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Miscellaneous - 39 BRIGHTWOOD AVENUE 4/30/2018 (3)
N_ O_ 0 N O O O O O 0 \� V m C) N E N cu0 co co LO CD I.f� N W N a p C� E Q Z o a 0 o c T c y LD O E p IL 0 Z F' u/i N c U �cu m � 0 o O W `n Z N O a co ~ _ ° wo U) o m O z M LU z a w F PC o Q E cacn p a Q C O • cu a;# N = �I L[)� �� m o N o rn z O (� L c� ^ N U 1 0 N N 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the , permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed ul on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, and may be_deemed-by the_Inspector_of-Wires abandoned-and_inualid_if he—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or.the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending'through August 15, 2012. 8 — Permit/Date Closed: to Zp _ j c * Note: Reapply for new ❑ Permit Extension Act — Permit/Date Closed: _I 11322 t A _C4 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [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 PRINTW INK OR TYPE ALL PWORMATIOA9 Date: 12--20-12- 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) -3c �,G 6 h �Wy o d Alt Owner or Tenant "S' o ti n W e i R v Telephone No. q-7,? 652,-9-727 Owner's Address M r Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building A A' � i 7 10 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: Add f "f I p C letion of the following table may be waived by the Inspector of Wires. " Attaen aaaanona� aeiau y ues�ieu, vi "� ��y«..�� y ••� _•• r--•-• � - Estimated Value of Electrical Work: / LO 6. 6 0 (When required by municipal policy.) Work to Start: / 2 - 26 - / Z-- 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 . urance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I"certify, tinder thepains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: Li 'el..,s SIX-; i'l��rt L Lu LIC. NO.: / D/ 5 Licensee: Al kz h Aa --u r,170 LV 5 & Signature ily-LTC. NO.: ( applicable, enter "exempt" in the license number line.) Bus. Tel. No.:.(a g � y 7 S o ° -7 2 If Address: >C�� S� D /- S.i leek Ale 030 2 1 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License. Lic. 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, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Telephone No. PERMIT FEE: $ Signature p omp No. of Total No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. Elrnd. ❑ o. o Emergency Lighting Satter Units No. of Receptacle Outlets (o No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches 3 No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons - - KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Other Local ❑ E]Connection No. of Dryers Heating Appliances KW Security Systems:'' No. of Devices or E uivalent No. of WaterKW Heaters No. of No. of Ballasts Data Wiring: No. of Devices or E uivalent —Signs Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: G O 5110 e- T G/,,ecicc r-7` er �__r_-_ � ,..7 h,. {bo Tv.cnortnv' niYVfYHs. " Attaen aaaanona� aeiau y ues�ieu, vi "� ��y«..�� y ••� _•• r--•-• � - Estimated Value of Electrical Work: / LO 6. 6 0 (When required by municipal policy.) Work to Start: / 2 - 26 - / Z-- 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 . urance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I"certify, tinder thepains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: Li 'el..,s SIX-; i'l��rt L Lu LIC. NO.: / D/ 5 Licensee: Al kz h Aa --u r,170 LV 5 & Signature ily-LTC. NO.: ( applicable, enter "exempt" in the license number line.) Bus. Tel. No.:.(a g � y 7 S o ° -7 2 If Address: >C�� S� D /- S.i leek Ale 030 2 1 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License. Lic. 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, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Telephone No. PERMIT FEE: $ Signature p ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for. the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall.be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: *** Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: Trench Inspection Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass IN Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: . e� Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass 1Z Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROU H SPECTION: Pass Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspecto s Signature: Date: FINAL INSPECTION: Pass M Failed Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ...TOWN OF MERRIMAC, MA........dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ,Y www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/Organizati6n/Individual): Q . 9 PaAC,40&� SGu %rle G Address: .> Fl?, 5e r City/State/Zip: SalCht /I/ J/ Phone #: Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I 5aVloyeos (full and/or part-time).* have hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. # ship and have no employees These sub -contractors have vsgorking for me in any capacity. workers' comp. insurance. [hlo workers' ccmp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] f employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. F] Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other 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. Dontractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. am an employer that isproviding workers' compensation insurance for my employees. Below is thepolicy andjob site !formation. isurance Company Name: olicy # or Self -ins. Lic. #: Expiration Date: / Z - Zl ib Site, ddress: .3 cl 301 G If -Wo -fW Are City/State/Zip: 41, .d .ttach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne 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 P up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of rvestigations of the DIA for insurance coverage verification. do hereby certify under the pains and/penalties of perjury that the information provided above is true and correct. ignature: Date: /Z Zv !L 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 #: e Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(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 for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license 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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1- 877-MASSAFE Fax # 617-727-7749 evi ed 5 -26 -OS ,%X71mu mace anvIrlia Y Date ..�.'..�.. G ,��.......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 1 This certifies that .... g.—^-:.....`::.................................................................. has permission to perform .,? P.. r -r?/ ........................................ wiring in the building of ....... ......J--* r . ....................................................... I ... .9...,.