HomeMy WebLinkAboutMiscellaneous - 44 WOODCREST DRIVE 4/30/2018 (2)At
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Date ... . .....- .6....2
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that ..... .... ................
has permission for gas installation ... r-:2 .....................
in the buildings of .. .... .................... .
at ............. North Andover, Mass.
Feed(:..... Lic. No. F?�.......
�GAS.-INSPEC
�..
Check #
4359
MASSACHUSETTS UNIN ORM APPUCATON FOR PERMIT TO DO GAS F'TTIITG
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations L& W &0j C,2 i ST D /2 r VC?
Owner's Name
New ® Renovation ❑ Replacement ❑
Date
Plans Submitted ❑
Permit #`3
Amount $ 3�o. c-9
(Print or type Check one: Certificate Installing Company
Name 1 &-V ' L h- EMSd rV' ❑ Corp.
Address 1" O - 30k 62-7r %404veAll ll "-4A 0/8"31 ❑ Partner.
.6
Business Telephone 719 3 7Z^2 P � ❑ Firm/CO.
11 Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ® No ❑
Ifyou have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy ❑ 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 F-1
I hereby certity 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 Marchusetts Stat Gas Code and Chapter 142 of the General Laws.
`%ED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
❑ Plumber 2673 4
❑ Gas Fitter License Num5er
❑ Master
❑ Journeyman
•
PKINTE iff-Mv mom ACE
(Print or type Check one: Certificate Installing Company
Name 1 &-V ' L h- EMSd rV' ❑ Corp.
Address 1" O - 30k 62-7r %404veAll ll "-4A 0/8"31 ❑ Partner.
.6
Business Telephone 719 3 7Z^2 P � ❑ Firm/CO.
11 Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ® No ❑
Ifyou have checked yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy ❑ 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 F-1
I hereby certity 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 Marchusetts Stat Gas Code and Chapter 142 of the General Laws.
`%ED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
❑ Plumber 2673 4
❑ Gas Fitter License Num5er
❑ Master
❑ Journeyman
Date. .: .
r
,r
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ................ ........................ .
has permission to perform ..rJ� ............................
plumbing in the buildings of ;�c ......... ...............
at North Andover, Mass.
Fee. . .. Lic. No..c 9v�J' .... .... .
r PLUMBI .G I PECTOR
Check # r
5597
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ISO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Date MAP 24,03
Building Location t7a,'w' Owners Name �yq�zK G':?o,�i� Permit
Amount 3 f„ &V
Type of Occupancy
New ® Renovation ® Replacement 0 Plans Submitted Yes ❑ No
FIXTURES
•s•
(Printor type) Check one:
Installing Company Name J7wary L FI oven/ ❑ Corp -
Address PO' 3aX 627f- "IA 0I063 1 El Partner.
P74-) ?-7Z-3)0-3
Business Telephone ❑ Firm/Co.
Name of Licensed Plumber: 17,0 ' v_ .t' b 1 _ d V SO A✓
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 0 Other type of indemnity 0 Bond
Certificate
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner 11 Agent 11
I 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 Permit Issued for this application will be in
compliance with all pertinent provisions of the M chusetts S to Plumbing Code and Chapter 142 of the General Laws.
By: Signaturec ensed rjum0er
Type of Plumbing License
Title . 2®5.3g
City/Town License Numoer Master® Journeyman En
APPROVED (OFFICE USE ONLY .
fly
n� Nb"Tk q
Zoning Bylaw Denial
Town Of North Andover.
Building Department
27 Charles St. North Andover MA. 01845
Phone 978488-9545 Fax 978-6884542
Street:.. W,DGr)._/V .._. _
Map/Lot: 4 67
A plicant:
Request: /5'x�
Date:
Please be advised that after review of your Application and Plans that your Application is
DENIED for the following Zoning Bylaw -.reasons:
Zoning
Remedy for the above is checked below.
