HomeMy WebLinkAboutMiscellaneous - 351 REA STREET 4/30/2018CERTIFICATE OF USE &OCCUPANCY
Town of North Andover
Building Permit Numbers Date a— E�
THIS CERTIFIES THAT
THE BUILDING LOCATED ON /���� ��% Rea (5 IL
MAY BE OCCUPIED AS �i����1`l�'� t( IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
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Of NORTH , CERTIFICATE ISSUED TO ��,�C `�® ye e_
p ADDRESS 5&COVd G-/" Ak&AaeVek
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Town of North Andover NORTH
Ot�t`eo ;b,c O
Building Department a o
27 Charles Street
o t ti y
North Andover, Massachusetts 01845 * ,�
(978) 688-9545 Fax (978) 688-9542404
COC FI[IN WNII
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APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION
~t�rrr�'
ADDRESS 1 VT Cfi `s (D (ZQ f) 3
LOT NUMBER t-0 Y a SUBDIVISION
DATE REQUEST FILED _ 30— 6 1
DATE READY FOR INSPECTION
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME
FRAlV1E..A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE
CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES'.
SIGNATURE
OFFICIAL USE ONLY
ROUTING
CONSERVATION DATE '
PLANNING DATE M nn I S1
D.P.W. -WATER METER au A zd,!5 L DATE /- 3a-01
D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED
PRIOR TO THE INSPECTION REQUEST DATE.
SIGNAT / IhW AUTHORIZATION
iso
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FORM U - 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.
FILLS OUT THIS SECTION *******
APPLICANT t/✓ ,< �jOGfC �
LOCATION: Assessor's N12p Number 2
SUBDIVISION
PHONE CS ;Z -76,3
PARCE-1-
LOT (S) Z
STREET REE .S( ST. NUMBER
USE ONLY f
*�*:�*�*:�*tet***���**:�***�***�*
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED—
COMMENTS P2 L:57-
PUBLIC
J`
PUBLIC WORKS - SEWER/WATER CONNECTIONS /,/ 14 - '),--
DRIVEWAY PERMIT
FIRE DEPARTMENT"
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
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2 2Date.,�r.
....
N ................ ....
.......
0 -
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .........a........
....................................
has permission to perform .....................
wiring in the -building of ... ...... " .............................
aC�. Z .... le ......... .......... .
....................... North Andover, Mass.
FeesA... . . ... Lic. No ............................ ........
... ': ...........
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
77ECOOMMOAWE4L7HOFMAS►S4(21US&77Z' Office Use only
DEPARTMFNIOMBLICS41VY
Permit No.
BOARDOFFIREPREYE7WONREGUTATIOAS5rG R1Z'Oi0
UV4 Occupancy &Fees Checked
PPLICATIONFOR PERMIT TO PERFORM=(MICAL WORK
ALL WORK TO BE PERFORMED 1N ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) -3 u % C�
Owner or Tenant
Owner's Address Address S0 SEG01/ 17 S-� t✓v �'✓ Dti vii /17-,
Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box)
Purpose of Building % Got ! &>An/2 —ff Q `� Utility Authorization No. b02 2(.7
Existing Service Amps Volts Overhead M Underground M No. of Meters
New Service % !'d Amps9--V It 6 Volts Overhead ® Underground Q No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlet
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
ground
0
grourid
M
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No, of Detection and
No. of Disposals
No. of Heat Total Total
Pumps '
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
LocalMunicipal
Other
No. of Dryers
Heating Devices KW
Connections
a
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
Ir UWXCo� RnU3rtbthetagtmarlatsofivEMdUSCMC UBILaWS
Iha%eaaEftLiablityhnva=PdLymAxkgCoT>iW Comamcrtssti atiaiac} Wdert YES IE NO
IhawahntlrJdvalidprafofsarnetothe0ffmYES M NOa Ifjcuhmec eiWYES,pl mirimetherAxofw agebydakirtgthe
NMANCE® BOND o OTIR o ftm)
E*maim Dat
Ester &dVakxdE7mhzl Wdk $
WorkoSmrt — aN - 0TH IrnpedmD*RqjmWd Roth Fnal
sighed undaie i$� ofpajtey
FIRM NAME �•yL.G -1! ®�/% C >r LiNa L= �Z3
L.ioensee f L'�� r;i✓e � �i c�
_ LiXrwNo , C- l5 -3 0
Btzi=Tel.Na
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OWNER'SMJRANMWANER;Iamawatedmt*Lioaw& not�thecnua=a erg@eorisst�mr>trale tasiequaedby adt�tsC$�alLaws
aod#Affiysg mMmcnthspm=appfi=atwai%mth'slacltmanem
(Please check one) Owner a Agent
Telephone No. PERMIT FEE $ ��.
a
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N° r/—'579 Date �..�.�..�' ........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that..................................a..........................................................
has permission to perform ...................... ..........................................................1
wiring in the building of.....................................................�'C.� ; .... ..
