HomeMy WebLinkAboutMiscellaneous - 55 LOST POND LANE 4/30/2018 (2) 55 LOST POND LANE L lq rU�
210/104.B-0221-0000.0
Locations-�'
No. � Date
NORrM TOWN OF NORTH ANDOVER
p Certificate of Occupancy $ 5-0
41
Building/Frame Permit Fee $
��b',^°•''tom Foundation Permit Fee $
ss�C"
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
�7
Building Inspector
9 0/18/95 12:04 150.00 PAID
10 3 Div. Public Works
-.. .,. , •: .._. ,..ate.., .�s,Emw.-. ., ,;,.� Y._, ....�_.� . ��;,:.. ,,. :;� _
i
Location /��--®� D
No. e �� Z Date
q
40RT" .TOWN OF NORTH,ANDOVER
r 0 p Certificate of Occupancy $
41
Building/Frame Permit Fee $
��s•,^°•"tom Foundation Permit Fee $
SACMUSE
Other Permit Fee $ r#
Sewer Connection Fee--- $
Water Connection Fee $
TOTAL $5��
wilding Inspector
!
10
10395Div. Public Works
PER-Aitr Nb. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
MAP+J0. I LOT NO. v� C! F ��� �J� �� f�?- ' 2 RECORD OF OWNERSHIP iDATE BOOK PAGE —
ZONE �J_ + SUB DIV. LOT NO. �3 14-11 Lac 1` /'� C -y-;7- �J
C' z,7Z/I) j 0
LOCATIO / 05r /'6N0 L9A/C PURPOSE OF BUILDINGS°. _ /e
OWNER'S`NAME f7 / Lot � /NC NO. OF STORIES SIZE
OWNER'S ADDRESS D Cl 6 O X S-3) //' 4/V x61/PC BASEMENT OR SLAB ,Q„9.� ,.,t;„U f
ARCHITECT'S NAME ! 3-'�q 4--) /-,�)e31 5^J SIZE OF FLOOR TIMBERS1ST f 0 2ND �,I./C) 3RD k
BUILDER'S NAME 4r,„y r e 6G K ' /10(/ C SPAN 7 "—
DISTANCE TO NEAREST BUILDING '?Z ! DIMENSIONS OF SILLS a = 2-
DISTANCE
DISTANCE FROM STREET �U• ' POSTS
DISTANCE FROM LOT LINES-SIDES / (�} REAR 2 d GIRDERS
AREA OF LOT � 7 1 3 FRONTAGE t"(5)o / HEIGHT OF FOUNDATION 7/ /0 " THICKNESS
IS BUILDING NEW ye.5 SIZE OF FOOTING lD �U X `
IS BUILDING ADDITION MATERIAL OF CHIMNEY eel L,�f I`
IS BUILDING ALTERATION //a IS BUILDING ON SOLID OR FILLED LAND s�
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ed 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 N
INSTRUCTIONS 3 PROPERTY INFORMATION
• LAND COST � 9-0- 006
SEE BOTH SIDES a EST. BLDG. COST
t
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
PAGE 2 FILL OUT SECTIONS I - 12
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 APP VED BY BUILDING P TOR
DATE FILED
Co
BUILDING INiP[CT011
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E OWNER TEL.#
6'✓C
PERMIT GRANTED ,., CONTR.TEL.#
CONTR.LIC.#
MAM FUM H.I.C.#
OCT ` 9 19a
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
AREA FULL FIN. B M AREA _
'/. 1/1 1/ FIN. ATTIC AREA _
N_O B MT FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDI!J'D _
ASBESTOS SIDING COMMCN
VERT. SIDING ASPH.TILE ---{I
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR I_
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR (� POOR _
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. (2 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
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. d COLS. STEAM
STEEL BMS. S COLS. _ HOT W'T'R OR VAPOR DIM m a—am
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G ,� ,
UNIT HEATERS
GAS
7 NO. OF ROOMS OIL
B'M'T 2nd _ ELECTRIC
1st 13rd I NO HEATING
- --,. ✓�e Er�narna�uuealr�. '1.14
DEPARTMENT OF PUBLIC SAFETY
t_ CONSTRUCTION SUPERVISOR LICENSE
r Nuiber: Expires: Birthdate:
CS 005693 01/13/1998 01/13/1954
Restricted,To: 00
DAVID A XINORED
40 MARBLERIDGE RD POSOX531
N ANDOVER, NA 01845
Restricted To: 00 17650
00 - None
IA - Masonry oily
12 Fasily Holes
Failure to Possess a current edition of the
Massachusetts State Buiildiny Code
is cause for revocation of this license.
