Loading...
HomeMy WebLinkAboutMiscellaneous - 4 Wood Avenue 4 WOOD LANE - - 2101046.0-0011-0000.0 J � NORTiy ® Of No. 644 o , dover, Mass., '.C. J. ote CCC MICMEWICK 44 CC P �� `S BOARD OF HEALTH PERMIT Food/Kitchen Septic,System THIS CERTIFIES THAT......... 1�t .M ................:,. –—B � G INSPECTOR OR�C r . .......... ............. ............ ....... ... .............................. Fo ...... .� .................. .. has permission to erect......... .....................:........ burgs on..... ...... ough _ dOM to be occupied as ....... .. .. .. .. yam.;..._ . provided that the person accepting this permit s alh I in everyispect conform to the terms of the applicallon on file in Fin this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of at Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough ::::b SIG Final PERMIT EMPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS U ST TS Rough .... .. ...... .............................................. Service BUILDINOR4411111SQ4OR Fin" (q'4< 9— Occupancy —Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises - Do Not RemovePt"­ ­ No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner - = Street No. SEE REVERSE SIDE Smoke Det. Date. ..l� .. . .... ..... .. f NORTH 'f TOWN OF NORTH ANDOVER F ,. P • PERMIT FOR GAS INSTAL ON SSACMUSEt This certifies that . . .-.i:- :.�.'. . . . . . . . . . . .. . has permission for gas installation, . - . . . . . . . . . in the buil/dings of at . .` � Tl�. . .f,�C�-^�. . . . . . . ., North Andover, Mass. Fee.cl? Lic. No.&/' .Ie \` - .: �-��. A °/. . GAS INSPECTOR� Check# 6544 M,ASSACHUSEM UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date `- NORTH ANDOVER,MASSACHUSETTS Building Loqations + Permit# c� 7 $ =73-7Owner's Name Amount New Renovation ❑ Replacement ❑ Plans Submitted CA w z V w x z zE- > d [k x a w a O x F CQ SU p SUB -BASEMENT OV C > G n0 F O BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR. 8TH . FLOOR (Print or type) �G 3 Check one: Certificate Installing Company ❑ Corp. Address II G C��`�r� �•\� `�Y►^`1 Q> .f�: Y�1/`d 11Partner. ' .Q lb`7� business Telephone �'7� , _t o '� ❑ Firm/Co. Name of Licensed Plumber'or Gas Fitter �� INSURANCE COVERAGE Check one: I have a current liability Insurance,policy or it's substantial equivalent. Yes l If you have checked yes,please indicate the type coverage by checking the appropriate box. No❑ Liability insurance policy ar-�-- Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber City/Town, ❑ Gas Finer (cense NUMDer Master APPROVED(OFFICE USE ONLY) ❑ Journeyman F Date......!�.V.......... ......... NoarM TOWN OF NORTH ANDOVER • 's PERMIT FOR WIRING SA US This certifies that .............PA.10.............................. has permission to perform ........... /-i .......................................... wiring in the building of....... .....L ate.....I T ... /E/y' ....G........................ .North Andover,Mass. Fee... �. Lic.No.145 OZA. ........ � ELECTRICAL INSPEC1YlR Check # Z-72- 8 16 8 7Z8168 i. ., Official UOnl C'ommonwea&of M7amai;Lef Use yp eUepartmenE o�}ire Jervicee Permit No. O r6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank 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: _J�y I✓v- D Op City or Town of: ,Va rt-T)4 ArIVVU 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) W O kl Owner orXona* TO I? S U P r1✓ Telephone No. C(77 S"i/r,1.3 Owner's Address -5 Is this permit in conjunction with a building permit? Yes rX No ❑ (Check Appropriate Box) Purpose of BuildingUtility Authorization No. Existing Service_20_0 Amps /IG/ a,}a Volts Overhead X Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity -1*U_J 0 J�,F_D FYI a Location and Nature of Proposed Electrical Work: I J fA/AV G- ll t L J TrdQ,r4 .S w t l G IE ( �L tis ds Rj V Al t—r A P't ZLC-4-�i krl L r 67`P-T''J Ao1& Completion o the followingtable maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators . KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.