............,..................
G
at .. �-.. �....:.':.''�
........................................................ .North Andover, Mass.
r-
Fee-.......,.. Lic. N��9.°.
.......:.....................................
/ ELECTRICAL INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
e�nfn�� 07 XXss,4e9eus5-77s
a 4;DSqat
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Officia.
Permit No. c—:�(6'/%
Occupancy & Fee Checked ��
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
(Please Print in ink or type all information)
Date %�' % )
To the Inspector of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number -3 / is FA
Owner or Tenant xzz (<",` ;T 2 5- _
Owner's Address J (3 �� �f "D
Is this permit in conjunction with a building permit Yes 9-' No ❑ (Check Appropriate Box)
Purpose of Building__ ..R C4 --,r / / :7/v C, Utility Authorization No.
Existing Service Amps Voits Overhead ❑ Undgrnd ❑ No. of Meters
New Service a OO Amps 9a Voits/
Overhead ❑ Undgmd lL` � No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
of
No. of Lighting Fixtures
No. of Switch Outlets
No. of Ranges
No. of Diposal
No. of Dishwashers
No. of Dryers
No. of Water Heaters
No. Hydro Massage Tuds
MAIL
10
No. of Hot fuse
Above ❑
In ❑
Swimming Pool
grnd ❑
grnd ❑
No. of Oil Burners
No of Gas Burners
No of Air Cond
Total
Tons
i
No.
Heat
Pumps
Total
.Tons
(
Space/Area Heating
Heating Devices
No. of
No. of
of
Total HP
Total
KVA
Generators KVA
No. of Emeraencv Liahtino
FIRE ALARMS No. of Zone
No. of Detection and
Initiating Devices
dotal
KW No. of Sounding Devices
No./ of Self Contained
KW Detection/Sounding Devices
❑ Municipal ❑ Other
KW i nrnl r e
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box.
INSURANCE = BOND = OTHER JJ�Ilpase Specify)
Estimated Value of Electrical Work$T7 / /��' i (Expiration Date)
Work to Start Inspection Date Resquested Rough Final
Signed under the Penalties of perjury: � /
FIRM NAME — f` -.] 1 l_ i LIC. NO. 17 i'� 61
Lkensee T. ? � >r4J � � .`ia �L
/T_Signature iti k--" LIC. NO. / yC) iC
l 5^ril/,,r> �!•y /1 Bus. Tel No. (o
Address ice' Y+r /7 Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
(Signature of Owner or Agent) Telephone No. PERMITTEE $ ��
Date ........ .....
4r1rC�
N°
TOWN OF NORTH ANDOVER
.� r .....'. 0
PERMIT FOR PLUMBING
This certifies that ....... y ..................... ...'.:.... .
has permission to perform . .....................
plumbing inthe buildings of ............
l
...... G'......�North Andover, Mass.
C�
Fee.' Z ... Lic. No. l�? %'.. P :' ' . -.,.t ...........
lPLUMBING INSPECTOR
Check # u
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
2 � j e � e� %�! V" Date
Building Locationy + c, Owners Name Perm_.
ount 9t,.g 9d
Type of Occupancy .51
New 9f[—]ElRenovation Replacement Plans Sub ed Yes No
1111'"'"'"'"
F1'*'T',I,RES
•
(Print or type)
Installing Company Name
i Address 16 ?e,,
'e'!l
Business Telephone /
MM
61
Check one:
Corp. _
Partner.
0 Firm/Co.
Certificate
Name of Licensed Plumber:
Insurance Coveraue: Indica the a of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity ® Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner
I hereby certify that all of the details and infon
best of my knowledge and that all plumbing w
compliance with all pertinent provisions of the
By:
Title
City/Town
APPROVED (OFFICE USE ONLY
El Agent
(or entered) in above application are true and accurate to the
ed under Permit Issued for this application will be in
in ' R Code and ACImter 142 of the General Laws.
