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Home My WebLink AboutMiscellaneous - 521 DALE STREET 4/30/2018 (3) BUILDING FILE � Date... /.LA.................. OF-&OR 0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • 144.This certifies that ...... has permission for gas installation ........ ................................ inthe buildings of................................................................................................................... at...1:3. ..1:3. ..... S ........................................... No A, ndover, Mass. . ......... Fee ......... Lic. No. ........................ . ..................................... ............ G S INSPECMR Check# 000* 62 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY MA DATE �� -� ��`�/ ;PERMIT# JOBSITE ADDRESS. � ..� �C. i. ?OWNER'S NAMEca q7 OWNER ADDRESS �a 1 .Olii .�e S TEL :FAX TYPE OR OCCUPANCY TYPE. COMMERCIAL. EDUCATIONAL ? RESIDENTIAL':, PRINT CLEARLY ,.. NEW:; RENOVATION REPLACEMENT PLANS SUBMITTED: YES-,•, NO APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER _ CONVERSION BURNER i COOK STOVE DIRECT VENT ML41EELILL DRYER. L FIREPLACE I f 1 FRYOLATO.R FURNACE i GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT i OVEN POOL HEATER (ROOM/SPACE HEATER w ROOF TOP UNIT TEST UNIT HEATER $ .. .... UNVENTED ROOM HEATER WATER HEATER f jf 'nrt.+.fvrc..t.:•1:1,.5 % -x.ra:..i.R:�btit w("_.tW dSnrS[...;e:_a i.:. ...-.... a....._..�. -.... �.,... .. ... ._ - INSURANCE COVERAGE . I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL:Ch.142 YES I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement.. CHECK ONE ONLY: OWNER ",j AGENT s SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge j and tha�all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of Y-ie Massachusetts State Plumbing Code and Chapter 142 of the General Laws" f PLUMBER-GASATTER NAME' 1 LICENSE#F 3 S$rr SIGNATURE j �` MGF ,__-, 'PARTNERSHIP # �LLC , ' MP . JP w„ JGF'..._Y LP 11 su,.. CORPORATION COMPANY NAME:.�,t�.,Ga.h�'(,w ��,� ?ADDRESS' CITY M STATE Yr/A- ZIP'. 19Y9 TEL FAX CELL 'EMAIL r ,, ��V1°`f.�/j �� The Commonwealth of Massachusetts w m Department of Industrial Accidents K Office of Investigations . $00 TT ashington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit. Buifi ers/Co>1 t ractors/Eltectricianis/Plumberrs A ficontInformation _ Please Plrnaat Lffiibly Nanll)te(BusinesslOrganization/Individual): Cj—Ili / FL< Off, Address- 7>1 MV/State/Up V� c "V �� X36- Z 3 Are yor!an employer?Check the appropriate box: Type of project(required): 1. 1 am a employer with _ 4.[]1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time). have hired the sub-contractors 2.E1.1 am a sole proprietor or partner= listed on the attached sheet: El Remodeling. ship and have no employees These sub-contractors have 8. (]Demolition working for me in any,capacity. employees and have'workers' 9. []Building addition [No workers'compo insurance compo insurance.t We are a corporation and its I0.0 Electrical repairs or .additions 5. required.]. ❑ r 3,[]1 am a homeowner doing all work officers have exercised their. I L[] Plumbing repairs or additions myself:.[No workers'compo right of exemption per MGL c. 12.❑Roofrepairs insurance required.] or I have hired 152,§1(4),and we have no 13.QOther the contrnctm-listed on the attached employees.[No workers' sheet compo insurance reguired.l Any ap;licant that checks box#1 must also fill out the section below showing tlieir worlcer..'compensation policy information, I HOmeo"Iners who submitthis affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'compo policy number. I ant aro:employer that is providing workers'compensatdon insuraance for ray employees.Below is the policy avid job site information. . Insurance..Company Name: Policy#of Self=ins.Lie: � � S �lr' U 0�3 �� ` Expiration Date:��Y/ /s Job Site address: �cq 1-C S i _ .______City!State/Zip: Attach'a copy.of the workers'compensation policy declaration page{showing the policy number and expiration date).Failure to secure ,overage as required under Section 25A of MGL c.152 can lead to the impe:itiori of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment',as well as civil penalties in the form of a S'L'OP WOM ORDER and a fine of up to$250.00 a day against.the violator.Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveK4_e verification. 1 do hereby certifY under the pains and penalties of perjury that the information provided above is true and.correct. 'signature: Date: �C�( ,hone: 11eporiuitnt of vublic Lofttq Occupancy A Fee Checked ��'1 •��• . ` .