- ..: ...... ,North Andover, Mass. Fee n ....... Lic. No1q f/ %t�,3 ` __. r v ......... .. � ELECTRICAL INSPEC`COR Check # �a 7466 �C\_ official - commonwealth of Massachusetts Use Only ' 4`1 -3 *P ermit No. Department of Fire ServiceS Occupancy and Fee Checked `�� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank) PLICATION FOR PERMIT TO PERFORM ELECTRICALWORK AP All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CM (PLEASE PRINT IN INK OR TYPE 4A L INFORMATION) Date: City or Town of: ''�r�C��^'`' To the Inspector of Wires: By this application the undersigned gives notice of his or her int tion to perform the electrical work described below. Location (Street & Number) �� �J ,� � J1i�' G7 1 c --�/ 5� :7 Owner or Tenant Telephone N Owner's Address * e47K Is this permit in conjunction with a buildingAppropriate Box) 1permit? Yes No ❑ (Check" Purpose of Building � ` �a f SC �o�'i'1s2. Utility Authorization No. Existing Service Amps / Volts Overhead ❑ _. Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Meters No. of Meters Completion of the ollowin table may be waived b the Inspector o Wires - No. of Recessed Luminaires t No. of Ceil.-Susp. (Paddle) Fans o. oi Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires ove n- Swimming Pool rnd. ❑ rnd. 0 INO. o Emergency-Eighting Battery Units No. of Receptacle Outlets No. of Oil Burners . FIRE ALARMS No. of Zones No. of Detection an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers PulilDetection/Alerting ea Totals ......um er ons o. o e - ontame Devices No. of Dishwashers Space/Area Heating KW Municipal Local ❑ Connection : ❑ Other No. of Dryers Heating Appliances Key Security ystems:* No. of Devices or Equivalent No. o aterKW Heaters o. o o• o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecom munications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to.the permit issuing office. CHECK ONE: INSURANCE 4k BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO -:A1 1983 Licensee: LOUIS CONTTNO Signature LIC. NO.,F�B788 (If applicable, enter "exempt" in the license number line) ` Bus. Tel. No.:a 7 8 — 3 6 3 — S 4 0 Address: 1 nrn r-iV_ N nu wEq P NP-YRRURY� Mn 01 985 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. 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, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent . FP ERMIT FEE: $ Signature Telephone No. 59 %5V8 ,,ORT1, °t'"�- 0OTOWN OF NORTH ANDOVER � PERMIT FOR WIRING Z!�� This certifies that- has permission to perform .fr`'' '""`f ....................... r wiring in the building of .:....^-.................................................. ,at..!,2..,9.................,..... ................ , North Andover, Mass. Fee!4 � ............ Lic. No:7..... ....... ...,....................................................... ELECTRICALINSP R F Check # JLN Commonwealth of Massachusetts IOfficial Use Only Department of Fire Serviced Permit No. BOARD OF FIRE PREVENTION REGULATIONS Map & Parcel APPLICATION FOR PERMIT TO PERFO ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMAT IOA9 Date: 7- City or Town of: 100RT# 1�1Y. VtIF 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) �S 7' 15f< IU Owner or Tenant Owner's Address - Telephone Is this permit in conjunction with a building permit? Yes,E. No ❑ Building Permit # Purpose of Building „�l/Yj�I� 1!2 11 Li MA(0 Utility Authorization No. c0 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Ams / Volta Overhead Und rd No. of Meters P g ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the followinc table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans o. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators , KVA No. of Lighting Fixtures Xbovhti Swimming Pool rnd a rnd. ❑ Butte Unlbency g ng No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No..of Switches No. of Gas Burners o eon an W. Initiating Devices No. of Ranges No. of Air Coad. Toons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Num er I TonsNo. oSelf-Contained Detection/Alertin Devices. of Dishwashers Space/Area Heating KW munNo. Local 11c ❑ Other Connection No. of Dryers Heating Appliances KW ecur systems: No. of Devices or Equivalent No. of Water KW Heaters o. of No. of Signs Ballasts Data Whing: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications g: . No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required bythe Inspector of Fres. 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 Q BOND ❑ OTHER ❑ (Specify:) 9 17 (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I cer*, ander the pains and penalties of perjury, that the information on this application is true and complete: FIRM NAME: CONTTNO FLECTRTC & QABLLIC. NO.: A 1 1 9 8 3 Licensee: LOUIS CONT I NO Signature LIC. NO.: E 2 8 7 8 8 (If applicable, enter "exempt " to the license number line.) Bus. Tel. Nog 7 8 - 3 6 3 - 5 4 2 0 Address: 1 rinN01,4N j)R„ WEST NF'WB1JRY _ MA 01 985 Alt. Tel. 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, I hereby waive this requirement. I am the (check one) D owner El oww's agent Owner/Agent-av Signature Telephone No. PERMIT FEE: a, N Commonwealth of Massachusetts Official use Only Department of Fire Service?Permit No. r —9-s BOARD OF FIRE PREVENTION REGULATIONS Map & Parcel APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perforated in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI01V Date: % — �'/ r0� City or Town of: DPT# AIVM),6;D2 To the Inspector o -Wlres: By this application the undersigned gives notice of his or her intention to perform the electricaloik`descnie'd fbeIdw Location (Street & Number)� Owner or Tenant Telephone 1194496W) 8 Owner's Address "eAf L L this permit in conjunction with a building permit? Yes. No ❑ Building Permit # Purpose of Building rA41 L/ t��'I�.t� Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New_ Am / Volts Overhead Und rd No. of Meters Amps g ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .S'E /� t/ 1 G G fi�%� Completion oithe followinz table may be waived by the Inspector of Mires. No. of Recessed Fixtures No. of Cell.-Susp. (Paddle) Fanso. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators . KVA No. of Lighting Fixtures Swimming Pool Above ❑ lint- ❑ nd. rnd. No. of Ernfriency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o eon an Initiatint Devices No. of Ran$es Ttal No. of Air Coud. Tuns No. of Alerting Devices No. of Waste Disposers eaTotamisp um er one DetectiodAlertin Devices . '_ ------• No. of Dishwashers Space/Area Headng KW Local ❑Connectic on ❑ Other No. of Dryers Heating Appliances KW :SecuritySystems: No. of Devices or Equivalent No. of Water Heaters KW o. o o. of Sim Ballasts Data Wh is : No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommu ca onsg: . No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the lhspector of Mires. 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 Q BOND ❑ OTHER ❑ (Specify:) 9/1 7 Estimated Value of Electrical Work: (When required b manic' alpolicy.)t p > Y 1p Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I cone, under the paint and penalties ofperfury, that the information on this application It true and completa FIRM NAME: LIC. NO.: A 1 1 9 8 3 Licensee: LOUIS CONTINO Signature LIC. NO.: E 2 8 7 8 8 (Yf applicable, enter "exempt " in the license number lira) Bus. Tel. Nog 7 8 - 3 6 3 — 5 4.2 0 Address: _ 1 nnNQArAN n -p GiFGT NF.WBTTRY _ MA 01 985 Aft. Tel. 