Type of Plumbing License
License umr— Master Journeyman
Location
r � }
No. 1 Date � J
r
TOWN OF NORTH ANDOVER
. s
Certificate of Occupancy $
Building/Frame Permit Fee
JACHUSE
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
_ _ Building Inspector'
TOWN OF NORTH ANDOVER
_
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED: i
SIGNATURE: /*
Building Commissidfer/InEeEtor of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
:5 s
31 3 is
Map Number Parcel Number
1.3 Zoning Information:
1.4 Property Dimensions:
R 2. S'4 1D
IY2, 901/ Fr z q1, q7
Zoning District Proposed Use
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide R red Provided
R red Provided
S'e-to, 68.7
(? "
1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information:
Zone Outside Flood
1.8 Sewerage Disposal System:
Public 0 Private V Zone ❑
Municipal 0 On Site Disposal System
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
GWYZGAle- 6�j eK C SO 566o t/.D 'S7—
Name (Prince Address for Service
79 7r= -
Signature Telephone
2.2 Owner of Record:
`Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable ❑
16
Licensed Construction Supervisor:
CS aq3 7
6o s 6-coti.0 S N, lqllp
License Number
Address
G
/.lit c�� ti ? p �f 7 C 3
— /
�.t .2
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor
y
4
��nn
F
Company Name
Regi ,'r=ation Nuntber-
Address
Expiration Date
Signature Telephone
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,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 .......9 No ....... 0
SECTION 5 Description of Proposed Work check all applicable)
New Construction PJ I Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ I Demolition ❑ 1 Other ❑ Specify
Brief Description of Proposed Work:
S;NG'/E 51-11;1V -,Pw4I/-466 - 6"gA.9G cyNy&D r--
OF X yo fr; dao F
I SECTION 6 - F.CTIMATM CnN4QTR17rTinN rncTc I
Item
Estimated Cost (Dollar) to be
Completed bypermit applicant
OFFICIAL USE ONLY '
1. Building
`.
6 0 U. 0 0
(a) Building Permit Fee
Multiplier
2 Electrical
S-060.0-0
(b) Estimated Total Cost of
Construction
�'e of
3 Plumbing
/ _ 0 p
Building Permit fee (e) X (b)
/4/ P17J. MONO
4 Mechanical HVAC
Qon
5 Fire Protection
d 0 ,
6 Total 1+2+3+4+5
Opp
Check Number
13JV1%,iiv1'q is vvVllqLicAUlilurEILAIIV1'N 1V DE UUMFLEIJED Wti-EN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, % 12 ���`r '�j yC as Owner/Authorized Agent of subject property
Hereby authorize c to act on
Myy bye 1alf-in all matte five to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AU HORIZED AGENT DECLARATION
C/C- L 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
of Owner/
Date
2—..2-$"- 0 C
NO. OF STORIES 3 SIZE
BASEMENT OR SLAB e / Z e-'7--7
SIZE OF FLOOR TIIyIBERS OTa ,c io
--
2 ° ZCd 3 ,? x /b
SPAN
DM ENSIONS OF SILLS J yC
--T—PrC73T-ED
DH\, ENSIONS OF POSTS Gp iY z'-� fZ
Ll C�
DIN ENSIONS OF GIRDERS
HEIGHT OF FOUNDATION"
THICKNESS p 'F
SIZE OF FOOTING a S! x/ a
a• X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND its
IS BUILDING CONNECTED TO NATURAL GAS LINE Al 7
I
11
Location / �_
No. Or l Y Date 14<:3 -o
NORTH TOWN OR NORTH ANDOVER
• L 9
4®
9
o •.
Certificate of Occupancy $ Y140
Building/Frame Permit Fee $
s�cMus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $1� 0
Check # �0L
3 /r
3 3 / /Building Inspector
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The Commonwealth of Massachusetts
Department of lndustriaUccidents -
Offica of lnves-6aadons
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
(Name Please Print
Name:
Lccation: 0 5 z 6B"'y'' S %
Cit.\/ /1/6 y l/ Phone #
F7I am a homeowner perfcrming all work myself.
