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HomeMy WebLinkAboutMiscellaneous - 58 PHEASANT BROOK ROAD 4/30/2018 \� G ov i June 16, 2015 NORTH ANDOVER BUILDING COMMISSIONER NORTH ANDOVER TOWN HALL NORTH ANDOVER, MA 01845 Claim Number: 033580315 Policy Number: 99940400003 Company Name: Arbella Mutual Insurance Company Date of Loss: 02/10/2015 Insured: JOHN MCCORMICK Property Location: 58 PHEASANT BROK RD N ANDOVER, MA 01845 To whom it may concern: I Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Very truly yours, Laura Barber CC: City/Town Fire Dept., City/Town Health Dept. •BrightClaim, LLC. PO Box 502048 Atlanta, GA 30350 • �`\\� � 9 LOT 2A lb EXISTING FOUNDATION T.O.F. = 134.0' 17.8'` \ ti; 5.9' - 36.3' 22.2' -- 28. 1 -28. 1MaeOt • FOUNDATION LOCATION PLANNwONQOAW?AL °"nw =wmw=ff m APPEIGINEE ZDAM fff- W N OF= WEAI C0057WXM (W cnw=mw pOES MW cal6ao AW On" MEsiminua 5"AS cfrEl UM John McCormack 0AMW °F Q01AANI Ma`M' CLIENT: pa OId Shill Mfr BE UM Nf "K aAUff FWANr THIS CERTIFICATION 15 RUDE AND UNJTED PUMV E °mw TMM 7mr Oulu"AOYE.MOW ww 7w WMEN FEMNSSaV OF CNOWM W t SDW NMC. TO THE ABOVE CLIENT. FURYIN38WK 7W OM WW IS 7W oapnaw M PNOPEW OF CIANSUOSEN t SEffa M= AND AN1' 1N NM OR USE IS PROMMYED.CNEWUMM & SEAGI TAM NO 1MMPONSM iIYY pw T)E LMU1 MMM USE OF 7W MLAlItMMf GN AW WON", LOCATION.-LOT 2A 'EVERGREEN ESTATES' " nai COMM= HOWM NORTH ANDOVER.A/A. SCALE. 1'=60' DATE.9/1/99 MicsAEL SE GI W .3 19 oa CHRISTIANSEN &SERGI Lam,,, '° pNOSJ foo Suwioe Sr. M4M*UL At 01M m. 970-375-MIO ®IBM Nr M UUNSDI : SOW Wr- DWG.NO.: 94036076 CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number a'2 g Date THIS CERTIFIES THAT THE BUILDING LOCATED ON cS8 7��i b R A37� 3r o o k MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. T;�,o CERTIFICATE ISSUED TO —�b �' /� o'` c 0 osV/ADO/` /l 4l ADDRESS s, .s� ^ U CM Building Inspector NORTH Tovm- 0a. , over °�A cor1edover, Mass., G jai gr jy ORATED P"? S H SE BOARD OF HEALTH Food/Kitchen PERMIT T Septic System =.O. M� ` BUILDING INSPECTOR THIS CERTIFIES THAT.. ..............:.....�.`..`.......COtNMI ..... � oundation11 t H �1d1 CC— has permission to erect..................1.................... buildings on....h,� ..AA.. 41 ....P�1���,�� Rout► c � to be occupied as...... �N ` !...... �.... ......ik r V C 3 S��1' �� �� Chimney .................... ....................................................................... provided that the person accep ing 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 INSP VIOLATION of the Zoning or Building Regulations Voids this Permit. u 61 UPCA PERMIT EXPIRES IN 6 MONTHS ��o (nol�� RouELE IC: / SPUNLESS CONSTRUCTION STAP AS ...... ........... ......R 4(...C. . .................... Service BUILDING INSPECTOR 3 i Occupancy Permit Required to Occupy Building GAS INsEC R o � � Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done FIPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 3/( 7 i TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 5/19/00 This is to certify that the individual subsurface disposal system constructed (X ) or repaired ( ) by Dave Maynard at Lot 2A(58)Pheasant Brook Road has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector K NORTy OF� 6 Q OL O i^ 10 �9SSAGHU`����y APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY :- ST mtqj-q6k grook ocid DATE REQUESTED FILED/READY FOR INSPECTION ,/7)(90 CLOSING DATE ON PROPERTY: v FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK'AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF 7TRUCTURE DOES NOT MEET ALL APPLICABLE CODES. 1 SIGNED , 4 /4�52_), ROUTING 'f Qv CONSERVATION PLANNING1 DPW -WATER METER 7 27- NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYIINSPECTION REQUEST DPW Si- na�t�re File: CC farm revised 618/98 MAR ! 0 20 f 00 BUILDING DEi Atj d 6i/dENTI Date. .���.�. .�� Nt-" 4184 ORTIy 3? 4, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHUS This certifies that . . ... . . . ..