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Home My WebLink AboutMiscellaneous - 314 SALEM STREET 4/30/2018 .> / 'F . S �ten Si�fi �. \. i NORTFi 01� of And(av(er O N +ICA o dower, Mass., LAKE k -. COCHiC.E.CK ADRATED P �(C S � �,� BOARD OF lE-IEALTH Y "`w Food/Kitchen y Septic System THIS CERTIFIES THAT....... : . .L.......C. ... / G /f r l' BUILDING INSPECTOR ............................................................ 1. oundation Ile has permission to erect........................................ buildings on ...... ... .......-5a��% Sf .. .........r..................................^ Rough �Js�d� i �: I to be occupied as.......................r� �,.. .ht ..�P ^�:r't.....�........✓.:. f:... ......-� ? �--�� - c ey provided that the person accepting this permit shall in every respect cform to the terms of the application on file inFina this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Iter at' n and Construc n of �� Buildings in the Town of North Andover. L � ^��-� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMrF EXPIRES IN 6 MONTHS ELECTRICAL CTOn UNLESS CONSTRUCTION,ST TSou �� =��-.I,,'I i! ll.C.r. ............................. F Service BUILDING INSPECTOR 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. �- •• - J.al�R.ae� .,ry'•a^ss� __�... .... •?IeiS'a'7MC^ T i tYA.:..P ?'T,:.'?'-- 'o .i .,u. :v:S.7.,..3"y""S:�lss.A:.r •, TS JNIFORM APPLICATION FOR D'ERMIT TO DO QASFITTINQ (Print a Type) NORTH ANDOVER, , Mass. Date____(-�o 1917D Building Permit # Location ,/ SA& � n Owner'a NameAff '111 New ❑ Renovation �FRIplaceme ❑ Plans Submitted: Yes ❑ No ccK h M O ; to p J rr w h V tl H31 X M X O ,X,, h < a X a 0 X < e M F a: o o x w M d d to s s a H r' I t7 F X .�1 F �. bar tl O tz �+ J 'W i i o e 06 5 a °u arc v a t1U11—saMT. OA'EMENT IST FLOOR 2NO,FLOOR I aROFLOOR 4tH FLOOR •TNFLOOR STN FLOOR 7TH FLOOR r aTH FLOOR Check one: Ceitfllcate Instaning CompanyName QCorp. Address U ad Pa ership 1111,qm/Co. Business Telephone �—f— ,3& Name of Licensed Plumber or Gas Fit r t / lG INSURANCE COVERAGE: :Chec e 1 have a current liability Insurance policy or Its substantial equivalent. I Yes No ❑ If you have checked,yej, please I cate the type coverage by checking the appropriate box. A(iabpity Insurance policy Other type of Mdemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: %naturs of Owner or owner's en Owner ❑ Agent ❑ I hereby certify that an of the details and Information I have submitted(or enler M abo application are ue ale to the best of my know go and that all plumbing work and installations performed under the mit Iss or this pp, o II be M mpllance with all ' pertinent provisions of the Massachusetts State Gas Code and Chapter 142 � T of License: • a Plumber Title na uro o n m of or as or Gaslitter �,�� Master license t C Joumeyman APPr10NE0(OFFICE USE ONLY) PAYM 57Q Date:. . . . . . . . ��. . OCT HORTIyO, ITOWN,i0 4MORTH ANDOVER pFtr�a° ,a,1.0 - 3? 't ., PERMIT FOR GAS INSTALLATION I? 95SACMUSEt - IG This certifies that . . . . .? f i has permission for gas installation .:":' f. . f'.:!. /4 in.the buildings of . . . . . . . . at f. r , North Andover, Mass. Fee. .` . . .�ic. No.&.�' .. INSPECTOR f WHITE:Applicant CANARY:Building.Dept. PINK:Treasurer GOLD: File 41 -57 Date.............................. , NORTH, oma TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING �,ssACHUS�� This certifies that ............. '�* .... �. .L ....................... Yf has permission to perform .... � % > 2/4i y �............ " J J i wiring in the building of.........b111!.h..... L... r �C...,,. ....................................... at....... f V... .,.qK4 1........T..................... ,North Andover,Mass. Fee..9K.00..... Lic.No. ........ <e .../.....�.!!�f......... EljgcTRICAL I61 risPECTUR Check # � 8772 Commonwealth of Massachusetts Official Use Only Department of Fire.Services Permit No._ �7 2 Z BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/071 neave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINTININK OR TYPE AU INFO&MTJOA9 Date: City or.Town of: NORTH ANDOVER To.the Inspector of Wires: By this application the undersigned givesnotice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant _ f� �� Telephone No. Owner's Address ,e Is this permit in conjunction with a building permit?4/(6, Yes Ei— No Purpose of Building LJ Appropriate Box) _ .v5�C �rol Utility Authorization No. Esliii Service `\ �`� �� I - t Overhead E] �Ps�,_ /1 Volts g ❑ No.of Meters New Service Amps / Volts Overhead ' ❑ Undgrd ❑ No,of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: " Com letion of the folloi4dn table ma be waived by the InspPector of Wires. No.of Recessed Luminaires �!" No.of CeiL-Susp. (Paddle)Fans �` No.of Total No.of Luminaire Outlets. No.of Hot Tubs Transformers KVA Generators KVA No.of LuminairesSwimming Pool Above ❑ In- o.o mergency ' d• md• � Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges No.of Air Cond. Total Initiatin Devices c� Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No,of Self Contained Detection/Alerting Devices No.of Dishwashers Space/Area Healing Kms' Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems: No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring; Si s Ballasts . No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and enol ' s/o ,U/1', � that the information - ation on this application is true and complete F1RM NAME; Licensee: Signator LIC.NO.: LIC.NO.: (If applicable, enter " et"in the license number line.) Address: - .s' !�y _- - / X79 R. Tel.No.: *Per M.G.L c 147,s 57 1,security work requires Dty Alt:Tel.No. g� o. OWNER'S INSURANCE WAIVER: I am aware that theLicensee does not Safehave'the liability insurance License: Lic.lcovera e normally required by law. my signature b h by waive this requirement I am the(check one)❑owner ❑owners agent - Signature Signature a Telephone Noy)P�OP--77� PERMIT FEE. $ 0� i , . 1 � �o �� O � i %. The Commonwealth of Massachusetts Department of Indusi#rr'd Accidents j • Ogee of Investigations 600 )ffl Isis ! ashington Street Boston, MA 02111 www.anass.gov/dia . Workers' Compensation Insu Applicant Info>r>nation rance Affidavit: Builders/Contractors/Electricians/Plumbers Please Print Leeibl Marne(Business/Organization/Individual) Address: City/State/Zip:_ Are you an employer?Check.the appropriate box: L.❑ I am a employer with 4, Type of project(required): j ❑ 1 am a general contractor and I employees(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.� ? ❑Remodeling ship and have no employees These sub-contractors have $. ❑Demolition working for me.in any capacity. workers' comp.insurance. [No workers'comp.. insurance 5. 9. ❑Building addition ❑ We are a corporation and its required.] officershave exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions Myself. [No-workers'comp, c, 1.52, §I(4),'and we have no 12. Roof insurance required.]t em 10 ees. ❑ repairs P Y [No workers' I3.❑Othtrr comp. insurance required..] 