� BOARD OF FIRE PREVEIITIOI{ REGULATIONS 521 UIR 12:00 3I90 (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 ALL INFORMATION) Date 11/4/97 %W or Town of._ North Andover ?o Ilio Inspector of Wires: The uderslgned applies for a permit.to perform the electrical work described below. Location (Street & Number) 521 Dale Street Owner or Tenant David Sikora Owner's Address Same Is this permit In conjunction with a building permit: Yes ❑ No O (Check Appropriale Box) Purpose of Building Residence, Utility Authorization No. Existing Service Amps _I Volts Overhead ❑ Undgrnd ❑ No, of Meters New Service Amps _J Valls Overhead ❑ Undgrnd ❑ No.of Meters Number of Feeders and Ampacily Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. or Hot Tubs I No. of Tlansro(mers KVA No. of Lighting Fixtures I Swimming Pool grnd.Above❑ in- grin I Generators KVA I No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners ( Battery Units No. of Switch Outlets I No. of Gas Burners FInE ALAnMS No. of Zones Total No. of Dclectlon end No. of Ranges I No. of Air Ccnd. tons Initiating Devices Heal Total To!nl No, of Disposals Noor Pumps Tons K%V No. o! Sounding Devices I No. or Sell Contained No, or Dishwashers Space/Area Heating K1V Detection/Sounding Devices I ther Municipal �—;O No. of Dryers Heating Devices 1M/ Local [I Conneclioh C •_ No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring r. No. Hydro Massage Tubs I No. of Motors Total HP OTHER: Reattach service to house due two stcSrm damacte Pursuant to the reoutrements of Massachusens general Laws _ — INSURANCE COVERAGE _ NO _ t I have a current Liability Insurance Policy including Completed Operaligns Cpvera08 or its substalolasteeinoicatenlho typo of coverage by have submitted valid proof of same to the Office. YES NO — It you have checked YES, p checking the appropriate box. INSURANCE X BOND = OTHER baso Soecrly) tExprratron 001131. Estimated Valu eYanles ryical Work S Final Work to Start "( Inspection Dale Requested: ov9 Signed undor of perjury: 14302A Ando LIC. NO. FIRM NAME LIC. NO. Licensee Robert J Branca Signature 8 475-4995 Bus. Tel. No. Address 206 AndoVer S AIL Te I. No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insurance coverago or Its substanrlal edurva!ont as ro- quired by M2553chusorls General Laws. and that my signature on this cermn application waives this reoviremeni. OwnereAgent (Pleasecheck onol Teleohone No. PERMIT FEE s Adv e (Signature or Owner cr Agentl TO Date.Z�-./ 1277 TOWN OF NORTH ANDOVER PERMIT FOR WIRING Pw 0,T- 4cm This certifies that ... ........ ...................................... ......................... .. .................. has permission to perform ........................ .................................. wiring in the building of ............................ ......................... at,, ........................................ .North Andover,Mass. Feek ....... Lic.No6q?t4........................................................... ELECTRICAL INSPECTOR �///,fit 3/97 09:46 15.00 PAID WHITE:Applicant CANARY: Building Dept; PINK:Treasurer 7352 Date. ....... NORTM pfi Sao 1ti0 _"1 TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACH 5 a a� This certifies that . . . G�. <'�. . �!.�,'7. . . . . . . . . . . . Ahas permission for gas installation . . . .. .f. . . . . . . . . . . . . . . . in the buildings of . .� !&�/.(./f. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .. ��* . . . . . . . . , North Andover, Mass. Fee. . 34a . . . Lic. No.. 6RS INSPECTOR ' +� Check# MASSACHUSETTS UNIFORMAPPUCATON F'ORPERWTO DOGAS FfrMG (Type or print) Date — /U NORTH ANDOVER,MASSACHUSETTS Building Locations J 2/. - 01411ei, 57— Permit# 7 7 Amount$ Owner's Name New D Renovation D Replacement ® Plans Submitted 0 � a o d F > m l: x a z O w e a z z O E'- w a q H w �a o o o W F a z v � x y Z a o a > I- z E z x w w 0 > < w > a �= Q > m z c H w a F w x o x 3 a v U Gti 4 a SUB-BASEMENT > F O BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) Name Che k one: Certificate Installing Company Corp. Address d ess Partner. Business I a ep one g — 0 Firm/Co. Name of Licensed Plumber or Gas Fitter '�; +/�j � INSURANCE COVERAGE Check one: 1 have a current liability insurance policy or it's substantial equivalent Yes ® NoO If you have checked +des,please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity13 Bond ED 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)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Coded Chapter 142 of the General Laws. By; Signature of Licensed Plumber Or Gas Fitter Title �• Plumber City/Town [3 Gas Fitter License Numoer Master APPROVED(OFFICE USE ONLY) ® Journeyman Location No. Date 4, A; °t "ORT",y TOWN OF NORTH ANDOVER Certific or5ccupancy $ 4L ;#= BulldirA�g/Frame �A#i e $ � �' ' ,SSACHUgE� Foundatioh P*P , "C Fee $ — ► vu '17t 1fB( p! �� $ Sewer Conne�trase,e $ Water Connection Fee $ �a• C %-5 a� � ;• TOTAL $ "? �S 0 Building Inspector Div. Public Works Location No. 3 Date �J t .p NaRTN TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ „ , .� ; • B,uildinglFrame Permit Fee $ Clu �ss�c,ugEth Foundation Perm4.Eee $ Ivo Other Pel-111ltlFee, $ ,k wer Connectii9o� Fee $ N u j ZWater•faonleion Fee $ TOTALe� Cgwk, t)g $ Building Inspector"' .r Div.Public Works' Ji +. /'''w / APPLICATION FOR PERMIT TO B61LD - NORTH ANDOVER, MASS. f1.Av el , PAGE 1 MAP hn0.i'.0 -� LOT NO. 2 RECORD OF 6WM.ERSHIP IDATE�' BOOKPAGE N — t .,ZC'NE ` I SUB DIV. LOT ��0. QYC. �� Z F�Ve OPEN} I I3 LOCATION I a e- PURPOSE OF BUILDING -SIN 1 ' 1 r a ►�,�I�� -amt PI..vol C' „,p� 7rt.' OWN;.R'S NAME G * Z np e�O yn eN-f Cor 1�I NO. OF STORIES T SIZE 3 h,, a ; 1716+1t, OWNER'S ADDRESS G_ 11✓G. c A/ , NI Re ad BASEMENT OR SLAB) (kSe- W- - I ARCHITECT'S NAME �1 . /`I SIZE OF FLOOR TIMBERS IST a)( 'O 2ND Qj( 'O 3RD a)( BUILDER'S NAME AYA-)IN V Y &I a /Q VOW C e SPAN t ;� I DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET loll POSTS o�--- -- ^3,j- 11 DISTANCE FROM LOT LINES-SIDES 20, O, REAR O GIRDERS AREA OF LOT , Acve- FRONTAGE 360 O f HEIGHT OF FOUNDATION Q� 1 THICKNESS �Q IS BUILDING NEW Yes v SIZE OF FOOTING a "'bv )0 - X IS BUILDING ADDITION M O MATERIAL OF CHIMNEY /`o/ve IS BUILDING ALTERATION "v 0 IS BUILDING ON SOLID OR FILLED LAND S O'l'C, WILL BUILDING CONFORM TO REQUIREMENTS OF CODE e S IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION, IF ANY //O IS BUILDING CONNECTED TO TOWN SEWER e IS BUILDING CONNECTED TO NATURAL GAS LINE e- S INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST /O � SEE BOTH SIDES c 6[ EST. BLDG. COS PAGE 1 FILL OUT SECTIONS 1 - 3 PERMIT FOR FOUNDATIO UREF Ob EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 REGULATED BY PARA: 114. 815. &C. SEPTIC PERMIT NO. I'Q/N e k ECTRIC METEPS MUST BE ON OUTSIDE OF BUILDIjp✓�jC/(�'j1 E 7_ 092 Q APPROVED BY ACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS I FEE PAR 00 4 PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DAT!k FILED BOARD OF HEALTH SIG IATURE OF OWNER OR AUTHORIZED AGENT F E E 10[iL6/{i►�6#Iti, ( � `` LESS FDAp� J �� M PLANNING BOARD PERMIT GRANTED - ml b15 21 DUE FROE R=ff� 2 ys RiD � BOARD OF SELECTMEN �r�-7�.6- 33S PERMIT FOR FRAMUBUILDING�,vo ��'_ ��_ -019 MAY 1 5 I� �' tl —OWNER TEL.# SATE: � �� FEE PAID: 3 y`� �-CONTR.TEL.# � //V BUILDING INSPECTOR CONTR.LIC.# —,l 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 8 INTERIOR FINISH CONCRETE _ B t ? I3 CONCRETE BL'K. PINE BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL UNFIN. 3 ' BASEOENT AREA FULL FIN. B M'TAREA _ FIN. ATTIC AREA _O B M"T FIRE PLACES N -� HEAD ROOM MODERN KITCHEN ' 4 ,; WALLS 9 FLOORS CLAPBOARDS B 1 2 3 �.`� DROP $IDI�niG CONCRETE �_ 11� '� WOOD SHI LES EARTH +1 ASPHALT SIDING HARD\!✓'D ASBESTOS SIDING COMIACN # VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY - STUCCO ON FRAME 1 BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME 1 CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR 171 POOR _ Ir.ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.( — GAMBREL MANSARD TOILET RM. (2 FIX.) )LAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER t ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO d . , 6 FRAMING 4 11 HEATING WOOD JOIST Ir PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. ST AM STEEL BMS. & COLS. HOT W'T'R AR.XAAAR WOODRAFTERS AIR CONDITIONING . RADIANT H'T'G UNIT HEATERS, IV NO. OF ROOMS GAS OIL B'M'T^ 2nd _ ELECTRIC _ 1st 13rd I NO'HEATING T ► ° iV 30 IrvC� o(' -T-1 vu 65� Q FOIUI U 1 TOWN OF NORTH ANDOVER LOT RELEASE FOLUI SUBDIVISION 0-1�-C" pcca- ASSESSORS MAP C SUBDIVISION LOT(S) 9 PERMAENT„ ADDRESS SIGNED 13Y U. P.W. STREET O� APPLICANT Y--Z i5 . PHONE l� � DATE OF APPLICATION TOWN USE BELOW THIS LINE PIN ING OARD ��tt tt - DATE APPROVED TOWN PLANNER DATE REJECTED CONSX,RVATIONr,COMMISSION DATE APPROVED CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALT �I�J DATE APPROVED /Aj/— HEA11qf ANITARIAN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT i SEWER/WATER CONNECTIONS M S 3 3 U //-z7— FIRE DEPT. 14,Lk je, RECEIVED BY BUILDING INSPECTION DATE S This form shall be signed by the agents of the Planning and health ilonrds, the Conservation Commission prior to the issuance ofyany building; permits for the subject lot. This form shall not. releive the applicant from the compliance of any applicable Town requirement or Bylaw. rwenW_II vy% 1I�En�I _ r1NAL 9r. VY C W f'1\1AL • d�11r1��(�� Fllri�� own of e Oncl%U V ea0L -No. 2 3 . r �, ; n. �RIO/EVI/AY ENTRY PERMIT � * " � ��-=_-- � y er•• Mass. �� 19 91 C H HEWICK J BOARD OF HEALTH _ 07 THIS CERTIFIES THAT... .. ... fg4 ....... ..