I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
Comcanv name:
Phone r:
Insurance Co. Policv rt
e:
h/:
Phone #--
Insurance Co. Policv
Failure to secure coverage as required under Section 25A or iVIGL 152 can lead to the imposition cf cnmir:al penalties m a fine up to 51,500.00
and/or one years' imonscnment as,veil as civii penalties in the form of a STOP WORK ORDER and a rine cf (5100.00) a day against me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the GIA for coverage verification.
1I do hereby certdy under the pains and
L
Slonature J/'�1^�✓�'
or perjury that the information provided above is true and correct.
L)ate
Print name N 07 CE Fhene m 6.11 - -7"
Official use only do not write in this area to be completed by city or tcwn cfriciai'
City or Town \ Permit/Ucensino
❑GSeck if immediate respcnse is required
Contact person: Phone
❑
Building Dept
Licensing Board
[j
Selectman's Office
health Department
Other
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MASchoct MaIANCE PEPORf I I
Massachusetts rpm NO I Persit I I
K45chect Softwam Versin 2.01C -,W by/Date
I I
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I ---I
CM- North Asdover
ST7u'E: Massachvsetis
HDD: 6322
CO CIAO ON TYPE: 1 or 2 Fai1V, Detached
9M SYSIFII TYPE: other W -Electric Resistance)
DATE: 10-31-1999
PRa1EX'f NOfd4gTIDN:�r� S T_
MAW IIIFOInWTTON:
Mt>SPJ1T0 BP.001I DDVEIA kw CORP.
COMPLIANCE: PASSES
Regsired UA • 567
Yovr loos • 429
Area or Cavity Cost. Olannq%Door
Perive"r R -Value R -Valve U-VdlvP
�{A
------------------------------------------------------------ -----------------
CEILIM(S 1440 30.0 0.0
Sl
CEILIO: Raised Truss 90 30.0 0-0
3
MVd1S: Mood Frase, 16' O.C. 2609 19.0 0.0
169
OLA2.IN0: Wiednos or Doors 311 0.32D
100
OIaLTM: Wisdows or Doors 67 0.370
25
DOORS 40 0.350
14
DOORS 38 0.4%
19
FLOM: Over UBcosdltiosed Space 1500 30.0 0.0
49
HVAC EQ1IF1d'Nf: Furnace, 86.0 AM
WX F.QIIPMEBt: Air Conditioner, 10.0 SES
COMPLIANCE SMTEMI)if: The proposed building design descrtbed here is
consistent with the hildlag plass, specifications, and other calcelatross
suhitted with the persit application. The proposed bvildiaq has bees
desigaed to lest the requirements of the Massachusetts Energy Code.
The heating load for this bsildiau, end the cooling load if appropriate,
bas been detrained nsinq the applicable Standard Design Conditiese fOwM
in the Code. The MV equipment selected to beat or cool tie bvildisq
shall be no greater than 1252 of the design load as specified is
Sertious 7^OCM9 1310 and J4.4.
Ovilder/Desigaer Date - -
I
F0RM U - LOT RELEASE FORM t.
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.
*****************************AFFLICANT FILLS OUT THIS
APPLICANT l EXJeti✓ct --JflC14C i PHONE 9191-76,3
LOCATION: Assessor's NI2o Number
PARCEL
SUBDIVISION LOT (S) Z
STREET RSA Sl ST. NUMBER
3�1
** t*****
""""OFFICIAL USE ONLY***************
RECOMMENDATIONS OF TOWN AGENTS r� C+SU�U►. I�ec- Siu
� �o
oar 3 a
b i
ERVATION ADMINISTRATOR
COMMENTS
TOW
DATE APPROVED
DATE REJECTED
DATE APPROVER
DATE REJECTED
N
.0�_
G'1.,_
—Cm S , v o�-- Ills .�� �✓ J
FOOD INSPECTOR -HEALTH
DATE APPROVED
DATE REJECTED
IAS
SEPTIC INSPECTOR -HEALTH DATE APPROVED
�) D EDZ to s ;�9_oeot e
COMMENTS
1-7 . 1 /1/I JL
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR
Revised 9197 jm
DATE
Soll
,,6,F
/I
r
Growth Management Eylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of.North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Building Permit (below) Address of Property for Permit (below)
_l ���� ToSic
Map and Parcel: Purpose of Application (check below)
Phan Nu r of plicant Single Family Two Family
3 --
I the undersigned applicant for the above property attest that the attached building
form is completed does comply with the EXEMPTION section 8.7.6 of the North AdovertGrowthi-ch this
Management Bylaw. I also understand providing this form does not absolve me or an
from the requirements of obtaining other permits required prior to the issuance of the Building Permiitpermit
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only of daily accepted when, the Building, Permit ig issued_
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit appiicaticn and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in-
existence as of the effective date of this by -Jaw, provided that no additional residential unit is. created._ .
