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HomeMy WebLinkAboutMiscellaneous - 34 HEMLOCK STREET 4/30/20181 lo r 7k� IF I I -� A +1 7 l * •• � r , s rC e 'i. r��C }f� � •.JY I +1 7 l * •• � r , s IL ✓ t•1 • 2V IL'o-L �l LV-e� - 2�� Location n�--► �-�� -� _ No. �5�1z- Date ",6 TOWN OF NORTH ANDOVER + +Certificate of Occupancy $ � ;+ CHUSEt Building/Frame Permit Fee $ �-. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 3 Check # 36 `/ 15542 /moi Building Inspector Al Location ?`� � No. !� Date MORTh TOWN OF NORTH ANDOVER s Certificate of Occupancy $ ��sswcausts� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -� Check # 1 4 " ' f Building Inspector TOWN OF NORTH ANDOVER ` BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING y 0013 �$i �' ': ff c. .f E A 5 � _.✓.r� -; e`��.`���� :xA. BUILDING PERMIT NUMBER: DATE ISSUED: aDt� SIGNATURE: Awllff Buildin CommissioneE/ for of Buildings Date L1 SECTION 1- SITE INFORMATION 1.1 ?Property Address: /1.2 ✓ 3 c/ /7eJK6oc� S� Assessors Map and Parcel Number: r✓ L/ L/ v' �/ Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqItired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Private 0 Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of/Record % ! //-4cG�CIlVCi ✓ 3 ���h Name (Print) Address for Service Signature ✓ Telephone t / / ` 6/,F .7 d CJ . 2.2 Owner of R cord:% Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address rs Signature Telephone Not Applicable ❑ License Number ' Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone IN r SECTION 4 - WORXERS COMPENSATION (M.G.I. 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 ....... ❑ 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: x-16 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFJ ILIAL USE t?NLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction (}' / 3 Plumbing Building Permit fee tel 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 I, t 4a e ! S'(c<//y-e as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all nra e t ork authorized by this building permit application. r--- ,�- --3 -z 3 - 01 Signatur of rer 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 NO. OF STORIES Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS 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 t 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. APPLICANT /_l �2 �r lve��a PHONE ASSESSORS MAP NUMBER c'� y LOT NUMBER SUBDIVISION LOT NUMBER STREET C� �7' e/�'►IOCk sic STREET NUMBER OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS 7 0!.!T xg `` DATE APPROVED Z d CONSERt ATION ADMINfSTRATOR DATE REJECTED COMMENTS Lh, �4 W TOWN PLANNER COMMENTS FOOD INSPECTOR - HEALTH SEPTIC INSPECTOR - HEALTH COMMENTS PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DATE TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units ... or to structures which are adjacent to such residence or building" be done by registered t;ontractors, with certain exception, along with other requirements. Type of Work: .S� � Est. Costf/23. y5 • Dd Address of Work 3�%a c�C Owner Name: /�f c� e l J lyevy� Date of Permit Application: 3 — 2,? —0 1 I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND UNER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name OR: Notwithstanding the above notice, I hereby apply for a perm property: / 3--23-0 1 Date Registration No. owner of the above CERTIFIED PLOT PLAN (PROPOSED ADDITION) NORTH ANDOVER, MA i ru.uv r E,i 15,267 sff — —32 17.44' . proposed 1 1 addition , 8 8 i screen Shed w 1o'xib, I Iti �a 30.0' proposed addition I I o I �I I I HEMLOCK STREET PREPARED FOR MICHAEL SILVERIO 34 HEMLOCK STREET NORTH ANDOVER ,MA N or CARMEN A. TESTA $q No, 14467 T '7►�BjON r lRN 8 �z s oO CARMEN A.TESTA DATE .A PREPARED BY. -NORTHERN ASSOCIATES INC. 401 SOUTH BROADWAY LAWRENCE,MA 01843-3522 DATE: AUG.24,2000 SCALE: 1"=30' Cl) m m Cl) 0 m CD O co CD CO) .p CD O CO) O CO) 10. O H C7 CD 0 r� CD a y. CD CO) 0 �r CCD O CCD O OT 01 CP up 3 � coo • O O N Q N • •— No � o 'o y CL m c) � r" � � � rm„ if a o g r*+ Z wg� h - O� .