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, I hereby waive this requirement I am the (check one owner 0 oww'sOwneent Signature t Telephone No. PERMIT FEE. S v; S��cv m d) At ff.' 3. 0S-0 Pati J Location 3 4i �1B.. Rt&01wwQb )�Vt No. / 5,a Date MORT" TOWN OF NORTH ANDOVER D Certificate of Occupancy $ CH Building/Frame Permit Fee $ wcHu Foundation Permit Fee $ Other Permit Fee $ TOTAL $ l SAO Check #/ -,,L —3 1 17052 A 'M , (A, -- Building Inspector DATE: SCOTT L. GILES FEBRUARY 2, 2004 FRANK S. GILES REVISIONS: -... SURVEYING 50 DEERMEADOW ROAD SCALE: 1 INCH= 20 FEET NO. ANDOVER, MA 01845 o' 20' 40' TEL: (978) 683-2645 E-MAJL,: FrankGilesSurvey@attbi.com FRANK S. GILES PLOT PLAN OF LAND LOCATION HIGHLAND VIEW AVENUE 39 BRIGHTWOOD AVENUE DRAWN FOR JOHN WEIR 45.00' SUBJECT PROPERTY PLAN #0358 N.E.R.D. DEED BK. 4648, PG. 296 ASSESSORS MAP #66 PARCEL #25 LOT 44 MAP #66 PARCEL#24 N/F TOOMEY LOT 63 EXIST. BLDG. EXIST. HSE. FND. C sumoQ LOT 64 LOT 65 EXIST. HSE. FND. 0 0 00 MAP 66 PARCEL 25 AREA = 7,650 S.F. [: EXIST. BLDG. LOT 43 EXIST EXISTING GAR ADDITION 3' 10' 7.6' 22'+/- EXIST. bulk ADDIT. hea 10' N EXIST. HSE. FND. HSE. #39 10' 9' Vl 45.00' BRIGHTWOOD I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BY LAWS OF NORTH ANDOVER, MA. AT THE TIME OF CONSTRUCTION. THE OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON -CONFORMITY WHEN CONSTRUCTED. C:\CLIENTS\WEIR JOHN\PLOT PLAN.DRG EXIST. BLDG. LOT 42 MAP #67 PARCEL 414 N/F JURKEWIC EST. AVENUE Date. P.7.).).':�..). ... ..o 0 N TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies thatq !. ..% .. . t /....... . has permission for gas installation . f4 H. •�.. -.. �I ,l? `r. t .... . in the buildings of . .............................. at ............ North Andover, Mass. Fee. ..... Lic. No...........`1- AS INSPECTOR Check # 4 j 5040 MASSACHUSETTS UNIFORM APPI (Print or Type/) s �r�h An � o,a r Mass. G 8Wding Location -3 FOR PERMIT TO DO GASFITTING :W2LQ,Y Permit #_ v If U Owner's Name S�,'�a�� Type of oy, New p� Renovation p Replacement O Plans Submitted: Yap No G Installing Company Name Check �C �"� T i��� �ea�i �Q Check one: Certificate Address Z c� 5� J 0 Corporation p t$ L S ❑. Partnership Business Telephone — to D Earn/Co. Name of licensed Plumber or Gas Fitter 'jl�or^o.-5 C-0rr0<- INSURANCE COVERAGE: I have a ameg�fwbility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142- Yes 42Yes ® No O it you have.checked yes. please Indicate the type coverage by checking the appropriate box A liability insurance policy d Other type of indemnity 0 sow O 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: OwnerO Agent O Sionature of Owner or Owner's Agent 1 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 the 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 taws. ` gy. T of license: j4ftmber Signature ter Dense lumber or Gas i Mks,er License Number K%1- l o 16 0 City/lawn yman a c Y v z Cr c I.- a, 0¢ o W. 01 r.. COo z Z 2 oCF er z < m W r < y o: . O s o= c< r C .e o W< o ra 2 of z m *' < 0 C O F o r W s d r= J r= r W W O O Z O z O a S z< << 6< t O O Sue—BSMT. BASEMENT 1ST FLOOR IL IND FLOOR 3RD FLOOR _ 4TH FLOOR SRI] STH FLOOR 6TH FLOOR 7TH FLOOR eTH FLOOR Installing Company Name Check �C �"� T i��� �ea�i �Q Check one: Certificate Address Z c� 5� J 0 Corporation p t$ L S ❑. Partnership Business Telephone — to D Earn/Co. Name of licensed Plumber or Gas Fitter 'jl�or^o.-5 C-0rr0<- INSURANCE COVERAGE: I have a ameg�fwbility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142- Yes 42Yes ® No O it you have.checked yes. please Indicate the type coverage by checking the appropriate box A liability insurance policy d Other type of indemnity 0 sow O 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: OwnerO Agent O Sionature of Owner or Owner's Agent 1 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 the 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 taws. ` gy. T of license: j4ftmber Signature ter Dense lumber or Gas i Mks,er License Number K%1- l o 16 0 City/lawn yman Location J Nrz Date ,.o��,� TOWN OF NORTH ANDOVER n Certificate of Occupancy $ (JU Building/Frame Permit Fee $ CNUS Foundation Permit Fee $ Other Permit Fee $ ti Sewer Connection Fee $ Water Connection Fee $ $ TOTAL $ �Buildir�g�-Inspec�tor� �. 3L�l� Cl�� I Div. Public Works 'n I Q N :t C u: z :L v C N cn N O C Q � 'r L-. O - Z •iC LIJ .p Q .} 'li C y - > n N 0 z 0 Q U Z Q W w C7 Z � tL Q� J Z Z y T � y y - 3— = Y W W z y a Z A 6 �' a Q Y FA Towel of North Andover NORTH OFFICE OF 3� oy COMMUNITY DEVELOPMENT AND SERVICES A 27 Charles Street lo0" North Andover, Massachusetts 01845 s WILLIAM J. SCOTT SACHUSE Director (978) 688-9531 Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION Please print. Jnt. DATE `t `Q C) C JOB LOCATION cJ -5 -1 P1, G' R W U t u`ti C / �Number /dStreet address Section of town "HOMEOWNER'y'nr l al J rt (��`1 ll. )-utr, � f 3 - I d Name/ Hom//��ephone Work phone PRESENT MAILING ADDRESS) �� �i'� C�11f,yiSDN Ai -L N City/Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 Sec- tion 109.1.1) 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 to six 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 . Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE h APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I d y NI N a! 31 4 45 u z 40 3 ' M. • I d y NI N , u z d y NI N OP x w z d u u� o w° v a � w riU z z Q w¢ w° to � v U m w w CD w a c u w w � V cn w p W p b � w I w Q w w C w7 ° ci) Q o cn ui z am 0 o CD L 1 L O N O V V ��Td •p CD Q C U y •E LC O W aO w (_on ) O m D v+ UJ/w/) N EQ O L =� c LLJO co C.) CD o Lij cr CL CD W W a. UJ V w N •r -L C .rc E S L m3-CD� `cam CM CD V U C7f CD CL = E L : N l0 m m Q. MOOP a Jin L N Ca 0.5 N v Gil+ m S �E m O R y cm L cm _ cm N m C Y O Ca C Q je N •O �+ C +: CA N O m O �t 0 Z opo CL =, Q m :gym= o m m 3 o N C/O ,0 m ,O•, ma = m m C Go •N m '+ m O L) oCD ma g COD CL N m C Ca c oy•m� .0 $ o. w 0 CD L C CD cmO p 17 •C U y •E � �= W aO w (_on ) �� v+ UJ/w/) O ® CL) LLJO co C.) ® CL Lij cr CL CL W W •cm< UJ V cc —J -M •r -L C Oco = L) MOOP a Jin CO) 0 v Gil+ L)cation 3 2 60 "%&I w)a G� � UQ No. / Date -12766 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 452 1 C) Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $5 Building Inspector C tjO� l4 03:01 25.00 PAID Div. Public Works Location L 7 Date - NaRTM TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ s ; Building/Frame Permit Fee $ CIM4 Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ i Building Inspector 09/02/9.1 M:01 25, P10 CATs A / / 1 Div. Public Works 'n i RIN z N u' N s 1J % y N O 4� F N_ O - z � � Qi C M to J to Y Vf Ln Z W x — } W L ^ - _ W V iu Z ^ W V LU Z O V) LL rr 7ys l x u_Z Z C z - ;Q ye WN Z W y J H W ` C uj Q .O faJ .. c � N O Z O U 8 <L W y < z W L W Uj < 1 z C Uj � LL G N W Z _ Z JTX H 2 LLI W N 0 3.. L LLJ (U7 Q Z Z < CJ W Z r W W �[ W �! a 2 — < w Z z - — Q 6 6 Lf_ = ; -• m - RIN z rn W rA co O EME4 4 r xrn r2 \ U% aQ< vi �1/j'i�r�r�/1i� w w U w x W <� W a w a W W ° w oP C x ° c� w H W ~ w O ° z cn O EME4 4 r xrn r2 \ U% aQ< vi 9 W w w W c-oy U w x W ° w a w a W W ° w q w" x ° c� w H W ~ w m' ° z cn v ° cn o � O N V C3 CL C O W m C d � o E a CFO 3 ts CDC o, N E5 m � c w S: y O 6 t; CD m c E N � � N H s N CD ca 3 -Y cm Em 'moo zip__ � N� s N N m m ;_= G cm's Q gCt 1O m O � m cc OOf C a. 0 c Q2 2 m C C = O , m ,,,, p W L uiW CO �♦.. fl .... � •H dZ W E '_'� a.o� O COD a 0.0 ~ C �= p H z s06 Mo. m 0 IW tm -0 co CO) co '9 mCD CD 0 m 0. H� co O O i C.3 CL cc 0 tma C Cqu V c Z CD CL V CO) c C C C cc CLH 0 t0 • rn I j i ,s t0 • ,� ,8 ,� 3 � o -7L -7L Location -3 No. -3 5�� Date NORTH f �� ♦ i �Ss�cHU Check # Z-- TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ 16185 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/In for of Buildings Da ShU I IUf4 I-NIIJK IN YUHMA ION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map N mber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: 1.7Water Supply M.G.LC.40.154)Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Mf4u��� � �v�►���y <SMfr�fl r� 3� ��ei�ru�y � Name (Print) Address for Service L 4 7 Signa Ai re T ephone 2.2 Ow per of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Tele hone SECTION 4 - WORKERS COMPENSATION (NLG.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 rinit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check licable New Construction ❑ Existing Building SK I Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ I Demolition ❑ I Other ❑ Specify Brief Description of Proposed Work: �— keV kfP J-- Kr5 t7N6 U-Coc TD AOCEFT- ti fw 5 i c o ;Nj L bcP-. - IM A 4- E- C C t(A to �fS i 0 S2 C6 ;.» 1i mono P? I'L-61-3 As JvEC 5 AP -LJ SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit app licant N. O ICIAit SE ONI.Y.� 1. Building Ct c 0—L-) (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) Oa 6 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, as Owner/Authorized Agent of subject property Hereby authorize to act on behalf, in all matters relative to work authorized by this building permit applicatiot Si iatitreier Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 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/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IST2 ND 3 SPAN DIMENSIONS OF SILLS Dl vIENSIONS OF POSTS M ENSIONS OF GIRDERS 1MIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE My M art - IV) S•i x914N w O ou m H w z z A o 0 w z z ° co a 0 U w W w ° a O w P-4 z to o c �, w w A cn o cn c� 0 .a' c ;a o :a c v p � c O H O v V •C'd dC M W c m C :L O CD L- CD H = Ea c := w «.. CL N O = O • : V r0. CM m C CL fq W C m L O N CO) G 01 m C � C CO Co p : � h • • : m O CS N m m C �cp¢ y CO i CmZ C d0 CD m y C CL 0 W m W �E v c,y V O O m C V* CL m � C. ti C C` * H •_ CL E L3. N H C O _, CD cm m O; cm c �C N m Z _ p Z 0 0 Im C/) 7 I4 p 0 CO O U U) O O v v _0 U) U) crW w W U) 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. ****************************',*AAPPLICANT FILLS OUT THIS SECTION********/*************** APPLICANT �O aAl e Y"l.Q iC��i(J V E( lk. �PHONE( 7e C- J3- � -0 LOCATION: Assessor's Map Number PARCEL SUBDIVISION// LOT (S) STREET39 &IC711TWPO Al, ST. NUMBER ************************************OFFICIAL USE ONLY*********************************** I RECOMMENDATIONS OF TOWN AGENTS: I CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMM DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTEO FIRE DEPARTMEN' RECEIVED BY BUII Revised 9\97 jm S John and Maureen Weir 39 Brightwood Ave North Andover, MA 978-683-1839 PROPOSED BATHROOM WITH GABLE DORMER DESCRIPTION OF PROPOSED WORK: 1. Remove old roof shingles and sheathing as necessary to add insulation and "proper vent" to existing pitched ceilings. 2. Re -sheath roof with 1/2" ply over old pine sheathing 3. Frame gabled dormer for bath to applicable framing codes (2x4 walls, 2x10 rafters, etc.) 4. Re -shingle entire side of roof with asphalt shingles adding approved ridge vent 5. Replace existing soffit with continuously vented type 6. Re -side and trim as necessary to tie dormer in with existing house 7. Double hung window size to be determined and centered in gabled side of dormer 8. Relocate closet in effected bedroom (displaced to make room for new bath) 9. Interior work in bath and effected bed room to be performed to all applicable electrical, plumbing, and building codes. LN -5-v 4- - ----- L-J- I-J---- ------------- -7- MED ' :vl- 468.4070 CHAD LOT 63 LOT 44 CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE:1 "=20' DATE: 12/12/2002 12/13/2002 Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road North Andover, Mass. HIGHLAND VIEW AVENUE LOT 64 PLAN #0358 N.E.R.D. SEE ASSESSORS MAP #66 N PARCEL #25 c TOTAL AREA = 7650 S.F. LOT 43 PLAN #0358 EXIST. ME.R.D. GAR. %AN co ^' EXIST. HSE. FND. #39 460' TO CHADWICK STREET 45.00' BRIGHTWOOD LOT 65 AVENUE RIM LOT 42 Town of North Andover * c Building Department '� •a 11.9 qOj++rE° �ew`,�gc 27 Charles Street $SACHU5E North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE .2X/1 3 JOB LOCATION c 3 % c&OL12- "00-1) 46K Number Street Address ) Section of Town "HOMEOWNER-�SS�l�F £, � 7-i) �01"q_?a3 fr(�E7je (l0/a — FtS/Q. Number Home Phone Work Phone PRESENT MAILING ADDRESS ff f �9k11/ //1-kioOD % if— o2,7f ��orl�� A 0/kYs— City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109.1.1) 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 to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedure; HOMEOWNER'S SIGNATU APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. 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 `3 7`� is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A.. The debris will be disposed of in: i/ (Location of Facility) U1 � NJ C� C4/11k4 Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building inspector HJ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: `JmN A- lcJfi� Location: City /Y ° X71 j� a ���L lel%+-- -- Phone # ----1 7� r/ e-3 /cP-3 NJI am a homeowner performing all work myself. 0 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. Company name: Address City Phone #. Insurance. Co. Policv # Company name: Address Citi Phone #: Insurance Co. Policv # 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 $1,500.00 and/or one years' imprisonment_asyell_as_chni,penaltiesln-the-form -a-STOP WORK_ORDER.and-a fine .of_($1 D-0M)-atlay.againstff.m. understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. / do hereby certify un r e ins and penalties of peilury that the information provided above is true and correct. M .2/ay/G3 Print name 0 KN A- W f- 1127" Phone Fe 6` 3 f S Official use only do not write in this area to be completed by city or town official City or Town Permit/Licensing ❑ Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #. ❑ Health Department ❑ Other t Date....!... OF NORTH ANDOVER PERMIT FOR WIRING "1wD 5—� i,,®c - Thiscertifies that............................................................................................. � D K has permission to perform .....:....................................................................... wiring in the building of ......v C..t2............................................................ 