-oTEmergency Lighting rnd. grnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALA RIMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: AA1 cL /G f Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of ElectricalPoInspections rk: (When required by municipal policy.) t/0Work to Start: e2 -0 to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains a d penalties of per' ry,th1�the inf rmation on this application is true and complete. C FIRM NAME: V J J� ht 1rty 6 LIC.NO.: Licensee: S Ar/'I SignaturLIC.NO.: (Ifapplicable,enter "exemlqjt'in the lie nse number line.) Bus.Tel.No.• '7 S 3t Address: S Lao nlIr Ii,.!>C Lir llf � �/ G�JT /`7{�_ Alt.Tel.No.: S 733 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally required by 1 By my si ture to ,I hereby waive this requirement, I am the(check one ❑owner ❑owner's agent. Owner/Agen Signature Telephone No.97P 6 Pd I r&3 PERMIT FEE: $ ��w� ��� �, � - � � � � r �'� � The Commonwealth of Massachusetts 1 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.b'ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): 1 A/ AF tV� Address: Y ? — 3 1— /Z L A (L/Z- City/State/ZipQ r? AC Cj ( )-7A 0 f�X Phone#: 2 & l Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. El am a general contractor and I * have hired the sub-contractors 6. F1 New construction �(1 am a sole proprietor or partner- listed on the attached sheet.employees(full and/or part-time). 7. Remodeling 2.�J $ ❑ g ( ship and have no employees These sub-contractors have 8. ❑ Demolition workin for me in an capacity. workers' comp.insurance. g Y P �'• 9�uilding addition [No workers' comp. insurance 5. ❑ We are a corporation and its \ required.] officers have exercised their 10.[1 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4).and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce pains and pe sof rjury that a information provided above is true and correct. Si nature: Date: V Phone#: Oficial 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#: 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 cant'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. # 617-7274900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.gov/dia Location uJ No. ( Date 140.1 NORTH TOWN OF NORTH ANDOVER Is r 9 •; ; ; Certificate of Occupancy $ �'�s'••°•ftp' Building/Frame Permit Fee $ JACNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #77l 14. 73 �` Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING : 1xf BUILDING PERMIT NUMBER: DATE ISSUED: r ©� SIGNATURE: /#44��A _ Building Co;zssionerflnspector of Buildings Date /0-- SECTION —SECTION 1-SITE INFORMATION . 1.1 PropertyAddr 1.2 Assessors Map and Parcel Number: Jo4/,/6 a6 Map umN ber Parcel Number 1.3 Zoningorm Infation: 1.4 Property Dimensions: Zoning District I Lot Areas Franta ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water SupplyM-G-L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record D n !�,skN Geo/teN k� �oB IANC c. Name(Pr�nt) Address for Service: Signature Telephone 2.2 Owner of Ricord: Name print Address for Service: i 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 1 1,2-k / Registration Number Address � Expiration Date q Signature Telephone !JO 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......V No.......❑ SECTION 5 Description of Proposed Work(check all a ticable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: + /�l J i.3 ( 1 I r N V I �P� t c�n�i�1 NG cum 80 5c�uQ.l GS SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant .,. 