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Miscellaneous - 316 STEVENS STREET 4/30/2018
316 STEVENS STREET 210/095.0-0006-0000.0 Location �i ✓Cy� `S -� No. Date TOWN OF NORTH ANDOVER 1 A 9 + ; Certificate of Occupancy $ sMUS<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1 v'1 20 Building Inspector z Date.......7.7....7..4..... NORTI� TOWN OF NORTH ANDOVER PERMIT FOR WIRING S' USf J This certifies that ......... 1, .L has permission to perform ...... 5� .�� ............................... wiring in the building of........................... ....S �90 ... . ................................ 31 b STS... at....................................... t/�/t.............. T..... ,North Andover,Mass. --00 vs,- Fee... '........... Lic.No. '�.Q............A �. . ......... ... ... `i,.... j ELECTRICAL INSPECTOR Check # 7472 Commonwealth of Massachusetts Official Use Onl-y7/ Department of Fire Services Permit No. ?q 2-- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave 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 PRINT IN INK OR TYPE ALL INFORMATION) Date: ® 7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) 3 �u-f /�• Owner or Tenant , Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes R-�- No ❑ (Check Appropriate Box) Purpose of Building S/ /� 7-//�lL Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: k Completion of the bllowing table may be waived by the Inspector of JVires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.O-TEmergency Lighting rnd. grnd. Battery 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Device Tons g No.of Waste Disposers Heat Pump I Number Tons I KW No.of Self-contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Si ns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent At OTHER: Alr kr /AL "/0 Attach additional detail if desired, or as required by the Inspector of Wires. i Estimated Value of Electrical Worw/ (When required by municipal policy.) Work to Start: 4/0-19-a 7 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 turd penalties of perjury,that the information on this application is true and complete. FIRM NAM E:SilL1-/VeN //-A/YFyAIA A,/cl LIC. NO.: Licensee: ,�p,�,�/17 o. .AUC L/ 14A.-, Signaturee LIC. NO.:.2.' 4/ 7 1i (If applicable, enter "exempt"in the license number line) Bus.Tel. No.:'? 7rf-69.24 %7y Address,-.27 It /l�G ,✓1y o 5'7, �/�Ia//.E'�`�(/� j 6� d/�9/Alt. Tel. No.: *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety "S" License: -"`��i-o. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner El owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. 0--0-7 t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s� www.mass.gov/dia i Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual):,Saa///!jN Ate?if ., AO f AZAeltl Address: a2 7 1_ .4A,) 2 s i - City/State/Zip: /1,//.; Phone #: 7cq- ,l9,,? 6 Y 7 Y Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. [ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. E] Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.[] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 LEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing 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 policy and job site information. _ 77�� Insurance Company Name: U YQ r) I 4- �1��Pe Policy#or Self-ins. Lic.#: 61C Z.3 S Yr 9 d?_ Expiration Date: 5-- j 0 � Job Site Address: 3 O rEVENlS S7- City/State/Zip:N. 4 AJ490V E6 f�J Attach 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 c. 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. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct Signature: .4� Q _Si�/ /"" Date: 0 7 Phone#: q 7e- 6 e.. V 7/V Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �7 � � � � � � � < ti .— s , ., , � . ,� , .. -7 Date. 07................... NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS 'This certifies that ... .................. ..................................................... has permission to perform ....... �y. ... ..................................................... wiringin the building of............... .. ......................................................... ...... ............ .North Andover,Mass. ............... Fee..... ............... Lic.No.q..F?43.. ....... ELECrRICA INSPECfW Check # V 7473 CommonwealthOfficial Use Only of Massachusetts O Department of Fire Services Permit No. Occupancy and Fee Checked % _ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave 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 PRINT IN INK OR TYPE ALL INFORMATION) Date: W/ /y —e" City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3/41, S7`,e P- Owner or Tenant i3a e d s Z P< Telephone No. Owner's Address 5' Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building / Utility Authorization No. /S/ - / �3 Existing Service Amps / Vold" ol Overhead ❑ Undgrd❑ No.of Meters New Service Z c-a Amps /2y 1Z y'e) Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .�, w /,-Z,vs Completion of the ollowin table ma be waived by the Inspector of Wire: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Tota Transformers KVA No.of Luminaire Outlets No.,of Hot Tubs Generators KVA A No.of Luminaires Swimming Pool Above ❑ In- No o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones INo.of Detectio No.of Switches No.of Gas Burners 2n and Initiating Devices No.of Ranges No.of Air Cond. Z Total No.of Alerting Devices Tons S g No.of Waste Disposers Heat Pump NumberTonsK.W. o.of Self-Contained Totals: Detection/Alerting.Devices No.of Dishwashers / Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kms, Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters KW Data Wiring: signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP elecommumcations Wiring: OTHER: No.of Devices or Equivalent f 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: ro -/>G 7 Inspections to be requested in accordance with MEC Rule 1 9 0,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 .n force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: / y/ r- LIC.NO.:Agf 3 Licensee: ,G_ /S s',,, ///' Signature LIC. O.: tH'9 11 (If applicable,1X11re.rempt-in the license number line.) Address: S Bus.fe� o.: �'�-z/o S/ vF Alt.Tel.No.: *Per M.G.L c. 147,s. 57-61,security work requires Department of Pub c Safety"S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee sloes not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(cheek one ❑ owner 0 owner's Owner/Agent PERMIT SignaturetoreTelephone No. FEE: $ .ti U's . t w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 r Workers, Compensation Insurance Affidavit: Builders/Cont A licant Informationractors/Electricians/Plumbers Name(Business/Organization/Individual): � �' S' �i Please Print Le ibl Address:_ City/State/Zip: � -�� Phone#: f-7-i— —6/x-7 _ Are you an employer?Check the appropr%"ed 1•❑ I am a em oyer with ntractor and IF ject(required): em �ees(full and/or part-time).* b-contractors construction 2. amae proprietor or partner- eattached sheet.t7. ship and have no employees deling These sub-contractors have working forme 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.[1 required.] officers have exercised their I am a homeowner doing all work right of exemptibti per MGL 11.❑Plumbing epairs or dditions myself.[No workers'comp. C. 152 1 4 g repairsadditions insurance required.]t .e ( ),and or have no 12.❑Roof re � ] ; employees. [No workers' Pairs comp.insurance required.] 13•0 Other *Any applicant that checks box#1 must also fill out the section blow showing theirwocompensation rkers' t Homeowners who submit this affidavit indicating they are doing atmust submit a eit; ng such. 1Contractors that check this box must attached an additional sheet showing the name of the subl work and then hire outside contractors�ontrs new workers'poncy COMP.and w affidavndreatian employer that is Providing workers'compensation insurance for my employees. Below is thepol licy information. iicy and bb site nffoo rmation, J e Insurance Company Name: Policy#or Self-ins. Lie.#: Expiration Date:_ Job Site Address: it Attach a copy of the workers'compensation policy declaration page(showin th tate/Zi —1�, g Policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 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 f of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office a Investigations of the DIA for insurance coverage verification the !do hereby certify under the pains penaltie of ferj>.ry that the information provided above is true Si na / e and correct. Phon #: —7 OJflcia!use only. Do not write in this area,to be completed by city or town offlciaL City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Ins ector 6.Other P Contact Person: Phone#: Date.t /��. . . 6 TOWN OF NORTH ANDOVER °oAL Y PERMIT FOR PLUMBING41 { . . . ,SSACHUSE� 1 This certifies that ' . .�.T. - . . . �� . . �. . . has permission to perform . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . ... .. . .�.�. 4.� . . . . . . . . . at . . 1 . . . . S�'�'C%J/ . Sf. . . . . . ., North Andover, Mass. . . . . . .yah. . . . . . . . �' . . .� - Check # y PLUMBING INSPECTOR �c% r 7417 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS n3/� Date BuildingLocatioS S /,/,, Owners Name o6'eWr C.SGUod Permit# -- Type of Occupancy / – fA/fie y Amount New j�' Renovation Replacement Plans Submitted Yes El No FIXTURES rA rx SLE BM lS'>C FLOOR 2l�FiOat 2 Q i 41ERfM seat 6M 7MFLOat gm HDat (Print or type) _ Installing Company Name /�f1 U/' T7/' PL 67 .