HomeMy WebLinkAboutMiscellaneous - 29 ALCOTT WAY 4/30/2018J
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No. 3S-3 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ C)
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ 3
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FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvalsipermits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
""""APPLICANT FILLS OUT THIS SECTION*****************"****-]
APPLICANTAW&t.&d,.
PHONE
LOCATION: Assessor's Map Numberr:�:�d&—o PARCEL/'� 0 lb
SUBDIVISION LOT (S)
STREET-- Olcb-�- w� ST. NUMBER
USE
1, RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED--__
COMMENTS
rOWN PLANNER
COMMENTS
DATE APPROVED
DATE REJECTED
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
Comm
PUBLIC WORKS - SEWERIWATER CONNECTIONS--__________
DRIVEWAY PERMIT
FIRE DEPARTMENT.
RECEIVED BY BUILDING INSPECTOR ----------DATE
Revised 9197 jm
North Andover Building Department
W Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150 A.
The debris will be disposed of in:
R/C-E ;R,14117111 -
"(Location of Facility)
6ofiatureAd -Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building inspector
q I'& ,
Town of North Andover
Building Department
27 Charles, Street
North Andover MA 01845
Tel: 978-688-9545
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE Z1119 14 15
ttORT#f
0
.3 CHUS
JOB LOCATION ,VZe471_
Number Street Address Section of Town
"HOMEOWNER 7f Z, FZ 4,6 Z;L
Nur�ber Home Phone Work Phone
PRESENT MAILING ADDRESS L_/
City Town
State
The current exemption for "homeowners" was extended to include owner -occupied dwellings
of 1 or 2 units and to allow such homeowners to engage an individual for hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Section (108.3.5.1)
Code
DEFINITION OF HOMEWOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which of two
there is, or is intended to be, a one family dwelling, attached or detached structures
accessory to such use and and/or farm structures. A person who constructs more than one home in a
two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Build . ing Off icial,
a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the
building permit. (Section 108.3.5.1)
The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other
Applicable codes, by-laws, rules and regulations,
The undersigned "homeowner" certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and reSom-Nents.
HOMEOWNER'S SIGNATU
APPROVAL OF BUI
Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with
State Building Code Section 127.0 Construction Control.
Revised 4.30.03
Home owner ExemptionsForm
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FORM U LOT RELEASE FORM P-P�klw- WAk
tz � 63
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fro
Boards and Departments having jurisdiction have been obtained. This does not relie%
the applicant and/or landowner from compliance with anyapplicable or requirements.
"""'APPLICANT FILLS OUTTHIS SECTION***—**—**—**--**********..
APPLICANT 'Jje)qe,'s '(PHONE
LOCATION: Assessor's Map Number
PARCEL
SUBDIVISION LOT (S)
STREET—ALo-0-0 WAq
14.
ST. NUMBER
USE
C6N-SERVATION
AGENTS:
DATE
DATE R
COMMENT r'l - . 1, �11
I
UJ A e�*
t
TOWN PLANNER
COMMENTS
DATE APPROVED
DATE REJECTEQ_
FOOD INSPECTOR -HEALTH DATEAPPROVED
DATE REJECTEQ
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE- REJECTED,
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT,
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9X97 im
MN me'
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers'Compensabon Insurance Affidavit
er
/I
Please Print
Location:. �29 ��Ze o 71 t/
C ity A10 --- LA Z!5—��Q Wf Y-, 1W. 4.19 -4 5 Phone # 9 e�� 72
DTI am a homeow . ner performing all Work myself.,
I am a sole proprietor and have no one working inany capacity'
F-1 I am an employer providing workers! Compensation for My employees working on this job.
Comoarw name:
Folure to secure coverne as required urider Seetion 26A or MGL 152 can Wed toft krpmWon of
anclior one yeare mprommatw wall -w
yrKmrstand thm a cepy or this staternent may be forwarded to ft Ofte of Irmesugamm & ft m for coverjg& AwUkMon_
Print
Official use only do not write in this area to be caMleted by city or tamn aTcjw
city or Town.
1�
AL
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MANAGE
I N C 0 R P 0 R A T E D
November 12, 2003
Michael McGuire
Town of North Andover
Building Inspector
27 Charles Street
North Andover, MA 01845
Subject: 29 Alcott Way
North Andover, MA
Dear Mr. McGuire:
This letter is to confirm that the Alcott Village Condominiums Association has
approved the deck for the above -referenced location as drawn.
If you have any questions, please feel free to contact this office.
pS'ereilyl
41U,
Richard Stern
President
200 Sutton Street - North Andover, MA 01845
www.suttonmanagement.com - (978) 689-9994 - Fax 685-8593
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SEE PLAN ENTITLED: PLAN OF ACCESS EASEMENt
TO BE CONVEYED BY N/F MERRIMACK
MERRIMACK COLLEGE. INC. COLLEGE1