Item # I Special Permits -Planning Board
Site Plan Review Special Permit
Access other than Frontage Special Permit
Frontage Exception Lot Special Permit
Common Driveway Special Permit
Con re ate Housing Special Permit
Continuing Care Retirement Special Permit
Independent Elderly Housi, S ecial Permi
Large Estate Condo Special Permit
M
Residential Special Permit
Perm
Item # I Variance
(— it Cothnrlr V
Lot Area Variance
Height Variance
Variance for Sign
Special Permits Zoning Board
Special Permit Non -Conforming Use ZBA
Earth Removal Special Permit ZBA
Special Permit Use not Listed but Similar
Special Permit for Sign
Special Permit preexisting nonconforminc
The 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 verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to
provide definitive answers to the above reasons for DENIAL. Any inaccuracies, misleading information, or other subsequent
changes to the information submitted by the applicant shall be.;grounds for this 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 plans and;.Ocumentation for the above file. You must file a new building
permit application form and begin the permitting process.
A� 'l 9 -o i
uilding Department Official Signature
9 Application Received Application Denied
Denial Sent: If Faxed Phone Number/Date:
Item
Notes
Item
A
Lot AreaNotes
F
Frontage
1
Lot area Insufficient
1.
Frontage Insufficient
2
Lot Area. Preexisting
2
Frontage Complies
3
Lot Area Complies
3
Preexisting frontage
H e- S
4
Insufficient Information
4
Insufficient Information
B
Use
5
No access over Frontage
1
Allowed
G
Contiguous Building Area
N
2
Not Allowed
1
Insufficient Area
3
Use Preexisting
2
Complies
4
Special Permit Required
`(e S
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
2
Complies
3
Left Side Insufficient
3
Preexisting Height
4
Right Side Insufficient
y e S
4
Insufficient Information
5
Rear Insufficient
I
Building Coverage
6
Preexisting setback(s)
1
Coverage exceeds maximum
7
Insufficient Information
2
Coverage Complies
D
Watershed
3
Coverage Preexisting
1
Not in Watershed
4
Insufficient Information
2
In Watershed
e S
Sign
3
1 Lot prior to 10/24/94
1
Sign not allowed
4
Zone to be Determined
2
Sign Complies
5
Insufficient Information
3
Insufficient Information
E
Historic District
K
Parking
1
In District review required
1
More Parking Required
2
Not in district
e S
2
Parking Complies
3
Insufficient Information
3
Insufficient Information
4
Pre-existing Parkilillillllill
Remedy for the above is checked below.
Item # I Special Permits -Planning Board
Site Plan Review Special Permit
Access other than Frontage Special Permit
Frontage Exception Lot Special Permit
Common Driveway Special Permit
Con re ate Housing Special Permit
Continuing Care Retirement Special Permit
Independent Elderly Housi, S ecial Permi
Large Estate Condo Special Permit
M
Residential Special Permit
Perm
Item # I Variance
(— it Cothnrlr V
Lot Area Variance
Height Variance
Variance for Sign
Special Permits Zoning Board
Special Permit Non -Conforming Use ZBA
Earth Removal Special Permit ZBA
Special Permit Use not Listed but Similar
Special Permit for Sign
Special Permit preexisting nonconforminc
The 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 verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to
provide definitive answers to the above reasons for DENIAL. Any inaccuracies, misleading information, or other subsequent
changes to the information submitted by the applicant shall be.;grounds for this 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 plans and;.Ocumentation for the above file. You must file a new building
permit application form and begin the permitting process.
A� 'l 9 -o i
uilding Department Official Signature
9 Application Received Application Denied
Denial Sent: If Faxed Phone Number/Date:
Plan Review Narrative
The following narrative is provided to further explain the reasons for denial for the application
permit for the property indicated on the reverse side: s
Referred To:
Fire
Police Health
Plannin a}�� PB7.:01i
artment of Public Works
sh�clt Dcst ril Commission
Other
G DEPT
a TOWN OF NORTH ANDOVER
• BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
-AT NOW MAE,
BUII,DING PERMIT NUMBER: DATE ISSUED:
SIGNATURE:
Building Commissioner/InMector of Buildings Date
SECTION 1- SITE INFORMATION ,.
1.1 Property Address:
SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT
1.2 Assessors Map and Parcel
AQ 3
Map Number
Number:
Parcel 6UF f9cp
CEO
2.1 Owner of Record
Name (Print) Address for Service:
1.3 Zoning Information:
.
