Loading...
HomeMy WebLinkAboutMiscellaneous - 35 MARIAN DRIVE 4/30/2018 (2)7/13/2016 20879 This is an e -permit. To learn more, scan this barcode or visit northandoverma.viewpointeloud.com/#/records/20879 OF pORTy 4ti 2 �o� 5 �4SSacrtus�fi This certifies that Paul E White TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING has permission to perform Bathroom remodel plumbing in the buildings of RAY, ALLISON, M. at 35 MARIAN DRIVE, North Andover, Mass. Lic. No. 11718 Date: July 13, 2016 1/1 ;Z1 �• d) jX httprJlnoW.J,andwermaHewpointcloud.cam!#hetord:FtOQ<$. tR tjl "plumbing Dermit a100I9-...x Town of North Andover, MA Q search ®' ,MCI Merylle 1N. Home 20879 s Add t av;rn My Profile *Plumbing Permit- In Conjunction with a Building Permit (Commercial or Residential) TIMELINE ®Submission received j Jul 12, 2016 at 995am Plumbing Permit Review _ t . In Progress ®Permit fee pay—" 0 Permit Issuance K Information Message from I Pe.a Sens to%1—YLLOMDEV_NICDH ' "B Copy Nwbnt ESC �J,ycian�t F2 mail.com Attachments t up�ad r;,e -OTFY13GIO01F_Tuejul 12 2016 13:05:.PDF Up:oadro Jvy 17, 2416 by Nsm' PRc ch— Primary Contractor i Change._ Search for your contractor using these This document was sent to the printer 4 X s Document required. Pdntm COMDEY_IQCOM m sneezy Time "718 AM 7/1272016 firms (BuvnessJ Narne. Total pagm 1 Tuesday, Jul 12, 2016 09:06 AM 0-b ai®,49f 4im00uz� 4 �J,ycian�t w Location 35 MARIAN DRIVE, NORTH ANDOVER, MA Onner RAY, ALLISON. M. Attachments t up�ad r;,e -OTFY13GIO01F_Tuejul 12 2016 13:05:.PDF Up:oadro Jvy 17, 2416 by Nsm' PRc ch— Primary Contractor i Change._ Search for your contractor using these This document was sent to the printer 4 X s Document required. Pdntm COMDEY_IQCOM m sneezy Time "718 AM 7/1272016 firms (BuvnessJ Narne. Total pagm 1 Tuesday, Jul 12, 2016 09:06 AM 0-b ai®,49f 4im00uz� The Commonwealth of Massachusetts u _.DepartmentoflndustrialAccidents .l Congress Sheet, Suite 100 Boston, MA 02114-2017 yV.y`t www mass.gov1dia Workers' Compensation. Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: l�(/_ d ,-I% City/State/Zip:_",LXIVIe�2- Are you an employer? Check the apliropriate box: Type of project (required): If] I am.a. employer with employees (full and/or part-time).* 7. Q New construction 2. Wam a sole proprietor or partnership and have no employees working for me in $, gRzmodeliTig any capacity. [No workers' comp. insurance required.] 3.F] I am a homeowner doing all work myself. [No workers' comp -insurance required.] t 9. F1 Demolition 10 Building addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole 11. Q Electrical repairs or.additions proprietors with no employees. • 12: �umbing repairs or additions 5. ❑ I am a general contractor and I have hired t . he sub -contractors listed on the attached sheet. 13 Roof re airs These sub -contractors Have employees and have workers' comp. insurance.