=i C � O y T1 • �V f / ,., a a m �? m ••► m H „► y SI IE =r m ® 2 fi =�oCe� U2 %o= O r Cn a m r 0 U2 o cn m o on m ♦:d l l t� y OH d m H m � O Ar1�i N = m d O� to O �o� % : z= 0 cn mo:w �� _ CD: CD: = ;w ca W a b: �. 4t 0 a� i=: d -x w oGv w C :p �' po m w n '4 z �^ y ro Q 7' > d o f z O ON 0 O C lD TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOyLrISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissione7 for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 3 c! l4e-m lock S7�-ee-� 1.2 Assessors Map and Parcel Number: (15 13 Map Number Parcel Number 1.3 Zoning Information: Zoning Distrid Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided .Zyr 1107 37,-X' 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service: 5-28 -.),5 8^ 77-7 Z Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone O Z M 90 mn r M r r Z Y/ f ! s 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 ....... ❑ SECTION 5 Description of Proposed Work checkaH applicable) New Construction ❑ 1 Existing Building ❑ I Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ I Demolition ❑ Brief Description of Proposed Work: ©! is 0 ' Specify V r )dC2 �1 1 rpt CAA 1-I i V I SECTION 6 - ESTIMATED CONSTRUCTION COSTS 1 X Item Estimated Cost (Dollar) to be Completed b rmit applicant OFFICIAL USE:(?NLY 1. Building � �O ©©_ (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction© ® a 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 co® Check Number �EL;11Uf4 /a UWPIEK AU LHUK1L,A1lUIN 1U ISE UUMYLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 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 I, 'Y" .4&T it, / s 5, �✓G#-f O 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 ,�el- SdverCa Print Name ,50' 7— o Z Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I 2 ND3 kD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DiNIENSIONS 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 It FORM U .- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fr Boards and Departments having jurisdiction have been obtained. This does not on the applicant and/or landowner from compliance with any applicable or requirements. VE �� _ / ���HrNL1GANT FILLS OUT THIS SECTION********************* APPLICANT /"l,Gr)Q`,rib PHONE_ 78 LOCATION: Assessor's Map Number C PARCEL,! `� SUBDIVISION �) � / LOT (S) ----� STREET 3 L/ `7 ,Y►� `©G � c�reG� ST. NUMBER - .... UMBER 7 yt�r+tit*fir***tt�t�t ONLY OFFICIAL USE mlmuH I IONS F TOWN AGENTS: �CQNSERVATION ADMINI RATOR DATE:APPROVED LATE REJECTED COMMENTSAll TOWN PLANNER DATE APPROVED DATE° REJECTED COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH. COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERJWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT ,RECEIVED BY BUILDING INSPECTOR DATE sed 9197 jm Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner. (978) 688-9545 - - le978) 688=9542 Fax HOMEOWNER UCENSE EXEMPTION Please print DATE JOB LOCATION 3 W Hen / o C k c�4 IJ Z7 Number Street Address Ma/lot .HOMEOWNER l /`G�G�iI �/✓�i111� q T@ . d S6 — / / %2 Neme . Home Phone Work PhanE PRESENT MAILING ADDRESS 6 v �n�d ✓ �I' 4 City Town !D C k S4r-,e e I O` S vS Zip Coc The current. exemption for "homeowners' was extended to include owner -occupied: dwellings of two units or less and to allow such horriegwners to .engage an individual1or hire who does . not possess a license,. provided that the owner acts as supervisor. (State Budding Code Section 108.3 5.1) .DEFINITION OF HOMEWOWNER: Persons) 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 dwelling, attached or detached structures ac- cesso y to such use and/or farm structures. A person who constructs More thy► one home in a two-year period shall not be'considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance wi a Building Code and other Applicable codes, by-laws, rules and regulations, , The undersigned "homeowner" certifies that he/she u erstands the Town of No. dower Building Department minimum inspection proced and requirements and he/she will comply with said procedures and requiremen . HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL A • 'MICHAEL SILVERIO 34 HEMLOCK STREET NORTH ANDOVER, MA 01845 EN 11 4" co► L� orr..