Zoning District Proposed Use
1.4 Property Dimensions:
Areas
(b 1% 0 AN
F onta e ft
1.6 BUILDING SETBACKS ft
SECTION 3 - CONSTRUCTION SERVICES
Front Yard
Side Yard
Not Applicable ❑
n
0 0 3, 5- 3 1
003.5-3
Rear Yard
Required Provide
Required Provided
Required
Provided
Company Name
Registration Number
Address
Expiration Date
1.7 Water Supply M.G.L.C.40. 54)
Public ❑ Private ❑
1.5. Flood Zone Infomration:
Zone Outside Flood Zone ❑
1.8
Municipal
Sewerage Disposal System
❑ On Site Disposal System ❑
,%1
9 9
SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Service:
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
®5eA AQ 14.
Licensed Construction Supervisor:
Address
J _03
iinature Telephone
Not Applicable ❑
n
0 0 3, 5- 3 1
003.5-3
License Number
Expirat n Dat
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
,%1
9 9
i
4
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 .......0 No ....... 0
SECTION 5 Description of Proposed Work(check all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑' Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
:SS ^ e4i.
l E s ci
16 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
a
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 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
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, 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 ame
Si ature of Owner/A ent D e
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR T MBERS OT 2 NO 3
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIN ENSIONS 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
gj 3
• 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.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT 0_25, ifQ ,�. El�/y �Q PHONE D� $�'% l �a�� � GG
),�� f wteCSctl�u�
LOCATION: Assessor's Map Number - PARCEL z. D A � a (
2e.clee
SUBDIVISION LOT (S)=�
STREET 1O0o 64677 ST.-NUMBER_��
************ **************OFFICIAL USE ONLY *****
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED
/COMMENTS
DATE REJECTED
TOWN PLANNER DATE APPROVEDr
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH
SEPTIC INSPECTOR -HEALTH
COMMENTS
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
The Commonwealth of Massachusetts
.Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02 911
Workers' Compensation Insurance Affidavit
Name Please Print
Name: cls �C+g If
Location
v,
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
IMP
I am an employer providing workers' compensation for my employees working on this job.
Company name:
Address
City Phone #:
Insurance.Co... Policy :#
Company name'
Address .
Citi. Phone #:
InsUranG:e:Co. ,: Policy..# .
Failure tb secure coverage as regiuired under isttion 25A or MGI 1152 can lead to etre tmposipon of criminal penalties of a'fiae up t6$1
and/or one years'inapnsonment-as.well,as-civi1.RenaltiesOR'(ORDER.and:alined($1to-n-aAayagainstme. 1
understand that a copy of this statement may be forwarded to the office of Investigations of the DIA for coverage verification.
I do hereby certify under the pains and penalties of pedury that the iirformation provided above is hue and correct.
W
Print name e95 eM 44L� Phone # l D, j .52r7 I/ 3
Official use only do not write in this area to be completed by city or town official' i
City or Town Permit/Licensing
0 I
Building Dept
nCheck if immediate response is required p Licensing Board
F1 Selectman's Office
Contact person: phone #. 0 Health Department i
Other {
�' � ✓lie �oor�rrio�zurad`�' o�✓C%iaaaTlu�aeti` �
t& RD'OF BUILDING REGWLATIONS
+� r License ,CONSTRUCTION SUPERVISOR
r Numtier,tCS 003531
� Birthdate 10/12%1958
Expires 10/12/2001 Tr. no: 6727 `.
i t ,Restncte'djT0: 0.0
ISCAR A HOEHN JR _ ��,�' f
KAREN LANE L•«e v!�, t} >
ANDOWN; NH 03$73 Administrator
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No. Date 43/ -f
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TOWN OF NORTH ANDOVER
Certificate of Occupancy $ _
"� 0
Building/Frame Permit Fee $
��SSACHUSEtA
Foundation Permit Fee $
`
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
e,u-�--
f%P .385
,
'13074/69/99 24:46
/-
Building Inspector
520.00 PAID
Div. Public Works
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14.