Growth Management Bylaw Exemption Statement `
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
Name of Applicant on Building Permit(below) Address of Property for Permit(below)
R/ - rLV e //J f _�__ Logi q (,Ie
Map and Parcel : Purpose CApplication (check below)
Phone Number of Applicant: A Single Family _Two Family
_ (68IT- &sSB
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth
Management Bylaw. I also understand providing this form does not absolve me or any party to this permit
from the requirements of obtaining other permits required prior to the issuance of the Building Permit.
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only officially accepted when the Building Permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit application and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in
exist nce as of the effective date of this by-law,provided that no additional residential unit is created.
The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
Bylaw.
This application is for dwelling units for low and/or moderate income families or individuals,where all of the
conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purposes of this Section"senior"shall mean persons over the age of 55.
This application is a part of a development project which voluntarily agreed to a minimum 40%permanent
reduction in density, (buildable lots),below the density, (buildable lots),permitted under zoning and feasible given the
environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland.The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling.unit on the
parcel.
This application represents a lot which is ready for building permits,(i.e.all other permits from all other boards and
commissions have been received and the project is in compliance with those permits), and the Development Schedule
does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per
Development until such time as the Development Schedule accommodates issuing building permits. Applicant must
supply approved form U with this EXEMPTION.
Please provide any and all information that would assist the Building Department in making a determination
that your application is allowed one or more of the above EXEMPTIONS.
By signin below I attest to the accuracy of the information provided and that the attached building permit is
allowe a EXEMPTION as cited above. Further I understand that the submittal of misleading and or
inacc yer,'
rmation, or the chlkn off of an above item which does not comply,whether done to my
know e not, is grounds for ythe Building Department to issue a Building Permit.
�� f 9Signa Ure of Owner or uthorize Agsigned the Attached Building Permit Dat
This form must be attached to the Building Permit upon application for such permit.
OCT ` 9
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:
APPLICANT: P �" �(.-6 f l� 1 A) Phone
LOCATION: Assessor's Map Number /�q&
Parcel _ TP f/Z,/S, z3*!7S
L T r P o S n�
Subdivision d �
Lot(s) lJ
Street D s T 1,04'y4o -y(f St. Number
********************* *O cial Use Only************************
RECO NDATION OF' GENTS: /
/ Date Approved
I
V Conservation AdidefiAtrator Date Rejected
Comments
i
I r_ '
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
/ Date Approved
c/ Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driv way pe •t L� D (- 9�
Fire De artment a� -
P
wReceived by Building Inspector Date
OCT'— 9 1,996
CERTIFICATE OF
USE a OCCUPANCY
Town of North Andover
Date
Building Permit Number
S( Z
THIS CERTIFIES THAT
S�v/
� L '( -pc) �fl
BUILDING LOCATED ON Los
THE �
c IN ACCORDANCE
MAY BE OCCUPIED AS
WITH
THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APDL
CERTIFICATE ISSUED TO
p ADDRESS
s
•
in41ector
�SsAcwus�
f N� ,TMS
_.
Town of Andover
No. 0 .; ` .tr "°1 n; to
51 2 -- 17
yy � or dower, 1 Mass. 40ZA 19 Q w
COCHICHEWICK
lei
DRATED PPS\ �5
S 1 BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUIJ.DING IN
THIS CERTIFIES THAT
„ lindation4
has permission to erect........................................ buildingson........`SS... .. .. ...... .... ..t7....... ! � o
to be occupied as....................................... '��/ ........r.I�./.!'q../ .............................................................. Chimney
provided that the person accepting this permit shall in every respect confor to the terms of the application on file in final �_ /3
:this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of 3�
Buildings in the Town of North Andover. PLUMBING INSP&CTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS �Y
ELECTRI AL SPECTO
UNLESS CONSTRUCTION ST S
tuLDINSPECTOR � /
i. Occupancy Permit Required t0 Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Fough
Final
No Lathing or Dry Wall To BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Insne.ztor.
