HomeMy WebLinkAboutMiscellaneous - 22 BUCKLIN ROAD 4/30/20181
4
6/14/2016
20570
This is an e -permit. To learn more, scan this barcode or visit north andoverma.viewpointcloud.com/#/records/20570
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that Robert A Sammataro
has permission to perform dishwasher replacement
plumbing in the buildings of CARON, WESLEY
at 22 BUCKLIN ROAD , North Andover, Mass.
Lic. No. 9333
Date: June 14, 2016
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Town of North Andover, MA
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20570
*Plumbing Permit - Replacement of Flztur&Appliance
(Commercial or Residentiall
TIMELINE
VI Anprevals
0 Submission received
lun, o. 2016.00:28em
Permit Fee
OPlumbing Permit Review
Total single family per
-
mProp{ess
futures/appliances
52.50 x
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-- replacement price
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Minimum single family
Map
futures/appliances price
$30.00 z
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Qpe unit
} »dcl Fee
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Total Fee Amount:
$3250
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6110/2016
Friday, Jun 10, 2016 10:50 AM
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20570.,
*Plumbing Permit - Replacement of Fixture/Appliance (Commercial or Resdentiall
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Plumbing Permit ReNevi
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Robert Sammataro ! 22 BUCKUN ROAD, NORTH ANDOVER,
6113-M-0515 ( MA
p samataror@mmcas._�er
Peanitf` uance
CARON, WESLEY .
Attachments i Eula_' r
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Primary Contractor
Search for your contractor using the search bar below. Either the Firm's Name or l'rcensee6h
required. -
..rmi(auvners)leame J:�-,fier;!txrne (u.enze^I•
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RubenA Sammataro
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9333 Master Plu Iter . .
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Friday, Jun 10, 2016 10:50 AM
t MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY m . h
_� MA DATE (p PERMIT #
JOBSITEADDRESS
� U� OWNER'S NAM `
P OWNER ADDRESS
TE FAX --T--
TYPE OR OCCUPANCY TYPE
20110
COMMERCIAL _ EDUCATIONAL i RESIDENTIAL
PRINT
CLEARLY NEW: _ RENOVATION: _ REPLACEMENT:
PLANS SUBMITTED: YES i NO_
FIXTURES l FLOOR -BSM
1 2 3 4 5 6 7 8 9 10. 11 12 13.
...BATHTUB
14
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
DRINKING FOUNTAIN
FOOD DISPOSER
FLOOR I AREA DRAIN
INTERCEPTOR INTERIOR
KITCHEN SINK.
LAVATORY
ROOF DRAIN
SHOWER STALL
SERVICE / MOP SINK
TOILET
URINAL
WASHING MACHINE CONNECTION
WATER HEATER ALL TYPES
7.
WATER PIPING
OTHER
- INSURANCE COVERnc;F-
i nava a uurreni rami-iry insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES ]ZP*"N0
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW {
LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY _ BOND _
OWNER'S INSURANCE WAIVER;1 am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit applicationgives this requirement.
SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT
I hereby certify that all of the details atil Jnformation I have submitted or entered regarding this application true and accur to the. best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will be lance Ith I eminent provisio f the
Massachusetts State PI ing Code and Cha ter 142 of the General Laws,
PLUMBER'S NAME LICENSE #
NATURE
MP j" JP-- _
CORPORATION PARTNERSHIP _# LLC _#
COMPANY NAMQT,ffi�A
CITY' Ll hd*A STATE ZIP f�7 TEL '
FAX J2 M& CELL EMAIII� n`
r.� A • / r. (Jla� ✓►l� 17!) /' it fM /�
Name
Addrt
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
Boston, MA 02114-2017
• .r,�
www.massgov/dia
NVorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians//Plgmbeiv
TO BE FILED WITH THE PERMITTING AUTHORITY.