1. Building (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 Tota] 1+2+3+4+5 a _ 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 My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION e— B Af- as Owne uthorize Agen 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 r r (GIIGL�'�I ��lba4fLD Print N' , , `D —/9—t1� Signature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlvMERS 1 ST 2Nn3 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 , J • Board of Build ng Regi uj q��o`/ a d�� HOME IMPROVEMENT CONTRACTOR Registration: 126893 Expiration: U810312002 TYPO: Supp;sment Card Home Depot At-Home servioes MIKE BEDARD 3200 COBB GALLERIA PKWY 4-2C , ALTANTA,GA 30339 Admin;strator ill ACORD.- CERTIFICATE OF LIABILITY INSURANCET 0312012000 TE(MWDO PRooucER r Serial# A1339 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SHEPARD&SCOTT CORP. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 352 SEVENTH AVENUE-SUITE 805 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR NEW YORK,NEW YORK 10001 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE I" D INSURER A: GREAT AMERICAN INSURANCE COMPANY RMA HOME SERVICES, INC. INSURER a: AMERICAN ALTERNATIVE INSURANCE CO. 3200 COBS GALLERIA PARKWAY INSURER C: ATLANTA,GEORGIA 30339 MURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRTYPE OF INSURANCE POLICY'NUMBER POLICY EFFECTIVE POLICY EXPIRA UMTS GENERAL UABIUTY EACH OCCURRENCE s 1,000,000 A X COMMERCIALGENERAL LIABILITY PAC 9026936 03/10/00 03/10/01 FIRE DAMAGE WY an Er) $ 100,000 CLAW MADE FX OCCUR MED EXP Wwapetwo s 5,000 PERSONAL&ADY INJURY s 1,000,000 GENERALIAGGREGATE s 2,000,000 GEN'LAGGREGATE UMITAPPLIESPER: PRODUCTS-COMPIDPAGO S 1,000,000 X POLICY PRO. LOC AUTOMOOLEUASLLITY CAP 9026937 03/10/00 03/10/01 cmeoEDsmut uMT $ 1,000,000 A X ANYAUTO (EA6wld.d) ALL OI NED AUTOS BOOILY INJURY s SCHEDULED AUTOS (�P ) X HREDAUTOS SoOLLY INAIRY $ X NON-0VMEDAUM (p-aeddw* PROPERTY "dK4 DAMAGE(pw s GARAGELIANLRY AUTO ONLY-EA ACCIDENT s ANY AUTO EA Mx s OTHER THAN AUTOONLY; AGO s EXCESS UABILITY EACH OCCURRENCE s 10.000,000 A X OCCUR F—]CLUMsMADE UMB 9026938 03/10/00 03/10/01 AGGREGATE S 10.000,000 • s DEDUCTIBLE s X AETENiION $NONE s VMORKERSCOMPENSATION AND 20A2 WC 0007353-00 03/10/00 03/10/01 X I T MTB R B EMPLOYERS.IIABWTY E:L.EACHAOCIOENT $ 100,000 E.LDISEASE-EAEMPLOYEE S 100.000 R.L. AS DISEE-POLICY LMT $ 500,000 OTFER DESCRIPTION OF OPERATIONSWCATIONSNEMICUESIEXCLUSION3 ADDED BY ENDORS EMFNTISPECfAL PROVISK" CERTIFICATE HOLDER X ADDITIONAL IN3URED;INSURER LETTER: CANCELLATION SHOULD ANY OF TME ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION PROOF OF INSURANCE DATE THEREOF,THE ISSUING INSURERYMLL W MFAVORTO MAL 30 DAY$..YIEITTW NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE L E"s BUT FAIIAM TO DO 50 WJ.L IMPOSE No OIS(.IGATION OR LasurY OF ANY Km UPON TME wsuREK TTs AOIJm OR r REPRESENTATIVES. IrrMORITEO REPRF;UW^Tiu WDEPfiM1DENTW Y • • A/`l��n /C o/71071 is A/�AOR/�A00/1OATM1.IAS• Town 0 „ A Andover No. o '� dower, Mass. 0— CSO ° Z LA 1 COC NIC HE WICK � �•9 a°RArED S BOARD OF HEALTH 1 PE IT. T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. iv..... ............ ................................. ......................................... Foundation .. .. has permission to erectso, uildings on... ... .. .. ............................................. Rough to be occupied a .... ........... .... ................... Chimney provided that the person opting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the pr sions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRU ELECTRICAL INSPECTOR Rough ......OF... ......... ............................ .................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Zoning Bylaw Review Form Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 9�797t a BUILDING FILE Phone 978-688-9545 Fax 978-688-9542 , -Street:. . . u�oo� .