1 `� U' b rj 1�............... NorthfAndover, Mass. at .................... .......................... Fee..�5 ........... Lic. No Eo�gi�....... :.✓..... V...... . .... :y .... `.:Q ELECTRICAL IlgspECTOR Check # 1"W' 4465- C�I�P C�DritritD1T111Pc�ItI� DfFISSc�PIISPffS Official use Onlyi r Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Q (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 /N INK OR TYPE ALL INFORMATION)Date: _ (l Z 1 � �i(/f�Q f p� To the Inspector of Wires: City or Town of: By this application of the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) -5 7 (_5 1< / Cfff7 "Iog�p /Z Owner or Tenant GYL/ Telephone N( - Owner's Address Is this permit in conjunction with a building permit? XYes ❑ No (Check Appropriate Box) Purpose of Building llG,LI� 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.) 1 IZ ! IYC, - 4: 1--A- Completion of the following table may be waived by the Insnertnr of Wira.c No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting FixturesSwimming Pool Above ❑ In- ❑ No. of Emergency Lighting grnd. grnd. Battery Units No. of Receptacle Outlets 6HC No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. 3 of Gas Burners No. of Detection and Initiating Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number T n W No. of Self -Contained I Totals: 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 No. of No. of Data Wiring: Heaters KW Signs Ballasts No. of Devices or Equivalent No. of Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee pro- vides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cov- erage is i, force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE fX BOND ❑ OTHER ❑ (Specify:) + Estimated Value of Electrical Work: (When required by municipal policy.) xpiration ate) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. f certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CONTINO ELECTRIC &*CARLP, TNr LIC. NO.: A1 19 83 Licensee: LOUIS CONT I NO Signature LIC. NO.: E 2 8 7 8 8 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-363-5420 Address: 1 noNnvAN r)RTVp., wpgT NEWBURY, MA 01985 Alt. Tel. 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, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: O� Signature Telephone No. FORM F.P. 11 HOBBS & WARREN - BOSTON (REV. 11199) Date ..... �.. 4' OR TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING > This certifies that f .� �!��^- �. � .. !1... J'�� ............ has permission to perform ...�.. . ..................... plumbing in the buildings of ..'.'........................ . t y at. S .Ut-r'`-. .................. . North Andover, Mass. U Feer%/...'...Lic. No.``./.f`.`.i.. r.ey�... PLU"IIN(Gr INSPECTOR Check # 5595 I& 'MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING or Typal nrA-lr� lav\ oyc�C'. Masa. Date A • �-2L�o petna BuMduing Loratlon� � A W©caye-OWWS Name 'S0\nY\ mut Mt'C Type of occupancy i�� �. \ New Q' Renovation O Replacement O Plans Subnfted: Yes O No FIXTURES Instalgnp Company P \-Mb1, moE Check one:. O Corporation 13 Business Telephone c1 --V 9 _ (n Q, 1 (n �ftir Co. Name of Licensed Piumba o w\ aD, C v1 o r� INSURANCE COVERAGE: I have ally Insurance policy or Its substernal equivalent which meets the requiremts erof MGL Ch. 142. Yes ® No O N you have checked yam. please indicate the type coverage by shed ft the appropriate bmL A IiabAibr Insurance policy Wr' Other type of IrWemNty ❑ _ Bond o OWNER'S INSURANCE WAIVER: I am aware that the licenseeoar not have the Insurance coverage requirw by Chapter 142 of the Mass. General laws, and that my signature on thk permit application walves this requirement Check one: -- - _ - Owner O Agent O I hereby cw* that all of the detals and irdm alim I haw eubn lbd for entered) in above app6atim are true and a=un to to the best of my tnowkdge and that all ointi ft wart and i tdd& m performed under the pem* band for this axWatim will be in oompianoe with atl WWrerrt provimu; of the Masu&m tts State ftAd inp Code and Chapter 142 of the Gam" Um rue Type d license: Master (� Amm tm m ❑ aPPR 6ZaF License .Number S\ \ O \ z x Z a z a t- a a a } o z K Z � W a W a 3g x to A i i a .V s~ y z =sm O a O 4 Q D C a x` < d< _ ! O O< a C W p O COW O jr -1 CF- < Y A6 m owl < i Q O O sus—SSMT. BASEMENT IST FLOOR 2NOFLOOR L 2RO FLOOR .ITN FLOOR STH FLOOR eTHFLOOR 7TH FLOOR STH FLOOR Instalgnp Company P \-Mb1, moE Check one:. O Corporation 13 Business Telephone c1 --V 9 _ (n Q, 1 (n �ftir Co. Name of Licensed Piumba o w\ aD, C v1 o r� INSURANCE COVERAGE: I have ally Insurance policy or Its substernal equivalent which meets the requiremts erof MGL Ch. 142. Yes ® No O N you have checked yam. please indicate the type coverage by shed ft the appropriate bmL A IiabAibr Insurance policy Wr' Other type of IrWemNty ❑ _ Bond o OWNER'S INSURANCE WAIVER: I am aware that the licenseeoar not have the Insurance coverage requirw by Chapter 142 of the Mass. General laws, and that my signature on thk permit application walves this requirement Check one: -- - _ - Owner O Agent O I hereby cw* that all of the detals and irdm alim I haw eubn lbd for entered) in above app6atim are true and a=un to to the best of my tnowkdge and that all ointi ft wart and i tdd& m performed under the pem* band for this axWatim will be in oompianoe with atl WWrerrt provimu; of the Masu&m tts State ftAd inp Code and Chapter 142 of the Gam" Um rue Type d license: Master (� Amm tm m ❑ aPPR 6ZaF License .Number S\ \ O \ yw (D IOD O C LA L e O 7 a G 0 �c 3 Cor- - M�wmr- ICD CD . r, >.M W N cem acv mo00v-- mann, r- a NN M o = �t = JOD- — 4D y -W� me 0=-ina'Y3 mom m. M CM %0 _ F -J mJr -ma mC-i L i m (U 0. m m 3O p N-� (�- p4 O—cm --a¢_T 0 m m� U N O Ln Ae1 -0m Om—'ca . ,3 t0 O 6D U LOO W m 'O m QuO 0 -0Q) 00 w CAWO -r� cQ m 1 C m3—m co 0 Q awz .O, m m am.. o =C ca 0 n w LL eaa� a o O ZZ_N. ec o x Z a F 2 .4 . 0 J Now Z !- OG in GGUfco U > o • o goUA o z » a. w Z _icn to dx o Q 0 g °'w a U. x " O ZL) x 0 CO cc J = N O 1�- Z yw (D IOD O C LA L e O 7 a G 0 3 Cor- - M�wmr- ICD CD . >.M .� d) -O O.j.� E— acv mo00v-- mann, r- a (Xis o = �t = JOD- — 4D y Z a me 0=-ina'Y3 mom m. 00 o °-'a 3�ma$.0 d. mJr -ma mC-i L i m (U 0. m m 3O p N-� (�- p4 O—cm --a¢_T 0 m m� U N O O)w -0m Om—'ca . ,3 t0 O 6D U LOO W m 'O m QuO 0 -0Q) 00 m ® �0wmr -r� cQ m 1 C m3—m 0 m CC � mE m OLL0p .O, m m am.. =C ca 0 n J, d Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that 7 4 . '.�. j.�... u''.'........... . has permission to perrm ...