HomeMy WebLinkAboutMiscellaneous - 475 STEVENS STREET 4/30/2018 SSR�E�
_4"15 sl �-t S
p051.0000.0
21010
1
1
i
ii
i
I
I
E
i
I
I'
i
i
WSafety Insurance
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845
i., RE: _ Insured: GINA M HOLT and WILLIAM HOLT
Property Address: 475-477 STEVENS STREET,NORTH ANDOVER,MA
Policy Number: HMA 0084333
Claim Number: BOS00045938
Date of Loss: 5/1/2014
Company: Safety Insurance Company
Claim has been made involving loss, damage or destruction of the above-captioned property,
which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be
applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please
direct it to the attention of the writer and include a reference to the captioned insured, location,
policy number,date of loss and claim number.
Lisa Monette Claim Examiner 10/29/2014
Safety Insurance Company
Homeowners Claims Unit
P. 0. Box 55098
Boston, MA 02205-5098
Phone: (857)233-8618
Fax: (617) 535-5833
Email: lisamonette@safetyinsurance.com
i
Safety Insurance
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER, MA 001845- NORTH ANDOVER, MA 001845-
RE: Insured: GINA M HOLT and WILLIAM HOLT
Property Address: 475-477 STEVENS STREET,NORTH ANDOVER, MA
Policy Number: HMA 0084333
Claim Number: BOS00045789
Date of Loss: 10/23/2014
Company: Safety Insurance Company
Claim has been m v -
made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be
applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate,please
direct it to the attention of the writer and include a reference to the captioned insured, location,
policy number, date of loss and claim number.
Lisa Monette Claim Examiner 10/24/2014
I
Safety Insurance Company
Homeowners Claims Unit
P. 0. Box 55098
Boston, MA 02205-5098
Phone: (857)233-8618
Fax: (617) 535-5833
Email: lisamonette@safetyinsurance.com
1-7
Location / -
i
No. Date
,.oRTti TOWN OF NORTH ANDOVER
9
` Certificate of Occupancy $
Building/Frame/Frame Permit Fee $
s.qcMust 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check # G 7
O Building i Zpector
.t s
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
,' '.-- ,;:r:• ..,. -� „r. _.... .., ,. .... ,.... 'B'.!'t7'P �-r fix `R:?a•" '�t�.'s
BUILDING PERMIT NUMBER. DATE ISSUED: la X
SIGNATURE:
Building Commissionerfl for 6TBuildhigs Date &ZLO v Z
SECTION 1-SITE INFORMATION O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
S17,S - y77. .V eVens sY
Map Number Parcel Number C
!/0 2 Tfi gna/a✓G t- /YI" rSS _ 11
1.3 Zoning Information: 1.4 Property Dimensions:
A3 /iao s-5
Zoning District Proposed Use Lot Area 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 Zone Information: 1.8 Sewerage Disposal System:
Public X Private ❑ ZOIle Outside Flood Zone ❑ Municipal On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m
2.1 Owner of Record
se
Name(Print) Address for Service: r
Aa 72Y
Si re Telephone
2.2 Owner of Record:
Name Print Address for Service: O
Z
M
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor:
License Number
M
Address
Expiration Date E
Signature Telephone r
3.2 Registered Home Improvement Contractor Not Applicable ❑ v
Company Name M
Registration Number r
Address
z
Expiration Date /1
Signature Telephone �l/
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 r
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes.......0 No.......❑
SECTION 5 Description of Proposed Work check all a Ucable
New Construction 0 Existing Building W Repair(s) Alterations(s) Addition A�
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
X_3a
Ar1, f nA,c- F__
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be (?FFI IAL USE bNLY
Completed by pennit applicant
1. BuildingZ°�o (a) Building Permit Fee
H
r)op 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 AUTHORIZATIO14 TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, I 1 as Owner/Authorized Agent of subject property
Hereby authorize to act on
My b f,inkill afters relative wor uthorized by this building permit application.