Burner',
Street.No. 9
SPraftlt�s _6'-4� IC�`d�► 1
Smoke Det.3 t
tom- - - -
MASSACtiUSETTS unwoIZM APPLICATIOU FO11 PERMIT -TO DO PLl1M I 4G <.
(Type or Print)
NORTH ANDOVER .Mass. �- Date: U/N
Building Location / Permit �20d
Owners Name
New Renovation ❑ Replacement ❑ Plans Submitted ❑ '
FI TURF '
" x •
of f77 O Z F-• ?
tit
W
W x pl a 0: x O - x W a
O w F- tet a tu W — 0-
.J X cc at _ z t.
to t7f df t— U y,t 0f x Q W a• �i K .
Q OC 0. d 4 0. a O
w x w o �' ¢ -� M t--07 X a 3c " e'
¢ x' o z x. t- x n o ¢
a > t- o W 0 o o m z x w t' o a x
a a x _ ¢ ¢ O .: ¢ .tr ix W a o a r
X .1 to Of O O J 3 Z F-- W U. O O 4 -Cc 03 O ' .
SUB— SSMT. -
tl
BASEMENT
IST FLOOR
t
2ND FLOOR �.
3RD FLOOR
4Tli FLOOR
STHF.LOon
GTH FLOOR '
I
7TEt FLOOR
J
13TH FL.00n
(Print or Type) Check one: Certificate
i Installing Company Name Corp. y
Address It- 1,vvz,,, �� ��ts 1�� yj 3g� ❑ Partner .
Firm/Co.
Business Telephone 1)C3
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
i Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
Insurance Waiver: I , the undersigned, have been made aware that the licensee of
` this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner ❑ Agent
I hereby certify that Al of the details and information 1 fa c submitled (Ore.tcecd)in aho.c appliolion arc Irue and iocurate to(lie bell of ury
"Owlcdge and that 21t Alun,bine work and installatinns lserfnr+ucd under 1•cnnit issued for dris a;+plication will be in compliance-ith all petlinent pro-
sision4 of file Massacl(utetts slate rlumbinr Code and Clupter 142 of tl,c(;cncral hws- r.
I3y
Title Signature of Licensed Pl tuber
City/Town- Te, Number
of Plulllbit License
I,icerlsumber Com' Nlasttr r ❑ Journeyman ';
APPROVED tOFrICE USE OP(LY)
- t
`
Date. . . . .6 . .11.7
TO 3200
`NOR7: do TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SSACMuS�
This certifies that . . . . -. ?/. . . . . . . . .
I
s ;
has permission to perform . . .�� .���� -. . . 1 . . . . .
plumbing in the buildings of . . . . .
at. . d., ', - d�r�,.. . . . . . ., North Andover, Mass.
Fee� vt�
� A"—Lic. No�ZD—""...,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �
PLUMBING INSPECTOR
o
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
4
a�1 .
omce Use Onty 6,q/
a- 014e Lffa IIIIIZ craft I Df gus;#1mitt Permit No.
r 1hpartmtrrt of 31trhtit —56af2iq Occupancy& Fee Checked 2
r BOARD OF FIRE PREIENTION REGULATIONS 527 VJR 12:00 3190 (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 / I 7 1
(X)i or Town of NORTH ANnOVFR To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number -�S S� Pe'
Owner or Tenant //.A_ 01
�67C_ c
Owner's Address r ✓dX o
Is this permit in conju�r,stion with a�ilding permit: Yes _ No r (Check A rlat2 Sox)
Purccse of Suildina JN t// ilt `41 ���Utility Autttprizat n No.