`.. . has permission to perform . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings ofd=. . . ,North Andover, Mass. Fee .. .Lic. No(�7.&J('.'k. PLUMBINLIG,INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING [Print or Type) p n oe'r Mass. Date /0 5 19� Permit # l0 Building LocationPh Qc c1.w t 'rctr)� �c _Owner's Name V Cl h.. �r Type of Occupancy_Z -Slz1-/1 New 21 Renovation ❑ Replacement 0 Ptans Submitted: Yes 0 No C FIXTURES Z X N N O ZUj F > W W X J N > V Q C C ¢ U V) X N Q ¢ < z~ z O z e OJ W H N Z N F U W H Y Q N U. X N N = Q < 0 0. OX S X C � y Q W O 7 W Q N G Q W N G J O C O .� F� ►� O 3j C �„ < Y LL = W = Q S 3 3 Z S Y 6 C z Z Q W LL Y W h < < S to N QQ C < CJ < G G Z Q C <F O SUB—BSMT. BASEMENT t 1ST FLOOR I I 2ND FLOOR l LkI 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR P / Installing Company Name ` ,\)eC cGs. One: Certificate L Address Corporation G 1066 0 Partnership Business Telephone S2� c+�"� _ ❑ Firm/Co. Name of Licensed Plumber INSURANCE COVERAGE: I have a curreliability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No 0 If you have checked yes, plea a indicate the type coverage by checking the appropriate box A liability insurance polky Other type of Mdemntty 0 Bond 0 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: Owner ❑ Agent 0 Signature of Owner or Owner's Agent I hereby certify that an of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumi e O hapter 142 of the General Laws. By �] Signature of LicensidPlumb& Title Type of License:Master�// Journeyman 0 City/Town O License Number `7 13f r BELOW FPR OFE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. -APPLICATION FOR PERMIT TO DO GASFITTING NAME 1 TYPE OF BUILDING VGV� Ilk01 ^^csc_l. LOCATI01J OF BUILDING PLUMBER OR GASFITTERCl.s� LIC. NO. 6\ \�� PERMIT GRANTED DATE 19 GAS INSPECTOR i `J 2 9 4 Date.. f�.. '.... ... .... Of NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION s i • ACMUSEt�• This certifies that . . . . . . . . . . . . ... . .: . . . . . . . . . . . . . has permission for gas installation .,5 �`l=1. . . . . . . . . . . . . . . . . in the bud f . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . at .V f . . .Alu • :; North Andover, Mass. Fee. . . . Lic. No.��:�Y. . . . . - . . . . . .. . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TONDO GASFITTING �5 (Print or Type) Mass. Date 19 �S Perm' x 3Z Building Location �� v �1 . A-Owner's Na Type of Occupancy, -5,4Ir �.,�,�,' /r,,� New [� Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ N N W N Y = ¢ of N U ¢ F- ¢ N C O O N F- N W C O U © t: S Jf O W < ¢ ¢ O < m N H r W Oy a ¢ j < ,; _ = Q W N ¢ W 2 U W ¢ N W Q W ~ W ~ = h W W b J < ¢ O V. f. W d 1- Z J ►� F' N a %- O � < W > ¢ W Q Z < 6 < < O Q W O it1 F. ¢ Q d U. 7 3 G d J U ¢ > D a !- O I SUB—asMT. BASEMENT JL IST FLOOR I I 2ND FLOOR 3RD FLOOR _ I 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR ` one: Cer+.ifxate Installing Company Name ��1cfiVL Address S h G�'�Corporation G 11066 _ ❑ Partnership Business Telephone (4-)cL ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �r,-Lv F!NSINSURANCECOVERAGE: i have a curren liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 19 No C7 if you have checked Yes, please indicate the type coverage by checking the appropriate box. l ' A liability insurance pdicy Other type of indemnity 11Bond F-1 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: Owner❑ Agent ❑ Signature of Owner or Owners 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 knorrlecge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all i pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene �La**By T of License: Plumber Signature sed Plumber or Gas Fitter i itle fitter Master License Number Cl 3 J f'itv/Tr wn _ Journeyman 13ELOW FOR O�ICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME & TYPE OF BUILDING J LOCATION OF BUILDING � � c� Sys PLUMBER OR GASFITTER LIC. NO. 1 PERMIT GRANTED DATE 19 GAS INSPECTOR �,; �`�� t,q �., .., �.