tho city or town may be provided to the applicant as proof that a valid affidavitis 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 ox permit not related to any business or commercial venture , (i.e. a dog license orpermit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Tnvestigaiions 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: Tho Coomojjwoajtb,ofUassa.,r vsPifs - Depat rent ofind-a5ftial A,cclde,.ts Offioe OURVestzgavoin 60 WashjV(m ixeei< Boston.,UA02111 ,- Tel # 617-727-4900 oA406 or. 1-877�N����`� Revised 5-26-05 Fax # 617-727-7749 WWW-MaagovIcha w ti Date ...... F :....7 .-0.r, TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that AlexQL /1.112�................................. .....................//.............. ................. has permission to perform .....r.( 4-AeLr t/ wiring in the building of .......... rs. '! ...,. . �<�-%W1................ at ......... �....5 ........!t .................... . N h Andover, Mass. Fee ../Z ."—'—. Lic. No.4271'.W ........ ........ ........ ... ELECTRICAL INSPECTOR l Check # 6 Nk 7 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit (p fix No. FL{ "% Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: -/,)MP To the Inspector of Wires: By this application the undersigned gives notice of his or her intent' n to perform the electrical work described below. Location (Street & Number) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Ute' No ❑ (Check Appropriate Box) Purpose of Building/ 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: Completion of the following, tahle mm, ho -nivel/ h„ the tncney of lVir— No. of Recessed LuminairesNo. 6 of Ceil.-Susp. (Paddle) Fans No. o Tota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminairesg 3 Pool Swimmin Above ❑ In ❑ rnd. rod. o. o mergency ig mg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. of Gas Burners No. o Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers / ( Heat Pum Totalsm Nuber Tons KW No. ofSelf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. o No. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: 4160 22W CU &641d Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (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:) 1 certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Z l�% ,C LIC. NO.: 6aq Licensee: 0 L`11Z (ft Signature LIC. NO.: Cf2 / 6 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.:—�j Address: f7 C111/ -Q 91' �— po1��5'`S Alt. Tel. No.: *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: 1 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. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. FPEI?MIT FEE: $ rt.gfL "7- /-C- q - ;(tg.eG %'112 11