Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 31 SILSBEE ROAD 4/30/2018
-d 31 SILSBEE ROAD 210/020.0-0063-0000.0 1 r Date.... . . Q 4 HORTM °ft"`° :•�"° TOWN OF NORTH ANDOVER 3? et�r _... �• OL FO P PERMIT FOR WIRING •Dq•TID��``� 3 CMUS� 414EIY This certifies that ..... .... .!..:�"......................................................................... has permission to perform ........................... ............ .... .................. _Si s wiring in the building of.... / ...................... ..:f...................................... ' at......... r.. ��h .. ................. .. .North Andover,Mass. r ,/ ,� � Fee..��.rr�.�Lic.No. .�......��.................�.. ........ ....... ....... ELECTRICAL INSPECTOR Check # 9VJi . � Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 3 BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM EL ,CTR CAL WOR All work to be performed in accordance with the Massachusetts Electrical Code( C),527 MR 12.00 (PLEASE PRINTININK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the ctor o By this application the undersigned gives notice of his o her intention t erform the electrical workldescribed below. Location(Street&Number) S le� Owner or Tenant D 1 Telephone No. Owner's Address S Is this permit in conjunction with a uildin permit? Yes No ( ❑ (Check Appropriate Boz) Purpose of Building .2� {'�' Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No,of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity Loca on d Nature of Proposed Electrical Work: ����� �� fix, 6Dr �cG-�-r`t S- .SPs�/ ` Ree�Ne� ------------------------------ Completion of the ollowin table may be waiv,edby the Ins ector o Wires. No.of Recessed Luminaires No,of Ceil:Susp.(Paddle)Fans NQ•of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming PoolAba0.tte Units ove rnd. merg grud. Iii- No. g of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers H=:SAR ber Tons KW No.of Self-Contained ..................._._. etection/Alerfmg Devices No.of Dishwashers Space/Area Heating KW Low❑ Municipal { Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or E uiv dent Heaters KW Si s Ballasts Data Wiring; No.of Devices or E No.Hydromassage Bathtubs No.of Motors uivaIent Total HP TelNo.oecommunications Wiring: OTHER: f Devices or E uivalent Estimated Value of Ectric Work: Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: O Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability t. The undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) Ffy IRM NAME the p ains and penalties o fpry'vu,that the information on this application is true and complete. Licensee: p t uN LIC.NO.._JZ3fl Pt�� Signature LIC.NO.: (If applicable, enter "exempt 'in the h nse num link)/ Address: S�f V I t D fBus.Tel.No.: 1 *Per M.G. c 147,s.57-6 1,security work requires Department of Public Safety"S"License: Alt.L cl.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabili ty e normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) Elow erco❑verowner'agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ The Commonwealth of Massachusetts k� '! Department of Industrial Accidents Wir Dice of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia . Workers' Compensation Insurance Affidavit. Bailders/Contractors/Eleetricians/Plumbers A ficant Information Please Print Legibly Name (Business/otganiration/Individual): � X, -------------- Address: U-/o1 City/State/Zip:_13uoe 4-�V Wlb�23Phone Are you an employer?Check the appropriate box: Type of project(required): l.❑ i am a employer with 4. ❑ I am a general contractor and I oy�(full and/or part-time),* have hired the sub-contractors 6 ❑New construction 2. I am a.sole proprietor or partner- listed on,the attached sheet. 1 7. ❑ Remodeling ship and have no employees These sub-contractors have working for mei' any aci workers' comp.insurance. g' ❑Demolition Yp ty. 9. Building [No workers'comp. insurance : 5. ❑ ng addition a p• � ❑ We area.corporation and its required.] officers have exercised their 10. lectrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions myself. [No-workers'comp. c. 1.52, §1.(4),and we have no .t 12.❑Roof repairs insurance required.] employees. [No workers' 13.M.Other comp. insurance required.] *Any applicant that checks bo>r#t t must also fill out the section below showing their workers'oompensuion policy information. Homeowners who submit this affidavit indicating they are daring all work and then hire outside connectors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub•contmetors and their workers'comp,policy information. !am an employer that is providing workerscompensation Insurance f ornr information employees: Below is the policy and job site Insurance Company Name: Policy 4 or Self-ins.Lic.#: Expiration Date: 1 Job Site Address: City/State/Zip: fAttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment,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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. !do hereby cY46-mtdep tft,pains and penaldgs o er fP jury that the information provided ve is pwe and correct Phone#: S Fthon only. Do not write in this area,to be completed by city or town official n: Permit/License# hority(circle one):Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: Phone#• Information and Instructions 'v Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. 