City/State/Zip: OVIK11kone #:__f
Are you an employer? Check the appropriate box:, Type of project (required):
1.Q I am a employer with employees (full and/or part-time).* 7. New construction
2.❑ I am a sole proprietor or partnership and have no employees working for me in g. Remodeling
any capacity. (No workers' comp. insurance required.]
9. ❑Demolition
3.01 am a homeowner doing all work myself. [No workers' comp. insurance required.]'
10 [3 Building addition
4. [] I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers' compensation insurance or are sole 11.[] Electrical repairs or additions
proprietors with no employees. 12. [] Plumbing repairs or additions
SCI I am a general contractor and I have hired the sub -contractors listed on the attached sheet. 13. ❑ Roof repairs
sub-oontraetors have employees and have workers' comp. insurance?
6.�e are a corporation and its officers have exercised their right of exemption per MGL c. 14. Q Other
152, §1(4), and we have no employees. (No workers' comp. insurance required)
•pry applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContr mrs that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is provworkers' compensation insurance for my employees Below is the policy and job site
Information.
Insurance Company Name:
Policy # or Self -ins. Lie. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00
and/or one-year imprisonm"eAtt,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. k copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
eoveraae verification.
I do
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 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 #:
Location 'J
Date
14ORTol , TOWN OF NORTH ANDOVER
0.
Certificate of Occupancy $
Building/Frame Permit.Fee
ite 114 U oundation Permit Fee $
Permit Fee $
Sewer, Connection Fee $
4
Water Connection Fee $
TOTAL $
Building Inspect
04/15/94 15:47 15-00
mtn
7146 Div. Public Works
L6cation
N
No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy 2 /1 Ujq I
Building/Frame Permit Fee
Foundation Permit Fee $ a-0
Other Permit Fee $
2 q Sewer Connection Fee $6 /.?-/3 u/1 3
2-7- Water 50nnection Fee $ *1 A,
TOTAL $
/Building' inspector
-00 PAID
6877 Div. Public Works
Locationa�
ZZ,
No. Date 12�
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ (�'D , (-) 0
Building/Frame Permit Fee $ -
Foundation Permit Fee $ zz!2--- -00)
Othe r Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
�—'Inspector
/��,�2/30/93 16:23 150.00 Pjuifding
D
.6836 Div. Public Works
Location, 5
No.
Date /Z-0-6?3
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
4�
Foundation Permit Fee ;$
Other Permit Fee
Sewer
Alp -3 4-�Z- Water
TOTAI
6904
Connection Fee $ &�2v
Connection Fee $
$
Building Inspector
1 0 roKw�;A z oez, Xel-
D),t W/blic Works
�l
PER117 NO_ 0
T
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MAP d4,40.0.
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APPLICATION FOR PERMIT TO BUILD -NORTH ANDOVER, MASS./�C •SO'v.� PAGE 1
INSTRUCTIONS
SEE BOTH SIDESrT _`E 2 ��
PAGE 1 FILL OUT SECTIONS 1 - 3 LESS FDA FEE L17 0
PAGE 2 FILL OUT SECTIONS 1 - 12 DUE FRAME PERMIT $ M
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED /19 // /7
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E�j�,JoZ
PERMIT GRANTED/
19
-ice
( &-T)
OWNER TEL #
CONTR. TEL # I/
CONTR. LIC.
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COS 'T�/ 71 . O
EST. BLDG. COST PER SQ. 'FT. 7 C/
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
//�/ JIK7 44
wNl WgnY Mirfb-lVR
I LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK PAGE
ZONE R
S DIV NCO.
iL
0a `J
r
—
i
LOCATION
PURPOSE OF BUILDING
✓ /SIZE
OWNER'S NAME Q
NO. OF STORIES
OWNER'S ADDRESS
N.N.