BylawThe lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
.
This application is for dwelling units for low and/or moderate income families or individuals, where all of the
conditions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running, with the land: For -
purposes of this Section "senior" shall mean persons over the age of 55:
This application is a part of a development project which voluntarily agreed to a minimum 40% permanent
reduction in density, (buildable lots), below the density,- (buildable lots), permitted under zoning and feasible given the
environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland. The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing are single family dwelling unit on the
parcel.
This application represents a lot which is ready for building
commissions have been received and the project is in compliance with rithose permits),p and thermitse D velopmentrom all oth erbScheduand
le
does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per .
Development until such time as the Development Schedule accommodates issuing building permits: Applicant must
supply approved fort U with this EXEMPTION.
Please provide any and all information that would assist the Building Department in making a determination'
that your application is allowed one or more of the above EXEMPTIONS.
By signing below I attest to the accuracy of the information provided and that the attached building permit is
allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or -
inaccurate information, or the checking off of anabove item which does not comply, whether done to my
knowledge or not, is grounds for refusal by the Building Oepartment to issue a Building Permit.
yi-ture ar uwner or AuthonZed Agent who signed the Attached 8urlding Permit Date
This farm must be attached to the Building Permit upon application for such permit
.
r
Growth Management Eylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of.North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Building Permit (below) Address of Property for Permit (below)
_l ���� ToSic
Map and Parcel: Purpose of Application (check below)
Phan Nu r of plicant Single Family Two Family
3 --
I the undersigned applicant for the above property attest that the attached building
form is completed does comply with the EXEMPTION section 8.7.6 of the North AdovertGrowthi-ch this
Management Bylaw. I also understand providing this form does not absolve me or an
from the requirements of obtaining other permits required prior to the issuance of the Building Permiitpermit
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only of daily accepted when, the Building, Permit ig issued_
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit appiicaticn and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in-
existence as of the effective date of this by -Jaw, provided that no additional residential unit is. created._ .
BylawThe lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
.
This application is for dwelling units for low and/or moderate income families or individuals, where all of the
conditions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running, with the land: For -
purposes of this Section "senior" shall mean persons over the age of 55:
This application is a part of a development project which voluntarily agreed to a minimum 40% permanent
reduction in density, (buildable lots), below the density,- (buildable lots), permitted under zoning and feasible given the
environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland. The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing are single family dwelling unit on the
parcel.
This application represents a lot which is ready for building
commissions have been received and the project is in compliance with rithose permits),p and thermitse D velopmentrom all oth erbScheduand
le
does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per .
Development until such time as the Development Schedule accommodates issuing building permits: Applicant must
supply approved fort U with this EXEMPTION.
Please provide any and all information that would assist the Building Department in making a determination'
that your application is allowed one or more of the above EXEMPTIONS.
By signing below I attest to the accuracy of the information provided and that the attached building permit is
allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or -
inaccurate information, or the checking off of anabove item which does not comply, whether done to my
knowledge or not, is grounds for refusal by the Building Oepartment to issue a Building Permit.
yi-ture ar uwner or AuthonZed Agent who signed the Attached 8urlding Permit Date
This farm must be attached to the Building Permit upon application for such permit
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17
Location3S Z S
No. '—f 0 Date 02- °'Q- 02,
�oRTM
TOWN OF NORTH ANDOVER
♦ s
• ; .
Certificate of Occupancy $
M�sE<�'
Building/Frame Permit Fee $ `� 57
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ a..S �--
0
Check #
15335
/ Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'✓.+'ys-. v'Sy� as
.w : .. .�
., .. .say.. .,. .... ,.. :.,... .. ,.... ., ._.. - ., x .