NORTH ANDOVER
OFFICE OF
RE_ ,
JOYGE
TOWN G c
NORTH , 4� "110`!Erk
MAR 22 F'
THE ZONING BOARD OF APPEALS
27 CHARLES STREET
NI ORTFI ANDOVER. MASSACI-iUSL•TTS 0181_
Any appeal shall be file
within (20) days after the
date of filing of this notice
in the office of the Town Clerk.
NAME: Kenneth Hoffman
ADDRESS: 44 Woodcrest drive
North Andover, MA 01845
NOTICE OF DECISION
Property at: 44 Woodcrest Drive
DATE: 3/10/99
PETITION: 001-99
HEARING: 3/9/99
F_A_`C (973) 683-9; 2
The Board of Appeals held a regular meeting on Tuesday evening, March 9, 1999 upon the application of Kenneth
Hoffman, 44 Woodcrest Drive, North Andover, MA requesting a variance from the requirements of Section 7,
paragraph 7.1 & 7.3 for relief of lot area dimension, and right and left side setbacks, to construct a 2nd floor addition
consisting of bedrooms, baths, closets. And to request a Special Permit from the requirements of Section 9,
paragraph 9.2 & 9.3 to construct a 2nd floor addition to exceed an aggregate of more than 25% of the original use on a
pre-existing non -conforming lot within the R-1 Zoning District.
The following members were present: Walter F. Soule, Raymond Vivenzio, John Pallone, Ellen McIntyre, Scott
Karpinski.
The hearing was advertised in the Lawrence Tribune on 2/23/99 & 3/2/99 and all abutters were notified by regular
mail.
Upon a motion made by Scot t Karpinski and 2n4 by Walter F. Soule, the Board voted to GRANT a Variance from
the requirements of Section 7, 7.1 for relief of right side setback of 2.25' and left side setback of 2.44' and for relief of
lot dimension area of 43,120 sq. ft., in order to construct a 2nd floor consisting of bedrooms, baths, closets. And to
GRANT a Special Permit in order to construct the 2' floor addition of relief greater than 25% up to 45% of the total
existing area. LCondition #1'W: Hoffman wiiF not be allowed to_siart constriction for this addition until he ties into
tTowrt sewers e ,]Condition #2: In accordance with corrected plan of land indicating the_abutters location as Mr.
g .� — —'
(Djermoun who is located North of 44 Woodcrest, and Mr. Crittenden who is located South of 44 Woodcrest Drive�ln
accordance with Pian of Land by Scott L. Giles, #13972, Registered Land Surveyor, dated 3/9/99. Voting in favor:
Walter F. Soule, Raymond Vivenzio, John Pallone, Ellen McIntyre, Scott Karpinski.
The petitioner has satisfied the provision of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of
these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning
Bylaw.
Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure
the granting of a Building permit as the applicant must abide by all applicable local, state and federal and building
codes and regulations, prior to the issuance of a building permit as requested by the Building Commission.
ml/1999decisioni2
Board of Appeals,
Raymond Vivenzio ;tic
acting Chairman
Registry of Deeds
Northern District of Essex County
Lawrence, MA 01840
04/08199
vAar�N��
od
��- t
J 1J �
/ 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.
*****************************APPLICA-NT ftLLS OUT THIS SECTION****************""`*****
APPLICANTPHONE
LOCATION: Assessor's Map Number 103 PARCEL
SUBDIVISION LOT (S)
STREETo/0/7 .e_ ST. NUMBER
USE
JECOMMENDATIONS OF TOWN AGENTS:
CON E VATION ADMINIST R DATE APPROVED { 3
DATE REJECTED
COMMENTS
T )dN PL09i E1!�r_ /�" DATEAPPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWER/WATER CONNECTIONS }
i f W221"'!
DRIVEWAY PERNVT '
FIRE DEPARTMENT
�'ie.
RECEIVED BY BUJLDMIG 4NSPECTOR DATE
Revised 9197 jm
The Commonwedlth`of Massachusetts
Department of Industria! Accidents
Mice ullue5#92 laps
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
locatiom a -O/— f.tA-C�i14-1 S
hone
city /22—,'
FA 1. C:r Pi,gj.f n # )T
I am a homeowner pertormmg all work myself.
