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HomeMy WebLinkAboutMiscellaneous - 51 BRIGHTWOOD AVENUE 4/30/2018 51 BRIGHTWOOD AVENUE 210/066.0-0022-0000.0 1 Ccmmerce InsurancesM The Commerce Insurance CcmpanySM Cac Citation Insurance Company SM SM Members of The Commerce Group,Inc.' CLAIMS DEPT. 11 Gore Road,Webster,Massachusetts 01570 (508)949-1500 www.Commerceinsurance.com October 25, 2011 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall NORTH ANDOVER MA 01845 RE: Our Insured: KENNETH DONOVAN/JEANNE DONOVAN Property Address: 51 BRIGHTWOOD AVE Policy#: BCLSLN Date of Loss: 10/23/2011 File#: XXV294-VTTJ55 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. GEORGE MILIOS Telephone: (508)949-1500 Ext: 11423 Claim Rep II,Physical Damage Toll Free: 1-800-221-1605, Ext:11423 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above,by first class mail. October 25, 2011 CcmmCrc Ccmpanies ..COME GROW WITH us CIC 254 (Rev.4/95) MAIL I48 !f Location No. Date MORTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ " Other Permit Fee $ TOTAL $ ti Check # 17822 Building InspecctW l W TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING v �x - rn BUILDING PERMIT NUMBER. DATE ISSUED: a-1c SIGNATURE: 1 .••� Building Commissioner/IEELiEtor of Buildings Date SECTION i-SITE INFORMATION IO 1.1 Property dress-- 1.2 Assessors Map and Parcel Number: .i C Wocr-i qqvk—.,- C) Map Num Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Rater Supply M.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record Ao-" Name( rint), Address for Service Signator Telephone 2.2 01,wer of Reco i Os Name Print Address for Service: rn Signature Tele one 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicabl ❑ Licensed Construction Supervisor: License Number wn Address Expiration Date Signature TelephoneJL r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number Address r Expiration Date ^ Signature Telephone Y/ i 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 au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) . ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: a SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be QFFTCIAL 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(e) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION 1b BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, W as Owner/Authorized Agent of subject property Hereby a th IJV )" `� CA' to act on My beha ;in all matters relative to work authorized by this building permit application bLJ Si ature of er Date ` SECTION 7b OWNERIAUTHORIZED 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/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB < SIZE OF FLOOR TINMERS 1 sT 2 ND 3 RD SPAN DEMENSIONS OF SILLS DIN ENSIONS OF POSTS DIN,IENSIONS 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 No. - - LA dover, Mass., z COCHICHEWICK ORATED fk? `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ... ........ ........... .......................................... .......... Foundation has permission to erect........ .............. buildings on Rough .. .... .............................................. to be occupied Chimney provided that the person accepting this per shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Col 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOqyj-� C � Rough S ............................................................ . ......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises Do Not Remove Rough 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. i North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: C Lrr wl e s (JpcmL-� (Loca ion of F ility) el(of Permit App is nt Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i NO eTM Of,a�a a'f,�O � s TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 D. Robert Nicetta, Building Commissioner 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print L DATE t JOB LOCATION c)�2 Num Street Address Map/L t HOMEOWNER l'�P� V, � �`)y �00 7 Name I I _(H_ome Phone Work ` Phone PRESENT MAILING ADDRESS ` , l-t 1' ` Lo� 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 HOMEOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be,one or two family dwelling,attached or detached structures attached or detached structures accessory 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 North Andover Building and x requirements and that he/she will comply Department minimum inspection procedures eq p y with said procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL Date�! :. ..�`f.......... �aORTIi 3?