BUILDING PERMIT NUMBER: DATE ISSUED:
SIGNATURE:
Building Cordnissioner/IREQEtor of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
3V
Map Number
MA^
' - I '�
Parcel Num
1.3 Zoning Information:
1.4 Property Dimensions:
Zoning District Proposed Use
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
ReqWred Provide ReqWred Provided
ReqWred Provided
1.7 Water Supply M.G.LC.40. 54) 1.3. Flood Zone Information:
1.8 Sewerage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone 0
Municipal 0 On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
.1 Owner of Record
IN � r.A��A i<,'i'tOES 351 REA s ��. T kjocVa
N (Print) Address for Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable ❑
)Ay r-0 ' Smmrs-,
Licensed Construction Supervisor:
lvS 07532-2
� �� � ��, AN p
'i�C
4 ��n Z,r
License Number
,
C�/iV/�
Address
Expiration Date
nature Telephone
cC«
3.2 Registered Home Improvement Contractor
Not Applicable ❑
77�-7—DyP+�c
Company Name
i 33 S 7
Registration Number
�qAY�,1'Z si- /�E7mv� m4
Address
(14-111
Expiration Date
re Telephone
r
r
SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 Description of Proposed Work check all applicable)
Failure to provide this affidavit will result
New Construction 0 Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition 0
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
,iI/ISI 1 ` # /.
i ♦ i .vl
I SECTION 6 - ESTIMATED CONSTRUCTION COSTS I
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
''F .,.W
x
ElfDEC
` �_- i_
I. Building
oCW • ��
(a) Building Permit Fee
Multiplier
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
Check Number
SEC HUN 7a UWNEK AU"lHUKMATIUN TO BE COMPLETED 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
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
Date
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
t
Print Name
Signature of Owner/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR T11VIBERS I S1r2 ND 3ko
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
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02191
Workers' Compensation Insurance Affidavit
Please Print
-S-ZVAqC K i►_.T; McKca._
Location: SEI R 5-Z AJ. At-4hoUCd-
f l am a homeowner
work myself.
[R71I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
Company name:
Address
City:— Phone #
Compjany name:
Address
City: Phone #
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the iMposition of criminal penalties.of a fine up to $1,501).0
and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do herby certify under the pains and penalties of perjury that the information provided above is true and correct
signature` \ X ��`L/ Date a OQ
�y
Print name Phone #� tm8l`fv0$ f
Official use only do not write in this area to be completed by city or town official'
❑Check if immediate response is required
Building Dept
Contact person: Phone #:
RM WORKMAN'S COMPENSATION
E]
Building Dept
El
Licensing Board
El
Selectman's Office
0
Health Department
n
Other
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150A.
The debris will be disposed of in:
-T7�1 C,k 0 0��C V-",
(Location of Facility)
Signature 6f Penni Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
BOISE CASCADE - BC CALCTm 2001 DESIGN REPORT - US Wednesday, January 30, 200214:28
Double -1 3/4" X 117/8" V -L SP 2900 Nle
ame: Untitled
Job Name - kroes Customer -
Address - Specifier -
Designer - steve collins
qP City, State, Zip - Company: - jackson lumber
Code Reports - ICBO 5512, BOCA 98-52, SBCCI 9852 Misc: -
BO
r5 lbs LL
)9 lbs DL
General Data
Version: US Imperial
Member Type:
- Floor Beam
Number of Spans
- 1
Left Cantilever
- No
Right Cantilever
- No
Slope 0/12
Tributary 01-00-00
Repetitive n/a
Construction Type n/a
Live Load
30 PSF
Dead Load
10 PSF
Part Load
0 PSF
Duration
100
Disclosure
The completeness and accuracy of
the input must be verified by anyone
who would rely on the output as
evidence of suitability for a particular
application. The output above is
based upon building code -accepted
design properties and analysis
methods. Installation of Boise
Cascade engineered: wood products
must be in accord=ance with the
current Installation Guide and the
applicable building codes. To obtain
an Installation Guide or if you have
any questions, please call
(800)232-0788 before beginning
product installation.
Rgge 1 of 1
Total Horizontal Length - 11400-00
Load Summary
ID Description
S Standard
1 exterior wall load
2 roof load
Controls Summary
Control Type Value
B1
2475 lbs LL
2209 lbs IDL
Load Type
Rei.
Start
End
Live
Dead Trib.
Dur.