'
BASEMENT OR SLAB ry - �
41
ARCHITECT'S NAME ��{{ ' (��,�'7�
ff�,,J2'�
f/�f
SIZE OF FLOOR TIMBERS IST a�y0//O 2NDvJCe-W,10 D
/ /L
BUILDER'S NAME
a
SPAN /
DISTANCE TO NEAREST BUILDING /
DIMENSIONS OF SILLS
DISTANCE FROM STREET /1,0 /
POSTS
DISTANCE FROM LOT LINES — SIDES
1 REAR / ,r
/
" GIRDERS
/
AREA OF LOT �/7>A�
FRONTAGE—,/
HEIGHT OF FOUNDATION THICKNESS /
IS BUILDING NEW V 9�/��� e S"
SIZE OF FOOTING /1 2 X
t��
IS BUILDING ADDITION A
�`
MATER:AL OF CHIMNEY
IS BUILDING ALTERATION l
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
OF APPEALS ACTION. IF ANY
�, // /,
l�BOARD
/�Ll
IS BUILDING CONNECTED TO TOWN SEWER
/
IS BUILDING CONNECTED TO NATURAL GAS LINE ( e S
INSTRUCTIONS
SEE BOTH SIDESrT _`E 2 ��
PAGE 1 FILL OUT SECTIONS 1 - 3 LESS FDA FEE L17 0
PAGE 2 FILL OUT SECTIONS 1 - 12 DUE FRAME PERMIT $ M
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED /19 // /7
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E�j�,JoZ
PERMIT GRANTED/
19
-ice
( &-T)
OWNER TEL #
CONTR. TEL # I/
CONTR. LIC.
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COS 'T�/ 71 . O
EST. BLDG. COST PER SQ. 'FT. 7 C/
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
//�/ JIK7 44
wNl WgnY Mirfb-lVR
ti
: w f
J �
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION—�
A
$ INTERIOR FINISH
CONCRETE
PINEHAR
3
1
2 I3
CONCRETE BL K.
BRICK OR STONE
D
PIERS
PLASTER
6RY W
_ DRY VJAII
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'TAREA
'/. V?
FIN. ATTIC AREA,
_
NO B M
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS
B
XI_
1
22 f 3
�—
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
HARDW'D
COMMON
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR _
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
_
STONE ON FRAME
SUPERIOR_
ADEQUATE POOR I NONE
5 ROOF
GABLEHIP
10 PLUMBING
BATH (3 FIX.(
GAMBREL
MANSARD
SHED
TOILET RM. (2 FIX.)
WATER CLOSET
/
FLAT
ASPHALT SHINGLES
LAVATORY
_T
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
TILE FLOOR
_
TILE DADO
6 FRAMING
11 HEATING
WOOD JOIST
A
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
7 NO OF ROOMS
GAS
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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B'M'T 2nd _ ELECTRIC
1st 13rd I NO HEATING E
L
FORM U - LOT RELEASE FORTS
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills /out this section*****************
APPLICANT: / COr Phone %
9
LOCATION: Ass�e/ssor's Map Number Parcel
Subdivision0._c�/(3� N �t S)(299
/`-1
Street-�C.�l<►/ St. Number
************************Official Use Only************************
RE MMMEKDA5�ONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Health Agent Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department y -Pig
(
Received by Building Inspector
f2 - 93
Date
d
I
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills /out this section*****************
APPLICANT: / COr Phone %
9
LOCATION: Ass�e/ssor's Map Number Parcel
Subdivision0._c�/(3� N �t S)(299
/`-1
Street-�C.�l<►/ St. Number
************************Official Use Only************************
RE MMMEKDA5�ONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Health Agent Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department y -Pig
(
Received by Building Inspector
f2 - 93
Date
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Evergreen .Management Corp.