°;'�`'°-;�•'."o°� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACHUSE� This certifies that ... � :.... ............................ has permission to pi form . , wiring in the building of......... ............................................ at............. ...... .-1) ,.-. ........... ,North /ndover,Mass. Fee.�,5 ..��7...Lic.No.�!si ��:..... . !............... ELECTRICAL INSPWM Check # 5430 ME C'017 MOATHEILTHOFL ASS4CBMEY S Office Use onl DEPAR7M UOFPUBLICSAFETY Permit No. BOA RDOF:7PERFORMELECMCAL tj1VREGUlA770NS527GVRI2:OD ^F I Occupancy&Fees Checked APPUCATTONFOR PE WORK ALL WORK TO BE PERFORMED IN ACCORDANCE,y6TTH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI(d7) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perfo the el',ctrical work described below. F Location(Street&Number) '( o 0 . V C / Owner or Tenant Owner's Address .5 Is this permit in conjunction with a building.permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service �. Amps I 201X0Volts Overhead ® Underground No. of Meters 4ew Service 2oQ Amps 0/Z tt Volts Overhead ® Underground No. of Meters Dumber of Feeders and Ampacity ocation and Nature of Proposed Electrical Work F '" r e ( " No.of Lighting Outlets No.of Hot Tubs. No.of Transformers =Total KVA No.of Lighting Fixtures / Swimming Pool Above Below Generators _ KVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Air Cond. Total FIRE ALARMS No.of Zones Vo.of Ranges Tons Jo.ofiDisposals No-of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices 1o.of Dishwashers Space Area Heating KW N,,of Sounding Devices No:of Self Contained Detection/Sounding Devices lo.of Dryers Heating Devices KW Local Municipal Other Connections o.of Water Heaters KW No.of No.of Signs Bailasis o.Hydro Massage Tubs No.of Motors Total HP iage.Rust=tDtheiegt ltsofMas wlucenGerlrallaws iabilityk&1anXPbJicyiIrh Complete Opff abonsCloverageorits YES NO validpmf ofsameto the Office.YES Ifyou hawdrcked YES,plea9eindiratedle ty)eofcoverage by box II�J.1 BOND r-1 MTIER r-1 (Please Specify) Expiration Date Estamlyd Value of Be Real Wodc$ hTccfionD&Re4rs1Ed Rough Final es of * 1!nS Lt3t J Lomse 35'0g4'�' Si r IicensuNo 4^E &L mes_sTel No. Ua—4 9 9 0 7 Alt Tel No. 60 :?-- 314--'173? LC WAIVER,I am aware that the Lion does not have the ir>s mro--coverage orils sutstmtial almalent as tequaed by Masswb sen Cttetal Laws on this pennvt appkcadon waimr s this requitement tine) Owner ® Agent ® �. Telephone No. PERMIT FEE$ L� �lgna ure of Owner or Agent Location No. ✓ �7- Date �aRT� TOWN OF NORTH ANDOVER 0� . o , 1+ � 9 a � Certificate of Occupancy $ 9 cNuBuilding/Frame/Frame Permit Fee $ swst Foundation Permit Fee $ Other Permit Fee $ TOTAL $ n Check # 1 8 / 44 e Building Inspe I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT BEPMj RENOVATf2 OR DEMOLISH A ONE OR TWO FAMILY DWELLING so BUILDING PERMIT NUMBER. �— DATE ISSUED: 3_ SIGNATURE: & saaai Building Co toner/I for of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Q'q / Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area s Fronts ftI 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 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 ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 'ist(iCt: inn ��O rn 2.1 Owner o ,Record NoA,m�"(Print Address for Service: \\ 1 Signa Telephone 2.2 Ow ecord: 0 Name Print Address for Service: z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ /bra.V"1!5- 2- IA67 ffi,�l 09,2 -767 � Lreno nsed Construction Supervisor: License Number A ss � � � 7 A6 > Exp raion Date azure Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ gt P r T7 Company Name AAe - M Registratiod Number r Ad s �— -`011-5— Expiration Date Si ature Tele hone .• h 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 unit. Signed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Prosed Work check as• Ikable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 0'0.