HomeMy WebLinkAboutMiscellaneous - 30 BUCKLIN ROAD 4/30/2018--. w u
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This p6itifies that
Date...
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
has permission for gas installation
in the buildings o
at Y .............. I North Andover, Mass.
Fee .. ....... Lic. N dlr--�-la ...
G s
A INSPECTOR
Check #
51145
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Narne of Licersed pjurnberw�
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INSURANCE-4L4()W.RAGS,_,
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poky OUwtYPe--jO(_irxfernnily CIL Elon6 0
OMMS INISU RAt4CE:
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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This certifies that :X ........ ..
has permission to perform ..... ................ .......
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plumbing 1, the b��uillci* &_
'I ings 0 .............. . ...............
/A
. V ............ ... North ndo�er, Mass.
0
Fee— .... LI No. -�2 -�4
UM�IN I �E'P
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Check # J�_
6493
UASSACHUSE I UNIFORM A
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Allabirdyinuvance
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YOU have- checked yM Pleaft UXJCWC the tyl* coverage by ChedUng the MWW=te bmL
Allabirdyinuvance
. Policy Other tyPe cyf lnd� - 0 Bond
0*N3M*WMHCEWNVEk I am aware -that the licen� don
toot ham the "'Surance coverage required
Mam Germal Laws. and VW My signatLwe an Wi �pxmft
Check one
Owner Agent. 0.
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
gt�t�
... . .... 6 1
F"
ml? 137.04.--"'—'����*, 4"L
BUELDING PERNUT NUMBER: DATE ISSUTED:
SIGNATURE:
Building Commissioner/IEEI�22tor of Buildings Date
SECTION I- SITE INFORMATION
1. 1 Property Address:
1.2 Assessors Map and Parcel Number:
C12
Map Number Parcel Nunlber
A.)
1.3 Zoning Information:
Zoning Disuict Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft)
1.6 BUILDING SETBACKS (ft)
Front Yard Side Yard
Rear Yard
Required Provide Requircd Provided
Required J Provided
1.7Water Supply M.G.L.C.40 54) 1.5. Flood Zone Infonnation:
Public D Private 0 Zone --- Outside Flood Zone D
1.8 Sewerage Disposal System:
Municipal D On Site Disposal System 0
SECTION 2 - PROPERTY OWARS111P/AUTHORIZED AGENT
2.1 Owner of Record
0 cL Y\ A r nu,,(- 30 P)J,
Name (Print) Address for Service:
;�Lm- V12
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
13
Mc—ensed Construction Supervisor:
99 ckj!fl�—,Km 1W by S*C4 W, tJH 03071
re
4101
ijn7a re Telephone
Not Applicable 0
License N3-mboear
C,
Expiration Date f
3.2 Registered �Home Improvement Contractor
6cm k d -C
Not Applicable 0
Company Name
d L;
Address
I Signature Telephone
Registration Number
ID
Expirati4n D4
00
M
X
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0
0
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I SECTION 4 - WORKERS COMPENSATION (KG.L C 152 8 25c(6) 1
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit %vill result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes ....... 0 No ....... 0
SECTION 5 Description o Proposed Work (check applicable)
New Constructi . on 0
Existing Building 0
Repair(s)..
erations(s) 0
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Description of Proposed Work:
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completedbypermit applicant
!FFTCI[AtUSk--' t V
.....
I . Building
9
(a) Building P erin i t F e e
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
.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 BU]ILDING PERMIT
1, , as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf. in all matters relative to work authorized by this building penuit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, as Owner/Authorized Agent of subject
property
Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print Name
Signature of Owner ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TEVIBERS 2 ND 3RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEfGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING A X
MATERIAL OF CHDvINEY
IS BUILDING ON SOLID OR FELLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
MORTGAGE PLOT PLAN
EK SURVEY
17 ROYA� STREET, LAWRENCE, MA. 01841 Tel. 508-975-1413
MORTGAGOR f1M'M15ZZA4cy11'9 —DEED REF. PC.
ADDRESS OF PRINCIPLE BUILDING PLAN REF. IZ30-9-
2,e7- 7 v1JrA'7_1w DATE OF INSPEC-naN _e!P�14
A'1- e4AO .' 119, 4-1,41- 6-. - / "- -40 f
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NOTF_ This Inspection was prvpered I FURTHER SATE THAT IN My PROFEMONAL
up$-cMCCfly �=2911094 PurPo*u and IN not to OPINION the princIple vtrtj
bt ralled lipon = a IU",IA EX SUAWy ocr T. gc��rv/v and accessory
no r"POaagtty for damages �Vtp AUDEL WtbuDdfnga, _40v)�:OjEm
rolimce by anyons other than the acid mortgag" No. 36869 with the setback requirements of the Joc.w
and It3 avaigng in conn*ction vfth its PrWo*.d zoning ardtnonoes, and that no enohroachments
mortgage flnoncing to sold mortgagor. Glsl�� of major knprovwnentg ofthar way across
CERTIFICATioN To: '&At L tO propwAy lines exc*Pt 09 uhawn.