� �� Check one: Certificate Corp. Address -- q / Partner. rG wt's i3 v� y rzH Busyness Telephone q 7 g . t/ 4/. .6a Firm/Co. Name of Licensed Plumber. G Fo/?G F "f, v Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: L— Liability insurance policy Other type of indemnity E:] Bond ❑ Insurance Waiver I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code d Chapter 142 of the General Laws. r By: 31PAUUUU1..1w113w1r1WU0C 41, Title Type of Plumbing License ` it V 0 ¢ City/Town rLcenum er Master Journeyman (� APPROVED(OFFICE USE ONLY i A7 OF NORTH 1M o= TOWN OF NORTH ANDOVER a PERMIT FOR GAS INSTALLATION �9SSACHU$ This certifies that . . �. . A— . . . . . . . . . . . . has permission for gas installation . . . . . . M '4't'�.S . . . . . . . in the buildings of j .5. . . , . . , . . . . . , , at . . �?�.�a. . . �!�". . . . . ��. . . . ., North Andover, Mass. Fee�l.6Q . . . Lic. No.�.qu �. !??f. . .Mel. . . . . GAS INSPECTOR F Check# 6037 MASSACHUSETTS UNIFORM APPLICATON R PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations 214 S 7 v 51 , Permit# Owner's Name Amount$ New Renovation Replacement Plans Submitted J w rn F W Gw x x z F o o a > w z e a w o� z d w d o�7, N y a�0 Z > w z a e e o ga y x o x a 3 a a v aa H o SUB-BASEMENT > BASEMENT 1ST. FLOOR I V- 2 FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STN . FLOOR N(Prinme or type) 6 G/, ���yr T/ C k one: Certificate Installing Company Corp. Address 4/ 1 /9 G/� W DD / ,� Partner. usmess 1 a ep one ye, 5-goFirm/Co. Name of Licensed Plumber or Gas Fitter_�,�6 j= �j�l� Z/15 7 J' INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked yes,please indicate the type coverage by checking the appropriate box. 13 Liability insurance policy 13- Other type of indemnity 13 Bond Owner's Insurance Waiver: I am aware that the licensee 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: Signature of Owner or Owner's Agent Owner Agent ri hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title 13 Plumber 5--4/4 2 City/Town Gas Fitter icense Number— Master um erMaster APPROVED(OFFICE USE ONLY) Journeyman c•"ORT"'4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 255 (10-4-2007) Date: October 17, 2007 " THIS CERTIFIES THAT THE BUILDING LOCATED ON 316 Stevens Street._ MAY BE OCCUPIED AS Sin a E mfivDwegink . IN ACCORDANCE WITH THE PROVISION&OF THE NIASSACHITSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS.AS MAY APPLY. Certificate,Issued to• RobeBOs& ad 31.6 Stevens Street North Andover,M sa sas1,11 s-M 01845 14— Building Inap rotor AORTiy Town Of ' b Andover No.251' �o dover, Mass., O • 0 COC MIC HE WICK V A01'? `s BOARD OF HEALTH PERMIT Food/Kitchen Septic System BALDjING I�IyS�'FF TOR� THIS CERTIFIES THAT...... G .... .... T........� .a.l ............................................................................... -Foundation Via. ,o - - � has permission to erect................. buildings on - ... ^. �1....... to be occupied as:. ... .....0.....�tlL.hi� ...... VK,... ...0 ...... ..`... $.... ......... . . ' �'� ney provided that the person accepting this it shall in every respect conform to the terms of the application on file in `�.� �" Fin;);;e 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. 6 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations ulations Voids this Permit. 7.Rough;��_.� � ,� ._� r PERMIT' EXPIRES IN 6 MONTHS � / UNLESS .CONSTRUCTI _ ELECTRICAL INSPECTO �`'� ................. .... ....................... .................. ... .. . .... . .... ... . ..... ...... BUILDING INSPECTOR - Occupancy Permit Required to Occupy Building GAS INSPECTOR r s Display in a Conspicuous Place on the Premises — Do Not Remove ` Rougr''k12 -o..7 No Lathing or Dry Wall To BeDone ek�FIRE DEPAR NT Until Inspected and Approved by the Building Inspector. Burner Street No.. SEE REVERSE SIDE Smoke Det. �Q _ l r NORTH Of��4•o y�tio FO- p •Ano� APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION Buildina Permit# ADDRESS/LOCATION OF PROPERTY :,_�J/0 Map ���� Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION � -�/?? -6 CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS$20.00)WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES Permit Issued to: 04 D Address e(je 79.J �fitiP� SIGNED R41 N CONSERVATION I�W� PLANNING DPW-WATER METER Pq 31407 SEWERIWATER CONNECTION a NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW wtb Signature File: Application for OC form revised Jan 2007 DEC 22,2006 15:38 000-000-00000 page .1 I hereby Certify that the structures shown REFERENCES: are located on the ground as shown. Assessor's Map 95, parcel 6N of Assessed lot area=37,500 s.f. $ JOHN Deed Book 5432, page 20Jc.o7 Goy Plan 5520 ENRD �.32e�r n G. Dick PLS F Q o suA�ti`c1t' � y ' � n � v o Certified Plot Plan of land of Robert A. Osgood, Jr, and Ann M. Osgood 316 Stevens Street North Andover, MA 20 July 2007 Scale: 1" = 40' John G. Dick PLS 48 Hathorne Street Salem, MA 01970 i ' -I'> tvaa EtpuXwpak Evytvccptvy AAX Phone 978.465.6436 Daniel.L. Gelinas, P.E. Fax Line : 978.465.5160 579A North End Blvd. Salisbury,MA 01952-1738 email da4geUnas@adeipbia.net Fax G June 25, 2007 Mark Rae fax/phone 978.683.7875 Cell 