ri atur o 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 Name
Signature of Own er/A ent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB c U—Qx,
SIZE OF FLOOR TIMBERS a X 1 2 3RD
SPAN
DEVIENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CH]NMY
IS BUILDING ON SOLID OR FILLED LAND 5o��
IS BUILDING CONNECTED TO NATURAL GAS LINE
r
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number J-�3 I Date
THUSCERTIFIES THAT /
THE BUILDING LOCATED ON " 116
,16` 17 fI '� Ty�N='
MAY BE OCCUPIED AS17v 0 le 56 ��1�4 IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
01 "°"'".'�° CERTIFICATE ISSUED TO _. U11111 -1p7
00 p ADDRESS y 7L5- `9 17 6 7`e v-e'�
�''"CNub`` Building Inspector
i ^Vy
1
r N R,T�y `
0Tof
4
Andover
No.4,13 / -
�` Z y 00
"L o dover, Mass. J 0-
o . LA
. 'rA COLIKICIIE WICK � � 1
04
.9S A T E O i`RM ID PE
BOARD OF HEALTH
f{ Food/Kitchen
i I Septic System /Y/'! "
THIS CERTIFIES THAT......W.�. /� /� Gi ��A �OBUILDING INSPECTOR
.............................................
has permission to erect.. �'����� buildings on:.7 f Foundation
.��.. . ... .......................5....� .. d rion
to be occupied as... C. P�f` Z BA.... 1�_11 O.O Roug
..:............................................................. Chimney �{✓
provided that the person accepting his permit shat in every respect conform to the terms of the application on file in 0�i�
�f—
this office, and to the provisions of the Codes and By-Laws relatin to the Inspectio , Alteration and Construction of Finale - J
Buildings in the Town of North Andover. �M I ,
1 • PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS
�NS-FR ;C ON STtlTo�
tELECrRI ALMPE
Gt�
, ... .....
,' ', BUILDING INSPECTOR � /
r ` r I r
to
i final
a gry
campy ild inn
_.._.._._ GAS INSPECTOR
Display in a Conspicuous f �, Rough
p Place on the Premises ,I;: Do Not Remove n ,z;
No Lathingor D Wall Dry a I To Be.Donp
Until Inspected and Approved by the Buildi Inspector. FIRE DEPARTMENT
r!i Burner L ,nom
+ Street No.
Smoke Det
SEE REVERSE SIDE I s
-----� l;�' . � ! /
FORM - U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
APPLICANT Ly;//,A,r 6,�.-�Q �`�LT PHONE
ASSESSORS MAP NUMBER LOT NUMBER
SUBDIVISION LOT NUMBER
STREET STREET NUMBER 417,5- - y7 7
OFFICIAL USE ONLY
RECONS EENDATIONS OF TOWN AGENTS
"I mammon
r lh^ s DATE APPROVED
CO SERVATION ADMINISTRATOR
DATE REJECTED
CONOAENTS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
CONMIENIS
DATE APPROVED
FOOD INSPECTOR
HEALTH DATE REJECTED Q
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS &—X) P�
PUBLIC WORKS—SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR DATE
"°"T"
Town of North Andover '
Building Department
27 Charles Street
North Andover, MA. 01845
D. Robert Nicetta '�,' °.•�`�g
SSAC S4�
Building Commissioner
(978) 688-9545
978 688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print
DATEp_ 7/ -7 e)6
i
JOB LOCATION
Number �n ST
Street Address
Map/lot
"HOMEOWNER O/T
Name
Home Phone
Work Phone
PRESENT MAILING ADDRESS ?S
�tve"75 .
City Town
State i
Zp Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings
of two 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 108.3.5.1)
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 or two 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.
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 OFFICIAL
a ,
a
P Reilistry of Deeds
Northern District of Essex County.