01. PrOPerty (a not In a Flood H=Yd A,,,,,
Thl3 CIrdIfliaCtIon Is boxed on the lo=:Uon of vwvlo [32. Property Is In a Flood Kazcwd Area.
of athert, and dOC3 not mprt3ult d y m cr�ce`rs 0 3. Infomatlan is blxufflclbnt to jje�ln% Flood Hazar,
PrOPWtY aurwy, thw-afwt Flood Hmwd daieftlned from jtj*�Qtjst Frodwul
-'ffw3ts Zhown am not lc� b4d Ubed for the satablivhment of Mood
property Ilhu:k Insurance RcIte Map Pangif Z,5e7
Cj?g _ 067L
4
0
D. Fobert Nicefta
Building Commissioner
(978) 688-9545
'978) 688-9542 Fax
Please print
DATE
Town of North Andover
Building Departrnent
27 Charles -Street ..
North Andover, MA. 0184.5
108 LOCATION
Number _Str�t Address
JOMEOWNER
ESENT MAILING ADDRESS
Town
-t40
State
Map / jo—t
7'
Work
The current exemption for -homeowners- was extend
of two units or less and.tD allow such h6meown ed to include owner-o=pied dWLq#hgs
not POrisess a license, Provided that the own ers to engage anindMd"411C06 whodoes.
er acts as sjj . we .
Pervisor *(St8te StWdng Code Section 1*
-DEFINITION OF HOMEWCWNER: oe. a s. i)
Person(s) who owns�a parcel of land on which hef-she resides or intends to n.,!sWe. on
there is, or is intended tc) be, a one or tVoK) farrWy dwelling. Which
-who structmes
cessory to �Such use and/or farm �tT�� Aperspn attached or detac:hed
two-year Period Mall no bie iderL%d a ho�r�& CM-"tnXts mme #on one ac
cons homein a
The undersigned *homeowner" ass�umes responsibility for co
Applicable oode!§, by-la%ovs, rules and regulaborm. mPhance with the State BWkbng Code and other
The undersigned "homeowner' certifies th�3t he/she understands the Town ct No. Andover
8 widing Department minwnum inspection Procedures and requirements and that he/she M11
�OMPI`Y With said procedures and re,=jrempnt,.,z
fOMEOVVNER�S SIGNATURE
3PROVAL OF BUILDING OFFICIAL
FORM U - LOT RELEASE 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 or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT D&)(e, � j PHONE
LOCATION: Assessor's Map Number-- (, PARCEL_
SUBDIVISION LOT (S)
STREET (,i (2aa ST. NUMBER
I************************************OFFICIAL USE ONLY I
I RECOMENDATIONS; OFTOWN AGENTS: I
CONS'ERVATION ADMINISTRrR DATEAPPROVED
DATE REJECTED
COMMENTS u2cr"J hd ~44 Sj? " z�o - ca,,54r,,�,6i from o,, -Se4
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
SEPTIC INSPECTOR -HEALTH
COMMENTS
DATEAPPROVED
DATE REJECTED
DATEAPPROVED
DATE REJECTED
DATEAPPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTO
Revised 9\97 jm
,TE_
6
North Andover Building Department
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:
A4
o it- C,
(Location of Facility)
Signatur'*Je of Permit Applicant
0 0�—
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
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BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 060490
�v Birthdate: 07/24/1953
- "-Djw
Expires: 07/2412004 Tr. no: 25
Restricted: 00
WALTER B SLOAN
99 CLUFF XING RD #D4
SALEM, NH 03079
--Wd—m—inistr�a—tor
i3O.RT" TOWN OF NORTH ANDOVER
Certificate of Occupancy
$ 4�42
Building/Frame Permit Fee $
A Foundation Permit Fee
$ ;,e,
Other Permit Fee
Sewer Connection Fee
Water Connection Fee
TOTAL
Bu�ftq Inspector
03/30/94 10:26 582.50
7092
-4 Div. Public Works
% ,52
Lbcation
No. Date
"ORTH
TOWN OF NORTH ANDOVER
6 6
0
0 Certificate of Occupancy $
-Building/Frame Permit Fee $
4110
,qCM Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ 6)
Building Inspector
eZ���213 U13 �6-21 150-00 PAID
J-4 . :
6837 Div. Public Works
Location.'
No. d13 Date IZ—Aq73
ItORTh
TOWN OF NORTH ANDOVER
0
co 0 A Certificate of Occupancy $
Building/Frame Permit Fee $
CHU Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
X/'�' Water Connection Fee
00
TOTAL
17
Build! I or
j� 346/
i1c Works
6905 D i /v//�' �Pu 'I'I'M
PERMIT NO. /o,
AAP +40.