�,•................... plumbing in the buildings of�Z.................... . at.' ..... .. ... , North Andover, Mass. FeeeO.? .. Lic. No. f '.. G�. �... ,_. �-�. inu "'e,NSPECTOR Check # 6244 J it 'MASSACHUSETTS UNIFORM APPLICA fPrint or Typs) N o cA" k n dg 4e. < . Mass. Ode, 8ug oao3�? t j r SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 0TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name E ht 17 FOR PERMIT TO DO PLUMBING - 2p0 Permit # �� ;,,Ownees NameSoh� e MaUc-e Qr� llV.1e� Type of Occupancy es i c� e�� o. O Plans Submitted: Yes ❑ No 01, - Vj" 61nJ lea r\q Check one:. Ceril kste ❑ Corporation i4,54\-, '❑ Partnerslt� Business Telephone °VSB- fnR 1 - Name a Licensed Plumber :Q3 omo S C�' C. o r N o t INSURANCE COVERAGE: I have a Current liabYfty instuance poficy or Its substantial equivalent which meets the requirements of MGL Ch 142. Yes 15 No O H you have checked y=. pease indicate the type coverage by checking the appropriate book. A Iiablilty insurance policy d Other type of Indemnity ❑ _ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have I the Insurance coverage required by Chapter 142 Of the Mass. General taws. and that my signature on this permit application wahres this requirement. Check one: ---- - - Owner ❑ Agent 0 I hereby cw* that a1 Of the details and inb=boo 1 hers Xftr tel for Wrtered) 'n above aWcmbon ars true and acmnts to the gest of my knowledge and that ani pkanbin9 work and installations perfanoed under the pwni t issued for this application will be in oompbm with all pertinent provistorrs of the 14mm usetts State Plumbing Cads and Chapter 142 of the Genwal Laws. I1<Y Title My/Town Type of License: Masts Awm"Mm ❑ Lioeoss Number M R \ p ( (g d ��� • Z =dl Z iL < } U 49 Nz W I W < Z N < a < a '~ s a = O = o z e si pa. a O � O= e W e a s p s = � O O Z W W M a< Q W J e o< W 9 1' el 1 a d 4 a: a In �L a f V < Y S d Z S a- 3e z d O O o e = z W W W �' 1L O 1L V W s < S < < Oh- s �t e g o o 3 z t. a U. o a< 3 a e o - Vj" 61nJ lea r\q Check one:. Ceril kste ❑ Corporation i4,54\-, '❑ Partnerslt� Business Telephone °VSB- fnR 1 - Name a Licensed Plumber :Q3 omo S C�' C. o r N o t INSURANCE COVERAGE: I have a Current liabYfty instuance poficy or Its substantial equivalent which meets the requirements of MGL Ch 142. Yes 15 No O H you have checked y=. pease indicate the type coverage by checking the appropriate book. A Iiablilty insurance policy d Other type of Indemnity ❑ _ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have I the Insurance coverage required by Chapter 142 Of the Mass. General taws. and that my signature on this permit application wahres this requirement. Check one: ---- - - Owner ❑ Agent 0 I hereby cw* that a1 Of the details and inb=boo 1 hers Xftr tel for Wrtered) 'n above aWcmbon ars true and acmnts to the gest of my knowledge and that ani pkanbin9 work and installations perfanoed under the pwni t issued for this application will be in oompbm with all pertinent provistorrs of the 14mm usetts State Plumbing Cads and Chapter 142 of the Genwal Laws. I1<Y Title My/Town Type of License: Masts Awm"Mm ❑ Lioeoss Number M R \ p ( (g d ��� • COMMONWEALTH OF MASSACHUSETTS LICENSEDIN ND GASFITTERS PLUMBERS ASAAMASTER PLUMBER ISSUES THIS LICENSE TO THOMAS P OCONNOR 728 FOREST ST co NORTH ANDOVER MA 01845-3321 10160 05/01/06 917019 U Location o� ZR jC 14 t Ly o 0 D A No. 14-5' Date NORTH TOWN OF NORTH ANDOVER O: �.�•o r•'�O •• OL 9 Certificate of Occupancy $ s.cMus t�' Building/Frame Permit Fee $ Foundation Permit Fee $ )0Z) Other Permit Fee $ TOTAL $ Check # f a rl 17019 /yl C f Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,for BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: -ANC Building Commissionedln for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 3 9 T� et 6 W-Tux-)oD A V S6� 1.2 Assessors Map and Parcel Number: C` Map Number Parcel Number ` n U 12'11-1 � Nip V �C-� 1" ►/�—' D (�S� 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: 77(o50 S -F- IS, Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zane Information: Public ❑ Private ❑ Zane Outside Flood Zane ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSIDWAUTHORIZED AGENT 2.1 Owner of Record IMAUU. E N F— wC t 2 3'1 2tC, �( Oo] � 1�(� .l�-N�o ✓£ Name (Print) Address for Service 91hos3—Is 3 49Telephone Signature 2.2 Owner of Record: dame Print Address for Service: S' nature 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 z Registration Number A4ress Expiration Date Signature Telephone 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 checkAapplicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition D,"' Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: QEMOJI�. EXtSQNLi' /4» 17100 A -i of NAoME,. ZEPLAz-t. w 1-04 IV t-* w ¢} D tb i n aN w ITt4 LI N -i rLA-NQ 1w4'111SM(rtS 7uE}ct�►n�l�i�►4c�c iMlcb 20:�M (Isr 1=1,O0, > SLCot)b FL'00 _ _1�Eb Zriffif"Al EYxON 116Wrom *11116 rag 011ZKO7i &I I "total DNIMiRI I�. l Item Estimated Cost (Dollar) to be Completed by pernut applicant OFFICIAL USE ONLY''� ........:. 1. Building C� (a) Building Permit Fee Multiplier 2 Electrical O Cv (b) Estimated Total Cost of Construction 3 Plumbing CS, d Building Permit fee tel X (b) pQ ; D — 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATrON TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, H A -t l_V_ErdJ 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 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' PrimName !(lA (t i. A e S A� Er c Si atureoi-Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIWNSIONS OF GIRDERS fiEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL. GAS LINE AC . FORM U'- LOT RELEASE FORM I INSTRUCTIONS: This form is used to verify that all necessary approvals/permits frau Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ---------" ----" wwwww"APPLICANT FILLS OUT THIS SECTION******* * * APPLICANT Myti ffe 4>6/40. LOCATION: Assessor's Map Number--6--6- SUBDIVISION umber6 SUBDIVISION STREET 460 14Twoo4 PIU PHONE " 3 " FS PARCELZ//S^ LOT (S) ST.NUMBER_.(_I� ********OFFICIAL USE ONL *** REQ0MMENDATI0tJS OF TOWN AGENTS: ONSERVATION AD NISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE -REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 im DATE Town of North Andover Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. FOR ROOFING, SIDING, INTERIOR REHABILITATION PERMITS 1) BUILDING PERMIT APPLICATION 2) DEBRI REMOVAL FORM 3) WORKERS COMP AFFIDAVIT 4) PHOTO COPY OF H.I.C. AND/OR C.S.L. LICENSES 5) COPY OF CONTRACT 6) FLOOR PLAN OF PROPOSED INTERIOR WORK FOR ADDITIONS / DECKS 1) BUILDING PERMIT APPLICATION 2) FORM U 3) MORTGAGE PLOT PLAN (MINIMUM) 4) DEBRI REMOVAL FORM 5) WORKERS COMP AFFIDAVIT 6) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 7) COPY OF CONTRACT 8) FLOOR/CROSSSECTION/ELEVATION PLAN OF PROPOSED WORK WITH SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 9) MASCHECK ENERGY COMPLIANCE REPORT (if applicable) FOR NEW CONSTRUCTION (SINGLE AND TWO FAMILY) 1) BUILDING PERMIT APPLICATION 2) FORM U 3) GROWTH MANAGEMENT BYLAW 4) CERTIFIED PROPOSED PLOT PLAN 5) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 6) WORKERS COMP AFFIDAVIT 7) TWO SETS OF BUILDING PLANS (one to be returned) TO INCLUDE SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 8) COPY OF CONTRACT (if applicable) 9) MASCHECK ENERGY COMPLIANCE REPORT 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 appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with application. Town of forth Andover ATTEST: Office of the