❑ I am a sole proprietor and have no one workine in any capacity
F1 I am an employer providing workers' compensation for my employees working on this job
COM oat, vr.aiae:
addres5:
city:" -e. /�is�.�SS
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:....:.:.:: . .
I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have
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City:
Phone*
insurxnccco.
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camanv. name:
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Failure to secure coverage as required under Section 25A of irIGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or
one years' imprisonment as well as civil penalties in the form of :t STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby
that the information provided above is true and correct
Print
official use only do not write in this area to be completed by city or town official
ctry or town:
[I check if immediate response is required
contact person:
(rcvixa 7/95. PIA)
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Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
WILLIAM J. SCOTT
Director
(978)688-9531 Fax(978)688-9542
In accordance with the provisions of MGL c 40 S 54, a condition of Building
Permit
Number is that the debris resulting from this work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL c 11, S
150 A.
The debris will be disposed of in:
(Location of Facility)
PermitApplicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through -the -Office of tale Building inspector
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 68&9535
uos ton v,_--massacnusetts.
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HOME IMPROVEMENT CONTRACTOf
iI Registration 100756
DSA
xPiration 06/23/00
CONSTRUCTION INC.
at i'J - Ru eta-
s `I..ADMINISTRATO
R 201MA'01841 :&elei,Street
Methuen 4
W,6
DEPARTMENT OF PUBLIC SAFETY
ONE ASHBURTON PLACE, RM 1301
BOSTON', MIA 02108-1618
CONSTRUCTION SUPERVISOR LICENSE
Number: Expires: Birthda.te-: 7
CS 025158 08/19/1999 08/15/195`6-'_.
Restricted To: 00
RICHARD J RUBERA
201 WHEELER ST
METHUEN, MA 01844 j
Keep top for receipt and change
of address notification.
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WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
1-.°
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TOWN OF NORTH ANDOVER
pt
_
PERMIT FOR PLUMBING
SSACHUS�
This certifies that ...
f-^........
has permission to perform ... .-) ........... .
plumbing in the buildings
of .. %�.�`: r� ,� r./w � . 4... .. .
at .......... . , North ' Andover, Mass.
Fee. ..: Lic. No...%
f
LB-I*NG INSPECT(SR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MAP-o3M A CSE SETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
N RTH nt4N )1)O MAS SETTS FORWARD
Date �C
Building Location LkLA � � Owners Name"-Aj�jPermit # Z106 L
Amount q 7
Type of Occupancy /1�Kkl/vp 1` e^1gVW-
New ZI Renovation ® Replacement ® Plans Submitted Yes ❑ No
FIXTURES
(Print or type)Check one: Certificate
Installing Company Name VP 0 Corp.
Address C!-� �
Business Telephone yq'; I Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance cdvkrage by checking the appropriate box:
Liability insurance policy El Other type of indemnity El Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I have submitted . ) ' ab ve application are true and accurate to the
best of my knowledge and that all plumbing work and ins io�~ erfo a it Issued for this application will be in
compliance with all pertinent provisions of the Massach in e d _
By: 7ig—n—aM ot Licenseaer
Type of Plumbing License "
Title Z (p -A
City/Town icense Numoer Master `{ Journeyman
APPROVED (OFFICE USE ONLY J��
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MMNMMMMMMMMMMMMMMMMMMMMMM
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(Print or type)Check one: Certificate
Installing Company Name VP 0 Corp.
Address C!-� �
Business Telephone yq'; I Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance cdvkrage by checking the appropriate box:
Liability insurance policy El Other type of indemnity El Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I have submitted . ) ' ab ve application are true and accurate to the
best of my knowledge and that all plumbing work and ins io�~ erfo a it Issued for this application will be in
compliance with all pertinent provisions of the Massach in e d _
By: 7ig—n—aM ot Licenseaer
Type of Plumbing License "
Title Z (p -A
City/Town icense Numoer Master `{ Journeyman
APPROVED (OFFICE USE ONLY J��
3207
Date ......