508.509..9430 SUBJECT: 316 Stevens Street,North Andover, MA Dear Mr. Rae: Regarding the flaming at 316 Osgood St,the framing including the LVL's satisfy the,Massachusetts State Building Code 6 Edition Chapter 36 and meets the drawing requirements Please callwith any questions.Cell 978.360.2562. I IL IL AA ZN OF Very truly yours; DANIEL L. Y GUCTUR S'I�tt1CTURAL Daniel L. Gelinas,P.E. No.33aN G-Fax framing per MSEC Mark Rae 06915.doc NORTH Of '•ANO WN OF NORTH-ANDOVER '_', . . •_ PPLICATIO 'OR PLAN EXAMINATION - ssA r i erniit NO: Date Received: i ate Issued: IMPORTANT: Applicant must complete all items on this page LOCATION--R/4--- _ Print PROPERTY OWNER —/Alel t ala 4 nj MAP NO.:_J ,J PARCEL: I rin ZONING DISTRICT:`' TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE - Residential Non- Residential New Building EI/One family -i Addition , �.Two or more family - Industrial Alteration No. of units: L Repair, replacement Assessory Bldg !_ Commercial Demolition N1ovin T(relocation) Other i:; Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED coN Identification Please Tyne or Print Clearly) OWNER: Name: 0)t�, 0 et � 5�,��0� Phone: I Signatur Address: CONTRACTOR Name: Phone: Address: f Supervisor's Construction License: Exp. Date: � Q 0 Hume Improvement License:_ Al L,,� Exp. Date: ! RCIIITEC'T:FN(JINFFR Name: Phone: Address: Reg. No. _ FEE.SCHEDULE:BOLDING PERMIT.510.110 PER$1000.00 OF THE TOTAL ESTLIWED COST RASED ON 5125.00 PER S.F. Total Project Cost S x10.00- FEE:` Check No.: Receipt No.: 'TYPE OF SE\k ARGE DISPOSAL Tanning/Massage Body ;art Swimming" Pools Public Sewer -- �4'ell -- i Tobacco Sales - Food Packaging-Sales i - Permanent Dumpster on Site Private(septic tank, etc. '.MOTE: Persons contracting with unregister(-W contractors do not hai,e acceNS 10 the gitaragyfiind Signature of Agent;Owner Signature of Contractor Plans Submitted Plans Waived Ll Certified Plot Plan D Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT D D DWater Shed Special Permit II D Site Plan Special Permit D Other COMMENTS DATE, REJECTED DATE APPROVED it CONSERVATION D ❑ _ COMNIENTS DATE REJECTED DATE APPROVED HEALTH D D CONIN1ENTS Zoning Board of:1ppcals: Variance, Petition No: Zonin,Dccision.'reccipt submitted Planninu, Board Decision: Comments Conservation Decision: Comments � arch& Sewer connection signature&date__-- _ - ---- - Temp Dumpster on site ycs__no -- Fire Department signature.'date — -- -- -------- BUildino Perinit Approved and Issued by: j Building Setback (ft.) Front Yard Side Yard Rear Yard Rei aired Provided Rei aired Provides Required Provided_ DIMENSION N umber of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) J.m: �n. 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Fonn ❑ 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) New Construction (Single and Two Family) ❑ Building Pen-nit Application ❑ Form U ❑ Certified Proposed Plot 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 Inall cases if a �arianee or special permit was required the Town Clerks office must stamp the decision from the Board of ;Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cope and proof of recording must be submitted with the building application Doc:I\S'PI:(TIONAL SERV ICES DEP,%R1'\IEvr:BPF0R\I05 Zoning Bylaw Denial ' Town;Of North Andover Building Department 400 06good St North Andover, MA. 01"5 �'�jS�CIW��1ry Phone 97>I4u-8546 Fax 97648i-9b42 Street Lot 95/6 Iscant Robert Os ood R oast I raze and rebuild gaiEl - Data: Please be advised that atter review of your Application and Plans that your Appltcatwn is DENIED for the following Zoning Bylaw reasons: Zoning K-2 Notes Item Notes Item A Lot Area F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexists y 2 Fro a Com les 3 1 Lot Area Complies 3 PMOXisting frontage 4 Insufficient Information 4 Insufficient Information B use s No access over Frontage 1 Allowed G Contiguous Building Ana 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Com sea 4 Special Permit Required 17 9M Q 3 Preexisting CBA yes 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 ComPliOs 3 Left Side Insufficient 3 1 Preexisting He' M 4 Right Side Insufficient 4 1 Insufficient Information 5 Rear Insufficient I Building Coverage 6 Preexists setbacks 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Com les D 1Natershed 3 Coverage Preexisting es 1 Not in Watershed 4 Insufficient Infornation 2 In Watershed j Sign _ 3 Lot Ixior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Cornplies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking N/A 1 In District review required 1 I More Parking Required 2 Not in district ' yes 2jInsufficient arks Complies 3 Insufficient Information 3 Information 4waxisti Parking RentedY for the above is checked below. Items Special Permits Planning Board item s Variance Site Plan Review Special Permit Setback Variance Access other than Frontage SPOC481 Permit Parking Variance Fronteae Excection Lot Special Permit Lot Area Variance Gammon Ddymmy Speciel Permit _1 Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board In dent Elderly Housing Special Permit Speciej Permit Non-Conformin .Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District S Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit for Sign R-6 Donsitv Special Permit n A special Permit preadsting nonoonformin Watershed Special Permit The above rWow end attached moenetim or such Is based an the plans and infa nMm aubmWsd. No de kdw review and or advice shall be beasd an varbsl srvlsnetiorr by the appdcsr,nor dm such vwbsl srF lsrntiorrs by the ap kw t am to pmwWo dsfsribn w*Avm:b th above mssorr for DENIAL. Any inow reciss,rrislssding Irk -110n,or Odw aubsaquarit danpss to the'don.o n subrrnts'by the appliant dW be grounds for this MOW to be voided et the discrdion Of the I3crddir►g oapsrbnerit. The aWcirsd ftur rnrt Ned Ilion Raisw Narrdira'dad be sttadW iweisa and incorporaMd hw= by Mwence. The vrid ostein a1 phmond do=ve tshon for the do a ft You must SO a new budding pemrt appdceib0n form ant tliebegiri psrmIN proosss. BuildingDepartment Offiael Ss nature Received Application Denied 8 APP Plan Review Narradve The following narrative Is provided to further explain the reasons for denial for the application/ permit for the property indicated on the raverse side: !Irin I '�aNla1 C-2 A Variance for the front setback is recruired throu h 'Rylaw- H-1 A Variance for the DrQposed re-built sin le famil dyielling d Board of Aippetder Section 7. 4 -Section 2. 27 , .& Table 2 B-4 A Sipecial Permit for a re-existin non-conforming zon nq Boar of Appeals under Section 9 . 2 of the Zbnixiq Bylaw — in ordpr to alter or extend the e. i r Ref and To: Fire Health Police Zoning Board Conservation Dqmrbnwd of Public Works Planning Historical Commission Other BUILDING DEPT FORM U - LOT RELEA,t rUKM 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 -vim -E, PHONES O v f LOCATION: Assessor's Map Number O PARCEL SUBDIVISION N� LOT (S) STREETS �A� �' J ST. NUMBER3/''!� OFFICIAL USE ONL TI OF T NTS: CO SERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALT DATE APPROVED DATE REJECTED SEPTIC INSPECTO ILF17AIL HJ DATE APPROVED DATE REJECTED . COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS O S DRIVEWAY PERMIT I FIRE DEPARTMENT ;DECEIVED BY BUILDING INSPECTOR DATE Revised 9197 Im I ct AORTN i TOWN OF NORTH ANDOVER OFFICE OF A BUILDING DEPARTMENT 400 Osgood Street +..Y� c'J# North Andover, Massachusetts 01845 ss,�c�si1 D. Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print ,yam � DATE: D G ( d�S JOB LOCATION:S � - O O Number Srtreet Address Map/Lot HOMEOWNER Name Home Ph a Work Phone PRESENT MAILING ADDRESS 4 5 -e"i Ov City town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to 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 HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances 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 North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL HOARD OF AITI"ALS 6X8-9541 CONS 1.RV,VVION OR8-9530 11}{.U:I'l l(i8k-)5di1 Nl 14NING o,$->5;;i The Commonwealth of,'Massachusetts Department of Industrial Accidents ;;'A:1"; Office of Investigations 600 Washington Street Boston, ,VIA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ;applicant information R Please Print Legibly Name 113usincss/l)r�unirution/In�li�idual): �' /�/ L ` /cJ,�' Address: �le L��/�' --- ---- City/State/Zip: . „ ,, i0_ A/ J/� -Phone #: � C2 Are you an employer?Check the appropriate box: Type of project(required): .❑ I am a employer with 4. ❑ I am a general contractor and 1 6. New construction mployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. + ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box it I must also till out the section below showing their workers'compensation policy information, y Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy ,f/or Self-ins. Lic.It: _ Expiration Date: Job Site Address: Attach 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 c. 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 tine 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. 1 do hereby certify a rd r11he, sins and penalties of perjury that the information provided above is true and correct. 