�. ���.�:�.��...� ,�,. ,n t m 3 cu�A444 N2 1868 Date.......7 Ar TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING o o ,SSACMUSEt This certifies that ......... ........ ................................ -r Tf-..�-A p ......... has permission to perform ...... . ........ ........... .... .. wiring in the building of.........I.-(). Y^...... ....................................... ... .. ...... ...........ff.,North Andove�,�, Oss. at.... le..................... ........i.-J .1 Fee.3.00A.0... Lic.NoKP..Ylt'>� ........... ...... ELECTRICAL INSPECTOR C 3 'P/ WHITE: Applicant CANARY: Building Dept. 09/10/99 11:24 00.Oo My:Treasurer THEC0NB10NWF.ALTHOFA14M(RU.S'= - Office Use only a DLPARTUEVT0FPUBL1C.A)= Permit No. BOARD OFF7REPREYEIVTTONREGUTATT AS9270,M12-00 Occupancy&Fees Checked APPLICATTONFORPER IAT TOPERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date 9167199 Town of North Andover - To de Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. AP PARCEL Location(Street&Number) �� �2 SAn�` �►'�� Owner or Tenant TO C f F- Owner's Address or 4I' OOV-C Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) reA jO 56Vice 945-34 Purpose of Building .J _ Utility Authorization N 946 15-37 Existing Service Amps / Volts Overhead Underground No.of Meters New Service ,�0 Amps/2-0/oZVOVolts Overhead Underground No.of Meters Number of Feeders and Ampacity Loc tion and Nature of Proposed Electrical Work W/�' jeW 4bL,cam. t .S�1z!/7C�2� � �" rn✓ 4JJ 6e, �, po No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA IO.of Lighting Fixtures Swimming Pool Above. Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Bumcm 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 No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Cormcctions No.of Water Heaters KW No.of No.of Sims Bailasis No!Hydro Massage Tubs NO.,ollMotors Total HP O�IER• r Insl>rameCacaa�.Plustmrttotheiaq�ana�sa�ltsC�aleralLaws IlmNea amartlmlilyhNrmwPo}xym&dngCmTictOpwAm Wxtiribalec� YES NO Iba%eshTdedvalidgoofcfsametothe0ffim YES NO Yf miavedrd<cdYES,pleasero�dre peofootaa-byd��gihe apptopau ebox M - INK ANCE d BOND a OIFIER �eSpeafy) t — JValueof lWdk 5-6-0 WcdctoStatt 1 ac�a,I�tRecd Rs�g11 L 1C�2 - Final Gc,,l/C Sigtedtulda� ' F2MNANELiarseNo 114 h `TJ/� Lia3>seJ, ) 9 Licame J�� 6 ;� tgnahue YA BI�TeLNo. W -7-7Y a _ 02 /�'I /� 5 �4 /"lx G/y AItTeLNa OWNEfZ'SINStJRANCEW 'Iamav✓atethatlheLicet>set rtotltin�eihemstxatxeaitsstat�antialec�uva)eirtasreg>�b�Nlassadn�settsGtnaalLaws arylffilmysigreimenthisperratappliatbonwaic�s dmta4Inat�ri (Please check one) Owner Q AgentI Telephone No. PERMIT FEESA(,/( V tgnature ot Owner or Agent Location S ��r � No. Date 40RT" TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 8 �'1�°'••°''t�' Foundation Permit Fee $ - ssACHUSE Other Permit Fee $ Sewer Connection Fee $ 97¢ Water Connection Fee $ �o8z dG TOTAL /� $ ,/h �� �n ✓ a 8 j3uui4ding nspe or � y7/09/99 12:51 1,082.00 f ` v Div. P/41"i Works / a PEA ZN1IT NOAPPLIC:ATMN FILM PERMITTO IM11 l)** *****NO RT11 ANDOVV.R, fVIA My NO- IOI-Nu. ----- 2. NI( nl(n()I D\\N1HSun — - --- ----- 1)106 ,�'I - HOOF: ------ P,\GF: �(� S 1 6 �7 531 O `i AWA0? aQ, 3 00, — /Nem/�y�'' !9 C>4 FA 6th , (� (so c t\ I ' FORM U - LOT RELEASE FORM L w 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 V�t0�M/GSE. Q� PHONE� �7 /'9 LOCATION: Assessor's Map Number /PARCEL SUBDIVISION eV C-r5lrelm E�ke4e_J' LOT (S)_� -f STREET 1'f1PQSG/I b(b0k R11 �j,/ ST. NUMBER �a ************************************ ***OFF6CIAL USE t�tt�e� REC ENDATIONS OF TOWN AGENTS: 1 0Me UN e d A ONSERVATION ADMINISTRATOR DATE APPROVED (v d q M DATE REJECTED COMMENTS +�� `( y � Gil C�kOha� L&" TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED `SEPTIC INSPECTOR-HEALTH DATE APPROVED oz DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS a DRIVEWAY PERMIT FIRE DEPARTMENT 15 •01 �tlt 2Z .fmrm r, RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm .f 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. PPLICANT FILLS OUT THIS SECTION********************'*** S�IIc '� i3 c,Y1 APPLICANT ��l C c�i oERI O m�6k PHONE J07- ��fo � zr' LOCATION: Assessor's Map Number �0(a to PARCEL ± � SUBDIVISION CveR666W tr S 474 S LOT (S) f-STREET ?HEASaT 313d0►� ST. NUMBER USE RECO ME D IONS OF TO AGENTS:I -_. CO ERVA ION ADMINI§TRATO DATE APPROVED DATE REJECTED01' . COMMENTS (4 J.f.' F TOWN PLANNER DAT . OVED DAT REJECTED COMMENTS I 1riJ FOOD INSP TOR-HEALTH DATE APPROVED DATE REJECTED PIC 1 ECTOR-HEAL H DATE APPROVED .242 DATE REJECTED '''` COMMENTS 6JUBLIC WORKS -SEWER/WATER CONNECTIO > QUVEWAY PERMIT F DEPARTMENT o C� Y P '� a• RECEIVED BY BUILDING INSPECTOR DATE ,..:-+'.t: ,�, }a.. •4'• .. .. _. �.r r.,--'ti:y��.w Wt •�.. ..T^t*^t .-.}.-.:. .ia- ..-e�-.r v �.r r{rr- _ �+ .. s .. .. r r y•. +i'•, '"r., ..ya. .'.,•,. .:iP..�./. .. -(- ii'�Y.• rr .4�.Yr•i.r 874 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. 19 Application by the undersigned is hereby made to connect with the town water main in + r1 C'�� �� �G?�� S-(I Street, subject to the rules and regulations of the Division of Public Works.. R09-9&The premises are known as No. (I "!E'G��w(� Street or subdivision lot no. ' 7/4- " /`t" 3O7_ 6(0 ngv- - ohrt1�lvrrntG� i P�PGs�n S .Owner Address Ail 0 IN r- Contractor Address Applicant's i ature PERMIT TO CONNECT W H WATER MAIN i <7 The Board of Public Works hereby grants permission to ��t to make a connection with the water main at eA)C!kf Street subject to the rules and regulations of the Division of Public Works. v •^' Board of Public Works By Inspected by Date S��QkfMes andfr'egulat'on Th e Commonwealth of Massach usetts ( Department of Industrial Accidents — OfMice of/nyest/gat/uns - 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit name: o�n M . I"' Gcorml1 7k nT" E {7 Phf mot I!- I�robk 1t0a r location: ,,��pp ,,�// 1_ `�� ^ �' /p // city I OAA P()A)V{f', �" A d IPyr phone# _T7��4 J 'bt7,-r f7 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I ari an employer providing workers' compensation for my employees working on this job. Company name addr ti- city: phone t#- inynranee cn_ policy I am a sole proprietor,general contractor, o homeowner circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name- address:- city: ame- address•- city:. phone qt nocr co. Do 14-Y company name;_ addren- city:. phone imurt>nce c4 po_;ct" Failure to secure coverage as required under Section 25A of'YIGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years' imprisonment as well as civil penalties in the form of:t STOP WORK ORDER and a fine of 5100.00 a day against me. I undersand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce fy deerrr the pains and penalties of perjury that the information provided above is true and correct Q Signature /tel` Date Print name O�r! M I vi C-Cor-M CIC Phone 4 �d� r�0�7 official use only do not write in this area to be completed by city or town official city or town: permit/license q r7 Building Department Licensing Board check if immediate response is required 0Selectmen's OQfce Health Department contact person: phone N; f 7Other (rwucd 3195 PIA) 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 an Building Permit(below) Address of Property for Permit(below) IYCor t'c _Loi' JA P4eg �,,,, 20�� Map and Parcel : ,06 Q Purpose of pplicaticn (check below) Phone be f plicant - [Single Family Two Family K6S 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 ig 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 existence 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.r are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a property 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 pernits.