40RTk TOWN OF NORTH ANDOVER
Of t.... ...A
16
" PERMIT FOR GAS INSTALLATION
Z
This certifies that. :.�:-�� :°.. .. , ... • •
has permission for gas installation .. .......... <.
b
in the buildings of .. . �' /, f �.����.........................
at �`. '�...«,�; �• : ,� ;'•i.. ........ , North Andover, Mass.
Fee..?.? -i.-.. Lic. No...�:.?�.'.: :..f..:. .........
ASINSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MAP
FORWARD_—
1PLARCIEL O U
MASSACHUSETTS U�ORM APOITFO F
or print)
INUK I H ANDOVER, MASSACHUSETTS
DO GAS FITTING
Date '-(-,e
(-,e 1 19 ql
Building Locations 1 li-A 1 Vf-7-- Permit 9 ), 07
�f Amount S � � � ,_.
t'14 4,WOwner's Name � �_�_���,,��
New Renovation ® Replacement ❑ Plans Submitted ❑
(Print or type)
lM
Name of Licensed Plumber or Gas Fitter ice,, t— a en,—
Check one: Certificate Installing Company
❑ Corp.
Partner.
❑ Firm/Co.
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑
If you have checked ves, please indicate the type coverage by checking the appropriate box.
Liability insurance policy❑ Other type of indemnity ElBBond ❑
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 I have submitted (or entered) inove application are true and accurate to the
best of my knowledge and that all plumbing work and instar ns perfo 'prAjr PVrmit Issued for this application will be in
compliance with all pertinent provisions of the Massachutts S Gas �Cefdert4 ✓�pter 142 of the General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
Gas Fitter License Number
?. Master
Journeyman
Ml
13 RD. FLO OR
:4T H FLO OR
(Print or type)
lM
Name of Licensed Plumber or Gas Fitter ice,, t— a en,—
Check one: Certificate Installing Company
❑ Corp.
Partner.
❑ Firm/Co.
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑
If you have checked ves, please indicate the type coverage by checking the appropriate box.
Liability insurance policy❑ Other type of indemnity ElBBond ❑
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 I have submitted (or entered) inove application are true and accurate to the
best of my knowledge and that all plumbing work and instar ns perfo 'prAjr PVrmit Issued for this application will be in
compliance with all pertinent provisions of the Massachutts S Gas �Cefdert4 ✓�pter 142 of the General Laws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
Gas Fitter License Number
?. Master
Journeyman
0
new u. Renovation u Replacement l 1 _ Plans Submitted; Yes,!] No
B.P.# gE.WER#` . FIXTURES .SEPTIC.# `
Certificate #
:r
INSURANCE COVERAGE: ;
111 ar�ei' `ui y+N Oc„n,y Or I,&suGsuitlai efuiii�7iara lie i:��iBets u'iB req:iTetits 01, MGL Ch. 142.
Yes
!f ;ou-have, checkedyejrpleaasee!indicate the;type coverage,pY�checking.the.appropriate box.
f !:ability insurance pdicy L7 Other�typetoUIndemnity L7 Bond O
iMEWS INSURANCE 'WANER 'I am,aware that tlie-licensee does not -have the Insurance coverage required by
:apter 142 of the Mass. General laws, and that my signature on this permit application waives this requirement.
Check one:
Owner. p 4 Agent O
Signature of:Owner. or Owner's Agent
I 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 Plumbi wand -(;h t .1, f the.Ceneral Laws.
BY
litre MAR
2 7 '1996..gnature:o 4 a ce urti: r{
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Certificate #
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Owner. p 4 Agent O
Signature of:Owner. or Owner's Agent
I 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 Plumbi wand -(;h t .1, f the.Ceneral Laws.
BY
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2 7 '1996..gnature:o 4 a ce urti: r{
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Date. 7- °? - 9.
TOWN OF NORTH ANDOVER
p PERMIT FOR PLUMBING
,SSACMUS� This certifies that ..(21 .-D Q. is A/e 4A s, , , , h a,
has permission to perform ...D1.5 �/i wlyS�.C,R ................
plumbing in the buildingsof e;, ? e% ! .......... ... .