4i mature: llate:�/✓"/�/ Ooh d Phone 'f: Ullic•iol use only, Do not write in this area,to be completed by city or town aVicial. City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other_ Contact Person: Phone#: TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 7,' x, , s� BUILDING PERMIT NUMBER DATE ISSUED. SIGNATURE: Building Commissioner/I r of Buildings Date SECTION 1-SITE INFORMATION I O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: v� 1 o `1 D � y1 p Map Number Parcel Number d 1.3 Zoning Information: I V l p\ 1.4 Property Dimensions: Zoning District Pr�Use �— Lar Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard ReqWred Provide Reqdred Provided ReqWred Provided 1.7 water supply M"G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System Public ® Private ❑ Zone Outside blood Zone �. Municipal io On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record N Print)' Address for Service: I!tre �.1 I� 2.2 Owner of Record: Address for Service: Z SWAM Telephone SECTION 3-CONSTRUCTI SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ C . re.e- n Licensed Construction Supervisor: Q —i License Number Ad�UAAA 's a a Eviration Date - SignatuF Telephone rM i 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number m Address Expiration Date z Signature Tel hone G) 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.......)4' No.......0 SECTION 5 Description of Proposed Work(check all applicable) New Construction Id Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 AccessoryBldg. - ❑ Demolition [R Other ❑ Specify Brief Description of Proposed Work: Iker�o`l � �Xi cb LQ_ ll.�a c�-Li)�`1 0Q all.c clon��rU C4- Vy9:k I ) sRC)Q lf'41 d�4j i V-P 1 1 v'1n SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be x �?FFfCIAi USEVNLY s Completed by permit applicant -,g'N", _ V. 1. Building p� (a) Building Permit Fee P So V�(� Multiplier 2 Electrical (b) Estimated Total Cost of (0 . 000 Construction 3 Plumbing 0 0 Building Permit fee(a)X (b) 4 Mechanical HVAC p 5 Fire Protection ti 0 Q 6 Total1+2+3+4+5 y" U Check Number SECTION 7a OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, `��,.., A (7(' �J as Owner/Authorized Agent of subject property Hereby authorize ' _v� to act on My lf,i all matters relati a to rk uthorized by this building permit application. e o Date SECTION 7b OWNfR/ATJTHORI#VD AGENT DECLARATION 1, C ISL(? 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 1 Prin e Si a e of Ow=/Agent U / Date NO.OF STORIES SIZE c24k BASEMENT OR SLAB e_n-A, SIZE OF FLOOR TIMBERS 1 i I '7 2 I 7� 3 . SPAN DIN ENSIONS OF SILLS X ' DIlvIENSIONS OF POSTS 3 \I DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING ao I% X 1 MATERIAL OF CHIMNEY tr`t IS BUILDING ON SOLID OR FILLED LAND Solid IS BUILDING CONNECTED TO NATURAL GAS LINE v I Residential Property Record Card PARCEL_ID:210/095.0-0006-0000.0 MAP:095.0 BLOCK:0006 LOT:0000.0 PARCEL ADDRESS:316 STEVENS STREET PARCEL INFORMATION Use-Code: - 101 Sale Price: 245,000 Book: - 05432 Road Type: T Inspect Date: 04/1302000 Owner: Tax Class: T Sale Date: 05116/1999 Page: 0203 Rd Condition: P Meas Date: 04/_13/2000 Tot Fin Area: 1767 Sale Type: P Cert/Doc: Traffic: M- Entrance: X OSGOOD JR,ROBERT A Tot Land Area: 0.66 Sale Valid: Y Water. Collect Id: RB ANN M OSGOOD -- Address: Grantor. CAVANAUGH,MAUREEN Sewer:, _ __ Inspect Reas: S 316 STEVENS STREET Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LKO Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CO Tot Rooms: 7 MainFn Area: 1010 Attic: N ; NBHD CODE: 6 NBHD CLASS: 6 ZONE: R2 ! Story Height: 1.75 Bedrooms: 4 Up'Fn Area: 757 Bsmt Area: 1010 Seg Type Code Method Sq-Ft Acres Inflii Y/N Value Class Roof: G Full Baths: 1 Add Fn Area: Fn Bsmf Area: 600 1 P 101 S 37500 0.86 203,343 Ext Wall: WS Half Baths: 1 Unfin Aiea: Bsmt Grade: DETACHED HED STRUCTURE INFORMATION Masonry Trim: Ext Bath Fix: To_t Fin Area: : V1767 Foundation: CN Bath Qual. T RCNLDi 139685 Str Unit Msr-1 -Msr-2 15-YR BIt Grade 06rid"/oGood P/F/E/R Cost Class - -- PV - S- - 512 - 1988 ... A A - 501//50 10,300 Kitch Qual: T . Y- Buiit: 1962 Mkt Adi: L2 Heat Type: HW Ext Kitch: Year Built: 1900 Sound Value SE S 80 1988 A A ///91 200 Fuel Type: O _ Grade: A -Cost Bldg: _'1167,600 VALUATION INFORMATION. Fireplace: Bsmt Gar Cap: Condition: A Aft Str Vail: Current Total: 381,400 Bldg: 178,100 Land: 203,300 MktLnd: 203,300 Cental AC: N Bsmt Gar SF: Pct Complete: Att Str Va12:_ - Pryor Total: 356,200 Bldg: 168,000 Land: 188,200 MktLnd: 188,200 Aft Gar SF: _. %Good P/F/E/R: /100/100/76 SKETCH �;,/, ! r 7 PHOTO -g 20 17 to 7 20 D a " 28 00�� 767 FU"8.75/8/F 1818 Sq.Pt. - 1 3' � 316 STEVENS STREET - 7 7 30 7 i r Parcel ID:210/095.0-0006-0000.0 as of 3/1/06 Page 1 of 1 t TOWN OF NORTH ANDOVER j APPLICATION FOR PLAN EXAMINATION i Permit NO: Date Received 7 t Date Issued: !� I RTANT: Applicant must complete all items on this page LOCATION 311D_._ �� 'Uyl ��T _ _ �__. - - _ F .v= _ _, Print Y PROPERTY 01NNER4 _ _ . /'> }} Print 10ONear Old Structure yes. rio, Uf s es no IVIAP NO: -r ! PARCEL. — ZONING D[$--,T CT; z.