��ti.�... _...._ . .. _... Applicant: -Tose Py+_ Sf�.Sanl r3o.h_rn,f40_ rr:>; _.. Request Rear 0e c/< Date. '�/ B /0 3' . Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning R-3 Item Notes Item A Lot Area F Frontage Notes 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies 3. Lot Area.Complies - r(e s 3 Preexisting frontage 4 Insufficient Information_ 4 Insufficient Information I Use 5 No'access over Frontage Allowed G ,Contiguous Building.Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies L4 e s 4 Special Permit-Required 4 e 5 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 4 file S. 2 Complies 3 Left Side Insufficient yes 1 3 3 Preexisting Height Ltg 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient ,)I 4es I Building Coverage 6 Preexisting setback(s) f t Coverage exceeds maximum — 7 Insufficient Information 2 Covera a Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed Lt s 4 Insufficient Information 2 In Watershed Sign J✓�� 3 Lot prior to 10124194 1 Sign not allowed — 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District I( Parking 1 In District review required 1 More Parking Required 2 Not in district 1 s 2 Parking Complies 3 Insufficient Information 3 Insufficient Information 4 Pre-existing Parking Remedy for the above is checked below. Item# Special Permits Planning Board Item# Variance Site Plan Review Special Permit C 3 Setback Variance Access other than Fronta e Special Permit Parking Variance Fronts a Exce tion Lot special Permit Lot Area Variance Common Drivewa Special Permit -Height Variance Congregate liousigg special Permit Variance for Sign Continuing Care Retirement Special Permit S ecial Permits Zoning Board Inde endent Elders Housin S ecial Permit S ecial Permit Non-ConformingUse ZBA Large Estate Condo S ecial Permit Earth Removal Spec ial Permit ZBA Planned Develo ment District S ecial,Permit Special Permit Use not Listed but Similar Planned Residential S ecial Permit Special Permit for Sign R-6 Density Special Permit jEEJ Special permit for preexisting nonconforming Watershed Special Permit rhe above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on vert ai explanations by the applicant nor shall such verbal explanations by the applicant serve to Provide definitive answers to the above reasons for Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds forthis review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all-plant and documentation for the above file.You must file a new permit application form and begin the permitting process. ` ��f/ ,6 /j� eJ�,r.�u v ..v3 y 8 0 Building Department Official Signa�ufe ApPlitation Received Application enied i Plan Review Narrative rc r T art n he.e is provided to fudher.explain the reasons for DENIAL for the LI f heproperty indicated on the reverse side: 1 x 4�^ y per- x a ra ?,yrs Lh..`w t�+ � ,[ _ nndn.�rro oaec� ® F jQio�Ie'AlS i5 /ems rry GyIV ON-c OSLJ�IY/r 114 r. CS �rve �vr—L Se 'C- e 3 VE S i�J� ety �tclL no 0,20 6 / �zl.�s e a/ ���✓.�c�� `�lr0v f7 r4 Le moat c .o 7C ,PDXAJS '. g. Referred To: Fire Health Police onin Board Conservation Plannin Department of Public or Historical Commission Other Buildin De artment > � lvVttltl 1slN v -L;1., l�l� PREPARED FOR DRILL HOLE so FOUND 2 290 JOSEPH & SUSAN J. I BOHENKO STONE BOUND YI FOUND rS�o -9180" � O PARCEL 17 SITE: SST ci/ LOCUS: NTS W I o MAP 46 PARCEL 11 PARCEL 10 � . AREA=28,365 SF S5�SSSS � t $ PARCEL 12 THE PROPERTY LINES SHOWN ARE THE g LINES DIVIDING EXISTING OWNERSHIPS,AND 5�anti THE LINES OF STREETS AND WAYS SHOWN S °57 ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED,AND NO NEW LINES FOR DIVISION OF EXISTING