Unf.Area Load
Left
00-00-00
11-00-00
30 PSF
10 PSF 01-00-00
100
Unf.Lin. Load
Left
00-00-00
11-00-00
0 PLF
200 PLF n/a
115
UnfArea Load
Left
00-00-00
11-00-00
35 PSF
15 PSF 12-00-00
115
Moment
12882 ft4bs
End Shear
3841 lbs
Total Deflection
U459 (0.287")
Live Deflection
U869 (0.152")
Max Deft.
0.287" (Limit: 1")
Span/Depth
11.1
Bearina Supports
Name Type
BO Post
B1 Post
% Allowable Duration
56.3% @ 115%
41.6% @ 115%
52.2%
55.2%
28.7%
Loadcaw Span Location
3 1- Intemal
3 1 -Left
3 1
3 1
3 1
1
Dim. (L x Ulf) Value % Allowed Case Material
3-1112"x3-10 4684 lbs 52.7% 3 Spruce -Pine -Fir
3-1/2"x 3-12" 4684 lbs 52.7% 3 Spruce -Pine -Fir
NOTES:
Design meets Code minimum (1-240) Total load deflection criteria.
Design meets User specified (U480) Live load deflection criteria.
Design meets arbitrary (1") Maximum load deflection criteria.
BCI® and Versa -Lam® are registered trademarks of Boise Cascade Corp.
✓lie &11'111111 .c" 01,111446-d'"&
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 075322
Birthdate: 04/19/1955
Expires: 04/19/2003 Tr. no: 75322
Restricted To: 00
DAVID E STUPACK
89 AYER ST C•�•»
METHUEN, MA 01844 Administrator
�%� jeOm-111I2CUP.CLa 1/1 (�(.Cld1Q.C1G[wecw
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Q : Registration: 133537
Expiration: 07/09/2003
Type: DBA
STUPACK CONSTRUCTION
DAVID STUPACK
89 AYER ST._.,
METHUEN, MA 01844 Administrator
NOTICE OF ASSIGNMENT
' 206910
VIPLOYER: DAVID STUPACK
D/B/A: STUPACK CONSTRUCTION
89 AYER ST
METHUEN MA 01844
THE.WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT IS AVAILABLE ON POOL
POLICIES. CONTACT AGENT FOR DETAILS.
kGENT DEANGELIS INS AGCY INC
)R 283 MERRIMACK ST
IRODUCER: METHUEN MA 01844-0000
rAX IDENTIFICATION NUMBER: 04-283-7759
BUREAU FILE NUMBER STATUS OF EMPLOYER
200610Y INDIVIDUAL
ADDITIONAL INSTRUCTIONS
COVERAGE UNDER ,THIS ASSIGNMEN
APPLIES TO MA. OPERATIONS
ONLY. FOR COVERAGE OUTSIDE
OF MA.t APPLY TO APPROPRIATE
POOL OR PLAN. .
INSURANCE COMPANY:
LIBERTY MUTUAL INS CO
INVOLUNTARY MARKET OPERATIONS
P 0 BOX 8094
WAUSAU WI 54402-8094
(800) 65377893
CLASSIFICATION OF. OPERATION
CLASS
CODE
ESTIMATED
TOTAL ANNUAL
RATE
ESTIMATED
PREMIUM
REMUNERATION • _
CARPENTRY=NOC
540
16.6
-_
$
CARPENTRY -DETACHED PRIVATE RESIDENCES
564
5100
10.6
531
CARPENTRY -DWELLINGS -3 STORIES OR LESS
565
10.6
'
EMPLOYERSGL"TABILITY 100/100/500
984
STANDARD PREMIUM
531
EXPENSE CONSTANT
090
24
ESTIMATED ANNUAL PREMIUM
775
DIA ASSESSMENT 4.7% OF STANDARD PREMIUM
25
EST. ANNUAL PREMIUM PLUS ASSESSMENT
$ 80
INSTALLMENT BASUANNUAL REQUIRED DEPOSIT PREMIUM $ 80
COMMENTS
COVERAGE EFFECTIVE 12.01 A.M. ON
08/23/01 WITH ABOVE INSURANCE COMPANY.
DATE OF NOTICE 08/23/01
0
PREPARED BY JOANNE SHEA
EXT 530.
�r
r4qPREFERRED
MUTUAL
II`I3URAI`JCE
COMPANY
COMMERCIAL LINES POLICY
COMMON POLICY DECLARATIONS
Policy Number: CPP 0100 55 69 51
Named Insured and Mailing Address (No., street, Town or city, County, State. zip code)
DAVID STUP.ACK DBA
STUPACK CONSTRUCTION
89 AYER ST
METHUEN MA 01844
Policy Period: From 07/03/2001 to 07/03/2002
named insured as stated herein.