- 72 F7 2 av cV7X0uey-uae� F� ✓yl ' 2�vc►NI -f- �' c+s � e�sf-p SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCL41 USE ONLY Completed by permit applicant 1. Buildinga ( ) Building Permit Fee 60 Multiplier 2 Electrical (b) Estimated Total Cost of /U Construction c�Q 3 Plumbing -- - Building Permit fee(a)x (b) 4 Mechanical HVAC may, - �� 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS A ENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, J 0 V ,as Owner/Authorized Agent of subject property Hereby authorize �cw' ( 0"aAnt) to act on My 4ffitlf,in all tters relative to work authorized by this Wilding permit application t r v `C Si pa u Owner Date SE ION OWNER/AUTHORIZED AGENT DECLARATION 1, 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 bl'o W,71':�OKwutn Print Name Signature o Owner ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVIBERS 1' 2 3KU SPAN DUVIENSIONS OF SILLS DINIENSIONS 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 JUL-22-03 08 :48 AM E K SURVEY 9784697046 P_ 02 T4^ II E K SURVEY INC •KAVERHIL.I,MA• Phone 976-1881985•Fax 97"9-7M j MORTGA O � DEED REF. _ '>♦��(o PG: AD RESS OF PRINCIPLE BUILDING ING PLAN REF TE OF INSPECTION 57 ��, DA SCALE V-10 I i t i ' i G A I � ' I a o- z � I i �I�Il�fir IIVOo� f}VE N A f I ! i \x T s nUDCL = I CERTIFICATION 1'0; rtO9td4ak &Ra _ Na xQW The location Qf the principle structurals This Mor�g i e Plot Plan was prepared specftalry for o� Vk eOdlfdeM . lnortpa9e purposes ly and It Is not Intended or represented f� �lt)sit i + with the local zoning bylaws In effect When constructed to be o propeny Ilnel of lend■un»y.Thh peen Is not to be..00d �>oo� +`� rW or Is ewempt from rio4mw allorcernnent to establish any of l e property lines for any purpose No action under Mass B L This VII.Chap 40A,Sec 7 l respons Iblllty is exto n4ed to the land owner or occupant. •Subject building is not In a Flood Hazard Area, 1 This eeftificatlon Is ed on iris locatlon d survey marker O Subjw building is In a Flood Hazard Area, i of others, Flood Hasard determined from the FIRM moo JOB 4111 Osteal I ' r io's 71 h N ---- ' --- - i i F------- --- -- 21'10 ------ --- - --�-' i UP i I �� I (� 5 r � A t r F _ k - R24 �"N3++ta rre.J Y 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 PHONE 7 ��- LOCATION: Assessors Map Num Ob PARCEL#0 SUBDIVISION n LOT(S) STREET ST. NUMBER_ OFFICIAL USE ONL 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 FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Rev IsW 9197 Jm a • The Commonwealth of Massachusetts > Department of Industrial Accidents Office of Investigations Boston, Mass. `02111 Workers'Compensation Insurance AfSdavit Nam Please Print Name: Location: City Phone # 71 1 am a homeowner performing all work mysW. 0 I am a sole proprietor and have no one working in any capacity dI am an employer providing workers'compensation for my employees working on this job. comRamf MM: 111VB"- /J 771,�� =:e Address i City s C-// /tel Insurance Pcoig is Company . A ,,V Address 66 Fbo-F rtiY/7 Z2='g 12ei, City4#6�i� >-L�� Phone Insurance Co. PokV 8 Facture to secure coverage as required under Section 25A or MGL 152 can lead to the imposition or aiminal penalties of.a fine up to$1,500.00 andlor one years'imprlsorrrrent.as rea0_as.chtN.pmakiwlnheimn dA STt]P WDMC ORDER.and_a.tko d.($1110.W)-aAW agoimt.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverege verification. I do hereby certify u pains and penatfles of pedwy that the l Hon provided above 1s true and coned Signature Date Print name Pto5-�-©�/.S` Official use only do not write in this area to be completed by city or town official' CIty or Town P Ina []Check ❑ []Checkif immediate response b Building Dept required ❑ Licensing Board Confect person: Phone# C] Selectman's Office ❑ Health Department ❑ Other r NORTPy '9 o of : Andover :�_ - 0 No. dto E qO y dover Mass. I� COC MICFIEWICN ADRATED S ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System woom BUILDING INSPECTOR THIS CERTIFIES THAT....� mrj. A)..q!.............'dd.N.*.Y a..........................................W—..... Foundation has permission to erect.........�.x�0t'` �.. buildings on A...... Rough p .............B.A..Ish.f w�v................ I.... to be occupied as j y le's Chimney provided that the person accepting this permit shall 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 elating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. t 16jt Z PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina` ELECTRICAL INSPECTOR UNLESS CONSTRUCTI N T TS e • Rough .. ........................... ... ............................. Service .. . . . .. . . LDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE J1 Smoke Det. Date.............. ...�z ........ ......... NORTh 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING US This certifies that ..(�Af �� ............................ ........................... has permission to perfzlrm ll'�/)/-It... .................... .......... ....... wiring in the building of '�-(.z- Ll -/-A .............. ........................ ............ /d—I 7;. /ce'.