HomeMy WebLinkAboutMiscellaneous - 704 FOREST STREET 4/30/2018 (2)O
C,
(T T
Q x
O m
W cn
�cn
OZ1
o m
o m
o �
CONSERVATION DEPARTMENT
Community Development Division
May 21, 2014
Joseph Lehmann
704 Forest Street
North Andover, MA 01845
RE: Selective removal of twelve (12) trees within the buffer zone to Bordering Vegetated
Wetland.
This is a follow up letter pertaining to your request to remove approximately 13 trees (one tree is
outside of the buffer zone) and prune several additional trees at 704 Forest Street. The trees
were identified during a site visit with the homeowner by the Conservation Department on
April 8, 2014, trees were marked with yellow tape. Removal of vegetation, including pruning
and cutting, is prohibited within the No -Disturbance Zone except in rare circumstances, such as
for safety.
Due to the potential danger imposed by the trees the Conservation Department will permit their
removal to prevent possible injury or property damage. These cutting activities shall be limited
to the trees identified at the site visit and shown in the photos below. DPW needs to be
contacted about the three small dead trees along the roadway prior to their removal (685-0950).
'Determination of property ownership is the responsibility of the homeowner.
The approved cutting will be subject to the following conditions:
❖ The work approved in this letter shall be completed by December 31, 2014.
❖ No machinery shall enter the 25' No Disturbance Zone (working from the driveway is
allowed).
❖ Work occurring within the 25' No Disturbance Zone is to be completed by hand (hand held
chainsaws are allowed).
❖ All tree limbs, brush, and other debris materials shall be taken off site and disposed of
properly.
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542 Web www.townofnorthandover.com
❖ Stumps of the trees shall not be removed and shall be left in place. Stumps may be ground
down or cut flush with the landscape.
❖ Care shall be taken to prevent damage to surrounding trees during removal of the approved
trees.
❖ Upon completion of the tree removal, all disturbed areas shall be properly stabilized.
❖ The applicant shall notify this department immediately following completion of work for a
final site inspection.
❖ Areas within 100 -feet of wetland resource areas shall remain in a natural state and no further
vegetation shall be removed without the prior approval of the Conservation
Department/ Commission.
Please do not hesitate to contact me should you have any further questions or concerns in this
regard.
Sincerely,
NORTH ANDOVER CONSERVATION COMMISSION
Heidi Gaffney
Conservation Field Inspector
Cc: Jennifer Hughes, Conservation Administrator
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 918.688.9530 Fox 918.688.9542 Web www.townofnorthandover.com
�n
�r
J
e'"`�:i8.�"_• Wit_ � Z. F� �`_`� f....�.i "•�%
b1
%F
rt
r i
Ar
14
// g l! � �-; , +
n "1R
k
•
�t a art y
4N 7QRy tP7`
• S
rt
Ar
14
s�
.i
• S
rt
"
..........
. . . . . . . . . .
, 10
lz
{
}
4t l ray �iE.. ,. r ♦�✓- ...�.
1.'f
IVA
gib; A- } �. \ ( �� �•_.
C �t �"� . ,{,{'� �� i9 to �ry'}� '4�� I i 3 �� 4 • �i �`� _ �7t 1. � f �.
Go.
!,
`r ` t
j
.. 3-•�"'r-�-� y.. vN. ::ice _
�.n�t�'.�rti�'iA, ,.. �...�i' L'E�_�.Y�lw �.,.J..F,t' .: :`.',s� ":�.H:+Xhtia•.a.� .�,.aic'�-w r ._ / a ��'
I
/ 2- - 41., � ,,o
Date ..... ....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that ................................................. ..........................................
Re7e /11
has permission to perform .......... ................................................
wiring in the building of ....... ........................................
70 L/ )C��ec-7 s -r
at ............................................................. 5—
....... /-). ,North Andover, Mass.
.......... ..........
........ Lic. No..-.. ...........
Fee 2�5
ELECTRICAL INSPECTOR
Check,,
Commonwealth of Massachusetts Official Use only
Permit No.�
Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLF-EEE PRINT' RV INK OR TYPE ALL INFORMATI0119 ' D ate: 1 �2 . / /
Greer Town of:To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) ,L''o R d a 9r,
Owner or Tenant !1,9-:sL , A is 6h 422 QoA,yL Telephone No.