Replacement or
Renewal Number of
NEW BUSINESS
DIRECT BILL
e
12:01 A.M. standard time at the mailing address of the
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS -INDICATED.
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
Commercial Property Coverage Part
Commercial General Liability Coverage Part
Commercial Crime Coverage Part
Commercial Inland Marine Coverage Part
Owners & Contractors Protective Liability Coverage Part
Commercial Auto Coverage Part
PREMIUM
$ 588.00
$ 4.00
$
TOTAL $ 592.00
Countersigned: 08/06/2001 By
entati ve
20-08100
DAVID J DEANGELIS INS AGY INC
283 MERRIMACK STREET
METHUEN MA 01844
(978)682-3397 1
THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART COVER-
AGE FORMS(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.
CD -1 (07-97) Includes copyrighted material of Insurance Services office, Inc., with permission. Copyright. Insurance Services Office. Inc.. 1983. 1984.
INSURED COPY
STUPACK & CURTIN
GENERAL CONTRACTORS
89 Ayer Street
Methuen, MA 01844
978-681-6087
978-265-2182 cell
Proposal and Contract
Client:
Katrina & Rich Kroes
351 Rea Street
North Andover, MA
First project
Proposed Work: The installation of a picture window in the living room of the
client's home to include the following:
1) The contractor shall supply necessary permits for construction project.
2) The contractor shall be responsible for the removal and disposal of all construction
waste produced from this project.
3) The purchase of a Vetter picture window, model # 5052, color to be determined.
4) The removal of the two existing windows in the living room on the front exposure of
the house. These two windows will then be mulled, or joined, with the picture
window, which will then be re -installed in the same location.
5) The purchase and installation of the necessary wall studs, headers, insulation,
caulking, and window casework.
6) Finish application of joint compound to the affected walls.
7) Finish work on any areas of vinyl siding affected by the job.
8) Installation of kick -plate under the front door.
9) Priming of new dry wall.
Terms: Our billing separates materials from labor, with any materials used being
directly billed to the client. We estimate that materials for this project will be in the
$700.00 to $900.00 range, depending upon the grade of window chosen, and current
market prices for the other materials at the time of purchase. Labor cost for the job
will be $2,000.00.
Payments will be made as follows: ($750.00 ) deposit due at contract acceptance.
($1,000.00 ) due at beginning of work.
($1,000.00 ) at full completion of work.
*At project completion the client will either be refunded funds if the material cost is les
than the $750.00 deposit, or will be billed for any material cost in excess of the deposit. s
Accepted: The above price, specifications and conditions are satisfacto and
hereby accepted. You are authorized to do the work as specified. ry are
Acce
Note: This proposal may be withdrawn if not accepted with in 30 days.
Addendum to the first project:
Second proiect
Proposed Work: The installation of two double hung windows in the base
client's home to include the following: ment of the
2.1) The contractor shall supply necessary permits for the constructionro'Ject.
2.2) The contractor shall be responsible for the removal and disposal of an
construction debris.
2.3) The purchase of two Vetter windows, specific models and colors to be
determined.
2.4) The framing and installation of the windows in two opposing corners of the
e
2.5) Finish work on any areas of vinyl siding affected by the job.
Terms: Any materials used will be billed directly to the client. There are
size Vetter windows which will fit in the proposed locations in the bas ement•rices for
P different
these windows vary from $259.74 to $311.22 each . This price does not include
snap -on divided light grilles, which are approximately $35.00 per window. We estimate
other materials needed to complete the job will be approximately to
materials are estimated to range from $640.00 to $744.00.
ately $50.00. Total cost for
Labor cost for the job will be $900.00.
Payments will be made as follows: ($700.00) due at contract acceptance.
($450.00) due at beginning of work.
($450.00) due at full completion of work.
*At project completion the client will either be refunded funds if the material cost is less
than the $700.00 deposit, or will be billed for any material cost in excess of the deposit.
Accepted: The above price, specifications and conditions for the second project are
satisfactory and are hereby accepted. You are authorized to do the work once the final
window sizes are determined. . /I
Date: I I�? 7,1 () L -
Respectfully submitted
Addendum to the second project:
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