733 Turnpike Street ! Suite 311 • North Andover, Massachussetts 01845 • Office 508-975-1420' • Fax 508-681-8447
0
April 15, 1994
Robert Nicetta, Building Inspector
Town of N. Andover
120 Main St.
N. Andover, MA 01845
RE: Lot 5-Bucklin Rd. ffleadowood Phase II)'
Dear Mr. Nicetta,
This letter is to infoinnyou that we have removed the dryer exhaust as you instructed within the home at,
22 Bucklin Rd. (a.k.a. Lot 5 Hillside, Meadowood Phase H).
As certified below by the seller and the buyer, 'a dryer will not be installed until'the exhaust. is approved by
the town of North Andover's building inspector.
Sealed as an executed agreement on this fifteenth day of April 1994.
Hillside Realty Corp.
Richard A.
Manager for Hillside Realty Corp.
Date'
Vincent J. P chanian, Buyer of 22 Bucklin Rd. Date
COMMONWEALTH OF MASSACHUSETTS
ESSEX, S.S April 15, 1994
Then personally, appeared before me the above named Richard A. Tobin and acknowledged the foregoing
instrument to be his own free act and deed as Project Manager on behalf of Hillside Realty COP, before
me
LINDA E. MARKHAM c CWadU— _
Notary Public
'ESSEX, SS, My Commission Expires February 24, 2000 April 15, 1994
Then personally appeared before me the above named Vincent J. Parechanian and acknowledged -the
foregoing instrument to be his own free act and deed individually before me
r' y� 0�
' LINDA E. MARKHAM
APVeW' Notary Public
. o lot5hr.wpS MY commission Expires February 24, 2000'
Phillips Common 0 Meadowood 0 Stevens Crossing 0 Cobblestone Crossing •. Foxwood
,.
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A clothes dryer produces combustible lint
and. the area around the clothes dryer
should be kept free of lint. It is
recommended that the dryer be exhausted
to the outside using 4" rigid or flexible
metal ducting.
When located in a bedroom, bathroom or
closet, the dryer must be exhausted to the
outside of the dwelling
Once location of the exhaust outlet is
determined, a 4-1/4" hole should be cut in
the wall to accept the exhaust hood. To
permit sufficient air circulation under the
exhaust hood, there should be no less
than a 12" clearance between the bottom
of the exhaust hood and the ground. When
possible, the exhaust hood should not
exhaust directly into a window well. DO
NOT terminate exhaust under a house or
porch.
NOTE: Where the exhaust hood is to be
installed through 'masonry, a special
masonry saw is necessary to cut the hole.
Install the exhaust hood and secure with
screws to the outside wall and seal with
caulking compound.
Install ductwork from the dryer to exhaust
hood. All joints must be made so exhaust
end of one pipe is inside the intake end of
next pipe. On flexible metal ductwork, all
joints should be secured with a 3-4630
clamp. DO NOT use sheet metal screws
when assembling rigid ducting. These
should be taped.
' APSE 5 1994
AI TPAENT
4
FLEXIBLE DUCTWORK
LIMITATIONS
Flexible metal ductwork should not
exceed 34' of straight 4" ducting. The
exhaust hood is equivalent to 8' of duct
and each 90 degree bend is equivalent to
8'. Asan example, if an exhaust hood is
used and two 90 degree bends, the
maximum straight run would be 10' NOTE:
If the radius•of a bend with 4" duct is 12"
or greater, the bend can be considered a
straight run. No more than three 90 degree
bends should be used in any run with an
exhaust hood.
RIGID DUCTWORK
LIMITATIONS
Rigid metal ductwork should not exceed
50' of straight 4" duct: Each 90 degree
elbow and the exhaust hood should be
considered equivalent to 8' of straight
ductwork. For example, if an exhaust hood
and two 90 degree elbows are used, the
maximum straight duct allowed would be
26'. Not more than three 90 degree elbows
should be used in any rigid ductwork run
with an exhaust hood. Four feet of straight
duct should be allowed between 90
degree elbows.
LEFT SIDE OR BASE EXHAUST
If dryer is to be exhausted out the left side
or through base, use the accessory 3-4652
exhaust kit, available from Maytag
Company. instructions are included with
the kit.
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