Zoning Board of Appeals A True Copy o Community Development and Services Division 27 Charles Street Town Clerk North Andover, Massachusetts 01845 Telephone (978) 688-9541 D. R6bert Nicetta Fax (978) 688-9542 Building Commissioner This is to certify that twenty (20) days Have elapsed from date of decision, filed without filingDate a�ANeI , Any appeal shall be filed Notice of Decision Joyce A. Bradsha, within (20) days after the Year 2003 Town Clerk date of filing of this notice in the office of the Town Clerk.. property at: 39 Brightwood Avenue NAME: Maureen E. Weir HEAR�l�iG DATE: December 9,2003 ADDRESS: 39 Brigbtwood Avenue PETITIQN; 2003-044 North Andover, MA 01845 TYPING DATE: 12/11/03 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, December 9, 2003 at 730 PM upon the application. of Maureen E. Weir, 39 Brightwood Avenue, North Andover, MA, requesting a Variance from Section 7, Paragraph 73. and Table 2 for both side setbacks, and a Special . Permit -from Section 9, Paragraph 9.2 of the Zoning ylaw to enlarge anon-conformg; pre-existing structure on,anonlot in order to add a mud room and cover a porch. on the 1 . floor and enlarge a bedron the 2"d floor. The said premise affected is property with frontage on the East side of boom . edrwood Aventie within the R-4 zoning district Published in the Eagle Tnbune on November 24 8a December 1, 2003. The following members were present: John M. Pallone, Ellen P. McIntyre, Joseph D. LaGrasse, Joe E. Smith, and Richard J. Byers- William J_ Sullivan chaired but did not vote.. . Smith and 2nd by Richard J. Byers, the Board voted to GRANT a Variance from Upon a motion by Joe E Section-!, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of 12' from the north. side setback for detached a and 7.4' from the south side setback for the addition per Plan of the existing gig Ind Land is North Andover, Mass., owned by�Maureen Weir, date 11/5.2003 [by] Scott L_ Giles, R P.L.S., #13972, Scoot L. Giles; R_P.L.S= Frank S. Giles RP.1-S., 50 Deer Meadow Road, North Andover, Mass., tood orth Andover; MA, date 10/31/03 15 pages]- and Plans for Weir Residence, 39 Brighw. Ave.,> Upon a motion by John M. Pallone and 2°d by Ellen P. McIntyre, the Board voted to GRANT the Special Permit from Section 9, Paragraph 92 of the Zoning Bylaw in order to construct a mudroonni enlarge an existing. 2nd floor bedroom and a covered landing an apre-existing, non -conforming struchse per Plan of Land in North Andover, Mass., owned by Maureen Weir, date 11/5.2003 [by] Scott L_ Giles, R.P.L.S., #13972, Scoot L_ Giles, R-P.L.S, Frank S. Giles R-P.1.S, 50 Dees Meadow Road; North Andover, Mass., and Plans for Weir Residence, 39 Brightwood Ave., North Andover, MA, date 10/31/03 [5 pages]. with the following condition: 1. The addition will be no. more than 26' in height. Voting in favor: Sohn M Pallone, Ell: h A LaGrasse, Joe E. Smith, and Richard J. Byers. McIntyre, Josef The Board finds that the existing front setback is within the requirements of Footnote 8 of Table 2 'obit ie =:Z - Zoning Bylaw, the applicant has satisfied the provisions of Section l0, paragraph 10.4 of the Zoning of this Variance will not adversely affect the neighborhood or derogate from the Bylaw, and the granting r i m Bylaw, and satisfied the provisions of Section 9, Paragraph 9.2. of intent and purpose of the Zoning tc r: D eration shall not be substantially more detrimental Zoning Bylaw that such change, extension, or altnr tl existing structure to the neighborhood. -- 0 Page 1 of 2 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-6$8-9535 Town of North Andover Office of the Zoning Board of Appeals Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner Telephone (978) 68879541 Fax (978) 688-9542 /'*� � •� vol n Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a. Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Decision 2003-044 M66P25. Page 2 of 2 Town of North Andover Board ofAppeals, Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 r -j ,:i5trtj of Deeds Esse-X Horth Count,-- Ree 381 Comm on Street 01/08/04 MAI waN NEIF � PL O 5 ^ Vo ~- # 24 Rec: Type C, p, 2O.00 0OC, 951 R. D. 5.0O DEC�1 , ,5O OO ' Type 2O.00 DOC, 952R. D, 5.00 150oo Total 150. Wal ��v # 26 payme`t Thomas J. Burke THANK YOU! Reuister of Deeds � 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 Numberis that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: LL S -rt�X sAr PM tll# (Location of Facility) p � �,,� �� ���o f 1 e�� Signature of Permit Applicant -/�-o3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector . Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE tg�l� U3 JOB LOCATION Number Street Address Section of Town "HOMEOWNER Number PRESENT MAILING ADDRESS �r41'11t� City Town 7S Home Phone State The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109.1.1) Work Phone Zip Code 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 to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIA Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. s Town of North Andover 0 �a Building Department * 27 Charles Street 9SsgCHUS10 North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE tg�l� U3 JOB LOCATION Number Street Address Section of Town "HOMEOWNER Number PRESENT MAILING ADDRESS �r41'11t� City Town 7S Home Phone State The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109.1.1) Work Phone Zip Code 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 to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIA Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. x � O %Z �' C jaQ Z C7 �— °' FMZ RID W p c �n w c � *AVb m 0 sr um ru a 3' a) E -I YZ LU O Z 0 u CL um m Q co2 O = *'' .1L O _ d GO Z c M ..NkA O.1LU 5 a' w c 3 0cu S o �:' �' 3 O w 0 ®3 W 0 O 0 .1. u aE Ln Q; -o Q; � N Ec a to ` 0cm ai a ° O u c Q ai a L �1 oc o c 13 mu o Q o o�-oc v m a W =H U O V O O O m s of ro t+ x E a H c E s � N_ CLEl y ` O tn m M w t NO � m Z O a`i u -o o ° zi z 1�m 5 mm L L CD N m 3 r c Nip . m ; .O 1 : {n�{°�•om-���," + � N ti L • a C.2 9L �m J:cmCD l � � O. C = •� Ind O m /•� � V 'y O L 1� �: V •–Z O f D �O c H m Nm_•c D = Lm�:mwaa N d H r0. N m a Z 4t , 4D 0 vyi 'az �° 5 Z oc 'E 5 •N O N LLJ cm CO2 CL C2 � o F- i- •O. ®._..I ao lu YI LLI C4 W W oc W U) a 0 a a :.co a cis Sa Cd a cd W wo Cd c m cn cn mm L L CD N m 3 r c Nip . m ; .O 1 : {n�{°�•om-���," + � N ti L • a C.2 9L �m J:cmCD l � � O. C = •� Ind O m /•� � V 'y O L 1� �: V •–Z O f D �O c H m Nm_•c D = Lm�:mwaa N d H r0. N m a Z 4t , 4D 0 vyi 'az �° 5 Z oc 'E 5 •N O N LLJ cm CO2 CL C2 � o F- i- •O. ®._..I ao lu YI LLI C4 W W oc W U) :.co Sa e'm ,cam c _ V6 a C� c 3 �+a a:. L mm L L CD N m 3 r c Nip . m ; .O 1 : {n�{°�•om-���," + � N ti L • a C.2 9L �m J:cmCD l � � O. C = •� Ind O m /•� � V 'y O L 1� �: V •–Z O f D �O c H m Nm_•c D = Lm�:mwaa N d H r0. N m a Z 4t , 4D 0 vyi 'az �° 5 Z oc 'E 5 •N O N LLJ cm CO2 CL C2 � o F- i- •O. ®._..I ao lu YI LLI C4 W W oc W U) PLAN OF LAND IN NORTH ANDOVER, MASS. OWNED BY MAUREEN WEIR SCALE. I"=20' DATE: 111512003 0' 20' 40' 60' Scott L. Giles R. P. L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road' THE ZONING DIST. IS R-4. North Andover, Mass. HIGHLAND VIEW AVENUE 468.40' TO CHADWICK S..TREET 45.00' NORTH ANDOVER BOARD OF AP EALS t LOT 63 MAP #66 PARCEL##24 TOOMEY EXIST. BLDG. LOT 44 LOT 64 e PLAN #0358 N.E.R.D. DEED BOOK 4648 PAGE 296 SEE ASSESSORS MAP #66 EXIST. HSE. PARCEL #25 FND. n o DATE OF FILIN ' Ll 7I3 - 0 LOT 65 DATE OF HEARING: f, - °l ' O 3 DATE OF APPROVAL:J X 9 TOTAL AREA EXIST. BLDG. 760 S. F. EXIST. BLDG. LOT 43 THE PROPERTY LINES SHOWN ARE THE PLAN #0358 LINES DIVIDING EXISTING OWNERSHIPS, AND EX►sr. ME:R.D. THE LINES OF STREETS AND WAYS SHOWN GAR. ARE THOSE OF PUBLIC OR PRIVATE STREETS 4' OR WAYS ALREADY ESTABLISHED, AND NO 4' NEW LINES' FOR DIVISION OF EXISTING 3'OWNERSHIP OR NEW WAYS ARE SHOWN. 