Lawrence, SIA 01840
1 09/06/00
wILLIm & GINA HOLT AN
D 54 Rec: Type FLAN 1 ,00
1. Inst 24640
Copies . 1.25
+" # 55 Recn Type DECSN' 10.00'
Inst 24.641
!:r!i r
+' Total 24.25
8 •56 Payment Check
THANK .'OU! Thomas J. Burke
i Register of Deeds
� i 4F
I
Ii -
�. A
RECEIVED
T JOYCE BRADSHAW
TOWN CLERK
;I
I � , ,,;�: •�• NORTH ANDOVER'
2000 AUG 15 P 1: S 8
I
North Andover
Zoning Board of Appeals
27 Charles Street
`! North Andover, Massachusetts 01845
Phone (978) 688-9541 Fax(978) 688-9542
-�, Any appeals shall be filed NOTICE OF DECISION
g within(20)days after the Year 2000
date of filing of this notice Property at:475-477-Stevens Street
in the office of the Town Clerk
NAN E: William&Gina Holt DATE:8/10/2000
Jqup'; �h ADDRESS: 475-477 Stevens Street PETITION: 019-2000
f
North Andover,MA 01845
HEARING:6/20/2000, 7/11, 7/24,& 8/8/2000
W" ?
The Board of A
� ppeals held a regular meeting on Tuesday,August 8,2000,at 7:30 upon the application of William&
y Gina Holt,475477 Stevens Street,North Andover,MA. Petitioner is requesting a Variance from the requirements
.'± of S7,P 7.1&7.2&7.3 for relief of a front,side and rear setback,and for a Special Permit from Section 9,P 9.1 &9.2
in order to construct a deck and add 2 bedrooms and dormers to the attic on a pre-existing non-conforming structure
within the R-3 Zoning District.
The following members were present:William J.SullivanScott
i" , Karpinski,Ellen McIntyre,George Earley.
"'Upon a moonmade KScott mski and 2"d by Ellen McIntyre,the Board voted to GRANT a dimensional
X Variance from S7,P7.2,&7.3�for prelief of street frontage of 70',relief of front setback of 22',relief of a side setback
;6 of 11.8',relief of rear setback of 5.4',in order to construct a deck to the rear of the property,and add 2 bedrooms and
i' dormers to the attic,on the condition that the proposed roof not exist higher than 22.6'in accordance with the Plan of
Land by:James Franklin,PLS,#37045,and in accordance with elevation drawings by:New England Engineering
Services,Inc.,dated 7/28/2000 file#390-2,390-3,3904. The Board voted to GRANT a Special Permit from S9,
P9.1&9.2 in order to alter an existing non-conforming structure on a non-conforming lot. Voting in favor: William J.
^; Sullivan,Scott Karpinski,Ellen McIntyre,and George Earley.
The ZoningBoard of '
Appeals shall have power upon appeal to grant variances from the terms of this Zoning Bylaw where the Board
'a
findsthat owning to circumstances relatingto soil conditions,shape,ortop go'
raphy ofthe land or structure and especially affecting
such land or structures but not affecting generally the zoning district in general,a literal enforcement of the provisions of this Bylaw
will involve substantial hardship,financial or otherwise,to the petitioner or applicant,and that desirable relief may be
substantial detriment to the public good and without nullifying or substamtisil deco m from the intent or y granted without
4 y, ,,Bim• g Purpose of this Bylaw..
Furthermore,if the rights authorized by the variance are not exercised withir;orie(1)year of the date of the grant,they shall lapse,and
-il may be re-established only after notice,and a new hearing. Furthermore,if a Special Permit
.ganted under the provisions contained
} herein shall be deemed to have lapsed after a two(2)year period from the date o1A which the Special Permit was granted unless
substantial use or construction has commenced,they shall lapse and may be iterestablished only after notice,and a new hearing.
.R r By order ofthe Z ing lard of Appeals,
L
1 V William'J.Sulliv ;Chairman
¢ ml/decisions2000/31 1'
Town of North Andoverof NORTH
�Z h. 'd• " ' E 0
Building Department o
27 Charles Street 4 _
North Andover, Massachusetts 01845 4
(978) 688-9545 Fax (978) 688-9542 40
R9TED '
�SSACNUS�� .
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 s 54, and a condition of
Building permit# the debris resulting from the 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/at:
Facility location
Signature of Applicant
�il � 1�a•�
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
- - 8'-6'
14'-7' . wn _
FM EXISTING ROOF LINE
PROPOSED RIGHT H
SIDE ELEVATION
FOR PROPERTY LOCATED AT
475-477 STEVENS STREET
NORTH ANDOVER, MA
PREPARED FOR GINA HOLT
477 STEVENS STREET
NORTH ANDOVER, MA 01845
SCALE: 1/4" = 1' JULY 28, 2000
31' N W ENGLAND ENGINEERING SERVICES, INC.