� ....J ......... North Andover,Mass. Fee..,�,2........... Lic.Nor�5-4 y ..................................................... ELEcmcAL MpEcToR Check # 542- 8 THE COMMOATHEALTHOFMASSAMUSETTS Office Use only DEPARTN&VTOFPI LICSAFETY Permit No. J.1 BOARD527CMR12-00 5�*�U Occupancy&Fees Checked APPLICATIONFOR PE ° TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANC&> H THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO ) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perfo the el`;ctrical work described below: Location (Street&Number) [ P 0 0©( v Owner or Tenant Owner's Address Is this permit in conjunction with a building.permit: Yes® No (Check Appropriate Box) Purpose of Building Utility Authorization No. I'I Existing Service (--)0 Amps 0/ Volts Overhead Underground No. of Meters New Service 2c92> Amps 42 004401 Volts Overhead ® Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work rrolit a d( h No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures / Swimming Pool Above Below Generators KVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW Ng.of Sounding Devices No of,Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local FiMunicipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydra Massage Tubs No.of Motors Total HP >THER- I I stnat)oe,Coverage.Futa ult 0 the w4we rents ofMassachusetts Ger>YA Laws lave aamentLiabl!yka ancoPokyinckxlingComplelt,, ul� Coverage or itss6alegtlivalerrt YES NO iawabmimdvalidproofofsametodrOffim YES If}xiuha�edieckeclYES,pleaseindicaVthetypeofoovetagebY !edmlg theqTfTflale box (SURANCEBOND F7 MHER F--j (PleaseSpecafy) ETkafKmDale Fstinatecl Value of Electrical Wodc$ otk to st ut Iaspoction DateR Rough Final filed underlie PenAes of��� ZIMNAME —73—p et— a Lj +1n S L.0(..) Lica-m-No. -Vt.__� Si ensee �c LioNo 4 a Bus ncssTel No. a'40�fi 4 0 7 0 Alt Td No. 60 ?L 2^'I 7.3 3 VNER'S INSURANCE WAIVER,I am aware that lbe lice does nothave the instuarlce ooveiage orits subs t al Nun alert as lequued byMasswhi>setts Cletietal Lam .that my sign&m on this peunit application waives this lequnenmt ease check one) Owner ® Agent Telephone No. PERMIT FEE$ ignature oT Uwner orgen Z The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations W� Boston, Mass. 02111 Workers'Compensation insurance Affidavit M 5 Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity a I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone#: Insurance.Co_ Policv# Company name: Address City Phone#: Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties cf.a fine up to$1,5oo.00 and/or one years'imprisonment-as_wellas_civil..penalties;intheform-of a_STOP WORK.ORDER-and_a fine-of-($1Do.oD)_aiday against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. y !do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. l Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required p Licensing Board Selectman's Office Contact person: Phone#: Health Department Other Location No. Date NORTN TOWN OF NORTH ANDOVER O F � 9 Certificate of Occupancy $ gU5 Building/Frame Permit Fee $ S 4C Foundation Permit Fee $ Other Permit Fee $ TOTAL $ w. Check # \ _ 0 17722 z Building Inspector a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING #S See"f6r BUELDING PERMIT NUMBER. DATE ISSUED: m X SIGNATURE: .� Building Commissioner/I for of Buildings Date /Q d SECTION 1-SITE INFORMATION I z 1.1 Property�Addresss: 1.2 Assessors Map and Parcel Number: O r/ 1CA I &.p-'Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Req4ired Provide Regaired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1117,71 jC, Di triCt: `;e's p,j,) M 2.1 Owner of Record uxca 4ve J r. e(Print) Address for Servnce: _0 -() /-N!� ✓ - 2 - (o901 S' na Telephone 2. Owner of ecord: Name Print Address for Service: 0 z M Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ IAA r Licensed Construction Supervisor: Llces1 . 09,27C7 0 ,�/ License Number Address ���".���'��/� Expirationon Dat ��L _ a= gnature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ //�✓�.Q.F,,t?fy/�� L,$ �."q � .t�"�1J��� ria Company Name Registration Number 7 q ®/93 ,t.P �/ •" a�� e !� Expiration Date Si nature Tele hone G) SECTION 4-WORKERS COMPENSATION(N.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 chee applicable) New Construction 0 Existing Building Repair(s) Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify ' Brief Description of Proposed Work: lJt/�Am-ne/zd0,-' �f LcJ�niz►.tC ,$Too:M .F. 12 . 1.vs �Nd) �c'/�l C�tJr !f/� ,l'�s T�/�, chi DEAL . 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 IV A Building Permit fee(a)X(b) 4 Mechanical HVAC /V q 5 Fire Protection Vl� 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTH09MATION TO BE COMPLETED WHEN OWNERS AGENT OR C NTRACTOR APPLIES FOR BUILDING PERMIT I, .