`- ..... North Andover, Mass.
Fee. ;Z a ± :... Lic... No..
G
PLUMBING INSP CTOR
WHITE: Applicant. 04101 MA;IUilding Depi P NK Treasurer' .. GOLD: File.
04; (901ntnaataeultll of :Massa C4Its ettv,
DepaHment (f Public Safety Permit No. _ C/ 1✓-.
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:0(1 -^e
Oaupanry 1t. 1,%. t h••(ke(I l
W (Ieasr blank)
APPLICATION FOR PERMIT TO PERFORM FLECTRICAL `YORK
All work to be perGumed in accordance with the Massachusetts rte( Iric al c .+r ".I' CMR 12:00
(PLEASE PRINT IN INK:OR TYPE ALL INFORMATION) .
City or Town of
The undersigned applies fora permit to perfoini the
Date
1r, the Incfx•rtnr of Wir---
Location (Street. R Ni unberl /-�,�/ 4420 O.D C 2 Es 7- Dg / d E
Owner or Tenant Sits /9 /) sr9 T i9 N S T,E i a�
Owners Address S Am E
Is this permit in conitinction with a building permit: Yes L1 No (Check Appropriate Box)
Purpose of Building Utility Autltn►isatinn No.
Exbtina Service -Amlx /vr
Wafts t7rhrxl ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts (Aerlx•.xl ❑ Undgrd ❑ No. of M(Kers
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work EPL AC E --ldz /S)yU)/l S H6te
OTHER-
INSURANCE
THER
INSURANCE COVERAGE: Pursuant to the requirements of Massachttcttes General Laws
1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial — fuivalent. YES G NO r uhmitiod v.,lid pr,
of same.to this office. YES 11 NO ❑
If you hive checked YES, please Indicate the type of coverage by checking the appropriate I>)%.
INSURANCE aBOND ❑ OTHER❑ (Please Specify) /V f / L E
(Expiration Dale)
Estimated Value of Electrical Work $
Work to Start
Signed under the penalties of perjury:
FIRM NAME
Inspection Date Requested: Rough
Final
LIC. NO. / / Z I% If
.Llcenfee "WU%##%'Q► wtreru{ cur Sight LIC. NO.
WWA 61313a 23 air: SIL
Address..�. wt a �.•�.,.. Bus. Tel. No.
1.603,,362.4065 Alt. Tel. No.
.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance r(w-,. c:r (n its r,tt,.tantial Pquivaleni as required by Massarhusetts
.General Laws, and that my signature on this permit application waives this requirement. (Avner '\$—Ilt (Please check ones
Telephone No. PERMIT Ff F S ��rd
(Signature of (Avner or Agent)
TOI AL
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers KVA
Above in- l
❑ L_I
No. of Lighting Fixtures
SwimmingPool rnd. •rn(l.
c:-•nerators KVA _
'4o. of Emergency Lighhll!:
No. of Receptacle Outlets
No. of Oil Burners
Millery Units
No. of Switch Outlets
No. of Gas Burners
rtPF ALARMS No. of 7ones
No. of Detection and
eta
No. of Ranges
No. of Air Conditioners Tons
Initiating Devices
No, of Sounding Dt•vi( —
Heal Total 111.1
No. of Disposals.
No. of Pum Tons KW _
v,,. of Self Containr,l
l )elcctionfSrwn ding I Vvil r•.
No. of Dishwashers
S acrlArea I leatin KWA,
i-mrip..I
lixalD Connection O(Pher
No. of Dryers
Heating DevictK KW
No. of o. of
I., Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No Hydro Massage Tubs
No of Motors Total HP
-
OTHER-
INSURANCE
THER
INSURANCE COVERAGE: Pursuant to the requirements of Massachttcttes General Laws
1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial — fuivalent. YES G NO r uhmitiod v.,lid pr,
of same.to this office. YES 11 NO ❑
If you hive checked YES, please Indicate the type of coverage by checking the appropriate I>)%.