Owner's Address <.a -A-J. /'_
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building 9&yj-a'dt.d1a�— Utility Authorization No.
lZi
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 1,* q a. t1 JLmmr2
C` .6 GSL o -C& .
Completion of the followinz table may be waived by the Inspector of Wires.
No. of Recessed Fixtures
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting FixturesSwimming
3
Pool Above ❑ In- E]
d. d.
No. o Emergency g g
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No: of Air Cond. Total
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
I.Number
I Tons
KW
No. of Self -Contained
Totals:
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Munic'pal 0 Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
o. of No. of
Data Wiring:
Heaters
Signs Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP .
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER f .G'"AA'L .tr /A T r s
—'� Attach additional detail if desired or as required by the Inspector of Wires.
i-* INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE eT OND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work (When required by municipal policy.)
Work to Stark /.,. /.�r- ) D Inspections to be requested in accordance with NEC Rule 10, and upon completion.
I certify, under the pains and enalties of perjury, that the information on this application is true and complete
FIRM NAME: !' �� �!�$/� CL gL��"✓J 1 V_ (� LIC. NO.: a i'
Licensee: !�? T--�.' p Signature
(If applicable, enter "exempt" in the license number line.)
Address: /f Q�_1jp
OWNERS SURANCE WAIVER. I am aware at -the Licensee does
required by law. By my signature below, I hereby waive this requirement:.
Owner/Agent
Signature Telephone No.
grgg( G.G� LIC. NO.:
Bus. Tel. No..
Alt. Tel. No.:
not have the liability insurance coverage normally
I am the (check one) ❑ owner ❑ owner's agent.
PERMIT FEE. $
Az- /,Z"., Jop'-,/
This certifies that
Date.. � 7 -
TOWN
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
has permission to perform .... 8- / A/./.4e5?r( .................
plumbing in the buildings of ...4--:-�h.M4w..................
..... j`- .. , North Andover, Mass.
Fee 7��5�.. Lic. No...��3$7........................... /P
PLUMBING INSPECTOR
Check # o
�Cf
FIXTIIRFIR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: j ar:� 4VJ(�1/W , MA. Date: U Permit#
Building Location:_ 7(]44 0 D r E S� S�, Owners Name: _ Leh ✓)')Q,V) Iii
DEDICATED
Type of Occupancy: Commercial Educational Industrial
Yp❑ ❑ ❑ Institutional ❑ Residential
New: ❑ Alteration: ❑ Renovation: U Replacement: ❑ Plans Submitted: Yes ❑ No ❑
FIXTIIRFIR
INSURANCE COVERAGE:
I+have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy 0' Other type of 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 ❑ Agent ❑
Signature of Owner or Owner's 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
Knowieage and tnat au plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Title M Plumber Signature of Licensed Plumber
City/Town RT Master License Number: 133g%
APPROVED OFFICE USE ONLY []journeyman1
DEDICATED
SYSTEMS
z
Z
H
tn
O
D
W
>
te
Z
~
V1
=
y to
W
0
D
W
aLn
H D:
Z W
Z Y
w Z
4AQ
o 2
W
a
N Z
Q�Q
N
a
a
< W
~
F
C' °° Vl w
0
J Q
Q H H
Q Z
> Q �
C' O
Y
Z
HLn owe:—
W "J Z
X
U d LL
J
H
a Y X 2 �a
Uj
O =
W
Z Q U. 3
5i
a
x Z v=i
IW- H w
Co
W
OI Q }
H
LU Q a
o o
o o>>
g g o=
o
a a
a a
u
a L
a
a m m
X Y
oc Cn(A
3
3 3 0
Q
t7 c3 3
3
SUB BSMT.
BASEMENT
1' FLOOR
2"D FLOOR
/
3RD FLOOR
4T" FLOOR
5T" FLOOR
6T" FLOOR
7T" FLOOR
8T" FLOOR
Check One Only Certificate #
Installing Company Name: � I���P,a° WK�.NI
❑ Corporation
Address:0('7.• �l'� lIM Q City/Town: t I State: i
04D. [I Partnership
n p
Business Tel: `7 �d" q_%n T — a ola o Fax: [�rpirm/Company
Name of Licensed Plumber:
INSURANCE COVERAGE:
I+have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes ❑ No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy 0' Other type of 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 ❑ Agent ❑
Signature of Owner or Owner's 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
Knowieage and tnat au plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Title M Plumber Signature of Licensed Plumber
City/Town RT Master License Number: 133g%
APPROVED OFFICE USE ONLY []journeyman1
Date. .% ......