� C.or� P�.� C,�Q•a•�- G M iL vaFbiz.T. 0 '0 � FOUJyDATIDI-I K2AF�1 CERTIFIED PLOT PLAN (PROPOSED ADDITION) NORTH ANDOVER, MA 170.00' 15,267 sft 320' 17.44' proposed -- addition /1 story $ wood/brick/ / 8 screen I 30.0' I proposed I addition 4 64nige- I �I I I - 1nZ4 HEMLOCK STREET PREPARED FOR MICHAEL SILVERIO 34 HEMLOCK STREET NORTH ANDOVER ,MA il^A Or a CARMEN A. TESTA Ne. 15167 lAM B /Z S' OD CARMEN A.TESTA DATE .A PREPARED BY:NORTHERN ASSOCIATES INC. 401 SOUTH BROADWAY LAWRENCE,MA 01843-3522 DATE: AUG.24,2000 SCALE: 1'=30' 11 J.WILLIAM HMURCIAK, P.E. DIRECTOR I 0 TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 Telephone (978) 685-0950 Fax (978) 6889573 '0' DRIVEWAY PERMIT DATE�'� LOCATION BUILDER phone OWNER C A U— hone 9Z6 -ZSg — 7 7 7 Z THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET. CALL THE SUPERINTENDENTS OFFICE BEFORE FINISH GRADING AND SURFACING FOR. APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. A Pr (, t cA wr Ii5 s�GNA-r've� q C/) m m m C/) U) 0 C o .1, c �+ y 0 §4 'gym o m n Q H m d C = Z :r- H --4 yN m o 'r 7 m a ?� m CA O O H m m C O O H T: C n y :O �y 7 a .•. l /� Co •, tG O ilr C O N CD . CD 1 mewio,a MM N l„ N �. O H z Cn Wfica N ��O y C/) CA cd "7 1 CRD � w � CD c � m m ON Fw cl) o g c� z C LA CD o �_r ? : �y O Gje-+ . W RAM r a •� CA o _u n ION:� a H 0. N m 5 o a° ° ° � d z(A z y M 7d b p � P-4 y O� o M M y 0 9 0 c Location { No. /yt Date ' .. 0 MORTN TOWN OF NORTH ANDOVER F p Certificate Occupancy $ of s'"•°' E<�' s�cHus Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ '� w Check #-� 1,779 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING :: L BUIDING PERMIT NUMBER: 410DATE ISSUED: SIGNATURE: Building Commissioned for of BuildingsDate JEl71UNN I-bllh UNFURAM11UN 1/.1 Pr erty Address: yC/ dye roc ,5-�- 1.2 Assessors Map and Parcel Number: tz Map Number Parcel Number 1.3 Zoning Information: / Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Providedred Provided 1 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 'c Name (Print) /' Address for Service X78 6 e7- 6096 Signature (' Telephone r M 2.2 Owner of Record: i Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: a Address i Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone O 0 O Z rn 90 0 M z Q SECTION 4 - WORI£ERS COMPENSATION (M.G.L. C 152 § 2506) 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 rmit. Signed affidavit Attached Yes .......0 No ....... ❑ 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: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item 1. Building Estimated Cost (Dollar) to be Completed b permit applicant "��� �} (a) . Building Permit Fee Multiplier ��}MW $ `� 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 O 3F Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT^ OR CONTRACTOR APPLIES FOR BUII.DING PERMIT /y e -It-, 6 as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relativt^�oSvvorl`authorized by this building permit application. Date SECTION OWNS 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 TIMBERS 1 ST2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Cl) m m U) 0 m u I. CO2 10 CD a Z CD O CL O o p CL Q CCD O a: C= co CD CD CA .p CD 0 O CO) i� 0 c CO) CD 0 CD CDa y CD CO) [Cca � C ?"o O d a Fy O Q y FL, O .O y -_I o Egoo m m O yOan a m Z CD �y y y CD O m N p -1 IE N O � O m = = m N 1V • m Om O ii O y, CD C =ry�1` 3 ►�. C=7 a a o � � � • •aft _CL VI O m N Cn cc,) O� 1 c (� y rrz^^ � y d d •�C cn d %I S'. CCD CD • /� c J y y Q to _ :` �a y A o _ 0 0 �oo�:�z cnCD cn o m 1 p 0` H O = V PC :0 z40aa h o tz oma: -1 C IV 7 O O O O p O R. d d y 0 c AA FORM - U - LOT RELEASE FORM 1- 3 a' INSTRUCTIONS: This form is used to verify that all -necessary approval / perrm s om Boards and Departments having jurisdiction have been obtained. This does not relieve the S YM PO f4e. applicant and or landowner from compliance with any applicable requirements. APPLICANT /_`2 j 1 �°Y� PHONE ASSESSORS MAP NUMBER LOT NUMBER C f SUBDIVISION LOT NUMBER STREET —1C/ / �r�IGC.I� S'�r� STREET NUMBER I............................................................... ..... OFFICIAL USE ONLY ..................................