INSURANCE aBOND ❑ OTHER❑ (Please Specify) /V f / L E
(Expiration Dale)
Estimated Value of Electrical Work $
Work to Start
Signed under the penalties of perjury:
FIRM NAME
Inspection Date Requested: Rough
Final
LIC. NO. / / Z I% If
.Llcenfee "WU%##%'Q► wtreru{ cur Sight LIC. NO.
WWA 61313a 23 air: SIL
Address..�. wt a �.•�.,.. Bus. Tel. No.
1.603,,362.4065 Alt. Tel. No.
.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance r(w-,. c:r (n its r,tt,.tantial Pquivaleni as required by Massarhusetts
.General Laws, and that my signature on this permit application waives this requirement. (Avner '\$—Ilt (Please check ones
Telephone No. PERMIT Ff F S ��rd
(Signature of (Avner or Agent)
Date........ 9y
HORTy-
a� e� 0 TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
L •. g
,SSACMUS�
This certifies that
....C� .........
.
has permission to perform I�: E'.�..�.5�.�.P.: 0,'.,�`: mcl 5.,.„ Z
wiring in the building of ...1. t..e.t.a?..�� ....u1:..�-,f'.....
..
at La. � �+ !?i??.. �� North Andover Mass. W
......................................... .
.... Lic. No. /`e .�
Fee :.. .�........ .................:.......................................:....... ......
0
ELECTRICAL INSPECTOR `
WHITE:'�Applicant, CANARY: Building Dept. PINK: Treasurer.. GOLD: File .
No 1795
Date...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
N ...... 5
�A.� q � it ci a(,( cc) -
This certifies that ... I---
....................................................................
has permission to perform .....e e �!OA.( ..................... e ...........................
t= wiring in the building of ........ Ti ..... O.o.f:. M ct.....
1,4 ...............................
.......
at77. . ....... ......... ............ ,�fNorth
-9 , rass.
Lic. No./11;.F.lz�?, ............. ..... ........ ......
Fee ...... ��(
I" ELEC
It- , TRICAL
70 -
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
� � y
Office Use Only
u �13�t11' Permit No.
lRepmml:tlt of Public —Aahtg Occupancy & Fee Checked (�
T BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE AL � INTORMATION) Date U
City or Town of `d' / J'L,To
The udersigned applies for a permit to perform
� the lectrical work des 'bed below. MAP
Location (Street & Number) �"
/'.
PC
Owner or Tenant .Jb J
LL
Owner's Address
Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps ! Volts Overhead ❑ Undgrnd ❑ No. of Meters
New Service Amps _ I Volts Overhead ❑ Undgrnd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
a
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total
KVA
No. of Lighting Fixtures
__
/
//„
G 0
Swimming Pool Above
grnd. ❑
In-
grnd. ❑
Generators KVA
/�
No. of Emergency Lighting
No. of Receptacle Outlets
V
No. of Oil Burners
I Battery Units
No. of Switch Outlets
I No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection andtons
No. of Ranges
No. of Air Cond. Total
Initiating Devices
No. of Disposals
Heat Total Total
( No of
Pumps Tons
KW
No. of Sounding Devices
No. of Self Conta' ed
---rSpace/Area
No. of Dishwashers
Heating
KW
Detection/So ding Devices
Local unicipal ❑ Other
No. of Dryers
Heating Devices KW
Connection
No. of No. of
Low Voltage
No. of Water Heaters
KW
Signs Ballasts
Wiring
No. Hydro Massage Tubs
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES X NO C I
have submitted valid proof of same to the Office. YES X NO C If you have checked YES, please indicate the type of coverage by
checking the appropriate box.
INSURANCE X BOND ❑ OTHER ❑ (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work $
Work to Start Inspection Date Requested: Rough Final
Signed under the Penal—ties of perjury. ' �
FIRM NAME �%8� �G/�C %/PSC �y �A
Licensee S. %�• �.%vRA ,T2 Sionature
LIC. NO. S '3-S
LIC. NO. �•S%� 3
�/IUiOZ11F y�l ua. Tel. No. ro
Address .Ec% 6;� ,e5- yc— k /J /�o. ��'�l� Alt. Tel. No.
OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one)
(Signature of Owner or Agent)
Telephone No. PERMIT FEE $ T✓, av
X-6565