° .. � 0 �. & �.�•.• •. gBUILDING INSPECTOR has permission to erect ..... .... buildings on ......... • Rough • �.�? ..':..F. �.... .......�c�.L.�a?CC�-- Chimney to be occupied as............ .. • ..................... Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA: 114. S. B.C. Final PERMIT EXPIRES IN 6 MON�II4 62 FEE PAID: ELECTRICAL INSPECTOR (( ((NN Rough PERMIT FOR FRAME/BIJtL'D1W'S CONSTR TA TS Service Final 0 0 .... .. .......... ....... .... .. .. ........ DATE: FEE PAID• BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Bur No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector ' 4 CERTIFICATE OF USE & OCCUPANCY Town of North Andover t t y 3 _ S Building Permit Number 231 Date_ SEPTEMBER 10 , 1991 i 1 THIS CERTIFIES THAT THE BUILDING LOCATED ON LOT #9 (521) DALE STREET MAY BE OCCUPIED AS SINGLE FAMILY DWELLING IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH p OTHER REGULATIONS AS MAY APPLY. i R f NORTH 0 CERTIFICATE ISSUED TO G & Z Development Corp. 27 Pleasant St . ADDRESS North Reading, MA ACHU Building Inspector b� Ci E�` a �.� f--__ �F"NAL :SEWER/W PLANNING . G " AL, 4 f�p C1 +f ..-.w A L 6 , O ; TowNo. 231 , . p o __ 3 �. �, dover )RIVEWAY ENTF. ' i ;ERMITf' 19 1 � r er, 'i��ass., l'umir Rte' s C HE 11C K 0R Pa ,�" e SS l ill BOA OF HEALT or ERMI v do je ppft ) THIS CERTIFIES THAT... .. .Z.... 4 ................ .. ....... .... .... • BUILDING INSPECTOR has permission to erect .....Wd��..... buildings on !....... �. ... .I...'... Rough . .�. � `... �! ►�... .„ �PzL� � Qn-'. •. • Chimneyto be occupied as........ .. ....... l Fina .Nle 9 /G' - provided that the person accepting this permit shall in every respect conform to the terms of the application on file in /'PLUMBING INSPECTOR-" this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction ofRough ( %��' ;6'? 'e Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY _ ' REGULATED BY PARA: 114. .1 B.C. Fi i L VIOLATION of the Zoning or Building Regulations Voids this Permit. FEE PAID: '��0L PERMIT EXPIRES IN 6 MONIF/IgELECTRICAL INSPECTOR _�-1 N SS CONST I - TA TS .. . q�� ` Rough PERMIT FOR FRAME/BUTL'iJlN 0` Final I ... .. ......... ..... .. .. �r b 4, q� DATE 6 FEE PAID• .BUILDING INSPECTOR t GA SPEC Occupancy Permit Required to Occupy Building R Display in a Conspicuous Place on the Premises Do Not Remove dBu �,4RE DEPT. No Lathing to Be Done Until Inspected and Approved bySmoke Det. � �t Building Inspector Location 1 L E- S / No. FJ 7 Date �d Z— NORTh TOWN OF NORTH ANDOVER Of11�ao ,a'�,y O? •� • OOp p Certificate of Occupancy $ Air # • : Building/Frame Permit Fee $ Foundation Permit Fee $ ter Permit Fee $ Z "141? Sewe14%1-tion Fee $ Water Connection Fee $ TOTAL /� $ clr Building Inspect" 5(� r Div. Public Works :RJ1IT N0._074— 5 L'` I CIN O,N FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I —e MAP 4d0. I LOT NO. C� P� 1 2 RECORD OF OWNERSHIP IDATE (BOOK ;PAGE — ZONE SUB DIV. LOT NO. C C� LOCATION -"'1„�� 5� -� PURPOSE OF BUILDING Z �00.r OWNER'S NAME \ M� S\k�-c� NO. OF STORIES2 SIZE N �p Oo S/' f OWNER'S ADDRESS 15Z\ JCS\� � �ec� BASEMENT OR SLAB ` ARCHITECT'S NAME J SIZE OF FLOOR TIMBERS IST z x 2ND Z-\0 3RD BUILDER'S NAME6 ',� �C�g,;�Q�a�'`wj� 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 V�� IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST ,3). 0co SEE BOFIH SIDES EST. BLDG. COST i' co Oeu,), PAGE 1 FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SO. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS 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 fjnC,,C.1\ )-� yqZ BOARD OF HEALTH 8 �TURE�OFOWN` AUTHORIZED AGENT Q„_ OWNER TEL.#__4 1 Z. b 3 3�F, F E E Z1S� �� CONTR.TEL. _�S?-3�`� CONTR.LIC.# oy 005'4 PLANNING BOARD PERMIT GRA ED BOARD OF SELECTMEN +v�¢.•a ��„�� Off- Z� �� ::�(.a� 'Y. >>Z- CA=+�Q\Z.