Existing Sarvice Amos Vcits Overread _ Unagrnd No. of Meters
New Sel-Ace �`2"]G Amps /100/ ,WvOits Overhead - Uncgma No. of Meters
Number of Feecers anc Ampacity
Lccaticn aria Nature of Prcposee Electr:cai .'/crx
Total
No. of _:gr; g in Outlets i No. of Hct 7---s7---s No. of :ranstormers K%1A
Abover— In-
No. of Lighting Fixtures i Swimming Pool grna. — cmc. '_ 1 Generators KVA
No. of Emergency Lighting
No. of Recectacie Outlets No. of Oil Burners ( ; .3arery Units
No. at Sw tcn Outlets �� No. ar Gas Burners I FIRE ALARMS No. of Zones
No. of ^_etection aria
No. of AanTotal ges No. cf Air Carc. tans I Initiating Oavtces
Nd.at Heat Total Total
No. of Oiseosals Ps Tons K 4 Vo. of Scunging Devices
No. at Self Contained
No. of Cisnwasners - SeaceiArea rearing KW Oetect:oniSouneing Cevtces _
I Muntciaat Other
No. of Crrers Heattnc ^ev:ces KW Legal Connect:on
No. or No. of Low Voltage
No. of .Vater Heaters KN j Sic-is Ballasts Wir:nc
No Hycro Massage ubs I No of `lotcrs Total "tP
OTHE
INSURANCE CCVERAGE: pursuant ;o the reeutrements of %Iassacnusetts.;enerat Laws _
I
I have a current Liaetiity Insurance Police! inciuctng C�mc:eiec aticns Caverace Cr ;is suos;anrlal ecuivatent. YES _
have suamirted valid proof C me to the Otflcs. YES _NO _ It you nave checxed YES. please indicate :he IVCB Of coverage ay
checxtng :he aoprac Cox.
INSURANCE — CNO = OTHER = (Pease Scec:y) (Exotranon Cate)
Estimated Value of E!ec;ncal Worx 5
Warx :a Start Inscec;:on Oate Recuestec: Rough �— F,na)
Signed unser ;he P halt:es of perjury:
FIRM NAME�. / L �^47� UC. NO.
Licensee /� Q,224—/ P< Cd�7— Signature LIC. NO.
�D /I Sus. :el. No.
U
Alt. Tet. No.
Address
OWNEa'S INSURANCE WAIIEA: I am aware that the !:censee aces nol nave ins insurance coverage or its suostanval eautvalentt as e-
cuvea ov Massachusetts General Laws. anc that my signature an ^:s oermr aowication waives this reawrement. Owner Agent
(P!ease cnecx one)
—etecnone No. PERMIT FEE S
(Signature of Owner or Agenti c�5o5
R
Date..... ...-.
7a696 ..
TOWN OF NORTH ANDOVER
' PERMIT FOR WIRING
,SSACMUS� - ..
This certifies that ........... .... ..0:�t ........`- ..<...: .t. ...0 :........
has permission to perform .... ...f.. .,!".....
wiring in the building of.... � ..
....
at..... .:...4G2.,i... �/�t. , ..r.... ,North Andover,Mass.
Feer,. ; ..sN. Lic.No/vb.a ..pp.
ELECTRICALINSPECTOR
43 � 61/23197 14:40-41j9 IV e IQj'5
WiiITE:Applicant CANARY: Building Dept. PINK:Treasurer `.
0117
N N
Ol yt •n y'!tip i
NORTH ANDOVER BUILDING DEPARTMENT
400 Osgood Street
ACHU
Tel: 978-688-9545
Fax: 978-688-9542
BUSINESS FORM FOR TOWN CLERK
DATE: 7/1 f S
NAME: �c�to s �, rvv-�,-
ADDRESS: L-C'S� Poo d L-VI Norm -Ay d oUe -
ZONING DISTRICT: J 1
TYPE OF BUSINESS: I ���'' (A
BUILDING LAYOUT PROVIDED: YES
AVAILABLE PARKING SPACES: y c
mold.
L:3-� p.-mac•--1/
ZONING BY LAW USAGE: YES NO
f ,
n
BUILDING INSPECTO IGNATURE
Revised 11.5.04
BUSINESS FORM FOR TOWN CLERK