'anY applicant that checks bo)c#l must also flII out the section below showing their workers''compensation policy information. r Homeowners who submit this affidavit indicating they are daring all work and then hire outside contractors must submit a new affidavit indicating such. lconmwtors that check this box must attached an additional sheet showing the name of the sub-contactors and their workers'comp.policy infarma6on. I an an en ployer that is.provulingworkers s compensation insurancefor infornwio& nry.employees: Below is the policy and job site Insurance Company Name: Policy#or Self-.ins. Lie.#: s Expiration Date: JobSite Address: Ci ty/State2rp: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). tion 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Failure to secure coverage as required under Sec 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. I do hereby certify under the pains and penalties of perjury that the information provided above is brie and correct Si acre: Date: Phone#: [Wlocica!use only. Do not write in this area,to be completed by cit},or town official Towdrt: Permit/License Authority(circle one):d of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspectorr t: Phone#: . 1 Information and Instructions . 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, i 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 cavy workers'cflrnpensation 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,not'the 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 nurnber on the appropriate lyre. City or Town Officiais t 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 permittlicense number which wilI be used as a reference number. In addition,an applicant � that must submit multiple pennit(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 fiture 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, IuIA 02111 Tel. #617-727-4900 ext 406 or 1-8.77-MASSAF'E Revised 5-26-05Fax#617-727-770 www.mass.gov/dia _. I - ZONING DISTRICT R3 F { Mai- 18.2009 j!i of ssq FRANK S. GILES O REVISINS: F SURVEYING ' `n 50 DEERMEADOW ROAD i 0 at713 SCALE: V=40' NO. ANDOVER,MA 01845 V efEss�o�oQ 0' 40' 80' 978-9752059 �- qNo suA� FrankGilesSurvey@comcast.net Ma 1 09 LEGAL REFERENCES: CERTIFIED FOUNDATION MAP 3713:i0I 45&68 PLOT PLAN OF LAND 1 -318 SALEM STREET LOCATION C IARRiJSO REALTY TRUST N F DAVID H PICKLES 7R,TRUSTEE FT.iC.ERE 314-318 SALEM STREET ' ,:I'l 314-3 8 SALEM STREET NORTH ANDOVER.MA.U 1(S NORTH ANDOVER, MA SEE l'LarJ#10619 PREPARDED FOR ;:,;, >>�aA DEED IiK.(�C 3I.PAGE 28 SZ1 8 DAVID PICKLES �6�5 IRON PIPE c R itIND o 9 r . c . N N MAP 37B LOT 68RE AREA=30,187 s.f. �; O ,.;„ a MF .')...1 E9..4 w A 11 - rA g 20' I._LLLLLL Q2 xfMME _LLL L�pL�JAL�L��LLL}LFi L -' LLL LOL LLLLLLLLLL t]t. A _ILLLLLLLL 20i N g rW o N;F a N89-43'15"E 56.21' a h.L-1N INt ERS(. 1 a o0 MAP 3 7B LOT 45 So. AREA=25,000 s.f. oTAt T�� 10,�., 0.5739 Acres s.f. 1 A a \ \ r 'S Oh .\\ \ - \ -ecl \ . 1(0'+- (TOTAL.WIDTH) \ 192.74' (FRONTAC:E) \ 164.67' (ORIGIN.0 FRONTAGE) \J \ \ 641`52" ai(N),ra dills � s VP�LSI, I Declare that this lilan and sm t eta teas done in I�cdrdauce t ith . �`SO Ng ON. the Procedural find Tedwical Staiidards fix the 1ilactice of Laud _ -— PyINN, I Surt•epulg i1i the Commonwealth 6f Massachusetts: THE OFFSETS SHOWN / H. WN ARE FOR .: USE( T T ) HE . .E .F i. , r THE B. ILI)1NG INSPECTOR ONLY ANDSUCH S , HU-E ISFOR THE DETERMINATION E K.MINATIUN OF Z(NNING CONFORMITY OR NON-CONFORMITY WHEN CONSTRUCTED. THE LOCATION(:)F THE BUILDING AS SHOWN HEREt)N EITHER WAS IN COMPLIANCE WITH THE LOCAL ZONING BY LAW INEFFECT WHEN CONSTRUCTED(.WITH RESPECT TO SETBACK REQUIREMENTS ONLY)OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS G.L. TITLE VII I3LJILD G CHAPTER 40A SECTION 7. ,R—g S.(- S ie.-41713 C.:';CLENTS'PICKLES'PLOT I LANDRCT