■.............................i M..1 ir..■ REC,OMMENDATIONS OF TOWN AGENTS 7 0 �� h'i`% DATE APPROVED �� G CONSEI&ATION ADMIMSTRATOR pp DATE REJECTED COMMENTS 0-k CON54ENTS RECEIVED BY BUILDING INSPECTOR DA' DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMIVfENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CON54ENTS RECEIVED BY BUILDING INSPECTOR DA' OL CERTIFIED PLOT PLAN (PROPOSED ADDITION) NORTH ANDOVER, MA I Eq 32.0' M I 17.44' iq I proposed 1 "' 1 addition 170.00' 15,267 sft 1 story o wood/brig screen porch IN ib ti I� I 30.0' i I i proposed I w addition I 1 0 ... t 1Vrtiy Town of North Andover Building Department 27 Charles Street r North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 `(978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION [ �� Q C K S�• Number Street Address l J r HOMEOWNER p`c�G'�I Sr l✓e�+l�7� �c��—C��`�l� Name PRESENT MAILING ADDRESS y 14,0claU ✓e!- Uty Town Home Phone 341 14ewlG C k s ,�_ State c/"f G / Ma / lot 6n 3- C-(50 - Work Phone 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 fur 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 he/she 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 th�ee To n of No 'er Building Department minimum inspection procedures and requirerfients an at.hel a will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFIC 9 N2 'i/ r 6 Date .... Z/-- - - /2 - - TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... 5-�'J.U.--fAIAr„1......!0 6 0-> i-:�- i -f c ra., 7- ................................................ has permission to perform . 1A q ................................... wiring in the building of ................ (� I .................................................................... at ...... 7 ........ .1.!./ ....... A. ................. orth 5- Pl Ando verl Fee..).Lic. N ...... .. .......,. ... ELECTRICALi;&PECTOR C� 14 ILV WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 0 ,i ornee n,e owtr� The Commonwealth of Massachusetts ' 7 P�rwle :b. Deportment of Pubfie Safety occupancy a roe checked�� BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 (leave blank) PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Ma„achusetts Eleetrleai Code. 527 CMR 12:00 ?LEASE PRINT IN INR OR TYPE ALL INFORMATION) Date -1 13) City or Town of/'}/ t; Awdawes To the Inspector a e undersigned applies for a permit to perform the electrical work described below cation (Street & Number) Owner or Tenan Owner's Address S win i MAP P (0f Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building R E ldg./ t 1 a L Utility Authori::aticn 110. Existing Service Amps / Volts everhead ❑ Undgrd ❑ Me. of Meters p New Service Amps / Volts . Ove:head ❑ .Undgrd ❑ Ila. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work � 'l P P_ p p L. No. of Lighting Outlets No. o_` llat Tubs No. of Iransformers Total KVa No. of Lighting Fixtures No. Above In - Swicaelag pool grnd. ❑ grnd. ❑ Generators 1C/A Receptacle Outlets No, of Rece p No, o: CL1 Burners No. of Emergency Lighting Batter Units ::o. of Switc*t Cutlets No. of Cas Burners FIRE ALAR.