13-1314" 7.6' MAP•#67 22'+i PROP. PARCEL#14 ADD. JURKE.WIC EST. bulk 2'_5" head O 10' LOT 42 5 co Ni 41- 13972 ai cdSTOk EXIST. HSE.��4I FNP. #39 10' THIS IS TO CERTIFY THAT I HAVE CONFORMED WITH THE RULES AND REGULATIONS OF THE REG[STERS OF DEEDS IN PREPARING THIS PLAN 460' TO CHADWICK STREET 45.00' BRIGHTWOOD AVENUE m C O v�� � M o m C 0 17 I NnW m C 0 �a o s� O N 0 17 I NnW m C 11111111111111111111111111111111111 II11111111111111111111111111111111 IIIIIIIII11111111111111111111111111 IIIIIIIII11111t11111111111111111111 1111111111111111111111ii11111111111 111111111111111111t1111111111111111 11111111t11111111111111111111111111 fi1111i1111111111111111111111111111 111111111111111111111111!1111111111 lillltillll111111111111111 I 1 I 111111111111111111111111 1111111111111111111111 .I.I.I.I.I.I.I.I.I.I. 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TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that �.% fi `� �°�� C ...................................................................................... has permission to perform....,*.../.1../,rJ....l........................................ wiring in the building of ...... q......... VJ1.'................................... Gvr% G at.....V.... 7.................................... . orth Andover M Fee . P,,s ` ...... .... Lic. No . ..... `/�y1........... .. �t... .. . ELEcTR[CALINSPECTOR Check # 5254 111�r TvmmonwraI14 of I.Ettssor4nsrmi Official Use Only Department of Fire Services Permit No. S BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked e (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: City or Town of:��4 A VDo llr2 To the Inspector of Wires: By this application of the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 31 17 (Z. G- r Owner or Tenant 3© f f L j W I E Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building -6-1 P -C & F F AAA (L �l I -f j2- -kF=7 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: V(/ 12. I Nr F A-1 7 0 j 7) jfQ VfF W ( UZ.1 ,., —a� r 5 A-4-0 `ice F C- Completion of the following table may ha waivarl by tha Incncnt~ of IA/]r No. of Recessed Fixtures a No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures r Swimming Pool Above ❑ In- ❑ grnd. gr d. No. of Emergency Lighting 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 ancT Initiating Devices No. of Ranges No. of Air Cond. T1,vU TotaTons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: No. of Self -Contained Detection/Alerting Devices No. of Dishwashers �h Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers No. of Wa'1br Heaters KW Heating Appliances KW No. of No. of Signs Ballasts Security Systems: No. of Devices or Equivalent Data Wiring: No. of Devices or Equivalent No. of Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: - muacn auumonaf oeran a aes/reo, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owr i, no permit for the performance of electrical work may be issued unless the licenses pro- vides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cov- erage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE EX BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) xpira io ate) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. f certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CONTINO ELECTRIC LIC. NO.:Ig� Licensee: LOUIS CONT I NO Signature LIC. NO.: E 2 8 78 8 (if applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-363-5420 8 8 8 Address: 1 DONO AN DRTVF, WP4T NFWRriRV � M1% 01988; Alt. Tel. 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, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent �- Signature Telephone No. PERMIT FEE: $ ��l L7 FORM F.P. 11 HOBBS & WARREN - BOSTON (REV. 11/991 4 1 W,ve- o k g_ s _o5 -� m M c Of CfommonwPatO of tt���ri�uset#s offl�lalt,seonly a S Department of Fire Services Permit No. _ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (leave blank) APPLICATION FOR PERMIT TO P RFORM ELECTRICAL WORK All work to be performed in accordance with the Mas chusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PR1Nt1NfNK`OR TYPE ALL INFORMATIOi�* i a �%v. .1, Date: J'�� °a��1 2 To the Inspector of Wires: City or Town of: By this application of the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 31 17 �, G-14 7—i .. U bf t `tib, =`,, ,► ..,. Owner or Tenant 3off LJ W l E 01 Owner's Address r7A /,cf Is this permit in conjunction with a building permit? W Yes Q No Purpose of Building ( P-Cf,.LF F-AAt (L � I S E Existing Service Amps / Volts Overhead ❑ Amps / Volts Overhead ❑ Feeders and Ampacity (Check Appropriate Box) Utility Authorization No. Undgrd ❑ No. of Meters Undgrd ❑ No. of Meters Nature of Proposed Electrical Work: _ W I f2.1 Nr, t2 F A:279 1 7 -12 -1y" -T gyp UfF of the following table maybe waived by the Inspector of Wires essed Fixtures (0 No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA ting Outlets No. of Hot Tubs Generators KVA ting Fixtures t Swimming Pool Above In- grnd. grnd. No. of Emergency Lighting Battery Units eptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones tches �� No. of Gas Burners No. of Detection an Initiating Devices ges d H No. of Air Cond. r1wU TonTotas No. of Alerting Devices to Disposers 0 Heat Pump Totals: No. of Self -Contained Detection/Alerting Devices I washers a Space/Area Heating KW Local E] Municipal Other Connection ers Heating Appliances KW Security, Systems: No. of Devices or Equivalent r Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent romassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owr,•t, no permit for the performance of electrical work may be issued unless the licenses pro- vides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cov- erage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE I$ BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) -(Expiration ate) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. t certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CONTINO ELECTRIC LIC. NO.: A!!983 ' 'Licensee: LOUIS CONT I NO Signature LIC. NO.: E 2 8 7 8 8 (C* if applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-363-5420 Address: 1 nnNnVAN DRTVF� WP4T NF__WuURY, MA O1�L85 Alt. Tel. No.: OWNERS 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ FORM F.P. 11 HOBBS & WARREN - BOSTON (REV. 11/991