� 0..i t\M� o� c2\q��ta� CotiS��jc�.o U '�� \ tC.1", \5 \N \,Z, Z \JeSA�\n� BUILDING IN GTOR WHITE: Building Dept. CREAM: Assessors CANARY: Treasurer a BUILDING RECORD y 1 OCCUPANCY 12 SINGLE FAMILY SiOkIES 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 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ —' DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/ 1/1 % FIN. ATTIC AREA _ NO BMT FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 _-2_f 3 f DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH ASPHALT SIDING HARD%'✓'D ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE t- \ STUCCO ON MASONRY �_ t STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR BRICK ON FRAME - - CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR _ ADEQUATE NONE rj ROOF 10 PLUMBING . GABLE IHIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO ___....�...__. _.__ r r ' 6 FRAMING II 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 ELECTRIC BstM T 3rd I NO CHEATING FINAL uJ L 1WAL PLANNNG I FINAL -- NORTH Town o 6Andover No. )RIVEWAY EN-flFlY PER�t,HTAh A"11 er, Mass.010MU igh C HE 1C SSA PE .RMIT T LD BOARD OF HEALTH THIS CERTIFIES THA IssolwWor,..................................... 1111111106 BUILDING INSPECTOR has permission to erexv. AT-Wes .... • Go_4404/.Apme.4 Rough to be occupied as...iVAtr . A "xy &CO. "Ap .4. Chimney .. . . Final provided that the person accepting this permit shall in every respect conform to the terms of the application on rile in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT . EXPIRES 1,W, "ONTHS ELECTRICAL INSPECTOR Rough UNLESS CONST UCT TA T Service Final . . ... . ... ........... *iU1*L*D*I*N(G;' 1*N**S'P*E*** OR BUILDING GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. STREET No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector t ✓n?2':.`�.ei}�a� ._`ri"'.:.L 4�`-L"..SiY1:i _iy�. e.�.w..�.n..a 2'��i...+ter..�.�..r-w__a...�..r-�.-.��rte......__._.. .. .._� o Location c 502 �� L S No. ]Z- Date �d L 7-1 TM TOWN OF NORTH ANDOVER p Certificate of Occupancy $ • ; Building/Frame Permit Fee $ st� Foundation Permit Fee $ AGNUS Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ � Building In_ 5049 Div. Publlc.Works Location A-1,,!5! No. tn; Date i N°RTM, TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ * > Building/Frame Permit Fee $ l ,k. 'Ss�cHus�t Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ f TOTAL $ Building Inspector 591.50 PAID 9 npq 8 8 3 Div. Public Works � PER3fIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4,10. LOT NO. 2 RECORD OF OWNERSHIP 'DATE (BOOK 'PAGE ZONE I SUB DIV. LOT NO. LOCATION �' �1� �� + PURPOSE OF BUILDING OWNER'S NAMEC� G / NO. OF STORIES ! ,T` SIZEV�• OWNER'S ADDRESS S� �J1�t� �T !eT]� BASEMENT OR SLAB - ARCHITECT'S NAME /1_t _Y//�A ` /`(rte/ eta SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME A�`C..`e. - - _ '�+4N��I LSPAN -- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS --- DISTANCE FROM STREET - A I �7 POSTS DISTANCE FROM LOT LINES-SIDES 6� REAR v " GIRDERS AREA OF LOT ` Cry i FRONTAGE 3S�- 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST :oil PAGE 1 FILL OUT SECTIONS 1 - 3 EBT. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METEPS 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 DUILDING IN*P[CTOR SiQWrLkBq0F OWNE OR RI D AGENT F E E OWNER TEL.# 76 1 r / f PERMIT GRANTED CONTR.TEL.# tp / 19 G CONTR.LIC.# 6 E3y1.5' H.I.C.# • of % 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 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL K. PINE _ BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'T AREA _ 1/. 1/2 FIN. ATTIC AREA ' N_O 8 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 HARD11J'D _ ASBESTOS SIDING _ COMMGN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRIO N MAS NRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER--B-LK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 0 6 FRAMING I 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 L OI B'M'T 2nd _ ELECTRIC lit 13rd NO HEATING NORTfq l 4 0 0 over 0 No. 269 13 rt ." dov 'r; Mass., — /9 _ 19 COC-C NE WICK V ADRATED Cl 5 BOARD OF HEALTH Food/Kitchen PERMIT T D, Septic System a i BUILDING INSPECTOR .. . .. THIS CERTIFIES THAT...................... ./4.).t'..I...................E./..C.O.P„�T........................................................ Foundation has permission to erect.....m.Q.(. O,6,C... buildings on ......... ../.........�.... .. ..�........... ' ••••• Rough tobe occupied as............................................. � �4c..�..�. ....... ..., ......... 1'T(`' ..........'................... Chimney I in ev respect conform to the terms of the licatiort.on file in provided that the person accepting this permit shat �y p PP 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 t VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough i....:................. Service B DING II�SECTOR Final Occupancy Permit Required to Occupy Building ra GAS INSPECTOR la in a Conspicuous Place on the Premises — Do Not Remote Rough Display y P Final No Lathing or Dry wall To Be"Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. +' Burner Street No. Smoke Det. RECEIY;7C JOYCE BRADSHAW PG � �� I �G BGA80 NORTH ANDOVER TpWN OF NORTH. ANDOVER Any appeal shall be filed H A S S A C H US ETT S MAY 6 3 15 P! '96 Nithin (20) days after the WORT" {ate of filing of this Notice ..