60 BEECHWOOD DRJVE
E NORTH ANDOVER, MASSACHUSETTS
(978) 686-1768:
DRAWN PAGE CHECKED L
BY: S.B. #: .4 BY: B.C.O..X.
FILE #:
BY* OLD.Jr.
REVISED
NORTH
Town of
4.. Andover
No.(S,3 =; x
�'
O =-_ o dower Mass.
D y 409P409PCOC CA MICHEWICK 1 1
A�RATEO P C-1
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT......��.�/��'� � ���i0'.......�0/
.......................................... Foundation
has permission to erect. I�w�� �.._ buildings on ..7... � �7 .S�''V'Ws Rough
..................... .
to be occupied as...I/VA9 � Z &A P0� 401#jW qj0 0Q Chimney
•f !k
. . .... . . . ... .. . .... ....................................................................................
provided that the person accepting his peril! in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relatin to the Inspectio , Alteration and Construction of
Buildings in the Town of North Andover. to 'A PLUMBING INSPECTOR
S I a bi�
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION ST TSELECTRICAL INSPECTOR
t gh
�...M......... ............................................................ Service
BUILDING INSPECTOR
Final
Occupancy Permit required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Re Rough
P move Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. Burner
FlRE DEPARTMENT
Street No.
SEE REVERSE SIDE Smoke Det.
NOTES:
' .1 . PLAN REFERENCE: Plans ' recorded- at
Essex North Registry of Deeds, Plan # 2791'.
2: For title reference, see deed recorded at Essex
' U? my North Registry of Deeds; Book 557; -Page 279.
3. Property" information and' -dwelling location taken
from .plan #2791 , recorded at Essex North
' Registry of Deeds
11 .5' OFO4. This property is 'located in the R-3 zoning
pR' ED district.
' DECK 2
2
9.3' 9.3'
THIS PLAN CONFORMS ' TO THE RULES -AND
REGULATIONS OF THE REGISTRY OF DEEDS.
EX!STING 41,- EXISTING �
tv DWELLING o ?� DWELLING o /j�/
Cn rn .
o o ao
DATE: NAME:
10
8.9 g g' LOCUS PLAN SCALE: 1 " = 500'
7.7,_J 35.16 7.7' 35.16 \
020.00' 020. 00' T ��
STEVENS STREET STEVEN
S STREET f .�
-
PROPOSED DWELLfNG ACADEMY \\
LN
EXISTING DWELLING LOCATION
LOCATION
FOR REGISTRY USE ONLY S!TE
TOWNOF f�ORT� ANDOVER
BOARD OF APPEALS rPSS/ I
DWELLING
DATE: LOCATION PLAN
r r FOR PROPERTY LOCATED AT
475-477 STEVENS STREET
NORTH ANDOVER, MA
— PREPARED FOR GINA. HOLT
f
SCALE: 1" = 20' MAY 8, ' 2000
.% N EW ENGLAND ENGINEERING SERVICES, INC.
60 BEECHWOOD DRIVE
~ y . NORTH ANDOVER, MASSACHUSETTS
(978) 686-1768
20' 20' 40' Y DRAWN PAGE I CHECKS
60' �'� 1" 50. 4G
BY: i #: BY: J I�iI &
- --- - ----- - ---- S -1P` FILE:#: DESIGN
390 BY. if.r. & P.C.O. Jr..
^ f
I
1
`I
,I.
22'-6'±
! 14'-7"
!I
EXISTING FRONT
ELEVATION
FOR PROPERTY LOCATED AT
475-477 STEVENS STREET
NORTH ANDOVER, MA
PREPARED FOR GINA HOLT
477 STEVENS STREET
NORTH ANDOVER, MA 01845
SCALE: 1/4 = 1' MAY 8, 2000
NEW ENGLAND ENGINEERING SERVICES, INC.