4
.
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. J1 b3 zi PAGE I
INSTRUCTIONS
SEE BOTH SIDES BLDG. PERMIT FLE $ Zz 0-2- �Lo
PAGE I FILL OUT SECTIONS I - 3 0,06
LESS FDA FEE-- -102: e2 L
PAGE 2 FILL OUT SECTIONS I - 12 DUE FRAME PERMIT
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED 13Y BUILDING INSPECTOR
DATE FILED
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E 19/ Z5I
PERMIT GRANTED
19
n
OWNER TEL.
CONTR. TEL.. -1
I
CONTR. LIC. # If
t� �-
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST c
EST. BLDG. COST PER SQ. -FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF ORLECTMZN
0
LOT NO.
2 RECORD OF OWNERSHIP IDATE
BOOK '.PAGE
ZONE
0- 77
F—
LOCATION,,"
PURPOSE OF BUILDING
A/
OWNER'S NAUE (!�l Je a C a, 1_
NO. OF STORIES SIZE
BASEMENT OR SLAB 021 =:?EaNIF—
MOT—, A 6 A,
OWNER'S ADDRESS 17W 7a- -7—
I- 2n Q I 5L
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2 N D 0 3RD
BUILDER S NAME e-Fo la, La u A/ A -Look
SPAN
DIMENSIONS OF SILLS
DISTAN6E TO NEAREST BUIL61NG /0
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES — SIDES 57 f REAR
GIRDERS 5—yl
AREA OF LOT 6�tm 0 FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW Ve _5-
SIZE OF FOOTING x
IS BUILDING ADDITION Vo
MATERIAL OF CHIMNEY
IS 13UILDING ALTERATION &/ u
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 13UILDING CONNECTED TO TOWN SEWER
A
IS BUILDING CONNECTED TO NATURAL GAS LINE v
INSTRUCTIONS
SEE BOTH SIDES BLDG. PERMIT FLE $ Zz 0-2- �Lo
PAGE I FILL OUT SECTIONS I - 3 0,06
LESS FDA FEE-- -102: e2 L
PAGE 2 FILL OUT SECTIONS I - 12 DUE FRAME PERMIT
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED 13Y BUILDING INSPECTOR
DATE FILED
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E 19/ Z5I
PERMIT GRANTED
19
n
OWNER TEL.
CONTR. TEL.. -1
I
CONTR. LIC. # If
t� �-
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST c
EST. BLDG. COST PER SQ. -FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF ORLECTMZN
0
BUILDING RECORD
OCCUPANCY
12
�INGLE FAMI
S�OkJES
TH IS SECTION MUST SHOW EXACT DIMENSIONS 6F LOT AND DISTANCE FROM
MULTI. FAMI
OFFICES
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA -
APARTMENTS
1
4-
--S. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION . . . . . .
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE
-- a
2 13
CONCRETE 8 LX
INE
BRICK OR STONE
HARDW D
PIERS
PLASTER
-6RY -WALL
UNFIN
3 BASEMENT
AREA FULL
F . 8 M*T AREA
14 1/2 1/1
F N. ATTIC AREA
t!O 8 M T
FIRE PLACES
T
HEAD ROOM
MODERN KITCHEN
4 WALB
FLOORS
CLAPBOARDS
B
1
3
DROP SIDING
CONCRETE
x
WOOD SHINGLES
EARTH
ASPHALT SIDING
HARDNP-I'D
ASBESTOS SIDING
COMIACN
Xi
x
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY
ATTIC STRS. & FLOOR
.:v r
BRICK ON FRAME
CONC. OR CINDER BILK.
3
STONE ON MASONRY
WIRIN 0
STONE ON FRAME
SUPERIOR OOR
11
ADEQUATE NONE
I Xj
5 ROOF
1 0 PLUMBING
IP
BATH (3 FIX.)
iANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
_25
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING
HEATING
WOOD JOIST
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL EMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T G
UNIT HEATERS
GA
7 NO. OF ROOMS
OIL
B'M'T 2nd
-id
ELECTRIC
NO HEATING
6
FORM U - 14T RELEASE FORK
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: C, 42 Phone
1,OCATION: Assessor's Map Number Parcel
Subdivision ap,&/17L�eww Lot(s)
Street aeg, C, St. Number '36
************************Official use only************************
RECOMMENDATIONS OF TOWN AGENTS:
073e. �CU�4r
Date
Approved
Conservation Administrator
Date
Rejected
Comments
A
Date
Approved
Town Planner
Date
Rejected
Comments
Date
Approved
Health Agent
Date
Rejected
Comments
Public Works sewer/water connections
driveway permit
Fire Department
Received by Building Inspector Date
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