# p 6.FJ We are a corporation and its. of� ers have exercised their right of exemption per MGL c. 14. FJ Other 152, § 1(4), and we have na, employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must•attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have „ employees. If the sub -contractors have employees, they must provide their works' comp. policy number.' lam an employer tliat is providing workers' compensation insurance for my employees.' Belo* is the policy and job site information. Insurance Company N Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby certif under thee pains and enalties ofpetjury that the information j7provided above above is true and correct Sianatllre: �Cr�E'. % Date: ,�/ Co�.'�/b 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): i 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. PIumbing Inspector 6. Other Contact Person: Phone #: Informati®n 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, 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 checkingihe'boxes that apply to your situation and, if necessary, supply sub-contractox(s) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees 'other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents fbi 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 they self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, AIA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia ,,,North Andover Board of Assessors Public Access Page 1 of 1 NOR7►1 rfh Andover Board. of Assessc J1 roperty Record Card Parcel ID :210/107.C-0043-0000.0 FY:2011 Community: North Andover Click on Sketch to Enlarge Click on Photo to Location: 35 MARIAN DRIVE Owner Name: GROVER TRS, JOHN A & JOAN M GROVER REALTY TRUST Owner Address: '35 MARIAN DRIVE City: NORTH ANDOVER State: MA Zip; 01845 Neighborhood: 6 - 6 Land Area: 1.01 acres Use Code: 101-SNGL-FAM-RES „Total Finished Area: 1868 sgft Total Value: 3619100 371,100 Building Value: 154,100 164,100 Land Value: T ` 207,000 207,000 Market Land Value: 207,000 _ Chapter Land Value: Price: 1 Sale 08/23/2001 Date: s Length Sale F-NO-CONVNIENT Grantor: GROVER, JOHN M Doc: `Book: ,.06326 Page: 0214 http://csc-ma.us/PROPAPP/display.do?linkld=1708858&town=NandoverPubAcc 12/12/2011 I A,v o� BORN N'Dla' a) N m N O' a.m; —:a C�IWUIC r I� CL ; O N c 0 �D. c H,0 `uj cc > �O.D$m Zs , Q�� s '000 d vUOUJ ,, i �w'o0) so m�a>Z U .m a .0 Im 72 0 Of W c - U N o 2 o'a IL t9 a CL i.. hit bi -6 c a or>,�° O 'OO O VC cc rn� smmmm'- O J co O � O ito i S Y Um ,Cc . M lo:m;c C. UU_m; LL'J V !a> x ..� mio'o o IDHHF-. 77a a o1zo 0 0 J m y m E E 0 U 0 E X w O H a z in M 0 co to o a� H z =� O W O LU �, O_ J NQ 0p0 N of a �a: as J W » W 2 X00 uim� c0: 0: 400 Q CL :000 3t�c9�ehz 0 Q 0 r ca a to H V N N C) :000 ;30) 004N YY CO m CD iNN Z OO t�1 .• ,z 0— a LL oO oa o - } Z N N O V C) 0 7 ZN r� ow _ 0'0L10 0 LLIcD�00cu m �z 0,00 C) ON W C Q w Ef moo O Quo 0 << H oo ? 00 f. LL d �I z L QQ lLO (� 0 �O�� LO N a .N v o >.000J _I J -v pW r r WO V = U'0)0) W > mm O _ dC.) n N0 Q m WV 0 00 .adv Z 0 000 d r C; 000 OOO MM h to C)�� , a Q W m,LO0 v 0 o. N m m d U 1aa :c HH O M Q to U) c O i— _ �= O z N 'c- N to d� I a o' o lV O mi M. N O: LO tf> Qf �' r m 457 c -,(V O L �Q m m om',ia� Q ECS o:c-0 °»0 m N ifA J.Q'C 0 E:m E Z.. c LL. w C,tA U V.00 'Q� Qmu.m ixzu)uco tna VN Z 0 4 m CD 0 coo CDs' .