(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. r- By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further Iunderstand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my kncwled or not, is grounds for refusal by the Building Department to issue a Building germi . 9 i ture of Owner or Aut nzed Agent who signed the Attached Building Permit Oa(e �� TAform must be attached to the Building Permit upon application for such permit. ORT#q Town o o Andover .. r No. o � ndover, Mass., aq C1 Cy T O LAKE co C: I"NEwICKICA %pS RATED PPG,��C� 1 SACHUS` I T FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ......: 4P..�.N....... .`1 ..�. .r..I C. ......................................................... ... .. has permission to excavate and pour foundation at � .. ............ 5S ................................�........ .... kJ ou It forthe purpose of..................... ................................ ................................................................................................. Md person accepting.this permit must returnto the office of the Building Inspector a-certified-plot-plan;show of building thereon before Foundation will be inspected. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. TofteC "* i asco W (A el .... ...........11!!� ...... ................... BUILDING INSPECTOR 1 NORTH T1r% Ar O" o D. .. L JAL 0v er .,� ,r � No. - - _ E dower, Mass., I. j9p dy. �Q A0RATE0 P"?aL �J S H 5� BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT...TO.�..�...........i��.....COMMI .. . ,. � BUILDING INSPECTOR 1 ..................................`.. .... .................... .. oundation has permission to erect..................I.................... buildings on ....ko.. A A...C45 ....P60SON�.... Rough to be occupied as......S.`'Vot !....... ���mf.' ......�.`.1.�. 1.u C. .................................................. 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 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 M f 0 6is Final ` PERMIT EXPIRES IN 6 MONTHS P 0 g UNLESS CONSTRUCTI N ST S ELECTRICAL INSPECTOR C Rough R � ' so ............ ........ ..... .............. ........................................................ Service BUILDING INSPECTOR Final 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. SEE REVERSE SIDE Smoke Det. r 8 ro �. 151 � � 6.9 LOT ZA c100 EXISTING FOUNDATION s. n yT.O.F. = 134.0' �G / 1 J 17.8'x` 21.5''_ / 5.9' 36.3' 22.2'-- 28. 1 2.2'28. 1' . FOUNDATION LOCATION PLAN ' cw" nuT nw PRNMRr mwxnw mwCarm a m nE /MDAlM71VrAL SEAMAN AMMOMM W W LOdll AFMr-4iW ZDfAW Br-uiia w EFrWWX CD#MM YlLM MW cmwwnow am NOT CaRs+cElt Mr amw aEsna MUM SUM As COVOWnX WENT: McCormack � or �� nra alai WMU NOT BE uam ar INE aiiNr FOR ANr THIS CEAVFCA170N IS RUDE AND LIMITED mmpaw Omm n"N ow wnmw AwwF. m,,r wlH 7w m m v PEJ111 WW or CAW MPMM A mid aye. TO THE ABOVE CLIENT. FWNEaii W 1Ma DMWW 6 11E Cdrtlff&Nna PROPEW OF CIA157MFIM t inial MC. AND ANr UMA RPMW GW IS & mild `MES NO NEWONAEUlr POR RE 1A au MdE m ow or im bin ww OR ANr mvp- LOCATION:LOT 2A "EVERGREEN ESTATES' whav CONARIM NORTH ANDOVER,A/A. "0 LASs9c SCALE. 1'=60' DATE.9/1/99 MICJ Ate yG SE GI y .311 0 ChIRISTIANSEN SERGI " °°� G �S Q� 1AAW SUR EMM L pN0 lw s1 SL NiAYEA/ uAK O/A30 1EL. 97E-MT-MIO ®im or amwavo Af! solar W- DWG.NO.: 94036076 ORTH Town o ^: : Andover T0 o, ndover, Mass., a q q q COCHICHEWICK �®�DRATED 7SS�4CHUSE P IT FOR 1h AF hXCAVATION AND FOUNDATION THIS CERTIFIES THAT ....7;n-h-!s�........ 6 has permission to excavate and our foundation at � �� p .. ....................... ....................�� . .kN...... R j .. UR for the purpose of..... .� N S.I .... A W11.�y..... b1 .!'!u� ....................6+611......V N LThe:person,accepting this permit must return'to the office of.the Building Inspector,..a-certified.plot planrshow of building thereon before Foundation will be inspected. Til Tr-,a0 % Fe-*, -ro C! VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. Wee' % 1 a SS0 pag . . . e .....jop'l.01. • BUILDING INSPECTOR