-,as Owner/Authorized Agent of subject property r' Here4 authorize_ to act on My behalf i i atter�lative to work authorized by this building permit application /` _ (_ ��i r • , 0(i� S nail ner Date SkFCTION 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 4 -Signature of Owner/Agent Date r NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1612ND 3 FD SPAN -- - - -- DIMENSIONS OF SIZ,LS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED I:AND IS BUILDING CONNECTED TO NATURAL GAS LINE � NORTIy Town 0 4 over No. LA 70 dover, Mass. Q COCHICHEWICK V ' ' AERATED O' �5 `S BOARD OF HEALTH PER IT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ... . .............................................. . .......:......................................... ... Foundation has permission to erect........................................ buildings on.... �../......... ........... trough to be occupied as. ' Chimney . . . .. ......... ... . . . .. . .. .... .. . ....................... provided that the person ac ptin is permit shall in every aspect confo the t s o the application on file in Final this office, and to the provi it f he Codes and By-Laws relating to th pectio Alteration and Construction of Buildings in the Town of North A over. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. trough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION I ST TSELECTRICAL INSPECTORS, Rough .......�r................................................. .................................................. . Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. ''„� !Y �/tf3 l lllfT 7.�YtlflloLX�� [14r��'+�IYFt'�ftc�cE.�. r BOARD OF BUILDING REGULATO'Ns., License: CONSTRUCTION SUPERVISOR J � Number: CS 082767 Birthdate: 40!27!1962 �f Expires: 10/27=06 Tr.no: 82767 Restricted: 1G ' DAVEY B WITHATJIw, 54 FARLEY AVE IPSWICH, MA 01938 Administrator 5,00r)crenclalv>d 14sace 04GL 0.112 S.601-) 1 A-Masonry only 1 G-1&2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. . t DIG SAFE CALL CENTER: (888)344-7233 9t a Exhibit A - Property Description Closing date: 04/01/2004 Borrower(s): Kenneth J. Donovan and Jeanne C. Donovan Property Address: 51 Brightwood Avenue, North Andover, Massachusetts 01845 A certain parcel of land in said North Andover, with the buildings thereon being Lot 46 on a plan entitled "Highland View Park" dated March 1906,by R.W. Seamans, Civil Engineer, recorded with Essex North District Registry of Deeds in Book 230,Page 600,bounded and described as follows: Southerly by Brightwood Avenue, forty-five(45) feet; Northerly Y b Lot 47 shown on said plan ninety-one and 51/100 (91.51) Easterly by Lot 61 on said plan; and Southerly by Lot 45 as shown on said plan eighty-nine and 64/100 (89.64)feet. Containing 4076 square feet of land according to said plan. Said parcel is also shown as Lot A on a plan entitled Plan Showing Lan d of Connie J. Cataudella North Andover, Mass."by Charles C. Martin Associates, R.L.S.,dated March 1983 and recorded with said Registry as Plan #9169 on June 7, 1983. I� a w The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations ,.� Boston, Mass. 02111 M sY•y Workers'Compensation Insurance Affidavit Name Please Print Name: Location: Cltv Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity LV I am an employer providing workers'compensation for my employees working on this job. Company name: 7'0/1-Y �9�i�,E- r�,e V L C- Address G/ /��ic•C/�yye City: -L 'C Phone Insurance Co. PORU.# Company name: Address City: Phone#: Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment-as weD_as_civil.penalties-in-the form d-a STOP WORK ORDER.and_a fine of.(.$100.00)allay against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties offperjthat the information provided above is true and correct. Signature _ 46 Date fZ i Print name Dliy& /3bili i�ts9s-1 Phone# 7 - 3 C-C;p 9/S- Official use only do not write in this area to be completed by city or town official' City or Town PermitiLicensin Building Dept []Check if immediate response is required Licensing Board p Selectman's Office Contact person: Phone#. I] Health Department Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector T Location No. y Date gORToy TOWN OF NORTH ANDOVER , Certificate of Occupancy $ + s : Building/Frame Permit Fee $ `^Foundation Permit Fee $ SACMUSE f Other Permit"FeeeG"" $ A `Sewer Connection Fee $ 1, `� tJ Water Connection Fee $ -- 1 1. TOTAL $ n �v C' Building Inspector j 6568 = Div. Public Works 41 PERJiff NO. `% 1 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. L/ PAGE 1 ,MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE — ZONE I SUB DIV. LOT NO. F—I I LOCATION / n I Q k4 w-oA PURPOSE OF BUILDING & 11 S� OWNER'S NAME a a-Fa u el-e-4 NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAMEf'Iw9 BUILDER'S NAME T SIZE OF FLOOR TIMBERS IST 2ND Ct -_j Q ILSON P da 3RD A an,aS e 7�^e SPAN -- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET " POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS a PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ?v16 Q PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SC. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS - PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED L( 'cl b BOARD OF HEALTH 81GNATURE OF OWNER OR AUT14ORIZED AGENT FEE (� � � V (y rSC4-8(p LQ PLANNING BOARD PERMIT GRANTED OWNER TEL.# -.0-7 19 CONTR.TEL.# 6 8q-21°f L CONTR.LIC.# d 6 U/(2 �1 BOARD OF SELECTMEN BUILDING INBPKCTOR i BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 l 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ '/. 1/1 '/ FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDIIJ'D ASBESTOS SIDING COMtACN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I-I POOR I_ ADEQUATE NONE i 5 ROOF 10 PLUMBING Y GABLE I HIP BATH (3 FIX.) _ GAMBREL 'MANSARD TOILET RM. (2 FIX.) FLAT 11 SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING I I MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING Y TONVI 01 "r 120 Main Street OFFICES OF: _ _ , APPEALS ..N NORTH ANDOVER North Andover. Massachusetts o 1845 BUILDING fie`:^�'�e (6 1 71 685 4=75 CONSERVATION �'""� DIVISION OF'_ ' HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECTOR In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number Y-z � 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 111, S 150A. The debris will be disposed of in: (Location of.Facility) Signature of Permit A plicant I'3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. •DEPARTMENT OF PUBLIC SAFETY l ONE ASHBORTON PLACE +� n9Mr IMF40t MINT CDr1i F;,i i GR. BOSTON,MA 02108 FE,7i5�i d l0� ''iO4 at; LICENSE CONSTR. SUPERVISOR E. _ EFFECTIVE DATE LIC-NO. 05 /01 /1X93 060112 err .son =:o':I`in o:' o^a D4';.e THOMAS 269 � ra:zr ii. Strzz` 269 FARRWOODDR ADMINISTRATOR Uc iuen MA 01844 13RADFORO MA 01835 'Z', i _ NOT YKD UWX SIGNED By LICENSEE AND OFFICIALLY STPD-Op.SKOIATURE OF THE COMMISSIONER SIONA OFUCENSEE w- �Y» .181,6012!• 0A-0+�,•�• 1 TNHpM�MC � • iT i �� ~ fLNAN1IF.lFLII� I Ir pR!'IfTI •1830 JC�a N gTe'r- —' 6s'e-c %> Y' a� lP � t •'r c1 y Page of PMP" Free Estimates 105 Haverhiii Street Ful?y insured - Methuen, AAA 01844 (508) 689-2191 rzder.s,on Roofing & Cal pent Shin les - Tar and Gravel - Slate Rubber"?oof - Single Ply - Copper Work PROPOSAL SUBMITTED TO PHONE DATE STREET JOB NAME CITY,STATE and ZIP CODE JOB LOCATION 41 ARCHITECT DATE OF PLANS JOB PHONE We hereby submit estimates for: iL --,._L 1 i j -1__is 3113 fi C< _ illi cit _ i1 ii J ;1L[-I = y C 11-3,. ?ty v �s1 �I0u y .ter � .: ,_- .�.� s > > Y 1_ i�� c l ✓ SOD _ _.., _ _El �L_ti _ I .. ': We Propose hereby to furnish material and labor— complete in accordance with above specifications,for the sum of: dollars($ ) Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices. Any alteration or Authorized 7"• deviation from above specifications involving extra costs will be executed Signature �/� -' ' �r �' ✓ `L,� -- only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond ; our control. Owner to carry fire, tornado and other necessary insurance. NOTE:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of ftopo.7"i — The above prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment Signature will be made as outlined above. Date of Acceptance: Signature NpRTH Town of Andover No. 424 _ fJVL � O L-A 0 dower, Mass.,.fEi a 1p 19At COCWCMEW CK �A0RATED S BOARD OF HEALTH . PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......4400T ....I'4..T Ott.�1.4 E.A. l. ............................................... Foundation has permission to erect.$# 40.9........ buildings on 0 0.60..r..�.......... Rough to be occupied as.....UrA1.#.ed 0..0.Ag..0 0.0#6..... ... .IY...................... Chimney ' e provided that the person accepting this permit shall 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 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 CONSTRUCTION STARTS ELECTRICAL INSPECTOR • Rough ... ... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. .,FWFR /WATFR FI NAL DRIVEWAY ENTRY PERMIT