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HomeMy WebLinkAboutMiscellaneous - 66 MEADOWOOD ROAD 4/30/2018 (2) / 0"0000-0600-0'SZO/o2 �2� OV08 OOOM0od31N 91 � Location d f9 `✓r�G�i.�s�-r-r-jZf No. . •� y Date "ORT" TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ,SSACMUSEtApz oalndation Permit Fee $ VORTMwErormit rFee $ Sewer Connection Fee $ WaterCsnnection Fee $ ["Tt 2 x.993 $ �•D C) de ! � Building Inspector 6185 Div. Public Works a. .. ♦ a r w .,y y fa�. � rry.k.'' /J//t-tP. _ r R . t / Location 2r-re No. �� Date ti t Q' N°oT.1ti ,- TOWN OF NORTH ANDOVER „ Certificate of Od ppc� L $ a rnrr Building/Frame Permit Fee $ �,vs Acaus�t Foundation Permit Fee Other Permit Fee,4 UN ,:Zi� ` >75 Sewer Connection fie $ / -k2() Water Connection Fee $ TOTAL $ ,� h r' &BM16inc In.�p cf 72t tor 6433 Div. PAic Works Location L t T7 F� v\0/',h A M.,t..114; lo No. c;I~K 1 Date 7 ba r1 NpRTH TOWN OF NORTH ANDOVER ,. p Certificate of Occupancy $000 2 � ° ...�; ;Building/Frame Permit Fee $ -7'/7 ��P &lz, _ �ssnCNUS AFoundation Permit Fee $ Other Permit Fee $ �. Sgwer Connection Fee $ 19 5 J 3 Water Connection Fee $ LI •�u`- TOTAL $ (v V7< a l '- wilding Inspector '. 6266 Div. Public Works PEWN41T N©., I I;z 4/ 0 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP K40. I LOT NO. ov 12 RECORD OF OWNERSHIP IDATE BOOK ;PAGE — ZONE -g_—Lo SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING I n e- OWNER'S NAMEQD NO. OF STORIES ! S17E Z, OWNER'S ADDRESS T N1l SEMENT OR SLAB ARCHITECT'S NAME }C�. r<c+✓ + Q SIZE OF FLOOR TIMBERS �18JTGA7 X 1/� 2ND )c it) 3RD BUILDER'S NAME 1 Fpmy% C�rYI c4Q n l J SPAN ,-� / •4 H.J DISTANCE TO NEAREST BUILDING 10 DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR 1 1 5 1 GIRDERS AREA OF LOT 61000 1_Z, ✓ FRONTAGE r).S J HEIGHT OF FOUNDATION `7�I►I l THICKNESS IS BUILDING NEW /p�5 SIZE OF FOOTING O!l X Ll IS BUILDING ADDITION Y MATERIAL OF CHIMNEY AIJA IS BUILDING ALTERATION L lO IS BUILDING O SOLID R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE p IS BUILDING CORRECTED TO TOWN WATER O G BOARD OF APPEALS ACTION. IF ANY 4 IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINII INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST �9 n� 6 AA � ff .U.J L.CiCJ SEE BOTH SIDES � 1I 80' EST. BLDG. COST f7. iJcLl. .l��t`"11 /hp � PAGE 1 FILL OUT SECTIONS 1 - 3 LESS FDA FEE. y d _ EST. BLDG. COST PER SQ. mj. t PAGE 2 FILL OUT SECTIONS 1 - 12 DUE FRAME PERMIT 4Z- EST. BLDG. COST PER ROOM 16 7256 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 71f 5 / DATE FILED BOARD OF HEALTH a SIGNATURE OF OW ER HORIZED AGENT FEE SU _ � �O. O OWNER TEL.# 975'% '-ZN2,,14- PLANNING BOARD PERMIT GRA`''DE CONTR. TEL.# �19CONTR.LIC. # �� m �R C4 BOARD OF SELECTMEN INSPECTOR i BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY SroRIES MULTI. FAMILY :THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM _ 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 UNF IN. 1 3 BASEMENT—) AREA FULL .FIN. B'M'TAREA '/. '/t °/, FIN' ATTIC AREA NO 8 M T FIRE PLACES "0 HEAD ROOM MODERN KITCHEN 4 WALLS -I' 9 ,. FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �— -a WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D _ ASBESTOS SIDING _ COMfdCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR BRICK ON FRAME- CONC. OR CINDER BILK. ^ STONE ON-MASONRY':. WIRING tG •F?x fi4 STONE ON FRAME1£:1xF n '.