'However the owner'-of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation,affidavit completely,by checking the boxes that apply to your situation and,if ; necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. if an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,nofthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current t policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the ` applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,- please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel.# 617-727-4900 ext 406 or 1-8.77-MASSAFE Fax#617-727-7744 Revised 5-26-05 www.mmass.gov/cUa ZZ0/ 3 N° J _ r J Date....."'. ...,�f.. ........ NOR711 �r �•io•e'1eh�0 TOWN OF NORTH ANDOVER O 9 PERMIT FOR WIRING �,S$ACMuS� This certifies that � .�....�.. N ... .....,...... ............................ 0-4 .i W,./� has permission to perform ......: ...............................C<`...V..... .�......'"..�... wiring in the building of......... ..?...v e..!...(J................................................ at...��...�...... .�...!.�. P C ...................... orth Andovei Fee...J �.:.4/� ... Lic.No. .... ................ y ...........»......... L LECTRICALINS yCTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer gym'` lrmW1WVJ"1VrrTAlLLLIfir lVL-,jLX"(.dlVaZj1J vtuceuseom DEPARTALENTOFPUBLIC&FETY Permit No. t BOARD OFFIREPREVEWONRWUMTIONS527CMR120 Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL 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) Dat Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant "TkI11CLEM Weak Owner's Address 151 c2/ Is this permit in conjunction with a building permit: Yes[Er No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps0 /20 Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work* NEW M96009 L FXX 00M n, 466V No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total "i • KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 0 ground El No.of Rerpptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets i1 . f/ No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pum s Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of ED Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP Oa HER c Ptasuartblheregtlaarla��Gt�taalLaws Iha%eaamotLi biltyk& m=Pbbcym&dngCaq*kOpw 6eCoArdWcrits�>baloWiv ad YES NO Iha` %hnitedwlidptocfcfsameiotheOT=YES I j.J F ffjcutmediadWYESplememdc*theWcfmuagebydxckirgte wpopriaiebox I3C/ND 0II1ER a (PIeSpecifj') EViralicn D* Wo k b st r� - Q D rn O6�Os�Fstirr>ated VahxdElechical Wt&, l 4 00-� li>� � - Final Sired under-&Pla�cfpajtay. FIRMNAME LioerseNa Lioatsee /�k�r2LEy �� ._.. ,� Lioa>seNo 6� Bes¢lessTel.Naq W 777 Adrtretr �r.�.,�_ Alt.Tel.NU OWNER'S INSURANCE WAIVER,I.ammyethatd'rL tw dDes theitrsuaaw=p"%hWWeglWatasm*rclbyMassadueftsGa>aalLaws anddratmysigr>at (n ispermi tlzistecpmarlent. (Please check one) Own r Agent c /�� Telephone No. JU_-J� �PERMIT FEE ✓ r I/ 9- I Commonweellh of Massachusetts I Dlvlsion of Registration Board of Electrical Examiners j AMDRI9J SOCRA 35 APPLE ROAD 621 BEVERLY MA 01915 JOURIIYMAY ILECTRICIAM;. t 631611 01)31/4-1- 220019 License No. Expiration Date Serial No. Driver's License 06-06-67 06-05-03 M 5'06' ops S3.41�43355 Date of Birth Expires sex Hs�ghf er 1 ' ' SOCHA ANDRZEJ RYSZARD 36 APPLE ROAD o APT 21 BEVERLY, MA 01816 r' i t �.1 CONTROL # 003475 i IMPORTANT If this license is lost or destroyed,notify your Board at the Division of Registration, 100 Cambridge St., 15th Fl.,Boston, i MA 02202. I If name and address shown heron is changed notify your Board of correct name or address to insure proper mailing of next Renewal Application. Always refer to your license number. License is subject to the provisions of the General Law as amended. It is a personal privilege,and must not be loaned or assigned to any other person. Keep this license on your person or posted as required by law. . D: Small vehicle less than 26,001 lbs, except I School Bus. Location 'S/ S' A I� Pd _ No. / (93 Date J _3 -01 NORTIy TOWN OF NORTH ANDOVER O 4 ; ; Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3 is Building Inspector TOWN OF NORTH ANDOVER . BUILDING DEPARTMENT r APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE.OR TWO FAMILY DWELLING BUILDING PERNUT NUMBER: 193 DATE ISSUED: 3,15L©O s SIGNATURE: Building Commissionerl,I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3 15 i f6 hy, Ad O Map Number Parcel Number \' 1.3 Zoning Information: V! 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Re Fred Provide Rquired Provided Recitlired Provided 1.7 Water Supply M.G.1.