__-_ Hastonc District y .., _ 7 a Machine Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Witepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition El Other D Septic ❑'Well ❑ Flood Iain 0:Wefland's 0 Watershed Distncfi 01Nater/Sewer,_ DESCRIPTION OF WORK TO BE PERFORMED: Identifica ' n Please Type or Print Clearly) OWNER: Name: Phone: Address: a�� �Tl�/��� S CONTRACTOR` Name Phone: fi Add ress: Supervisor's,Construction'License. �. _ _ - Exp. Date. Horne r1lprove mentLicense: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. I-_ Total Project Cost: $ /7// FEE: $ Check No.: Receipt No.: "� ' NOTE: Per ons IonAtracting with unregistered contractors do not have access to the guaranty fund SS gnaturetofrAgent/ wne Sig�ature�of"contractor;. Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Pians Submitted ❑ Plans Waived-0 ..Certified Plot Plan ❑ Stamped Plans ❑ TI'PE:OF.SEW,E E_IDtSPD AL Public Sewer ❑ Tanning/MassageBodyArt ❑... .Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private,(septic tank,etc.. ❑ Permanent Rftmpster on-Site El .-THE.FOLLOWING SECTIONS FOR-OFFICE USE ONLY ` INTERDEPARTMENTAL SIGN OFF - U FORM -DATE REJECTED .--.... DATEAPPROVED PLANNING'& DEVELOPMENT: ❑ ❑ COMMENTS CONSERVATION Reviewed on Si` nature COMMENTS j , I HEALTH k Reviewed on Signature COMMENTS I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection lSi_gnature Date Driveway Permit DPW Toiv;s Engineer: Signature: Located 384 Osgood Street FIRE DEPARTM 'NT::-Temp Dumpste_-f on site . yes no Located atu124rMair`Street ' - -• -, Fire Dep rime►it signature/date M* COIIAM.ENTS Ili r-w._ _.Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. .Total land area; sq. ft.: - ELECTRICAL: Movementof.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 I NOTES and DATA— (For department use ® Notified for pickup - Date (f j Doc.Building Permit Revised 2010 ,r Building Department rhe fol:�wing is'a li t of the requited forms to be filled out-for:the.appropriate-permit to.be obtained. Roofir•g, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp-Affidavit o . Photo Copy Of H.I.C. And/O'rC.S.L. L censes ❑ 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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) Li Building Permit Application o Certified Proposed Plot Plan o 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) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior 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 apn•�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 I Location No. r or Date !!:7 J17 0 . TOWN OF NORTH ANDOVER o o Certificate of Occulfancy $ D Building/Frame Permit Fee $� ,0"., C ' J d Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check .27378 Building Inspector S,. 19� CUSTOMER NAME W GI 0 O C� ADDRESS 31 D -1-eV:vn S S t 3 Tracy Lane, Hudson NH 03051 CIN �� {-� ���c�\1 p 2 STATE M A zip 0 t 1:64 Toll Free: (888) 85-SHEDS HOME PHONE(q ) c�,o g, C�a•O g ORDER DATE 3-a3- L 4 �-- r Tel: (603) 883-1362 Fax: (603) 882-9566 CELL PHONE (G��) a,�5 - '�,d R 5 DELIVERY DATE mwww.reedsferry.com EMAIL ' Sheds • SIZE- .t7`/ $ 0,=2,9 9` Ramp4'x ------------------------------------------------------------------------------- QTY. x$ ea.$ ,'-SHED STYLE — Ramp 4'x ------------------------------------------------------------------------------- QTY. x$ ea.$ - -- ❑American Classic ❑Victorian Cottage 5/8"PT Plywood Flooring Per Sq. Ft.of FlooF-------�-------------------------- NO OF SQ.FT. l 10 x$ 2.00 ea.$ 2x6 PT Floor Joists 12"On Center------------------------------------------------ NO OF SQ.FT. x$ 0.35 ea.$ ❑Antique Saltbox ❑Victorian Cottage w/Shed Dormer Additional Wall HT Per Lin.Ft.------------------------------------------------ NO OF LINEAR FT. —x$ ea.$ Historic Colonial ❑Victorian Cottage w/A Frame Dormer Additional Window(s)'------------------------------------------------------------------------- QTY. —x$ ea.$ ❑Country Carriage ❑Grand Victorian w/Shed Dormer Change Standard Winw to Medium or Large--------------------------------------------- QTY x$ 65.00 ea.$ LI Traditional Gambrel LI Grand Victorian w/A Frame Dormer Window Box---------- --------LIZ------tLLALY— QTY. 2 x$ Z 's' ea.$ -5-6 Additional Transom Window---------- ------------------ QTY _x$ ea.$ - Additional Fiberglass Door------------ ---------- ------------------------------------ QTY. f ' x$ 7 ea.$ 210 ❑Pine ❑Cedar T&G Change_Door to_Door-------------------------------------------------------------- QTY —x$ ea.$ Additional Overhead or Roll-Up Door-------------------------------------------------------- QTY x$ ea.$ Vinyl ❑Vinyl Shake Change 5'Fiberglass Door to Overhead or Roll-Up Door---------------------------------- QTY x$ ea.$ ❑Cedar Clapboard ❑Plywood Upgrade to Lite Door----7------------------------------------------------------------------- QTY x$ 100.00 ea.$ Sill Plate ------------ 15------------------------------------------------------ NO OF LINEAR. FT r x$ 5.00 ea.$ ROOFi Loft 4'x ---------------------------------------------------------------------------------- QTY. x$ ea.$ Cupola 21 with Glass Arches&Copper Roof---------------------------------------------- QTY x$ 515.00 ea.$ 7101 White ❑Lt Brown ❑Lt Gray - Copper Weathervane-------------------------------------------------------------------------- QTY. x$ ea.