•_"'; •^ - SUPERIOR k POOR _ ADEQUATE VAI NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING 1 TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR J TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. r TIMBER BMS. &COLS. STEAM STEEL BMS. 6 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 NO HEATING _n a • F FORM U - LOT RELVASE FORK 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 lav, regulations or requirements. **************n*�*Applicant fills out this section***************** APPLICANT: 1"t Phone ?757- /42-6 LOCATION: Assessor's Map Number Parcel Subdivision �c.�-�a-wa-vt� Lot(s) Street �"`��-O� St. Number _ ************************Official Use Only************************ RECO • RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments P A Date Approved �A Iq Health Agent .. Date Rejected Comments � � Public Works .- sewer/water connections driveway permit J (/ o 9 Fire Department 1' -77 Received by Building Inspector Date rI 41`t JUL I g Lo7- *-8 37,41os.4 � WI � �' • ' i '4.8S9AC. g p �Ex�rriv�; ,F 757 39 Al •�avvDAT/O,s/ �-4CA`T/ON F,com ' /'N S S //EREBY CE.�T/FY TO TyE'T/TLE/.1/SU.PO.P A,VO �L o/ Rcl—, /V T?� THE B4 N,Y THgT T,YE OwELL/.vc./S GOCATEO O.V T/1E GoT AS S.Sf�/nt/ANO T//.7T?OGIe-S CO,�/FGtP�y( //(� lY/Tf1 T.4�E TOw^rOF.�G A.vao�E�ZO.vrvG .c�EGVG,art�,vS ,4L�6r4.P0/.✓6 SETBAC.t'S FEO�'1 STPEET,S�GOT G/HES. "' �eTi� �,v�oYE.�'� /J��9SS GOG4TEO /�{/ T ETFE E AL FGA H Z O A.PEAaT OiPAN�/V FDiP .`�H MRssq 2S77o 98 �/o B /7�E.4oawaaa .�.q c T o� EFFREY S. /.^ � . / /993 sl�� Bovvo,Py�Er iov_ BOvvOA.eY/.t/FO.P�1- E 6 SE.P/�/G"ES AT/O(/ TA.t'E.y F,PDiY! EX/STivG ,PE'Co,POS. Q; A.t/OO/�E,C, if1.4SS.vG,�!/SE7TS 5:/8/O . CERTIFICATE OF USE & OCCUPANCY Town Of North Andover Building Permit Number 240 Date OCTOBER 7, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 66 MEADOWOOD ROAD (Lot #8) - Type C MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/ 1 CAR GARAGEIN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Meadowood Realty Corp. F: •'` �p 733 Turnpike St. ADDRESS North Andover, MA 73uilding Inspector IAORTH Town of 00 �0 over f(X Z t. � ' � dower, Mass. sII/f�I� / 19 t.? co �Ic�A A0RA-rED f4 BOARD.OF HEALTH Food/Kitchen f I ' .. . PERMIT Septic System Pr ':'THIS CERTIFIES THAT��.1�...�����.... ���e�.•�•�•••����� --- oundato �l L� 7- � BUILDING INSPECT-OR. has permission to erect. &Fbuildings on `` 1...�il � � Rough�a.��('. J--3-1­;P5 to be occupied asa /V. .g.0##jY.j•RY ��ACOW.A 0*� Chimn provided that the person accepting this permit shall in erespect conform to the terms of the application on file in Fi t Y C; this office; and to the provisions of the Codes and By-Laws relating to the InspecflER�N1EFOR PONN oWill! f �` Buildings in the Town of North Andover. REGULATED BY PADA. 114M SA PLUMB�N TPECTOR 'VIOLATION of the Zoningor Building Regulations Voids this Permit. ou L-� 9 g p -L FEE PAIDL(1 PERMIT EXPIRES IN 6 MOI�j4 ��,, ELECTR CAL INSPECTOR :PERMIT FOR FRAMUBWLUINGSS CONSTRUCTION STARTS • ;,� Rough �/� �'7 �. FEE PAIQ' ' / '�11TE: �! J Service . . ................ . ......... BUILDING INSPECTOR Final ok Occupancy Permit Required to Occupy Buildirig 'AS I SPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Firs 1 d � C .3 No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRED PARTMEN Burner SPA-0 ��e Street No. PLANNING�g� 6 ANAL �J��d CONSERVATION 7 / J cftj,- )VI:, Smoke Det. OCIAMD /%A►ATG77-uia � R � / FINAI /.j j4e DRIVFWAY FNTRY PERMIT(1LY. D,6A!<!-7, , Date..T(;A . .. .... -/ftRT NO M 02 '` TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACHUSEt This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . in the buildings of . .. /P . . . . . ... . . . . . . . . . . . . . . . . . . . . . at . .�`. . . . .... �uc�`.� .4° North Andover, Mass. . Fee. 2t��� . Lic. No.s . 