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ as SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT n 2.1 Owner of Record Mum I Kra l tr 0A III :�I S1'l5�� �'r�' IW �nl�oy-rr, &I, tw Name(Print) Address for Service 01/ V Signature Telephone 2.2 Owner of Record: 0 Name Print Address for Service: C 2 Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Cowiniction Supervisor: C License Number Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address r Expiration Date Signature Telephone SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. ' Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 71?r /�y 'J SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed by permit applicant 1. Building cp C-:;� Cl Q �— (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of v Construction �� 7 3 Plumbing Building Permit fee(e)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 BUILDING PERMIT L ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED 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 '\ , Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR MMERS 1 s 2 3KD SPAN DIMENSIONS OF SILLS DB ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM A .� INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ......................``..i��..................................................... APPLICANTp�l"' d �A�4 © �V t�(( PHONE ASSESSORS MAP NUMBER a C-�2 LOT NUMBER SUBDIVISION LOT NUMBER STREET STREET NUMBER OFFICIAL USE ONLY ......................................Now..................................■ . RECO ATIONS OF TOWN AGENTS an a an offinow a an am 00,000008 �. DATE APPROVED 7 T C SERVATIONADMINtSTRATOR �j DATE REJECTED CONRAENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECENED BY BUILDING INSPECTOR. DATE Town of North Andover. , 40RTH JOYCE B NA $4*e of the Zoning Board of Appealsoho' °: � 9 TO Development and Services Division NORTA�city William J. Scott Division Director •=--- 2001 MAR 21 A 9: I ( )27 Charles Street D. Robert NicettaTelephone orth Andover, Massachusetts 01845 978 688-9541 Building Commissioner Fax (978) 688-9542 This is to certify that twenty(20)days have elapsed from date of decision,filed iilhout filing of anjappe4l. Any appeal shall be filed Notice of Decision Date Within(20) days after the Year 2001 Joyce A.Bradahaus date of filing of this notice Town Clerk in the office of the Town Clerk. Property at: 31 Silsbee Road NAME: Kathleen& Kevin O'Neill DATE: 3/13/2001 ADDRESS: 31 Silsbee Road PETITION: 002-2001 North Andover, MA 018#5 HEARING: 3/13/2001 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,March 13, 2001 at 7:30 PM upon the application of Kathleen&Kevin O'Neill,31 Silsbee Road, North Andover, MA requesting a Special Permit from Section 9,Paragraph 9.2 of Table 2,in order to allow the addition of , a 2'dfloor dormer and bedroom and closet and to extend a residential structure on a pre-existing, non- .� conforming lot within the R-4 zoning district. The following members were present: Walter F. Soule,Raymond Vivenzio,John Pallone, Scott Karpinski. Ellen McIntyre. Upon a motion made by John Pal'lone and 2nd by Scott Karpinski the Board voted to GRANT a Special Permit to allow for the addition of a 2nd floor dormer and bedroom and closet on a residential structure on a pre-existing, non-conforming lot, as per Plan of Land by: Scott L. Giles,PLS, #13972, 50 Deer Meadow Road North Andover, MA dated: 1/31/2001. Voting in favor: WFS/RV/JP/SK/EM. The Board finds that the applicant has satisfied the provisions of Section 9 Paragraph 9.2of the zoning bylaw and that such change, extension or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. Furthermore, if the rights authorized by the Variance are not exercised within one(1)year of the date of =- -_ grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two(2) Year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Town of North Ando -- ; Board of Appeals,• Raymond Vivenzio, acting Chairman Ml/Decisions2001/5 ESSEX NORTH IREG STRY OF DEEDS LAINt',"ENC-E, MATS."� ATTEST:A True Copy A?'�Li;w' �:�JFY: :gTTEaF'T: Town Clerk IEGISTER of DSD I . Registry of Deeds Northern District of Essex County Lawrence,. MA 01840 Registry of Deeds 04/18/01 Northern District of Essex County Lawrence, MA 01840 KATHLEEN O,NEILL GA 04118141 4 # 45 Reca Tyoe DECSN 30.00 KATHLEEN ONETLL GA T st 1.1531 # 46 Rec., Type PLAN 30.00 # 151 1 Cert. Copies 0.75 Inst 1.15 Copies 1.00 Total 0.75 Total 61.00 # 152 Payment Cash' 4.75 # 47 Payment Check 61.00 THANK YOU! Thomas J. Burke THANK YOU! Thomas J. Burke Register of Deeds Pegister of Deeds Town of North Andover o� 11, Building Department A 27 Charles Street x y o x North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 "..:(978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE i l JOB LOCATION / J► ��2 Number Street Address Map/lot "HOMEOWNER _._& )//r F LA / -1 71 YS" Name Home Phone Work Phone PRESENT MAILING ADDRESS ty T wn State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two units or less 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) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which helshe resides or intends to reside,on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. 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 requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Town of North Andover t%ORT 0 Building Department : 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 °�4°O[q,Al.K ACHU DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: OZ V1 V-f-U-S TU L'�,v,s Pz V- 01'\ Facility location VILL Sig ature of Applicant 5� Date' NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. NORTH 0 0And oK..4w.. .