60 BEECHWOOD DRIVE
37' NORTH ANDOVER, MASSACHUSETTS
(978) 686-1768
DRAWN PAGE CHECKED
BY: S,C3, #: BY: P.C'o' lk,
DESIGN Jr+ FILE #: OSI BY: 13,C,O, Jf
REVISED
s
t t t c t
s
22'-6"f
14'-7"
EXISTING RIGHT
SIDE ELEVATION
FOR PROPERTY LOCATED AT
475-477 STEVENS STREET
NORTH ANDOVER, MA
PREPARED FOR GINA HOLT
477 STEVENS STREET
NORTH ANDOVER, MA 01845
SCALE: 1/4" = 1' MAY 8, 2000
31' N W ENGLAND ENGINEERING SERVICES, INC.
60 BEECHWOOD DRIVE
NORTH ANDOVER, MASSACHUSETTS
(978) 686-1768
DRAWN PAGE CHECKED r IY
BY: 513, #: 3 BY:
FILE #: DESIGN
BY13.C,O, Jr,
REVISED
Location
No. Date ,
NORTH TOWN OF NORTH ANDOVER
0;� .ao ;a,h•0
3? •. a O
9
t
+ ; , Certificate of Occupancy $
41
NU E<�' Building/Frame Permit Fee $
�CS
Foundation Permit Fee $
Other Permit Fee $
,-
TOTAL $ /11
Check #
/N /
+
1 37n- R" Building nspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED: Fn
-7
SIGNATURE:
Buildin Commi loner/I for of Buildings Date
SECTION 1-SITE INFORMATION Z
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
/2 s 5`7 2 5Lwe_y1sLV ' C�/
,C(1 • A6�o I/ � ��J 5 .5
Map Number C� Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
ZoningDistrict Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide R 'red Provided -Required Provided
1.7 Water Supply M.G.L.C.40. 54) Zone 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
2.1 Owner of Record
Name(Print) Address for Service
Cf 2 6- Z
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone .
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor:
1 License Number
Address Mn
i
Signature Telephone Expiration Date
3.2 Registered Home Improvement Contractor Not Applicable ❑
i
Company Name
Registration Number M
Address r
Expiration Date ^z
Signature Telephone V
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......E No.......❑
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: (�
��P liln O J-e oZ S (J-e Pq"C p S
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be t3FFICIA USE t}NLY"
Completed by permit applicant
1. Building (a) Building Permit Fee
Multi Tier
2 Electrical (b) Estimated Total Cost of / Q 9 6 �—
Construction l a ���0
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 AUTHORIZA TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT
1 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
1 as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name
Signature of Owner/A ent Date i
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIIVIBERS 1 2 3
RD
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
NORTH
Town of North Andover ?°•' "•"°
3, a._•,r • Oc
Building Department p
27 Charles Street
North Andover, MA. 01845 'ssNC`C .•���g
MUSB
D. Robert Nicetta
Building Commissioner
(978) 688-9545
(978) 688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print`
DATE
JOB LOCATION
Number Street Address Map/lot
"HOMEOWNER
Name Home Phone Work Phone
PRESENT MAILING ADDRESS �2'
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings
of two 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 108.3.5.1)
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 or two 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.
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 OFFICIAL
BUILDING DEPART\ii T
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A
The debris will be disposed of in:
Location of Facility
Signature of Permit Applicant
Da
NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of
the Building Inspector
NORTH
cTo" ' o _ 4Andover
O �� ti •�•
..
.......
...............
....