7. eG�A . .NSPECTOR Check# M 73 6776 MASSACHUSETTS UNIFORM APPLICA7MN FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date CL/ Building LNations L. Permit# Owner's NameAmount$ ❑ f � s New Y Renovation D Replacement Plans Submitted ❑ w , v� U vi rij Z .1 GC E. F, Cc Ww w p O C z w w Go b Q a m z o > w w > a — a W ° > `� F x ° G z e o o° z w ° SU B -BASEM ENT 3 U > o 0 F O BASEM ENT IST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR TH . FLOOR 6TH . FLOOR 7TH . FLOOR. BIH . FLOOR. (Print or type) ` Name 1,04itl, . ® f,4— H Check one: Certificate Installing Company anY Corp. . Address a j/1 0 Partner. usmess 'e ep onei v �C airm/Co. Name of.Licensed Plumber'or Gas Fitter INSURANCE COVERAGE I have a current liability Insurance,policy or it's substantial equivalent Check one: If you have checked,Yes,please indicate the type coverage by checking the appropriate box. No� Yes Liability insurance policy � Other type of indemnity D Bond Owner's Insurance Waiver. I am aware that the licensee does_not_h_a_e the Insurance coverage required by Chapter 142 of Mass. General Laws,and that my signature on this permit application waives this requirement. P me Signature of Owner or Owner's Agent Check one: 13 Agent t hereby certify that all of the details and information I have submitted(or entered)Owner in applications e best of my knowledge and that all plumbing work and install s e d accurate to the compliance with all pertinent provisions of the Massach S ep ed under Permit Iss ed for this application will be in de and C apter.l of the I Laws. BY Signature of Licensed umber Or Gas Fitter Title ©Plumber City/Town.. Gas Fitter (cam ' Icense i�- erMas _ APPROVEDOFFICE USE sE ONLY) Journe yman ne c.on monwealth of Massachusetts o I Department f Industrial ticcidents -iY Office o f •Q 1-r�vestc ations 600 Washirngon Street Boston, MA 11111 t w►vrv. �2llSS.e Ov/ditl Workers' Compensation Insurance.Aficavlt: Builders/Contractors/Eiectrians/Plumbers A Iicant Information ci /� _Please Print Leaibfv Name (Business/Organization/individual): Address: . Z City/State/Zig: t� /A4 Phone#: Are yon an employer?Check the appropriate box: I. I am a employer with 4. ❑ I am a aA Type of project(re7on ---__ a..neral contractor and I employees(full and/or part-time).* have hired the sub 'on 6•. ❑ New construc 2.❑ I am a sole proprietor or partner- listed on the attached sheet # 7• ❑ Remodeling ship and have no employees These stab-contractors have working for me in any capacity. workers' comp. insurance. 8. ❑ Demolition [No workers' comp. insurance S. ❑ We are a corporation and its 9. ❑ Building addit required.] o fficen have exercised.their 1L13.[] ❑Electrical repa3.❑ I an a homeowner doing all work right of exm self. ptton pet MGL Plumbing reparatons Y [No workers' comp. c. IS2, 1(4),and we have no insurance required.] t employees. [No.workers' Roof repairs comp. insurance required.] Other *Any applicant.that checks box#1.must also fill out the section below showing th-ir,workers'camperssation policy information. 2 i-nD=o s th l ch l,,this •box a,,rdeaii inuicatia�ale}'are duir•� c=,c:�Y 4.•;rl Lhcn hi— outside con"4u'urn musi submit a new affidavit indica n -=ch. XContrartora thal check this box.must attached an additional sheet showing the nante.of the sub-co,tractors and their workers'camp. oli S I am an.e P P � information. employer that is providing workers'compensation insurance for npr a to e�. information mP Y •s Below is the poficy and job site Insurance Company Name:. Policy#or Self-.ins. Lic.