�. .r over No. _ - - ta "M -moo o/ o - �Aover, Mass., C 0,: , IC V A0RA rE D p C, S H BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �f3�/t!A) + &W V�I1� O ���' ', BUILDING INSPECTOR THISCERTIFIES THAT.............:........................ ............................................................................................................. Foundation has permission to erect... ....... buildings on �1 ........A Rough to be occupied as S ho of �e m e� Ap.+ of. 'D� 0,11 Chimney ............................................................. . y ........................... provided that the person accepting this permit shall in every respect conform to the terms of thea lication on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. rn P t1p.3 jjqt? PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough ERMIT EXPIRES IN 6 MONTHS Final vac © LESS CONSTRUCTION ST ELECTRICAL INSPECTOR Rough ........ ... ... ...... ............ ................:........................................ . Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i ck - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -_ _- _- • • • • • • • • • 161,7 t .'.' . .'.'•'•'•'•'.'.'•'•'•'•'• ,• , • • • • • . • . • . . . . . . . . • . . . • . • • , , . • • • • . . • . . • • • • • • • , . • • . . • • • , • • • • , . . • • . . . . _ _ • , • • • • . • • • . . . . . . . . . . • . . . . • • • • . . . . • . • • • • . • . • . . . • • • . • . . . . . . • . . • . . . . . . . . . . . . • _ _ . . . . • . • • . . . . . . . . . • . . • . . . . . . . . . • . . . . . • . . . . • . . • • • . . • • . • • . . . . • • . . . • , • . . • . . • - . . . . . . • . • . . • • . . . . . • • • . • • . • • • . . • . . . . • . • . • • • . • . . . . • . . . . . . . • . . • • . • . • • • • . . . • • . - • • . • . • . . , • . . . . . • • . . . . • • . . . . . • . , . . . • . • . . . • . . . • • • • . . • . • . . . . . • . . . . . • . . . . . . . - _ . _ . • . • . • . . . • • . . . , • . . • • • • . • • . • • . . . . • . . . • . . . . . . . • . . . . • . . • • . • . . • . . . . . • . • • . . . . • • ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' '__ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SECOND FLOOR PLA N T . . . . ; t (PROPOSED) _ — . • . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . _ _ _ .'.'.'.','.'.'.'.'.'.'.'.'.','.'.'.CN�•V,11'.','.','.'.',',8d ' '.'.'.'.'.'.'.'.'.'. .'.'.'.'.'.'. .'.'.'.'.'.'•'.'.'.'•'.'.'.'•' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i• . . . . . . . . . • . . . . • . . . . . . . . . . . . . . . . . . . _ — . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .;, . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . — _ — — . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . I . . . . • . . . . . . . . . . . . . . . . . . — — . . . . . . . . . . . . . • • , . . . . . . . . . . . . . . . . . . . . •. . . . . . . . • • , • • . BATH DOWOfZ (EXISTING) N BEDR❑❑M CL BEDROOM — — (EXISTING) (EXISTING) — — _ C L PLANS FOR == KATHY & KEVIN ❑ 'NEILL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 31 SILSBEE ROAD NORTH ANDOVER , MA, ��=S=CALEil/4' = 1'-0' DATES 1/2/00 ----------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- ----------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------- - - ------------------------------------------------------------------------------------ - - ----------------------------------------------------------------------------------- - - ----------------------------------------------------------------------------------- - -------------r--------------------------------------------------------------------- - ----------------------------------------------------------------------------- Ml I ER❑NT ELEVATI❑N ® ® a w PLANS FOR KATHY & KEVIN O ' NEILL 31 SILSBEE ROAD NORTH ANDOVER , MA . SCALEi1/4' = 1'-0' DATEi 112100 r PLAN OF LAND IN NORTH ANDOVER, MASS. OWNED BY KEVIN P. AND KATHLEEN M. O'NEILL' SCALE: I"=20' DATE:1/31/2001 NOTES: THE ZONING DIST. IS R-4 ELEVATION VIEW 0 20' 40 60' ASSESSORS MAP 20 PARCEL 63. NO SCALE LAND COURT PLAN 8813-5 LOT 7A, DEED LANDCOURT BOOK 77 PAGE 105. Scott L. Giles R.P.L.S. TOTAL EXIST. BUILDING AREA=1700 S.F. a A Frank. S. Giles TOTAL ADDITION=300 S.F. o QBE ROS°° 50 Deer Meadow Road TOTAL ADDITION OVER EXIST= 18% North Andover, Mass. THE FRONT OF THE BUILDING LINES UP WITH THE EXISTING BUILDINGS 250' EITHER SIDE OF THE LOCUS. 21' 8 � e 11��I�S64 NSF M 1 p5 � z N 6g°p3 2 \rn c 'cr t!1 �X`ST mX opo Nm Co 0 rn ° Oz o� GSR TA 13' Co ONQ o m� °o kl- m O z 25- m-7 po ------------ o- (3 o o , 0 0 mac\ 0 56°X312 AL1.OR �Z m �0 �0 z 0 0 Z THIS IS TO CERTIFY THAT I HAVE CONFORMED A G WITH THE RULES AND REGULATIONS OF THE Cn REGISTERS OF DEEDS IN PREPARING THIS PLAN NORTH ANDOVER THE PROPERTY LINES SHOWN ARE THE BOA OF APPEALS LINES DIVIDING EXISTING OWNERSHIPS,AND THE LINES OF STREETS AND WAYS SHOWN ESS�� NORTH � � ® DE —�� ARE THOSE OF PUBLIC OR PRIVATE STREETS Z u� OR WAYS ALREADY ESTABLISHED,AND NO LAWRENCE, MASS. NEW LINES FOR DIVISION OF EXISTING A TRUE C,'C PY: ATTEST: Jc - OWNERSHIP OR NEW WAYS ARE SHOWN. f� REGISTIwR OF OF-ED C � G 9 ^ L � !L S y No. 13972 DATE OF FILING: `A DATE OF HEARING: i DATE OF APPROVAL.