HomeMy WebLinkAboutMiscellaneous - 27 HIGH PLAINS ROAD 4/30/2018Y, z
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00
Date
N2 2998
RTN
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that C oc /�
....................................................
has permission to perform ....... /.-. �� ............................... *,2 .............................
vnnng in the building of ............ R. ..........................................
at. -Q .. 7.. /Y n/4...,p &P .... North Ando;yer. Mass,2
Fee.3.. .00... Lic. No . ............... 40 ... �r. �T
,5�: . ..... 7z .... ............
ELEcrRicAL INSPECMR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
DEPARTA&WOFMLICS4MY
BOARD OFFIREPREVEMONREGULATIOASS27CIfR 12-00
Office Use only
No.
ncy & Fees Checked
PPUCATION FOR PERAW TO PERFORM ELECMCAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Datg��
Town of North Andover To the Inspector of Wires:,
The undersigned applies for a permit to perform
Location (Street & Number)
Owner or Tenant
Owner's Address
I
below.
Is this permit in conjunction with a building permit:
Yes EMNo
7—
M
(Check Appropriate Box)
Purpose of Building
T�ta—1
Utility Authorization No.
Existing Service Amps Volts Overhead Underground No. of Meters
U ED
New Service Amps Volts Overhead M Underground M No. of Meters
Number of Feeders and Ampacity
flocation and Nature of Proposed Electrical Work'
No. ofLighting Outlets
No. of Hot Tubs
No. of Transformers
T�ta—1
KVA
'No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
ground
ground
No. of Rleptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local M[Lmicipal
Other
No. R Dryers
Heating Devices KW
Connections
M
No. g(Water Heaters KW
No. of No. of
%- I I
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
IINM=COM�
thmeaammtLmbkh-ar�PebL,ymkxbrgcm#4i2E9-�Covw,Vcritssk4fftialeW�� YES NO
lhaNeaibm9Wvandpwf6f§ame1odieOffm YES NO If�cuha%edrdWYESpkMirdC*#r bydakirigtr
WOL
PqRJRANCE BOND OTHR
Expir-Am Date
EsMvkdValuedUeclncaIWdk
WotkIDSW hqxWcnD*Rapestod Ratigh Fmal
Signed ur&TV Rmbies cfpajw
FIRM NAME -- -- - - ---=
Lkalsee C, C
Adck, /60
OVvqNM'SMURANUWAIVER,I.ammmhttheLiom nut
mddrinTy*ubzecnftpemitWpficafimvm'%tsdismw'mnat
(Please check one) Owner M Agent
— LiomseN6 ZFz5t7/-;�'
Business Tel. Nh 422
I AJLTeL N4 e�a 3 — Vf 10 7IV2�
I � 0 \ —.1e
Telephone No. PERMIT FEE $
Location C.2 xre ?M Al
0.
N Date y:Y!7L2�',,
RTN TOWN OF NORTH ANDOVER
ertificate of Occupancy $
Building/Frame Permit Fee
S Foundation Permit Fee
Other Permit Fee
S ew
er Connection Fee
Connection Fee
TOTAL
Building Inspector
PAID
86/% 3:39 33.�
82, Div. Public Works
�� A
4j�
Locat !on
0_
N -C) Date
RT"
TOWN OF NORTH ANDOVER
-certificate of Occupancy
-Building/Frame
$
Permit Fee
$
C
Foundation Permit Fee
ther Permit Fee
_Sewer Connection Fee
Water Connection Fee
TOTAL
Buildin ector
06/201% 13%42 71.50
12)
Div.
Public Works
PER111T NO.
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE I
MAP 4,10. 10e"
,:5_7LOT
NO. czR
2 RECORD OF OWNERSHIP IDATE
BOOK 'PAGE
Z OC% E
SUB DIV. LOT f4O.
—129
LOCATION
PURPOSE OF BUILDING eo
OWNER*S NrM--Eo -r AWIZAJ.
NO. OF STORIES SIZE
OWNER'S ADDRESS 93
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST2XIO 2ND
3R . D
BUILDER'S NAME NIL voQ5-N
SPAN 16
DISTANCE TO NEAREST 13UILDING
DIMENSIONS OF SILLS
POSTS
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES + REAR 150
GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING x
IS BUILDING ADDITION opau Dff!:k
MATER:AL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS I - 3
PAGE 2 FILL OUT SECTIONS I - 12
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 -w
SIGNATURE OVOWNER 011,040THORIZED AGENT
F E E
0
PERMIT GRANTED
i g��— 19
a
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
OUILDING lN8PK=*
OWNERTEL.#
CONTR. TEL. #
CONTR. LIC. # 6 76
H.I.C. # /035Y-7
BUILDING RECORD
I OCCUPAN CY 12
SINGLE FAMILY STORIES TH S SECTION MUST SHOW EXACT DIMENS16NS OF LOT AND DISTANC-E FROM
—[OFFICES I
MULTI. FAMIL LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA -
APARTMENTS ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. -
J.
CONSTRUCTION
2 FOUNDATION
Z7'
8 INTERIOR FINISH -
--- a 2 13
PINE —
HARDW D
PLASTER
CONCRETE
—
CONCRETE BL K.
BRICK OR STONE
PIERS
DRY WALL
LTN__F —IN
3 BASEMENT
AREA FULL
IN. B M'T* AREA
14 1/2 1/1
FIN. ATTIC AREA
NO BMT
HEAD ROOM
FIRE PLACES
MODERN KITCHEN
4 WALL$
9 FLOORS
CLAPBOARDS
_�Q__NCR
_�TH ETE
TA
B
1
2
3
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
HARDW'D
—COMMON
__iSPH —TILE
VERT. SIDING
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STIRS. & FLOOR_
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I I _POOR
_'ZD E 0 UAT E I NONE 1
5 ROOF
10 PLUMBING
GABLE
I
HIP
BATH Q FIX.)
GAMBREL
A
MANSARD
JOILET RM. 12 FIX.)
_FLAT1
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
'KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TI.LE DADO
6 FRAMING
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL EMS. & COILS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H*T'G,
UNIT HEATERS
7 NO. OF ROOMS
_9AS,
OIL
ELECTRIC
B:.WT1 2nd
I., 3rd
NO HEATING
J.
FORM U - VERIFICATION FORM
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 lawt
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT Phone,
LOCATION: Assessor's Map Number Parc el
Subdivision Lot(s)
Street /V1 "b2K St. Number 27
************************Official Use Only************************
RE;COMME TION OF GIENTS:
Date Approved
Consery tio Administrator Da Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Food Inspecto alt
Se 't
p ic InkT6-6--E-or-Health
Comments
Public Works sewer/water connections
driveway permit
Fire Department
Received by Building Inspector
11
.Date Approved
Date Rejected
Date Approved �V,Z/ �A
.Date Rejected
Date
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Location
No.
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CH
Foundation Permit Fee $
Other Permit Fee $
TOTAL s Z
Check #
1�,7
7"
14754
BuildirA61inspector
F 7 TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERNUT NUNIBER: DATE ISSUED:
SIGNATURE:
Building Commission7r/In§'=tor of Buildings Date
SECTION I- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
27
c-13
III-rg2 7�e
Map Number Parcel Number
1.3 Zoning Information:
1.4 Property Dimensions:
/ 1fQ2-(F /0 1
Zoning District Proposed Use
Lot Area (sf) Frotitage (fl)
1.6 BUIELDING SETBACKS (ft)
FrontYard
Side Yard
Rear Yard
ReqWred Provide
Required Provided
-4
E292jred Provided
+- .--
1.7 Water Sppl-y M.G.11C.40. 54)
1.5. Flood Zone Information:
1.8 Sewerage Disposal System: -
Public 0 Private 0 Zone
— Ontside Flood Zone 0
municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Recoid
a.,,-
��/ 1440-5 490 AW-73'40)cQ-,�
Name (Pfint Address for Service
/4�
Signature Telephone
11c.,v c - 5 4-.273
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable 0
A—) 0�'10'2 LAt/
Licensed C,4nstraction Supervisor: 9 0 C) 22 3 3
� License Number
Address
�/�3
Expiratiod Date
Signature
Telephone
3.2 Registered Home I,mprovement Contractor Not Applicable El
S"IA" .�l -0 z
14 -
Company Name
Registration Number
0/
Address ii
Signature Telenhone Expiration Dat
SECTION 4 - WOREIRS COMPENSATION (MLG.L C 152
Workers Compensation Insurance affidavit must be completed and
in the denial of the issuance of the building permit.
Sianed affidavit Attached Yes ....... 0 No ....... 0 —
SECTION 5 Description o Proposed Work (check applicabl(
this application. Failure to provide this affidavit will result
New Construction Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition 11
Accessory Bldg. 0 Demolition 0 Other 0 Specify
Brief Description of Proposed Work:
PCO kC-�l 19 �C'
I qF.CTION 6 - F.STTMATF.-n CONSTRUCTION COSTS
"cL),JE-
Item
Estimated Cost (Dollar) to b e
Cqmpleted by permit applicant
V, ,,
A,
V
RIM
1. Building
(a) Building Permit Fee
Multiplier
&,"
2 Electrical
(b) Estimated Total Cost of
Construction
oozl
'� L
3 Plumbing
Building Permit fee (a) x (b)
V31
4 Mechanical (HVAC)
5 Fire Protection
6 Total �1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner/Authorized Agent of subject property
Hereby atithpn*ze�, 14 to act on
Mybenh','mal!,priatter:s�re �iive to wf ork authorized by this buildingpermit application.
- a4 9�-1 Z/O
Signature of Owner Date
SECTION7b OWNWAUTHORIZED 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
Siiature of Ownerient Date
1109= MUMMEMEM
NO. OF STORIES SIZE -2-8 o- 5 a r—r-
BASE1%,ENT OR SLAB
SIZE OF FLOOR TINMERS 2 ND 3 RD
SPAN
DINENSIONS OF SILLS
DUvIENSIONS OF POSTS
DEMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION TFUCKNESS
SIZE OF FOOTING X
MATERIAL OF CHRvINEY
IS BUILDING ON SOLID OR FILLED LAND
L IS BUU-DING CONNECTED TO NATURAL GAS LM
FORM - _V - LOT IMLEASE FORM
INSTRUCTIONS: This form is used to verify that all -necessary approval /permits from
Boards.and Departments. having jurisdiction have been obtained. 7his does not relieve the
applicant andor lagdowner from compliance with any applicable requirements.
I WE F Now w man a W!��n a Nos a
no; n e� i? 7,5- eji- 2e.3
APPLICANT 70�f -PHONE f /6 -T
ASSESSORS MAP NUMBER LOTNUMBER 73
I SUBDIVISION LOTNUMBER
STREET STREETNUM13ER
......................
OMCIA-L.USE ONLY
8 on a as 0 EWEN am Masson no 9 0 USE mans a 0 a an 0 a a 0 a 01 ... Val nownsuffism
RECONDAENDATIONS OF TOWN AGENTS
a 0 w ussawwwwwasswon ............... 0,41"Unnow WE museums Emmon's
DATE APPROVED
CON§EkVATIONADMI�MTRATOR
DATE REJECTED
DATE APPROVED
TOWNPIANNER
DATE REJECTED
CON04ENTS_
DATE APPROVED
FOOD INSPECTOR -'BEALTH DATE REJECTED
SEPTIC INSPECTOR - IMALTH
CONffVffiNTS
PUBLIC WORKS - SEWER / WATER CONNECTIONS
DRIVEWAYPERMIT
FIRE DEPART&1ENT
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR DAM
LOT D
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03/29/2000 15:24 19789763987
....... — - -- - LANDMARKINS PAGE 02
ACOMP. F.1 Q. E
DATE (MMOWM
-`N E-.P.*::16:
�.c
03/29100
PRODUCER
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Landmark Insurance Agency, Inc
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
198'Xasxachuxetts Avenue
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
North Andover NX 01845-4190
COMPANIES AFFORDING COVERAGE
Lawrence 1k. Michaud, CIC
COMPANY
Phon&No,_ 970-690-§829 Fogma, 978-975-3987
A Preferred Mutual Insurance Co.
INWRED
r.OMPANY
B safety Insurance Co.
Swiming Pool Center, Inc.
COMPAW
Ray Charland
C Eastern Casualty Ins, Co.
670 So.�Unicn St.
COMPANY
Lawrence MR 01643
ID
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEF� ISSUED TO THE INSURED NAMED ABOVE I -OR THE POLICY PERIOD
INDICATED, NOTWITHSTANOING ANY REQUIREMENT, TERM OR
CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFCRI)ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND cONOMONG OF 3UCH POLICIES. LIMITS SHOWN MAY HAVE MEN REDUCED BY PAID CLAW,
CO
LTR
TYPE OF RMRANM
I
POLICY NUMBER
POLICY EFFEnVE
oATE (MkwDDNY)
POLICY EXPIRATION
DATE (MMfiXYYY)
LIMITS
96NERAL
LIAIBAM
GENERAL AGGREGATE $2000000
JL
X
CCAWERCIAL GENIERAL LIABILITY
CFP 0140520316
03/01/00
03/01/01
PRODucre coMPiOP A00 12000000
CLMMS MADE EXROCCUR
PERSONAL ADV INJURY S 100i"000
EACH OCCURRENCE 11000000
OWHER'S & CONTRACTOR'S PROT
FIRE DAMAGE (Any — Me) 6 Excluded
MED WtP (Afty &* parftn) 5 Zxcludad
AUTOMOBILE
LIABILITY
—
A14Y AUTO
1022438
03/22/00
03/22/01
COMBINED SINGLE LIMIT $1000000
ALL OWNED AUTOS
—
X
SCHEDULED AUTOS
BODILY INJURY
(Per ponw)
X
HIRED AUTO$
X
NC40WNED AUTOS
BODILY INJURY
(Fler *wIdw*
PROP6FITY DAMAGE
GARAGE
UABILITY
AUTO ONLY, EA AO=rjNT j
ANY AUTO
OTHER THAN AUTO ONLY;
EACH ACCIDENT III
AGGREGATE I
EXCESS LIAKFTY
'EACH OCCURRENCE I
UMBRELLA FORM
UC0100540211
03/01/99
03/0 1/00
AGGREGATE $1000000
OTHER THAN UMBRELLA FORM
03/01/00
03/01101
WORKERS COMPENSATION AND
EMPLOYERS' UABILITY
7
C THE PROPRETCW
PARTNERSMXECUTNE INCL WC98470026
I L EACH ACCIDEW $500000
02/28/00 02/28/01 EL DISEASE, POLICY LIMIT $S00000
OFFICERS ARE: EXCL
OTHER —
EL DISEASE - FA EMPLOYEE $500000
A C rcial Applica CPP 0140520316
03/01/00 03/01/01
OF OPERATIONSILOCATIONSrwNcLEisiop—gC44 ITgMS
8wiffAing Pool InStAllAtion/BgrVice/Rapsir
SHOULD ANY OF T14E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THERE -OF. T14E ISSUING COMPANY WILL ENDFAVOR TO MAL
sample Cart
X0— DAYS WFUTTEN NOT" TO THE CERTIFICATE HOLDER NAMrao To THS LCFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE No OBLIGATION ON UABLITY
OF ANY KIND UPON THE �=Y, ITS AGENTS OR REPREnNTATIVE&
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NORTH ANDOVER BUILDING DEPARTMENT
1600 Osgood Street
North Andover
Tel: 978-688-9545
Fax: 978-698-9542
B USMESS FORM FOR TOWN CLERK
DATE:
NAMM: e -
ADDRESS: 1!�, 1"
J
ZONING DISTRICT:
TYPE OF BUSINESS:_ Ald
BUILDING LAYOUT PROVIDED: —YES NO
A7VAMAWCE PARKING SPAMS:
ZONING BY LAW USAGE: YES NO
SIGNATURE
13USMSS FORM POP TOWN CLERK
2AO Rome Occupation (1989132)
An accessory use conducted vffin a dwelling by a resident who resides in the dwelling as his principal
.address, which is clearly gecondary 'to the. use. of the. -building. for �ving pluposes. Home occupations shall
mcEde, -b�t not'lirnited to the following uses; personal services such as furnished by an artist or instructor,
but not occupation involved with motor vehicle repairs, beapty pazlors, animal kennels, or the, conduct of
retail business, or the manufacturi�g o�goods, which impacts 66 residential nature, of the neighborhood.
4. For use of a dwelling in 4ny residential district or multi-fimily district for a home occup6tion, 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 thd h6me Owdpation and residing in said dA Wling,
b. The use is carried on strictly within the principal building;
c. fhere shall be no exterior alterations, accessory buildings, or display which are, not custornaW
-with residential buildings; .
d. Not more than twents-five (25) percmt 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;
C. There will be no display of go�ds orwares -visible from the. stred;
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 vithin the neighborhood;
g. Any such building shall include no features of design not customary in buildings for residential
use.
1—t. k . . . 2.- 2 1.- /Y
'imatu Ve Date -