- r�aa! a a io N w 1° LL LL.a aQ c. mm. 0'0 0 LL °o v z c LL C'LL_ ` . o IU } r+ _ w�¢�H' ww�C7U'd� z z W I�leN'�O,HF- ttoo lIOr1 fn X m U. Uf"LL rr Pr Ir lx rn,yL!LL m E mM.m o to 0EZ w�� O O'm m m(�d'._. �_� m o,mm.mLLY �O M;U- S'W Fo— Om0'Y W m m.Q eco J of N. z 3::r VN:,O3:` V Z.O,�z! E L' _!� mo'F U H o� @ @ F o c Y cn;�n''a0 J.m LL 1:1:LL U' a W1 Cl) 0 r ca a PERAUT NO. 117_ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP NO. I LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE ZONE SUB DIV. LOT NO. - LOCATION C Ma."a�->1 bf Jt vUO PURPOSE OF BUILDING OWNER'S NAME n 4 j®jCJ� /'t rwi f- / h V l7.y NO. OF STORIES E SIZE 7-'1 i, z( 7` OWNER'S ADDRESS _ �� Marla -y► D�� 1/e BASEMENT OR SLAB ARCHITECT'S NAME ko V'Lje /f _ SIZE OF FLOOR TIMBERS IST 2ND � 3RD BUILDER'S NAME `®f �ID "W SPAN DISTANCE TO NEAREST BUILDING ' y DIMENSIONS OF SILLS .z X� 6(v DISTANCE FROM STREET 6 ,POSTS JJ DISTANCE FROM LOT LINES - SIDES loo REAR G GIRDERS x/o AREA OF LOT ' CACY-0- FRONTAGE 3 p� © HEIGHT OF FOUNDATION A/1 THICKNESS A, IS BUILDING NEW ;+,� l SIZE OF FOOTING i® 4 X V IS BUILDING ADDITION MATER;AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND® I �J WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ` �I eS IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ?`/'I` 7.5 _ A L SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE le, 5 PERMIT GRA TED } / 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST S© o EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH I PLANNING BOARD BOARD OF SELECTMEN ' f /�A BUILDING INSPECTOR t Nt/'ld 101d S30` -ld321 SIH1 '43SOdW12I3df1S '013 'S30VH -VE) 'S3H:)UOd H11M-SEMa-l1f18 30 SNOISN3WIQ 10WX3 dNV S3N1-1 101 WOMA 30N` .LS1a ONV101JOSNOISN3WIO 10b'X3 MOHSisnW N01103S SIHl ONIIV3FI ON _ Pic tsl ZL I AON`ddf1000 L (Ia0:)3a 0Nla1lna DIKD313 Pub 1,W.8 SW008 dO 'ON L 110 SV`J Sa31V3H ll Nn TTH 1NVIOVa ONINOI110NOJ aIV _ Sa31dVa DOOM aOdVA aO a.1.M lOH WV31S WA TV lOH 03:mod 3JVNafld SS3l3dld _ _ S10J 18 'SW8 1331S 'S10D '8 'SW8 a38W11 1SIOf 00oM ONIIV3H L L II ONIWVad 9 OOVO 3111 ' aoOld 3111 S3—dnixl3 Na30OW `JN13008 11M 83MOHS 11V1S ON18Wnld ON IIAV80 ? ayl 31V1S FINIS N3HD11X S30NIHS DOOM ,IIO1VAV1 S3IONIHS 11VHdSV 13SO1D a31VM"Cld'VSNVVV ('X13 61 'Wa 131101 'VIA 13a8WVO 318VO X13 E H1V5 ON19Wf11d OL d008 5 �_I 77 3 CIV good dOl3WV63 ONISIM NO 3NO1S AaNOSVW NO 3NO1S )115 b30N1:) a0 'JNOJ — I 60013 8 'Sa1S DI11V 3WVad NO XDIaS ),aNOSVW NO )lDldS — E � �—z I 8 3111 'HdSV NO OJJf11S AaNOSVW NO ODDf11S ONIOIS '183A NOWWO:) —3WV8J JN101S SO1S38SV (TtM aVH ONMIS 1lVHdSV HAV3 S3I0NIHS DOOM 313aDN0D SOaV UVIJ Sa00ld 6 I SIIVM . b N3H:)11)1 N8300W WOOa 0V3H 1.W.S ON w % 7, 1111d V3aV S30Vld 3x11 V36V :)I11V 'NH V38V .1.W.9 'N13 1N3W3SVE E E L — — S N13Nn I1VM Axa 631SVld Sa3ld GA(MVH 3NO1S a0 >01H 3NId ')I.18 3138DNOD 3198DNOD HSINId HOIH31NI 9 NO11VONf10d Z NOlion d1SN00 S1N3WAVdV ST:)I3�Jo_ AlIWV3 'I11f1W I kIIWV4 310NIS ZL I AON`ddf1000 L (Ia0:)3a 0Nla1lna .9703 N Date./b.-/) -- -/) ....... ............. .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 3. % . ( ....... VII . e . ................................ ..... ............. .... ........ ... ................... has permission to perform .-e...�AI ..... jo�n/ wiring in the building of .......................................................... ........... vh ........................................ 4 " ............. . n . ...... , North Andover, Mass. 2 Fee;. -V ........... Lic. No.. . ......... /- 4EL i I �..... Check # 141- �► Commonwealth of Massachusetts Official Use only Department of Fire Services Permit N D Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS[Rev. m7) leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with ft Massach ceps Electrical Code (MEC), 527 CMR 12,00 (PLEASE PRINT IN INK OR TYPE AU INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of mires: By this application the undersign gives notice of his or her hire don to pa &nn the electrical work described below. Location (Street & Number) a s m/Y 6 /9V bd �/ r, Owner or Tenant J ah -12 , LOVE(- Telephone No. Owner's Address Is this pertnit in conjunction with ■ building permrt2 - Yee ❑ No (Check Appropriate Box) Purpose of Bunding Utility Authorization No. Existing Service Amps — t Volta Overhead ❑ Vodgrd ❑ Na of Meters �— New rvice — -Amps " / Volts Overbead ❑ Undgrd ❑ No. of Meters Number of Fellers and Ampacity Location and Nature of Froposed Electrical Work: lift 5e ` t7ruM�'� q*AA- SLgkke.S, A.Q,� make ok 0,410 �.....,tor......r,e. r.11—ii.v b.hta mnw hn waiwa by d e hueeotor of W m. No. of Recessed Luminaires No. of CeiL-Susp. (Paddle) Faaa of T anerormen KVA Na Of Lamiaaira Outlets No. of Hot Tubs Generators KVA No. of Luminaires Abov[3 r1 Swimming Pool ad! ud. No. -of x0grgency uptog Matte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and o. Initiation Devices No. of Alerting Devices No. of Ranges No. of Air Coad. Tons No. of Waste Disposers n`P Totals: ata r cos o. o e - n n unection/Alertion Devices _aw No. of Dishwashers Spate/Area Heating KW Local ❑ C�ued�ion ❑ Odler Na of Dryers Heating Appliances KW ente No. of teesr or Equivalent No. 61 Water ,o. o No. asts Dateo. navie or ivalm Neatenaof No. Hydromassage Bathtubs No. of Motors Total HP i t b ° Na of Devices or E sive OTHER: Attach additional detail 00(r ed, or as ngxwed by the /especw of Wire. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start: Inspections to be requested in aocordancc 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 forte, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify.) I certify, under the and PetraAder of pjury, that the WdrmWon an this appamdon isLure and eongrlde. FIRM NAME: &vi Rexilyt LIC. NO.: A I I a • SaturC ty LJQ NO.: v i a Lit�asec. l>,MC _ (ifa livabie. t ter "exenrJ� in�the license number f ine4 Bus. Tel. No.• Address: tit v c `�= . latae MA • Ol q �o Alt. TeL No.• t *Per M.G.J. e.14?, s. 57-61, riry wont requires dqmvmnt of public Safety -S- License: Lie. No. 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, l hereby waive this requirement. 1 am the (check one) ❑ owner 171 owner's 8202t, thirst stent Telephone No. PERMIT FEE: S 1,o�3� �1 M le i M