-2 NocrrN Zoning Bylaw Review Form Town. Of North Andover Building Department 27 Charles St. North Andover MA. 01845 "�S"`NvSEt Phone 978-688-9545 Fax 978-688-9542 Street' I e JR,o a& . Ma /Lot: d a / to -3 Applicant: V-u tP--� l - R I e-- Request: --Re uest: Ra a r a r rn+� C,,, i�c 1!6.0 Date: Please be advised that-after review of your'Application and Plans your Application is /DENIED for the following Zoning Bylaw reasons: Zoning Item Notes Item A Lot AreaNotes F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 1 Lot Area Preexisting e 5 2 Frontage Complies 3 Lot Area Complies 3 1 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed S G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required 3 Preexisting C8A Lie S 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 1 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height lie S 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexisting setback(s) e 5 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting LiC S 1 Not in Watershed- �( �S 4 2 In Watershed Insufficient Information j Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district S 2 Parking Complies 3 Insufficient Information- Remedy for the above is checked below. Item # S ecial Permits PlanningBoard. Item # Variance Site Pfan Review Special Permit Setback Variance Access other than Fronts e S ecial Permit Parkin Variance Fronts a Etion Lot TSPel Permit Common DrivewaySpecial Permit Lot Area Variance Con re ate Housin .S ecial Permit Nei ht 4iance ...... Continuing Care Retirement Si�lpecial Permit Variance for St n Inde endent Elderl Ho11 1 usin S ecial Permit S ecial Permits Zonin Board S ecial Permit Non-Conformin Use ZBA Large Estate Condo S ecial Permit Planned Develo ment.District S eels!Permit Earth Removal S ecial Permit ZBA Planned Residje�ntial S ecial Permit S ecial Permit Use not Listed but Similar R-G Densi Slat Permit tS cial Permit for Si n Watershed S al Permit Ra er pj Pec is I p� a, u I Additional Information The above review and attached explanation of such Is based on the plans,request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building De rtment.The attached document titled°Plan Review Narrative"shall be attached hereto and incorporated herein b refere . Th buildin partment will retain all.plans and documentation for the above file. ilding Department Official Signature dZ- Application Received Application Denied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for the action on the property indicated on the reverse side: A �, �' ��.t p���.� 'fib°� �► , � ��.�v N sl� 0� 44 A-) C1 �' Xt Sfti1 r _r ON" Cnti Referred To: Fire Health Police Zoning Board Conservation HiDepartment of Public Works Plannin storical Commission Other BUILDING DEPT ZoningBylawDenW2000 �NOHTir A Zoning Bylaw F--,view Form 9 to Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 SACAU 5� Phone 978-688-9545 Fax 978-688-9542 Street: l 5, 11&6 e e Oa Ma /Lot: -R n / to 3 Applicant: V,,e u 't p L< R I e N ( EI l l Reguest: rv�.Pj 4- }Za: ,r- �ar`mer C v� �vc�rca'.v Date: I -QV p 1 Please be advised that-after review of your'Application and Plans your Application is AXIMOW/DENIED for the following Zoning Bylaw reasons: Zoning Item Notes Item Notes A Lot Area F Frontage 1 Lot area.Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting e- 5— 2 Frontage Complies 3 Lot Area Complies3 1 Preexisting frontage 5 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed S G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required 3 Preexisting CBA Lie 5 5 Insufficient Information 4 Insufficient Information — C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height S 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient 1 Building Coverage 6 Preexisting setback(s) 5 1 Coverage exceeds maximum 7 Insufficient Information. 2 Coverage Complies D Watershed 3 Coverage Preexisting `i �S 1 Not in Watershed `( e S 4 Insufficient Information 2 In Watershed i Sign 3 Lot prior to 10/24/94 1 Sign not all 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Re wired 2 Not in district �e. S 2 Parking Complies 3 Insufficient Information Remedy for the above is checked below. Item # Special Permits Planinling Board. Item# Variance Site Pian Review Special Permit Setback Variance Access other than Fronta e S ecial Permit ParkinVariance Fronta a Farce tion Lot S ecial Permit Lot Area Variance Common Drlve.wa Sp ial Permit Hei ht Variance Contin Conn ate Housin .S ecial Permit Variance for Si n uing Care Retirement Special Permit Inde endent Elderl Housin .S ecial Permit Special Permits Zoning Board S ecial Permit Non-Conformin Use ZBA Large Estate Cando Special Permit Planned Develo men#.District S eciaLPermit Earth Removal S ecial Permit_Pse S ecial Permit Use not Listed but Similar Planned Residential S ecial Permit R-6 Dens S ecial.Permit Special Permit for Si n Watershed S ecial Per Ra Other pj I'ifc la I Pe r VA Supply Additionallnformation The above review and attached explanation of such Is based on the plans,request for or information submitted. No definitive review and or advice shall bee based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies,misleading information,or other subsequent.changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building De rtment.The attached document titled-plan.Review Narrative"shall be attached hereto and incorporated h:2ilding ibefere . Th buildup partment will retain all. an and documentation for the above file. Department Official Signature o2— Application Received Application Denied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative indicated on the reverse side:The following narrative is provided to further explain the reasons for the action on the property . 