TOWN OF N TH ANDOVER
O � p
PERMIT FOR -OAS INSTALLATION
This certifies that .. . �. �' ...� `. ! 'r ...... .
has permission for gas installation ....
in the buildings of ... ........ .
at ......� ............... ..... .. , North Andover, Mass.
Fee. .3 Lic. No.. 0. F. ...
'GAS INSPECTOR `
Check # �[
6084 aye
MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations -70
Date
Permit #
Amount $ 3 p
(Print or type)
Name of Licensed Plumber or Gas Fitter }�
Check one: Certificate Installing Company
p Corp.
Partner.
E]Firm/Co.
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes 13 No13
If you have checked+Les, please indicate the type coverage by checking the appropriate box.
Liability insurance policy t;y Other type of indemnity 13 Bond 13
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 1:3 Agent
_. __...., ..— — q„U ,,,,UM IMIU11 , 11dVV suomiuea for emereu) 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 MassachusettsSate Gas CAand Chapter 142 of the General Laws.
own
ROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
'Plumber ) - aa4
Gas Fitter License Number
Master
Journeyman
Owner's Name Lt
ma in V)
New
a
Renovation
D
Replacement
[2],*'
-k
Plans Submitted
D
(Print or type)
Name of Licensed Plumber or Gas Fitter }�
Check one: Certificate Installing Company
p Corp.
Partner.
E]Firm/Co.
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes 13 No13
If you have checked+Les, please indicate the type coverage by checking the appropriate box.
Liability insurance policy t;y Other type of indemnity 13 Bond 13
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 1:3 Agent
_. __...., ..— — q„U ,,,,UM IMIU11 , 11dVV suomiuea for emereu) 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 MassachusettsSate Gas CAand Chapter 142 of the General Laws.
own
ROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
'Plumber ) - aa4
Gas Fitter License Number
Master
Journeyman
a
w
vl
z
a
v;
G
E.
x
0
z
w
Q
w
x
w
Orj
�
x
O
>
w
z
d
w
z
°�
[�
F
w
C7
O
>
F
w
a
F
w
d
z
w
x
>
o
x
z
3
a>C
a
d
O
O
w
a
o
SU B-BASEM ENT
a
u
x>
a
BASEM ENT
1ST. FLOOR
2ND. FLOGR
3RD. FLOOR
4TH. FLOOR
5TH. FLOOR
6TH. FLOOR
7TH. FLOOR
8TH. FLOOR
(Print or type)
Name of Licensed Plumber or Gas Fitter }�
Check one: Certificate Installing Company
p Corp.
Partner.
E]Firm/Co.
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes 13 No13
If you have checked+Les, please indicate the type coverage by checking the appropriate box.
Liability insurance policy t;y Other type of indemnity 13 Bond 13
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 1:3 Agent
_. __...., ..— — q„U ,,,,UM IMIU11 , 11dVV suomiuea for emereu) 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 MassachusettsSate Gas CAand Chapter 142 of the General Laws.
own
ROVED (OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
'Plumber ) - aa4
Gas Fitter License Number
Master
Journeyman
NORTH
"c
O 9
41
1► +O++r, o .A" 49
,SSACNUS�
Date .
TOWN OF NORTH A
PERMIT FOR PJet"1MBING
This certifies that ? `7. /- .f.<. �. ...........
has permission to perform .... S .` .. �'`-' ................ .
plumbing in the buildings of .. t .`.'. `
at ...-2� � .. � ��!�.�. t7. 4-� ...... , North Andover, Mass.
3G 3��7
Fee. .... Lic. No.. � ...... .....�...... �`.'�..-�.... .
PLUMBING INSPECTOR
Check #
7.461
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS '7
Date — 67.
Building Location -70q Owners Name Lf A 110, n Permit # 6
Amount -76
Type of Occupancy
New Renovation Replacement ® Plans Submitted Yes El No El
FIXTURES
(Print or type)G/� Check one:
Installing Company Name I-{- b .y\ f P P ;man ❑ Corp.
E]Partner.'
11 Firm/CO
Certificate
Name of Licensed Plumber ig an C (CP Ma,y\ +
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Q Other type of indemnity 11 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
Signature Owner El 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 Mass h etts S Plumbing Code and Chapter 142 of the General Laws.
Alkl
Y
BYSignature Or rcens um er
Type ofPlumbing License
Title ('?)-1�il%
City/Town rcense er Master® Journeyman
APPROVED (OFFICE USE oNLY 11
L�
Date ....... t'q' , 7— 1, — 47 *7
.......................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
544 -
This certifies that .....................d,, i ..C-. .v�..Zz�enz.... ev . ......
has permission to perform .......... ....................................
wiring in the building of ........... .....................................
at ........................ . . North Andover, Mass.
6—
Fee..Lic. No.. `5. rZghf ........... .4 ... .. �..
i ELEMCAL INSPEcrp'R' 7
Check # C
7487
LIN
C.oinmonwaa& of MassacLet`fe Official Use Only
Effm cc�� cc77 Permit No. / 7
loomeLJaparfinent o/}ire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
City or Town of: To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant '"
Owner's Address
Telephone No.
Is this permit in conjunction with a buildi permit? Yes � No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑
New Service Amps / Volts Overhead ❑ Undgrd ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No. of Meters
No. of Meters
Completion of thefollowing table may be waived by the Inspector of Wires.
No. of Recessed Luminaires v-�2
No. of Ceil: Susp. (Paddle) Fans
o. o Total
Transformers KVA
No. of Luminaire Outlets "'7
No. of Hot Tubs
Generators KVA
No. of LuminairesSwimming
Pool Above Eln- Elo.
rnd. rnd.
o mergency Lighting
Battery Units
No. of Receptacle Outlets 3
No. of Oil Burners
FIRE ALARMS No. of Zones
No. of Switches
No. of Gas Burners
o. of Detection and
Initiating Devices
No. of Ranges d ✓
No. of Air Cond.Tons Tot
No. of Alerting Devices
No. of Waste Disposers
Heat Pump I
Totals:
Number
ITons
KW
o. o Sel-Containe
Detection/Alertin Devices
�-
No. of Dishwashers
Space/Area Heating KW
n ElOther
Local ❑ Connection
No. of Dryers
Heating Appliances Kir
Security
o D vices or Equivalent
No. of WaterKW
Heaters
o. of No. of
Signs Ballasts
Data Wiring
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications NofDeier firing:
No. of Devices or E uivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of I'Vires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: (; _ Inspections to be requested in accordance with MEC Rule 10, and upon completion.
INSURANCE COVERAGE:'Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such cover a is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
I certify, under the ains a enalties of perjury, that the information on tis applfi ation is true and complete.
FIRM NAME: IV W LIC. NO.:
Licensee: �r' t!�� 10. Signature LTC. NO.: n
(Ifopplicable, enter exempt in the license number line.) .taus. Tel. No.: fD
Address: D Alt. Tel. No.:
*Per M.G.L. c. 147, s. 57-6I, security work requires Department of Public Safety "S" Licen : Lic. No. .—
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $
i,� ..
4173
Date.. d31 A L
;•t`":'_::~�oTOWN OF NORTH ANDOVER
PERMIT FOR WIRING
�vba �J"Pc .
This'&rtifies that.............................................................................................
has permission to perform.....A,.4 ...... .T
...................................................................
k — t M A
wiring in the building of ....:J..�................................................................
= r S p ri—
at ..................� . c(....................... ................ , North Andover, Mass.
Fee ......1.. - ....... Lic. No... Ar ; -n ... ................ t !."... ... '`-........
ELECTRICAL INSPECTOR
Check #
ThEC0AW0NWEALTH0FM4SS4CHUSEnS Office Use onl
DFM4AR7AV1 OFPUBUCSAFEIY
BOARDOFFIREPREVEMONREGUTA770NS527CMR12.00 Permit No.
Occupancy & Fees Checked
APPLICATIONFOR PERMIT TO PERFORMELECTRICAL WO
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 Ci 3 (jZ
.Town of North Andover
To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work
described below.
Location (Street & Number) US 1
Owner or Tenant ® US
Owner's Address c />Vyl-P
Is this permit in conjunction with a building
Purpose of Building
Existing Service �� Amps `— Vo-
New Service Amps / Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot
Yes [D No [2 (Check Appropriate Box)
ty Authorization No.
Overhead � Underground � No. of Meters
Overhead � Underground � No. of Meters
No. of Lighting Fixtures
Swimming Pool
Above
round
No. of Receptacle Outlets
No. of Oil Burners
No. of Switch Outlets
No. of Gas Burners
No. of Ranges
No. of Air Cond.
Total
—
Tons
No. of Disposals
No. of Heat
Total
Pum s
Tons
No. of Dishwashers
Space Area Heating
No. of Dryers
Heating Devices
No. of Water Heaters KW
No. of
No. of
Si ns
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
Below
No.
generators
Units
FIRE ALARMS
Total No. of Detection and
KW Initiating Devices
KW No. of Sounding Devices
No. of Self Contained
Detection/Sounding Devices
LJ ConnectionsEl
No. of zones
Other
Total
KVA
KVA
v, a,nergency t,,ghnng Battery
OTHER•
txxaata��..ovet-dam, ttot<tett�gtutartans� , jaws
haveaalnaYLialxlRyhmuaroepbZccyir>chxbgC.Urnp]ee CoVeageorits st>b6wmUegtuvalerY YEEJ S NO
ha�s<Ibrrril>edvafidptoofof to[be Office YES r'iCb f3ouhavecltedEdYES, irxlic�etiletypeofco by
hed�lgthe � bo L._J
VSURANCE s BONA � OrIj� � (may)
, Ex}>rrarionDale
irotktoStatt � EslirtW
dVahteofF7ecttiglWolk $
iQrt�,riinrk�t-t�wPt�,h;a.�'„A.;�,.,. �-+ , ��� r � //
�..,-
3[hatrrlysignahneonthispemritapp)t � this mquiremerit
lease check one) Owner Agent p
Signature
o caner or gen
..,,�.�._ , - �� �•,. - Al Tel No
theinsutancecoverageOritsst>bsWntWequivalerttasrequired byNiassadmse tsGeneralIa
Telephone No. PERMIT FEE
Utili
F
-�,
Location 7,1; '7`—
No. Date
i
�,. TOWN OF NORTH ANDOVER
Building Inspector
i
Certificate of Occupancy
��
$
s'•�°'E<� Building/Frame Permit Fee
AC Mus
$
Foundation Permit Fee
$
Other Permit Fee
$
/_
%
TOTAL
$
r
4v /D
Check #
18 12-1 95
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT H!Mj RENOVATF, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
see Alt'(OW
BUILDING PERMIT NUMBER: DATE ISSUED:) 7,; -3, (o I
SIGNATURE: �/�l / ��" C��Q�
Building Commissioner/I for of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
. 1.2 Assessors Map and Parcel Number:
,s
Map Number Parcel Number
1.3 Zoning Information:
Zoning DiZTct Proposed Use
1.4 Property Dimensions:
Lot Area Fronts R
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
RcqWred Provide Required Provided
red Provided
1.7 Water Supply M.G.L.C.40. 54) 1.3. Flood Zone Ini mation:
Public 0 Private 0 zone Outside Flood Zone ❑
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
-EA006 WLS
,Name (Print) Address for Service: 5r�(,r
aam" (17
Signa re Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature Telephone
Not Applicable
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
so
M
X
3
assaiz
O
v
rn
V
0
z
M
90
0
r
v
rn
r
r
z
G)
SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 6 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building unit.
Signed affidavit Attached Yes .......0 No ....... ❑
SECTION 5 Description of Proposed Workcheck as
a cable
New Construction
Existing Building ❑
Repair(s) ❑
Alterations(s) ❑Addition
❑
Accessory Bldg. ❑
Demolition
Other ❑ Specify
Brief Description of Proposed Work:
x o2 a'/ �E NL%�GEB�tE NT �E� K 6F T R65ur£ Tx rnT-o yjcy3 W(TN
MlHA60Y ��"�kl��(�fy-�'x6�d�®Isis 2_''A1Q'W1TA V"6f-N-TrKw1" 3CAM5
A9C yoffLt 2X`S�00 lf�'x 6TAN 91 OV
C
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completed by permit applicant
OFIH'ICIAL USE ONLY
I . Building
0 `
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I'I as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
E�
T-J=A V A/ ,as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
J-0.5604
Print e
Signaturaf r/Agent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1' 2 ND 3RD
SPAN
DM ENSIONS OF SILLS
DRV ENSIONS OF POSTS
DRAENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X —
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUU DING CONNECTED TO NATURAL GAS LINE
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
APPLICANT FILLS OUT THIS SECTIO
APPLICANT J 0�'- re q / HONE ( A �t5 - - Z
LOCATION: Assessors Map Number PARCEL
SUBDIVISION LOT (S)
STREET O M. E.5 I '-(—'S-T. NUMBER 70
OFFICIAL USE ONL
CONS E ATION ADMINISTRATOR DATE APPROVED
I DATE REJECTED
COMMENTS LO/K.
K. CO( +
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
DATE APPROVED
DATE REJECTED
DATE APPROVED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Rovhw 4197 jm
. %K-e-r-7-
This plan was not made from an
instrument survey. Offsets and
distances shown should not be used to
establish property lines.
This plan is intended for mortgage
purposes only
and was not prepared for recording.
I certify that the structure shown on
this plan in conformance
with the Zoning Laws in effect of the
time of construction.
I certify that the parcel shown is
Po -r located within a flood
hazard area as depicted on HUD F.I.S.
plans for Community No.
Location:' 7d� ro"-r,- :r, -r.
Scale: T = &d Date:
Registry: N v.
Title Reference: jt;( - j eei zjsz-.
Plan Reference: �'�►J Np. �aZ�
MAWWN
Corey
♦ Donahue,
Andover
Mass.
-- +F_T�A-/je, L -o&0 1Psfar-T10� --
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c11,S150A.
The debris will be disposed of in:
JLC"r Aev len a.� fl'.6) Divi 4
(Location of Facility) Zakc6Fi&i'PI) (JH
( ignature of Permit Applicant
Nate
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
a
• M°RTH TOWN OF NORTH ANDOVER
OFFICE OF
p BUILDING DEPARTMENT
400 Osgood Street
}� -�� North Andover, Massachusetts 01845
D. Robert Nicetta,
Building Commissioner
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
Telephone (978) 688-95454
Fax (978) 688-9542
JOB LOCATION: -7 D LI— Fme, t .5t,
Number Street Address Map/Lot
HOMEOWNER _ro5e 1Qt, LC I`lyn -cYik (�i7A C, S 6% n
Nam6 Home Phone Work Phone
PRESENT MAILING ADDRESS % t 5f 5T
of,
QVC
City Town
P"t f 0
State
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less
and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the
owner acts as supervisor). State Building (Code Section 108.3.5.1)
DEFINITION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended
to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not
be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other
Applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements. A �_ /-1 n
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Il(MRl)OF, WIT \I S 698-9541 CONSFRV \TION 688-9530 1IF LI'll6Sx=9540 PLANNING 08-9535
........
�o
��2.
N
m
m
m
m
H
m
H
El
m
cv
CA
d
CA
10
0
CD
.� i Z H
CL C2•
CL H
aCO -v
O
ov
CD
CDCL
o
Q =r
�C m CD
CD o CD
C CD y
o. v as
-• o
o I
Co CCD
� v
y O
10
CD z
O CD
3
C
CD
0
R
I
"ted:
cn
n
O
cn
C�
�0
z
Ilp
=q
C
C?�O
�
O
�•y A C y
m V�
—1
= m 0 m C.)
'�aa n m
Q
o
Z
y m .* C �. =
=r.0 H
O
M
w ft !! T)
n
?
m ...►fid y
07
CD
—4 m p
x
O
m m S
X �oar
=
o = --
to
A
15.
Z<.Ci 40
O y C! V.
CD
H
to
� V
CL
0
CDCD CO:
to
JL
�. ycD
CA
CL cr
� W
�
.� �� m : S N
?
cf,H
CO)
H� :�
-F
am�:�: c
y'� 3Z
.�
�O.
to
� O
IF
zCA
oa zi�1
0
Sir,
Z
- caCD
o �
= CD
.O
CL
0
A V •
0.� i� c
w �
=q
y
0
0
o
G�
�
^�
�
�'
O
r
'..T.1
n
"'v
't9
O
w
07
D
c
LL
x
a
0
y
0
0