#: Expiration Date: Job Site Address: Attach a copy of the workers' compensation policy declaration Q City/state/Zip: Failure to secure coverage as required under Section 2SA of pane(showing the policy number and expiration date). fine up to$1,500.00 and/or one-year imprisonment,as well as civil pc.e alo52 es in thleade to imposition of o a STOP W aminal penalties of a of up to.5250.00 a day against the violator. Be advised that a co WORK ORDER and a fine investigations of the DIA:for insurance coverage verification.copy of this statement may be forwarded to the Office of I do herebp cern oder the pains penalti o er u rP ! rJ rhat the information provided above is true and correct Signature: Af ...... L -r— Date: 1 ) Phone#: Uncial use nnlp. Do not write in this area, to be completed b3,city or town official City or Town: PermittLicense issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/TownClerk 4. Electrical inspector S. Plumbing Inspector 6. Other Contact Person: Phone#. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined.as"..very person in the service of another under any contract of hire, express or impliecL oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and includi-na,the legal representatives of a deceased employer,orthe receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dweliing house having not more than.three ag artments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment em be deed to be an employer." MGL chapter 152, §25C(6)also states that"every state o►r local licensing agency shall withhold the issuance or renewal of a license or permitto operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence a►f compliance with.the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states"Neither -the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public wor;l< until acceptable evidence of compliance with the insurance requirements of-this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary;supply sub-contra.ctor(s)name(s), address(es) and phone number(s)along with their cord-fcate s of insurance. Limited Liability Companies (LLC) or Limite=d Liability Partnerships(LLP)with no employees other than the members or.partners,are not required to carry workers'compensation insurance. If an_LLC or LLP does have.. employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The,affidavitshould be returned to the city or town that the application for the permit or license is being requested,not the Depar=tment of Industrial Accidents. Should you have any questions regr -ding the Iaw on if you are required to obtain a workers' compensation policy,please call the Department at the nMThber,list d below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the afr"rdavit.is complete and printed legibly, The Department has provided a space at the bottom of the affidavit foryou to fill out in theevent the Office OF Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/iicense applications in arry given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or Iicenses. A new affidavit must be filled out each year. Vae-re a home owner or citizen is obtaining a Iicens-- or permit not related to any business or commercial venture (i.e. o dog license or permit to burnleaves etc.) said person is NOT requited to complete this affidavit The Office of Investigations would like to thank you.in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department ofLridustrial Accidents Office of Lnvesfigafioaa 600 WashLing•ton Street Boston; MA 62111 Tel. # 617-727-4900.e=406 or 1-877-MASSAFE Revised 5-26=05 Fax 4 617-72.7-7749 WNW'.mass.Dov/dia