`1S No. of tones ttI of Detection and Toral No. of Ranges No. or Air Cond. tons Initiati:tg Devices No.; of Sounding Devices No. Self Contained Deteecc tion/Sounding Devices Local ❑ Municipal o Other Connection No. of Dis osals p No. of Ileat Total Total Pt::aos Tons KW No. of Dishwashers Space/Aces Heating KW No. of Dryers Y Ileatin Devices KW g �� No. of Water HeatersSigns No, of to• o Ballasts Low Voltage Wlrin No. Hydro Massage Tubs No. of Motors total IIP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Lows I have a current Li billty Insurance Policy including Completed Operations Covernge or. its substantial equivalent. YES NO ❑ 1 have submitted valid proof of same to this office. YES LJ No If you hav;70ONO ked YES, please indicate the type of coverage by checking the appropriate bore. INSURANCE ❑ OTHER ❑ (Please Specify) 'astimaced Value f Electrical Work S %Q,0a op Work to Start vZ-/ 9f Inspection Date MUST CALL INSPECTOR FOR Ipgp-FY'TIONS___ Signed under the FIRM NAMEe,11 %/f_, Licens Lties of perjury: a RR66 Et e-eAkI Signature LIC. NO. 1 Q LIC. NO. "6730 Bus. Tel. Ib Address -6.SO(56'.311 t`�/� l �m ME' oal�!5_,' Alt. Tel. No.�j$1-3Q6-3080 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts Ceneral taws, and that my signature on this permit application waives this requirement. Owner Agent• (please check one) Telephone No. PERMIT FEES (Signature of-Owtter or Agent Location No. a Date a3 9 1-69 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ r Foundation Permit Fee $ Other Permit Fee Rp/ $ ._ Sewer Connection Fee $ Water Connection Fee $ _ TOTAL $ ; 3 6 Building Inspector 07/22/99 13:30 35.00 PAID Div. Public Works e on In I L.; z 1 xl ,U�ry4\ Y J � a s .�e O W � Z L In N n T z W-- y % z ;� 6 V � U V 4 Z p a C � C Z C oma, C: uj a _cm Z W Y Z uj .� _ v t `u• Z V p 1 ,U�ry4\ Y J � a s .�e O W � Z L _ In N n T z W-- y % z ;� 6 V � U V 4 Z p a C � C Z C oma, C: uj a _cm Z Y Z _ In N n T z W-- y % z ;� 6 V � U V 4 Z p a C � C Z C oma, C: uj a _cm Z Cl) m DO Cl) 0 m .7 CA CD az CD O d C,2 L�_7 S. nto o p C.� Cr coo O Go CSD ao CD �CD LTJ CO) .p cood d O Cl). O CO) d C) co O r!� CD CDC CO) co CA O CD 0 CD c?�a E d 2 O N c Q W d C m -Co. C, �m � C9 C CO) RCD m O C 97 o a?� m m O m y O y �co G :>[)CCD, CG O :O ..► O H cc,,)) W =r O V C H 7. o..�m �a o CD N �- m ow C gg ik 3 C4) tip H CCD t0 ..' H V m � � � H 3 m 0 co, Miz b � CD oil� y D rl� s 30 � e =ca. CD �Od=CL= _ 0 '4� � i fP O o -" CD cn O cn tp 'TJ z �n w ►n 7d C� CA M x w ,O A "C b - w p GJ n cn x z 0 LA) ji ko y 0 0 c BUYER: - Silv8rio,ltichael spection excludes the fO all: _ .f 1 . ,,,.) sheds as to ZO*3 ..: lents. 324.43 (K -Ata) S>� D p I sT��Y 0 wc�aa r�� * �4 T . �cl l03 IoZ Ical loo ��� �DE�P� Z33.� (Pc,A►J� a 3Z5 trP�Ci�� 99 -0 THE ( First Franklin Financial Corporation �) +ND ITS iffi INSURERS. - - - MORTGAGE INSPECTION PLAN 'ERTIFY THAT THE 811ILMGS SHOWN DO ( ) WNFORM TO SETBACK REQUIREMENTS LOCATED IN L `'RONT. SIDE, & REAR SETBACK ONLY) OF Hortj4 Andover KkXl- A v,.p fez it '1445TRUCTED, OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS. G.L i V In; 41APTER 4()A, SECTION 7, (INLESS OTHERWISE NOTEC. MASSACHUSETTS FUR, /CER11FY THAT THIS PROPERTY IS Not �LOCA� 01 THE ESTAbUSNEI, FLOOD AZARf AREA• COMMUNITY PA14EL NO.: 250098 OoO3C DATE: 02_93 HIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED AIE OF TIDE LATEST DEED OF RECORD. HENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY LME IT IS ADVISED IAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. OS CERTIFICATION IS BASED ON THE LOCATION OF DEED B00K 11,7 PAGE 318 CERT. NO. SURVEY MARKERS OF OTHERS, AND DOES 1407 PLAN BK. EPRESENT A PROPERTY SUR Y.,-YEWCATION OF SURVEY MARKERS USED AND PAGE OFFSETS, AS SHOWN, AY BE ACCOMPUSIUED gILN INSTRUMENT SURVEY. DRIVEWAYS APE NOT DEPICTEI) PLAIT / 1i024 DATED _ t1 aTHIS CERTIFICATION, _ MORTGAGE_ PURPOSES ONLY. ����. z2 OFFS S SHO E NOT TO BE _ ,1999 USED FOR S lit .OF PROPERTY LINES SCALE: V- 4<:,,�i:tKTKf.9� BRADFORD FuQ �,� � ENGINEERING CO. P.O. BOX 1244 JAMES W. HOUGIOUKAS R.L.S. #9529 HAVERHILL MA. 01831 TEL. (918) 373-2396 FORM U -1 LOT RELEASE FORM 'INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT Adc)d sd per/D PHONE 6K-00'72) LOCATION: Assessor's Map Number PARCEL - SUBDIVISION LOT (S) STREET4C., ST. NUMBER 3 OFFICIAL USE ONLY" RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED 2( 8. tt ��,, • _, DATE PEJE=CTED / COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED_ COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS `i PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE