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HomeMy WebLinkAboutMiscellaneous - 284 SUMMER STREET 4/30/20180 -4 C/) p m '2V d��_ 1�1 MASSACHUSETTS UNIFORM APPUCATION FOR PSSMIT TO DO GA! (Print or Type) <5Z\ NORTH ANDOVER Mass. Date tuilding Location 9ZY �-qmney- s-�, Permit # Owners Name Pei 77 Renovation Reolacement Plans Submitted New — M= 09M Ulf-MaIrm (P -int or Type) Check one: . Certificate Instailing Company Name 44 li6,. c,4 Corp. Address d. v. Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Cas Fitter .&�Xn '4rd""' Insurancr- Coverace: lnd;c2-.a z�-e zype of insurance coverage by checking the appropriate box: Liability insurance policy = Czi-.er type of indemnity = ..Sond- Insurance Waiver: 1, the undersigne,-J, have been made aware that the licensee of this appiLelition does not have ary one of the above three insurance coverages._ I CIL1� Signature or owneri-age of properzy Owner = -Agent I h=hy ceniry that i1i of the details and informadon I -have Luhruitted (or entercd) in above zoplication are true and accurate to the best of mY kno-tcdge and tiLat aLL ;1(umbinr work and Instadatiatts -.cr-far=c1_ undzr* Pur.nuc i=uzd cc.- thil sprkication WiU b�c in cognpLiancs Wittz Ld pertln=t P90TWOrts OC Lha.WA&%ar_6tuict:s SWC QS "a Ind C:iaptcr .1 4_' CX L:w Ceunc:zj Laws. By T i &-' I e APPROV'ED (OFFICE USE 0MLYJ G, a s f i e r Signature of License,_4 Ma S t e r Plumber �r sfitter journeyman L.L�:ense Number 92 WJ ul t UA C U, ul Q = -K - C > us 0 UA U, U. LU MI > U1 0 I -A z I ST FLOOR =X0 FLOOR 2FM FLOOR I 47H FLOOR ST K FLOOR LOOR TrK FLOOR a -r,4 r-Lawz (P -int or Type) Check one: . Certificate Instailing Company Name 44 li6,. c,4 Corp. Address d. v. Partner. Firm/Co. Business Telephone: Name of Licensed Plumber or Cas Fitter .&�Xn '4rd""' Insurancr- Coverace: lnd;c2-.a z�-e zype of insurance coverage by checking the appropriate box: Liability insurance policy = Czi-.er type of indemnity = ..Sond- Insurance Waiver: 1, the undersigne,-J, have been made aware that the licensee of this appiLelition does not have ary one of the above three insurance coverages._ I CIL1� Signature or owneri-age of properzy Owner = -Agent I h=hy ceniry that i1i of the details and informadon I -have Luhruitted (or entercd) in above zoplication are true and accurate to the best of mY kno-tcdge and tiLat aLL ;1(umbinr work and Instadatiatts -.cr-far=c1_ undzr* Pur.nuc i=uzd cc.- thil sprkication WiU b�c in cognpLiancs Wittz Ld pertln=t P90TWOrts OC Lha.WA&%ar_6tuict:s SWC QS "a Ind C:iaptcr .1 4_' CX L:w Ceunc:zj Laws. By T i &-' I e APPROV'ED (OFFICE USE 0MLYJ G, a s f i e r Signature of License,_4 Ma S t e r Plumber �r sfitter journeyman L.L�:ense Number ............. Date. TOWN OF NORTH ANDOVER M - t PERMIT FOR GAS INSTALLATION ,0 'I'SACH This certifies that ....................................... has permission for gas installation,.". ................. in the buildings of ........... ............................. at ................................... North Andover, Mass. Fee.......... Lic. .......................... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Spy Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form Q — Order of Resource Area Delineation 242-1256 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. General Information Important: When filling out From: forms on the North Andover computer, use Conservation Commission only the tab key to move This Issuance is for (check one): your cursor - do not use the Z Order of Resource Area Delineation return key. Amended Order of Resource Area Delineation To: Applicant: William Gillen Name 54 Spring Hill Road Mailing Address North Andover MA. 01845 Property Owner (if different from applicant): Same Name Mailing Address City/Town State Zip Code City/Town 1 . Project Location: Summer Street & Mollytowne Road North Andover Street Address City/Town Map 38, Map 65 Lot 32 & 91 Assessors Map/Plat Number Parcel /Lot Number 2. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents: Abbreviated Notice of Resource Area Delineation Plan Title Title Title 3. Dates: 5/8/04 Date Notice of Intent Filed 8/4/04 Date Public Hearing Closed 8/6/04 Date of Issuance State Zip Code 4/28/04 last revised 7/23/04 Date Date wpaform4b,doc - rev. 12/15/00 Page 1 of 3 A Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form Q — Order of Resource Area Delineation 242-1256 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Order of Delineation The Conservation Commission has determined the following (check whichever is applicable): Z Accurate: The boundaries described on the referenced plan(s) above and in the Abbreviated Notice of Resource Area Delineation are accurately drawn for the following resource area(s): Z Bordering Vegetated Wetlands Z Other Resource Area(s), specifically: Limits of the Vernal Pool all local/buffer zones associated with the Bordering Vegetated Wetland & the Vernal Pool. F-1 Modified: The boundaries described on the plan(s) referenced above, as modified by the - Conservation Commission from the plans contained in the Abbreviated Notice of Resource Area Delineation, are accurately drawn from the following resource area(s): Bordering Vegetated Wetlands [] Other Resource Area(s), specifically: inaccurate: The boundaries described on the referenced plan(s) and in the Abbreviated Notice of Resource Area Delineation were found to be inaccurate and cannot be confirmed for the following resource area(s): F� Bordering Vegetated Wetlands E] Other Resource Area(s), specifically: The boundaries were determined to be inaccurate because: wpaform4b.dod -rev. 12/15/00 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 4B — Order of Resource Area Delineation 141-1256 - Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Order of Delineation (cont.) This Order of Resource Area Delineation determines the boundaries of those resource areas noted above and is binding as to all decisions rendered pursuant to the Massachusetts Wetlands Protection Act (M.G.L. c. 131, § 40) and its regulations (310 CIVIR 10.00) regarding such boundaries. This Order does not, however, determine the boundaries of any resource area or Buffer Zone to any resource area not specifically noted above, regardless of whether such boundaries are contained on the plans attached to this Order or to the Abbreviated Notice of Resource Area Delineation. This Order must be signed by a majority of the Conservation Commission. The Order must be sent by certified mail (return receipt requested) or hand delivered to the applicant. A c a so �nust be mailed or 5pf0s? hand delivered at the same time to the appropriate DEP Regional Office (;zee' Appendix A) Sigi This Order is valid for three years from the date of issuance. This Order is issued to the applicant and the property owner (if different) as follows: R by hand delivery on E� by certified mail, return receipt requested on Date C. Appeals g '& /0'/ Date ' , The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office (see Appendix A) to issue a Superseding Order of Resource Area Delineation. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request for Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G. L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CIVIR 10.00). To the extent that the Order is based on a municipal bylaw or ordinance, and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform4b.doc - rev. 12/15/00 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Ap�pendix A - DEP Regional Addresses Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Mail transmittal forms and DEP payments, payable to: Commonwealth of Massachusetts Department of Environmental Protection Box 4062 Boston, MA 02211 DEP Western Region Adams Colrain Hampden Monroe Pittsfield Plainfield Tyringham Wales 436 Dwight Street Agawam Conway Cummington Hancock Hatfield Montague Monterey Richmond Ware Suite 402 Afford Amherst Dalton Hawley Montgomery Rowe Warwick Springfield, MA 01103 Ashfield Deerfield Heath Monson Mount Washington Russell Sandisfield Washington Wendell Phone: 413-784-1100 Be ket Becicherlown Easthampton East Longmeadow Hinsdale Holland New Ashford Savoy Westfield Fax: 413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton West Springfield Fax: 508-947-6557 Blandford Erving Florida Huntington Lanesborough New Salem North Adams Shelburne Shutesbury West Stockbridge TDD: 508-946-2795 Brimfield Buck and Gill Lee Northampton Southampton Whately Charlemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Levereft Orange Southwick Williamsburg Chester Granville Leyden Otis Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington DEP . Northeast Region Clarksburg Hadley Middlefield Peru Tolland Wakefield Walpole DEP Central Region Acton Charlton Hopkinton Millbury Millville Rutland Shirley Uxbridge Warren 627 Main Street Ashburnham Ashby Clinton Douglas Hubbardston Hudson New Braintree Shrewsbury Webster Worcester, MA 0 1605 Athol Dudley Holliston Northborough Southborough Westborough Phone: 508-792-7650 Auburn Dunstable Lancater Northbridge North Brookfield Southbridge Spencer West Boylston West Brookfield Fax: 508-792-7621 Ayer Barre East Brookfield Fitchburg Leicester Leominster Oakharn Sterling Westford TDD: 508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster Fax: 508-947-6557 Berlin Grafton Lunenburg Paxton Sturbridge Winchendon TDD: 508-946-2795 Blackstone Groton Marlborough Pepperell Sutton Worcester Bolton Harvard Maynard Petersham Templeton Wrentham Boxborough Hardwick Medway Phillipston Townsend Yarmouth Boylston Holden Mendon Princeton Tyngsborough Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury Truro Acushnet Dennis Gay Head Middleborough Raynham 20 Riverside Drive Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville, MA 02347 Avon Duxbury Halifax NewBedford Rochester Wellfleet Phone: 508-946-2700 Barnstable Eastham Hanover North Aftleborough Rockland West Bridgewater Westport Berkley East Bridgewater Hanson Norton Sandwich Fax: 508-947-6557 Bourne Easton Harwich Norwell Scituate West Tisbury TDD: 508-946-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham Brockton Fall River Mansfield Pembroke Somerset Yarmouth Carver Falmouth Marion Plainville Stoughton Chatham Foxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plympton Taunton DEP . Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Randolph Wakefield Walpole Andover Chelsea Holbrook Methuen 205 Lowell Street Arlington Cohasset Hull Middleton Reading Waltham Wilmington, MA 0 1887 Ashland Concord Ipswich Millis Revere Watertown Phone: 978-661-7600 Bedford Danvers Lawrence Milton Rockport Rowley Wayland Wellesley Fax: 978-661-7615 Belmont Dedham Dover Lexington Lincoln Nahant Natick Salem Wenharn TDD: 978-661-7679 Beverly Billerica Dracut Lowell Needham Salisbury West Newbury Bo ton S Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfield Newburyport Sherborn Westwood Braintree Framingham Malden Newton Somerville Weymouth Brookline Georgetown Manchester -By -The -Sea Norfolk Stoneham Wilmington purlington Gloucester Marblehead North Andover Sudbury Winchester Cambridge Groveland Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfield Wpafornri - Appendix A - rev. 11122/00 Page I of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA. Appendix E — Request for Departmental Action ' Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information Important: 1. Person or party making request (if appropriate, name the citizen group's representative): When filling out forms on the computer, use Name only the tab key to move Mailing Address your cursor - do not use the return key. Cityrr)wn State Zip Code Phone Number Fax Number (if applicable) Project Location Mailin 3 Address City/Town State Zip Code 2. Applicant (as shown on Notice of Intent (Form 3), Abbreviated Notice of Resource Area Delineation (Form 4A); or Request for Determination of Applicability (Form 1)): Name Mailing Address Cityrrown State Zip Code Phone Number 3. DEP File Number: B. Instructions Fax Number (if applicable) 1. When the Departmental action request is for (check one): I F] Superseding Order of Conditions E] Superseding Determination of Applicability Superseding Order of Resource Area Delineation Send this form and check or money order for $50.00, payable to the Commonwealth of Massachusetts to: Department of Environmental Protection Box 4062 Boston, MA 02211 Wpaform4b.doc - Appendix E - rev. 2/00 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Appendix E — Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office (see Appendix A). 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Wpaform4b.doc - Appendix E - rev. 2/00 Page 2 of 2 .