�tio ,;:scsbcaRlI'mm ka0two !docidmYe 3r ' i,.zve elaps^d frOf�l Oii deClsbcl ad in the Office of the Town a wi :,znccngaenepveaL Clerk. ,,ayWA.Bream+ Tawe Geek AcMUSE ' NOTICE OF DECISION AT.TES—3- A Mue 3:ATrue C'any Date . May_ 29 ,1996 . . . . . . . . . . . . . . . . G Date of Hearing May, ,Z1,, .1,99G Town,Clerk . . Brenda & David Sicora Petitionof . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A Premises affected , 521 Dale Street N { Referring to the above petition for a special permit from the requirements No. And. Zoning Bylaw Sec. 4.136 Paragraph 3 (b) (ii) Watershed Pro. Dist. ofthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . £ room and a 2 r car,gaage with SO as to �� a1.�Q,�i . 4� .thy axi-ti.c> -af. a• �amaly. . . . . . . . a game room above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s' After a public, hearing o vyen=o �-the abovet date, the Plannin; Board-voted, ' CONDITIONALLY to ,APPROVE . . . . . . . .the . SPECIAL . PERMIT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . based upon the follolving conditions : CC: Director of Public Works Building Inspector Jp� Natural Resource/Land Use Planner '/ KA Health Sanitarian Sign ed V Assessors Police Chief Joseph V. Mahoney.. Chairman. . . . . Fire Chief Applicant Richard Rowen, Vice Chairman , Y . . . . . . . . . Engineer File Alison. Lescarbeau:Clerk, , , Interested Parties Richard. ...della. . , , , , , , , , , Town of North AndoverOf NORTH OFFICE OF �? .`` 0 COMMUNITY DEVELOPMENT AND SERVICES ° . A . . 146 Main Street North Andover, Massachusetts 01845 '��"°,•.,°•%^'��y SSA'CHUSE May 29, 1996 Ms. Joyce Bradshaw Town Clerk 120 Main Street North Andover, MA 01845 Re: Watershed Special Permit/521 Dale Street Dear Ms. Bradshaw, The North Andover Planning Board held a public hearing on Tuesday evening May 21, 1996 at 7:30 p.m. in the Senior Center behind the Town Building, upon the application of Brenda and David Sicora, 521 Dale Street, North Andover, Ma 01845 requesting a special permit under Section 4.136 Paragraph 3 (b) (ii) Watershed Protection District of the North Andover Zoning Bylaw. The legal notice was properly advertised in the North Andover Citizen on May 1 and May 8, 1996 and all parties of interest were duly notified. The following members were present: Joseph V. Mahoney, Chairman, Richard Rowen, Vice Chairman, Alison Lescarbeau, Clerk, Alberto Angles, Associate Member, John Simons and Richard Nardella. The petitioner was requesting a special permit to allow for the addition of a family room and a 2 car garage with a game room above. The addition is less than 325' from the edge of a wetland ,., �_•., .resource area within the Watershed Protection District. The premises affected is land numbered 521 Dale Street in the Residential - 1 (R-1) Zoning District and the Watershed Protection District. Ms. Lescarbeau read the legal notice to open the public hearing. David Sicora, owner of the property was present and stated that he is proposing an addition to his home within 325' of a wetland resource area. He has hired a state certified biologist who stated to Mr. Sicora that there will be no impact or degradation in the watershed. The home is on Town sewer and water and the homeowner plans to install gutters, downspouts and a drywell to harness Watershed all the water. Ms. Colwell stated that the project has been reviewed by TRC and the W a Council with no major comments. She stated that the wetland resource area is across the street from the home, so it is doubtful that the construction will have any impact. Y BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Ms. Lescarbeau asked how large is the addition.and was told 1,000 sq feet. On a motion by Mr. Nardella, seconded by Ms. Lescarbeau, the Planning Board voted unanimously to close the public hearing. Ms. Colwell had a draft decision ready and the Board reviewed it. On a motion by Mr. Nardella, seconded by Ms. Lescarbeau, the watershed special permit was unanimously approved as amended. Attached are the conditions. Sincerely, U �A� ioseph V. Mahoney, Chairman North Andover Planning Board ,a �v 521 Dale Street Special Permit-Watershed Protection District The Planning Board makes the following