Zo
EµORTh 1
Zoning Bylaw Review Form
" J Town Of North Andover Building Department
" 9 �r' 27 Charles St. North Andover, MA. 01845
SMCHUSE Phone 978-688-9545 Fax 978-688-9542
Street: 47-5---n477'Stevens-St
Ma /Lot: 96/51
Applicant: William&Gina Holt
Request: Extension of non-conforming lot for V floor addition and rear deck
Date: 5/22/00
Please be advised that after review of your Application and Plans your Application is
DENIED for the following Zoning Bylaw reasons:
Zoning
Item Notes Item Notes
A I Lot Area F Frontage
1 Lot area Insufficient Yes 1 Frontage Insufficient Yes
2 Lot Area Preexisting Yes 2 Frontage Complies
3 Lot Area Complies 3 Preexisting frontage Yes
4 Insufficient Information 4 Insufficient Information
B Use 5 No access over Frontage
1 Allowed Yes G Contiguous Building Area
2 Not Allowed 1 Insufficient Area
3 Use Preexisting 2 Complies
4 Special Permit Required 3 Preexisting CBA Yes
5 Insufficient Information 4 Insufficient Information
C Setback H Building Height
1 All setbacks comply 1 Height Exceeds Maximum
2 Front Insufficient Yes 2 Complies Yes
3 Left Side Insufficient Yes 3 Preexisting Height Yes
4 Right Side Insufficient Yes 4 Insufficient Information
5 Rear Insufficient Yes i Building Coverage
6 Preexisting setback(s) Yes 1 Coverage exceeds maximum
7 Insufficient Information 2 Coverage Complies
D Watershed 3 Coverage Preexisting Yes
1 Not in Watershed yes 4 Insufficient Information
2 In Watershed j Sign
3 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 Yes 2 Parking Complies
3 Insufficient Information
Remedy for the above is checked below.
Item # Special Permits Planning Board Item # Variance
Site Plan Review Special Permit C/3,4,5 Setback Variance
Access other than Frontage Special Permit Parking Variance
Frontage Exception Lot Special Permit Lot Area Variance
Common Driveway Special Permit Height Variance
Congregate Housing Special Permit Variance for Sigh
Continuing Care Retirement Special Permit Special Permits Zoning Board
Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA
Large Estate Condo Special Permit Earth Removal Special Permit ZBA
Planned Development District Special Permit Special Permit Use not Listed but Similar
Planned Residential Special Permit Special Permit for Sign
R-6 Density Special Permit A,1,2 Other Special Permit non-conforming lot
&C,6
Watershed Special Permit Supply Additional Information
i
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 uilding department will retain all plans and documentation for the above file.
c � ,5— D c57 as`Q o
uilding Department Official Signature Application Received Application Denied
Denial Sent: If Faxed Phone Number/Date:
r
w
Plan Review Narrative
The following narrative is provided to further explain the reasons for denial for the application for
the property indicated on the reverse side:
Rein R�asons:for Denial
Y
Reference
Y
A&C A special permit is required for the extension of a preexisting nonconforming
lot due to the frontage, front and side setbacks and area of this parcel.
C3,4,5 A variance is required for the side and rear setbacks on the proposed rear deck.
Referred To:
Fire Health
Police Zoning Board
Conservation Department of Public Works
Planning Historical Commission
Other BUILDING DEPT
ZoningBylawDenia12000
I
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY D LLING
BUILDING PERMIT NUMBER. DATE ISSUED:
SIGNATURE:
Building Commissioner/Inspector of Buildin ate
SECTION 1-SITE INFORMATION
1.1 Property Address: and Par 1 Number:
1-1-nls- -�H� � , o
Map umber Parcel Number
1.3 Zoning Information: 1. Property Dimensions: _
� } 51
ZoningDistrict Proposed Use Lot Ar s Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
'71. 44c'
1.7 Water Supply M.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 ❑ J
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
2.1 Owner of Record
11 ;CAM °�-G C�CA
Name(Print) Address for Service:
AVe2
ga- 5
Signature Telephone
2.2 Owner of Record: G
Name Print Address for Service:
z
M
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor:
License Number
On
Address
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑ �®
Company Name r r frn
Registration Number . 1 i W2820 i r—
P
Address
Expiration Date G)
Si nature Tele hone
t
e r
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 check all applicable)
New Construction ❑ Existing Building 0 Repair(s) ❑ Alterations(s) Addition 0
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
ECEMU 7�Sldl i e
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be w �'OM, CIALUSE ONLY
Completed by permit applicant
1. Building , C�� (a) Building Permit Fee
Uo Multiplier
2 Electrical (b)(b) Estimated Total Cost of
3 Construction
3 Plumbing 000, ° Building Permit fee(a)X (b)
4 Mechanical HVAC °L
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
I
Hereby authorize to act on
My behalf,in all matters relative to work authorized by this building pennit 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 Name
Signature of Owner/Agent Date
I 1:11i!I OSBORN
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1ST2ND 3PD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL,OF CHININEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
FORM U - LOT RELEASE FORM
f �
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
APPLICANT ���� PHONE
LOCATION: Assessor's Map Number PARCEL ��
SUBDIVISION LOT (S)
ST. NUMBER
STREET
OFFICIAL USE
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR 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
8
FIRE DEPARTMENT ►t� 1 2 200
RECEIVED BY BUILDING INSPECTOR DAT, TTI 7
Revised 9\97 im
BUILDING DEPARTMENT
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in a property licensed solid waste disposal facility as
defined by MGL c 11, S 150A
The debris will be disposed of in:
-CACJ�ra 11-1)�
Lo 101
n of Facility
Signature of Permit Applicant
i Date
NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of .