$ ❑Weathered Wood�d;Black ❑Dk Brown Architectural Roof Shingles-------------------------------------------------------- NO OF SQ. FT _x$ 1.00 ea.$ ❑Slate Gray ❑Brick Red ❑Custom Rubbermaid Kit-------------------------------------------------------------------------------- QTY _x$ ea.$ Other-------------------------------------------------------------------------------------------- QTY. —x$ ea.$ i• Other-------------------------------------------------------------------------------------------- QTY —x$ ea.$ ❑Almond Black ❑Blue • =• " `°� SUB TOTAL$ �3 �,I s ❑Clay ❑White ❑Red $ ❑Gray ❑Green ❑Brown WINDOW TABLE SALES$ BACK `Shutters included on all Windows El Burgundy D SALES TAX$ SINGLE DOOR W ' SHEB-REMOV 2 ` J ❑White ❑Gray LJ Blue El Almond ---0 LJ Flint Gray ❑CreamLu ®�. ? -7 /_ 1 D TOTAL$ 44 El Tan ❑Pearl ❑Sagebrook DOUBLE DOOR r8 r 2� LESS 25%DEPOSIT$(-) U !�' qG LJ Reeds r--y Reeds Red Beige ❑ FRONT Clay � TOTAL AMOUNT DUE ❑Olive Wedgewood ❑Custom UPON DELIVERY$ 3 -9 SALESPERSON XV/I�� �•-» 0 4J 0(7 C)c Q� AMOUNT RECEIVED$ �d Seo- �g , JA6 CREDIT CARD ❑CHECK ❑CASH ❑TyPE f NO. CUSTOMER SIGNATURE Date North Andover MIMAP March 25, 2014 095-0°0009 , o � 095 0 0024, R3 03;6:0=0009 Stevens Pond 095 0;0008 a N 095:0=0007 290jSTEVENSjSIP 037'C=0004; �o i 09610 X0073 N I 4 0950;0006 R3? R- 3;1;6;SfTEVEN'S SjT' d i 037:0-0033 095 0=0071 ,3,�1�J9 SLEUENS 3T` �f 320:STEVENS SfT 505 PLEASANTSJ,; 09-kA0074' 037?C- 0032 5 S� 32TEUENS SST 096:0'1007' 2 096':0-0002 —Rail Line `:u Wetlands Zoning - .. . Interstates d Exempt Lands CS Busine s 1 District _I C Busine s 2 District Horimnlal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR O Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack =Busine s 4 District ORT - -- Valle Planning Commission MVPC usingdata provided b the Town of Roads - ©Busin Business District t y g ( p y '4 North Andover.Additional data provided b the Executive Office of r Easements O Planne Commercial Dev `,r e�t�•c i�e��� Environmental Affairs/MassGIS.The information depicted on this map is G Corrido Development Dist g purposes only.It may not be adequate for legal bounds ry ❑MVPC Boundary - O Corrido Development Disl p _ for plannin gp° n,interpretation.THE TOWN OF NORTH ANDOVER definition or regulatory C3 Municipal Boundary O Corrido Development Dist I- p MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Zoning Overlay I i.IndusM I 1 Distnct ♦ - ; THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY gAdull Entertainment 0 Ind' 12 District * y e f OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Q Industn 3 DisMcl r B Downtown Overlay District • o a �7 r ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF O Indus I S District � ®Historic District °o^` ,�``�j THIS INFORMATION ®Water Protection Reside ce 2 District •r�o ❑Reside ce 2 District ElParcels to R—ide ce 3 District CNU - 0Hydrographic Features de ce4 District -Streams 1"=95 ft de ce 5 District _ p�rde ce 8 District ,��age esidential District NO RT1y Town of s E �. Andover No. Mower * _ - I` ver, Ma LANss, O . 1 /� COCNIC M�WICN rA0 �`V s u BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT N� S � BUILDING INSPECTOR .....................�............... .......... .. ........... ........................ ............ .... . .. .. ..... .. has permission to erect .......................... buildings on .��A*..... ®.0...... . ..N...................... Foundation Rough tobe occupied as ........... .Y,� .... OLAM�..............................................................:................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Final PERMIT EXPIRES IN 6 THS ELECTRICAL INSPECTOR UNLESS CONSTRU Rough Service ............. ................................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Smoke Det. North Andover MIMAP March 25, 2014 * a e £ s s ufs r 7177w �� 3 xt t•�♦ ry � T rg9 fpp„yy i Y Z Y'RR. n> •.,y �'*?r'wj F'� �',' ,� --� -�–�� �"�' «Qf��,r�.C��'r`�.+v �.� ,�� _ .�,r's s``� �� 3 1 ,-:.1.. S �.. d'^aA �Z t .na _ d'r �t ,N tv yf L `� s �' ^ #?" � �+.}� R; `":+ �' - q ,bi • •j'c Interstates —I —SR Horizontal Datum:MA Slateplane Coordinate System,Datum NAO83, -:Roads Meters Data Sources:The data for this map was produced by Merrimack Co Easements - f pORT1�q Valley Planning Commission(MVPC)using data provided by the Town of MVPC BoundaryO �t�ao r��ti0 North Andover.Additional data provided by the Executive Office of j. ba t O -Environmental Affairs/MassGIS.The information depicted on this map is ❑Parcels - F A - for planning purposes only.It may not be adequate for legal boundary definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER ' MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Y ; THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT - o t • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION �SS�cNuSet 118 ft I