findings regarding the application of Brenda& David Sicora, 521 Dale Street, North Andover, MA 01845; dated May 3, 1996; requesting a Special Permit under Section 4.136 paragraph 3(b)(ii) of the North Andover Zoning Bylaw to add an,addition to an existing home thereby allowing surface and sub-surface discharge of stormwater within the Non-Discharge Zone of the Watershed Protection District. FINDINGS OF FACT: In accordance with 4.136(4)the Planning Board makes the finding that the intent of the Bylaw, as well as its specific criteria, are met. Specifically the Planning Board finds: A that as a result of the proposed construction in conjunction with other uses nearby, there will not be any significant degradation of the quality or quantity of water in or entering Lake Cochichewick. The Planning Board bases its findings on the following facts: i. a certification from a Registered Sanitarian and Certified Soil Scientist dated April 16, 1996 stating that there will be no significant effect on water quality or quantity in Lake Cochichewick- ii. the proposed addition is connected to the Town sewer system and is located more than 100'from the edge of the wetland resource area. iii. infiltration trenches will be used to filter all roof drains and driveway runoff. B. that there is no reasonable alternative location outside the Non-Discharge Buffer Zone for any discharge, structure or activity, associated with the proposed construction as the entire lot is located within this zone. In accordance with Section 10.31 of the North Andover Zoning Bylaw, the Planning Board makes the following findings: The specific sit is an.appropriate location for the proposed use as allTfmasible stor nwater and erosion controls have been"placed on the site; 2. The use will not adversely affect the neighborhood as the lot is.located in a residential zone; 3. There will be no nuisance or serious hazard to vehicles or pedestrians; 4. Adequate and appropriate facilities are provided for the proper operation of the proposed use; 5. The Planning Board also makes a specific finding that the use is in harmony with the general purpose and intent of the North Andover Zoning Bylaw. Upon reaching the above findings, the Planning Board approves this Special Permit based upon the following conditions: 1 •J , SPECIAL CONDMONS: 1. This decision must be filed with the North Essex Registry of Deeds. The following information incorporated by reference into this decision: Plan titled: Plan of Land in North Andover, Mass. Prepared for: Curran Construction Stone Post Road Salem,New Hampshire 03079 Prepared By: Merrimack Engineering Services Park Street Andover, Massachusetts 01810 Scale: 111 =40' . Dated: May 1, 1.996 Letter from Steven Eriksen, Registered Sanitarian and Certified Soil Scientist of Norse Environmental Services, Inc., 3 Pondview Place, Tyngsboro, Mass 01879, dated April 16, 1996. Any changes made to these plans shall be approved by the Town Planner. Any changes deemed substantial by the Town Planner will require a public hearing and modification by the Planning Board. 2. Prior to any work on site: a) A performance guarantee of five hundred dollars ($500) in the form of a check made out to the Town of North Andover must be posted to insure that construction will take place in accordance with the plans and the conditions of this decision and to ensure that the as-built plans will be submitted. b) All erosion control measures as shown on the plan must be in place and reviewed by the Town Planner. c) The site shall have received all necessary permits and approvals from the North Andover Conservation Commission, Board of Health,..and the Department of Public an Vt�orks bein compliance with the above pern•,its and pprovais. d) All plans for the tie-in to the municipal sewer must be reviewed and approved by the. Division of Public Works. 3. Prior to verification of a Certificate of Occupancy: a) No pesticides, fertilizers, or chemicals shall be used in lawn care or maintenance. The applicant shall incorporate this condition as a deed restriction, a copy of the deed shall be submitted to the Planning Board and included in the file. 4. Prior to release of the Performance Bond: a) The applicant shall submit a certified copy of an as-built plan which shows all 2 i construction, including sewer lines, infiltration .trenches and other pertinent site features. This as-built plan shall be submitted to the Town Planner for approval and shall be stamped by either a Registered Professional Land Surveyor or Practicing Engineer. b) The Planning Board must by a majority vote make a finding that the site is in conformance with the approved plan. 5. In no instance shall the applicant's proposed construction be allowed to further impact the site than as proposed on the plan referenced in Condition#2. 