10V 0(� e )C L A, Referred To: Fire Health Police Zonin .Board PlanniConservation Department of Public Works Other thern Historical Commission BUILDING DEPT ZoningBylawDenia12000 PLAN OF LAND IN NORTH ANDOVER, MASS. OWNED BY KEVIN P. AND KATHLEEN M. O'NEILL SCALE 1"=20' DATE:i/3112001 NOTES: THE ZONING DIST. IS R-4 ELEVATION VIEW of 20 40 60 ASSESSORS MAP 20 PARCEL 63. NO SCALE LAND COURT PLAN 8813-5 LOT 7A. DEED LANDCOURT BOOK 77 PAGE 105. Scott L. Giles R.P.L.S. TOTAL EXIST. BUILDING AREA=1700 S.F. MER pRop Frank. S. Giles TOTAL ADDITION=300 S.F. ooR o0 50 Deer Meadow Road TOTAL ADDITION OVER EXIST.= 18% e R�'FR North Andover, Mass. THE FRONT OF THE BUILDING LINES UP WITH THE EXISTING BUILDINGS 250' EITHER SIDE OF THE LOCUS. 21' 7 72-1 N o$ z EX�PR' � °° # G a CA O oN '0 CC) O Q m o ��z 25k�- I e:j m p mp l h Ac�L 1- O o° SOT F cr 133 S 'o cr_ o w (J\ - CL , 101'�2 O �In o g6°X3,25 �L00 Z m -�o 0 77- 0 O 77- THIS IS TO CERTIFY THAT I HAVE CONFORMED WITH THE RULES AND REGULATIONS OF THE G REGISTERS OF DEEDS IN PREPARING THIS PLAN m NORTH ANDD VER THE PROPERTY LINES SHOWN ARE THE BOARD OF APPEALS LINES DIVIDING EXISTING OWNERSHIPS,AND THE LINES OF STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED,AND NO NEW LINES FOR DIVISION OF EXISTING OWNERSHIP OR NEW WAYS ARE SHOWN. H N • 4 DATE OF FILING: F��S13972972 DATE OF HEARING: t LAND SU DATEOFAPPROVAL: ���� + o N- ,_ .1 u i Date....... ... . f NpRTI,� '+ �``°.;•_:"�o� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING �,SSACNUS� This certifies that ....... has permission to perform ........ ..u.►"'!.. .......Pu.!! ..........C�. �`?... I wiring in the building of......�......... . '.......t.................................................. at........�?....�.......s...... ..5.. '.t.,Q.-............................ .North Andover,Mass. 4 Fee... r W�u:��C)CJ Lic.No.l �M�.......................................... .................. . 77 ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Service Final Rough ,> 04P CfommonwratO of M8998chusetts Office use Only Department of Public Safety Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR2:00 Occupancy a Fee Checked [Y 3/90 Ileave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 q 1 t (PLEASE PRINT IN INK OR TYPE ALL INFORMATI NI Date /0 41 � ��I+1/--'� To the Inspector of Wires City or Town of + `r v i— 11n The undersigned•applies for a permit to perform the electrical work described below. Location (Street 6 Number) Owner or Tenant V I a q' � o�/ Owner's Address .ate e, Is this permit in conjunction with a building permit: YesNo (Check Appropriate Box) y Purpose of Building t�� Utility AuthoE:dgrd* No Ams 12 0 / G=-Volts Overhead ❑ No.of Meters Existing Service p New Service Amps / —Volts Overhead 1:1Undgrd ❑ No. of Meters Number of Feeders and Ampacity f t, �'� 0 r Location and Nature of Proposed Electrical Work 6 TOTAL No. of Hot Tubs No. of Transformers KVA No. of Lighting Outlets ADOVe In- Swimmin Pool rnd. ❑ rnd. ❑ Generators KVA No. of Lighting Fixtures No. of Emergency Ligh ting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Conditioners Tons Initiating Devices Heat ota ro—tal No.of Sounding Devices. No. of Disposals No. of Pumps Tons KW No. of Self Contained yDetection/Sounding Devices ` No. of Dishwashers Space/Area Heating KW Municipal � No. of Dryers HeatingDevices KW Local[:]* Connection ❑Other No. o No. Of Low Voltage No. of Water Heaters KW Si ns Ballasts Wirin No. Hydro Massae Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES 0 NO❑1 have submitted valid proof of same to this office. YES O NO U If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ 1 6F0 Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: r ` 1 g r FIRM NAME .0`fits—!