the Building Inspector
r.
t
e
KORTI{
,use.
iTown of North Andover ° • °
Building Department �a•• w •
27 Charles Street x•
North Andover, MA. 01845 '•����'��
1SSwtMt35�t
D. Robert Nicetta
Building Commissioner
.(978) 688-9545
978) 688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print
DATE 5 a�
JOB LOCATION
Number Street Address Map/lot
"HOMEOWNER w6a
Name Home Phone Work Phone
PRESENT MAILING ADDRESS H-�J Ske\Pm l S (Qt�
11.00,60"1
, K')G O
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings
of two 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 108.3.5.1)
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 or two 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.
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 OFFICIAL
i
no -LU �.,
CARLBetter S N �
11�
� , APR
REAL ESTATE ffl nMMe @ � I 5 000
SCHRUENDER DIVISION 73 Chickering Road(Rt. 125/133), North Andover, MA 0 :845(978)685-5000 Fax;(9;78)685-5900
April 5, 2000
Building Inspection
Town of North Andover
North Andover, MA 01845
TO WHOM IT MIGHT CONCERN:
Please be advised that I looked at the application for 475-477
Stevens Street and in my opinion the home is not in the Historical
District. It therefore does not need approval from the Olde Center
Historical Commission.
Any questions please call me at 978 685 5000.
Sincerely,
i
George H. Schruender, Jr.
Chairman
North Andover Historical Commission
MORTGAGE INSPECTION PLAN
BARRY M. SULLIVAN P,L,S,
45 LEWIS ST,
• READING, MA, 01867
OF
ARRY
a St9 AVAN
�A No. `•2$ L/
V7r) qr
�l
� aorta s I�p�.s S v
c 1o�Ge- (oz, — 3 � NtS onL
5-AW D
04 d)
Ik
w
,GOT S
O �
-30�� h� s
v
M A KS 1-0 A `6 1—
?fit -
4z75- g77
� y- I Ary i-1 i \00
rd a.e tM 4o1T ,AX�o .Q
Gzbl� zpo Wl f--utL p
It�'r S�e eQ ,'o n vh a ✓� //�,,��
�'oZ ►=nov� Gablc 06
P.�IdR '4e 7 9
lx�
- zoo I
THIS TAPE SURVEY, CERTIFICATION & MORTGAGE INSPECTION PLAN ARE MADE FOR
THE USE OF FOR MORTGAGE PURPOSES ONLY
BASED ON MY KNOWLEDGE INFORMATION & BELIEF, I CERTIFY THAT THE BUILDING
� GVCITYSNF❑RM (S) TO THE ZONING BY-LAWS (DIMENSIONAL REQUIREMENTS) [IF THE
OF "1&T/1 AAlooV6'R MASSACHUSETTS
THE STRUCTURE (S) IS/ARE V�ff-- IN THE SPECIAL FLOOD HAZARD AREA AS SHOWN
ON THE FEDERAL .EMERGENCY MANAGEMENT AGENCY MAP OF THE /CITY ❑F
�c/a2Ti5�/��lIDOVER MASSACHUSETTS
COMMUNITY PANEL NUMBER_ zS009B
FLOOD INSURANCE RATE MAP EFFECTIVE DATE
f
qlh�W
/CITY DATE REGISTRY REFERENCE SCALE
• ,t/o2ry.I��OovER 8/x//999 ,GSScX 1 IN.= /h