6. No open burning shall be done except as is permitted during burning season under the Fire Department regulations. 7. The Contractor shall contact Dig Safe at least 72 hours prior to commencing excavation. 8. The provisions of this conditional approval shall apply to and be binding upon the applicant, it's employees and all successors and assigns in interest or control. 9. This permit shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced. Therefore the permit will expire on cc. Director of Public Works Building Inspector Health Agent Assessor Conservation Administrator Police Officer Fire Chief Applicant File 521 Dale Street Watershed 3 .'Jl1 C FORM U - VERIFICATION 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: �A/ (�/yt2 Phone 6h LOCATION: Assessor's Map Number a9sl Parcel Subdivision Lot(s) Street �Z ( St. Number ********************** *Official Use Only************************ RECOM150DATI S WN AGENTS Date Approved ORA/ Conservation Administrator Date Rejected Comments WhoC Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit k, .Fire Department Received by Building Inspector Date FORM U - VERIFICATION 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 local or state law, regulations or requirements. ****************Applican fills out this section***************** APPLICANT: !)/K) Phone LOCATION: Assessor's Map Number 6F LJ Parcel / S Subdivision Lot(s) Street 2- S St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections / - driveway permit V Fire Department4,)keLj off' 'aS ��'�L �� 6 �r6 Received by Building Inspector Date I� MORTGAGE INSPECTION BAY STATE SURVEYING ASSOCIATES 234 CABOT ST., BEVERLY MA LOCATION ' ./")2 /Y...A42429�1% ,qSS, NOTES: .f� This is a Mortgage Inspection survey and not an SCALE (�� FT. DATE , ,/. �.�......... •instrument survey,therefore this plot plan is for e (REFERENCE ................ mortgage Inspection ection purposes only. .. :� .X..1. 4?... ? 1sT.. ....... •This survey is based on survey marks of others. Bushes,shrubs,fences and tree lines do not „,, ,;,, , ,, ,, ,,,,,,,,, ,,,,,, ,,,, ,,,, necessarily Indicate property lines. To , /Y! DA,T�/� , „,/!')off,,,«?;� .In my professional opinion the building(s)are not located C The location of the building(s) as shown,either complied with the in the special flood hazard zone, as defined by H.U.D. local zoningset backs at the time of construction or is exempt P •Whenever an offset is 1't or less, an instrument survey Irom violation enforcement action under glass. G.L.Title Vlt is recommended to determine prop. fines. Chapter 40A Section 7. •Offsets shown are approximate by tape survey. i Of soa T o S s� o :Oyu lAli 1 f 1 _ til i 1 U. I1' V1 tll / N + q8� to o �� d CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED ASA54m, IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO C s ADDRESS S Z ( /4 ssACHUS Bui t pector Locatior. [ c. I No. Date ,.ORTM TOWN OF NORTH ANDOVER s F Certificate of Occupancy $ • Building/Frame Permit Fee $ sACHUSEt� Foundation Permit Fee $ J/ n ~ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ /c TOTAL $ Building Inspector t" j� Div. Public Works a + Location— No. Date °.N°RT;�ti° TOWN OF NORTH ANDOVER Certificate of Occupancy $ > Building/Frame Permit Fee $ CHU Foundation Permit Fee $ c Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL , $ oBuilding Inspector 1033 Div. Public Works .. . � NORTIy own of �Ldover No. 269 fl o ° 4 �l« dirt dover, Mass., (o / 19 COC"IC ME WICK ADRATED pP�\�,�C, 5 BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..................... ../�}�.�.. ................... /. r.....ap—A......... Foundation p . .� buildin s on .........�..Zj........�... ..1. ...........T. ................. �� has permission to erect.....A �.�. 1... ../.�,F,C.... g $ to be Occupied as............................................. _11U..f..�. ....... ..., ......01'T(`.�:1/.1CE............................... Chimney V� in ev respect conform to the terms of the application on file in provided that the person accepting this permit shall � p pp 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 Fina` UNLESS CONSTRUCTION STARTS ELECTRICAL SPE O oug ....................................... ... . ... . .... ...... ... .......................................... Ser e B DING INSPECTOR Final ] T Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det.