✓� ` `' `� LIC. NO. d� Licensee '-'ba QSignature LIC. NO. Qf C 0� Bus. Tel. No./ 3. a - Address ' Alt. Tel. No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required b Massat huseM 11/Ge eral Laws, and that my signature,on this permit application waives this requirement. Owner Agent (Please check orielo y Telephone No. t+ `I L PERMIT FEES /l (Signature of n r or Agent) COMMONWEALTH OF MASSACHUSETTS DIVISION OF REGISTRATION OF ELECTRICIANS AS A REG JOURNEYMAN ELECTRICI ISSUES THIS LICENSE TO ROBERT F CHANDLER 37 BIRCHWOOD DR HAMPSTEAD NH 03841-5310 29972 E 0�7/�311//0�1 773268 Y r CONTROL# 8265102 IMPORTANT If this license is lost or destroyed, notify your Board at the ` Division of Registration, 100 Cambridge St., 15th R., Boston, Mass.02202. If name or address shown hereon is changed notify your boar of correct name or address to insure properlicenseailing of next number.Application. Always refer to your License is subject to the provisions of the General Laws as amended. It is a personal privilege, and mustnot be license olno n d or assigned to any other person. Keep this person or posted as required by law. + MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ` (Type or print) 2 y — NORTH ANDOVER,MASSACHUSETTS Date Building Location, 3/ 5��5�G Permit # Amount Owner's Name /112S 0'N ell New Renovation El Replacement El Plans Submitted n FIXTURES e up w � SiBB3VIL ISL ROCR ZID FLOCK �FLDCR 4M FWM 5M ROCR 6M FLOCK TM FLOCK 8M AOCR (Print or type) Check one: Certificate Installing Company Name 11 R+tt-7-tYL jot H' Corp. Address -�-3,5;, h.±22a 700-6 37-, Partner. l�12677AncW nAt$S �. Firm/Co. Business Telephone 97c- y 7S- 2-719, Name of Licensed Plumber: l�t/� �/�lY�> �T� �c�GlfTr►2 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond Insurance Waiver: I,the undersigned,have been made aware tliat the licensee of this application does not have any one of the above three insurance +gnature Owner Agent 0MRS a bat of my jmawkdge and that an plumbing wa&and patcmcd�r)rr Permit ior ftp apQo®000 wabe m compliance with all pertinent provisions of the Massach etts State Ping Code and Chapter 142 of the General Laws. By; 5ignature o I um er Type of plumbing license Title -2-o2-39 City/Town ' + =fi7C"m er Master � Journeyman u i�— APPROVED(OFFICE USE ONLY NORTH BUILDING PERMIT cf TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION p / IL i e« Permit NO: Date Received 1 A�RArgo Date Issued: —6�— — V\ �SSgcHus�� � MPORTANT:Applicant must complete all items on this page LOCATION t -�i '.. S)C,ry513 - '04 Pant PR3PEftTY OWNER / C'`Li n r .. :a /c . Print ` MAP.210PARCEL. ZONING DISTRICT HistoricUstrictyes no: Machne=Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Buildingne family Addition Two or more family Industrial Alteration No. of units: Commercial epair, re lacemen Assessory Bldg Others: Demolition Other 'Septic:� WII Flo dplpin 1/etlands 1Naters�hed D strict. ater1 ewer DESCRIPTION OF WORK TO BE PREFORMED: a2 DeeYcv�9 c L fF cr-55.�2� Identification Please Type or Print Clearly) OWNER: Name:_/-{y Phone: f-7,0'-6Y9- Address: 3 / S&5,660 1;26 CONTRAGTOR;w Na e. nfr �/�'1c C'ut Ph©ne ��� Address: r2C1 adGtJ. " ec/h� 75� S,upervisor's Construction:License: 033 ZZ3� Exp:: .Date.. Gln flornefllmprovement License: p Exp. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ qoo-&o FEE: $��y Check No.: Receipt No.: NOTE: Persons contracting with unregistered I actors do not have access to th guaranty fund W Signature of A ent/Owner Ignature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales -Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS i CONSERVATION Reviewed on Signature I COMMENTS A HEALTH Reviewed on Signature z COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street f,IRE.�EP.ARTMENT Temp D.urnpster on stte .yes no "Located.at 124�Main:Street -:Fire Departi:nent etatureldate i COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit c/ ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Piot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior p p to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. Thea applicant must h pp ten get this recorded at the Registry of Deeds. One co . b Y and roof a must be submitted with the building application copy p of recording Doc:Building Permit Revised 2008 Location 2/ si (s h e e, No. . Date NORTp TOWN OF NORTH ANDOVER 419 Certificate of Occupancy $ � s�CNusE� Building/Frame Permit Fee $ �2 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #q 1 F E 23160 Building Inspector 'F WORTH Town - of 4Andover . No. - ��. .L A dover, Mass., COCHICMEWICK 7,ps RATED 7 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System i BUILDING INSPECTOR THIS CERTIFIES THAT......... ........ IJ .. ......................................................................... ........... """. Foundation has permission to erect...... ........ ....... buildings on �1 ,r�z G. ............. ................... Rough tobe occupied as................ .�........... .� r7 .z..............................:............................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIT TS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina, No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department o f Industrial Accidents Office of, nvestigadons 600 Washington Street Boston, M4 02111 Workers' Compensation Fnsurance A da as�bov/dia An licant Information � ' Builders/Contractors/Electricians/Plumbers Please Print Legibly Name (Business/Organization/Individual): /f/ LF✓ST Address: A l City/State/Zip: SA,+v1Jgy,t/ Nov dj. 97_ Phone#: G��3 �_ f� Z Z 7 7 FA6u an employer?Check the appropriate home m a employer with q.• ❑ I am a o F7. ype of project(required): ployees(full and/or parttie * have hit ae�contractor and Ithe sub-contractors ❑NeuJ constructionm a sole proprietor or partner_ listed on the attached sheet t '+�R ship and have no employees em°dehng These sub-contractors have working for me in any capacity. workers' com . ' g ❑Demolition [No workers' comp. P insurance. 9. ❑Building addition p insurance 5. ❑ We are a corporation and its 3.❑ required] officers have exercised their 10.0 Electrical r I am a homeowner doing all work right of ex ��°r additions myself. 4),an n Pte'MGL .11-0 Plumbing repairs or additions Y [No workers'comp. C. 152 I insurance required.] t em to ees4),and or have no 1 P Y [No workers 12.[]Roof repairs E, _ comp.insurance required,] 13•❑ Other Homeo netPli s thatchecks h��t mus!;so l out the section beiov Ehm _:Y�.u, W21erS WIIO SrrUIIi]t affidavit indica or.,— CQII2Y...�=^.e.^.Y..:.'e;j r.u.w:`1Ci7 'Contractors that ch=k t his box must attached an additional sheet shower and hire outside contractors eruct submit a new affidavit indicating such. _the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the poli �a,� information. cJ ,fob site Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: Attach a copy of the workers'compensation policy declaration aQ Cityy///State/Zip: b F e (showing policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminalpenalties fine up to$1,500.00 and/or one-year imprisonment,as well as civil e Of up to$250.00 a da aor. ised penalties in the form of a STOP WORK ORDERand of i Investigations of the DIA for insurance overages nficauon copy of this statement may be forwarded to the Offie of ti e I do hereby certify er the pains and penalties o er u $irtt the or Si e: f P �' f matron provided above is true and correct Date.:_S--`� Phone#: Official use only. Do not write in this area, to be completed by city or town o fficial City or Town: Issuing Authority(circle one): Permit/License# 1.Board of Health 2.Buildinb Department 3. Citv/Town 6. Other Clerk 4.Electrical Inspector 5.PiumbinR�s pector Contact Person: Phone n: Information an- d Instructions Massachusetts General Laws chapter 152 requires all employs to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every peon in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,associaLtion, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the it' representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three apartnz tints and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of suchemployment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to c-anstruct buildings inthe commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work um-til acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.,, Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors) name(s), address(es) and phone number(s)along with their cerd cate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers' comp ensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be ret'iuued t0 the vitt'{Sr tC1 nTi that the auuuCuuGn for the^eramt or license LC being re^gV1-S*Xd,not f.'.^.e��'epaTL^..e It or Industrial Accidents. Should you have any questions regarding the law or if you arerequired to obtain,a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit(license number which will be used as a reference number. In addition;an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under`.`Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each . year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would like totha please do not hesitate to give us a call you have nk you in advance for your cooperation and should h yquestions, any The Department's address,telephone and:fag_number. . The Cammonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-72.7-4900 e=4,06 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-72.7-77/49 v ry v,.mass..aovf dia Massachusetts- Department of Public Safet} IWEM Board of Building Regulations and Standards Construction Supervisor License License: CS 33238 Restricted to: 001. RICHARD A MCCULLY 8 PRESTON DRIVE SANDOWN, NH 03873 Expiration: 5/20/2010 Comm isimier Tr#: 26469 �'1ze �o�rmEo9uueo./.�l o�./�aaaac�euaetis Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 101779 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration :6/29/2010 Tr# 267900 Boston,Ma.02108 Type DBA NORTHEAST C6k0 EXTERIORS ;? Richard McCully 8 Preston Dr at signat Sandown,NH 03873 Administrator �� Not valid witho RICK McCULLY V)roposal Page No. 603-887-2277 of Pages NORTHEAST CUSTOM EXTERIORS RESIDENTIAL REMODELING 8 PRESTON DRIVE•SANDOWN, NH 03873.603-887-2277 LICENSED AND INSURED PROPOSAL SUBMITTED TO: DATE: NAME: - JOB NAME: STREET: STREET -31 5/c 5r3 X20 CITY&STATE ZIP CODE: CITY&STATE: ZIP CODE: PHONE: ^-7U y 6b Q- 44477— We hereby submit specifications and estimates for: We hereby propose t furnish labor and materials - complete in accordance with the above specifications, for the sum of dollars ($ 40 D ) with payment to be made as follows: yY'or✓ �orn/°C�T'Ti� All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by kmen's Compensation insurance. Authorized Signature 31Ceptanee of Proposal LDate ve prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work fied. Payment will be made as outlined above. SignatureSignature NOTE:This Proposal may be withdrawn by us if not accepted within days.