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This certifies that ... N (... t9 4S „C
has permission for gas installation �'`.�V.A,,,.-r""
in the buildings 3-ai46to. of. .�" d, ,�'►'l.�-�t,�� , , , , , , , ... .
at .. �.� .. . ��'. � , . �• ,.North Andover, Mass.
Fee �OLic. No.. 7�� .3.5 ....................... �6. .
GASINSPECTOR
Check # As L
8340
kA G \ - ogll-• as 91.1113
k
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
jv
CITY a aC MA DATE -- PERMIT #
JOBSITE ADDRESS �� 5 _ 'qSs "�o��TOWNER'S NAME
GOWNER
ADDRESS SQ. TE FAX
TYPE OR
PRINT
_'ia•l$_�• _
OCCUPANCY TYPE COMMERCIAL] EDUCATIONAL RESIDENTIAL
CLEARLY
NEW�N RENOVATION: 0 REPLACEMENT: D PLANS SUBMITTED: YES -1 NO-�
APPLIANCES 7 FLOORS- BSM 1 2 3
4 5 6 7 8 9 10 11 12 13 14
BOILER (T .: j
=J =j =j _ .. I I= 1.
BOOSTER.:
CONVERSION BURNER
COOK STOVE - .,� 1 . ^_ — . I . .
DIRECT VENT HEATER.I �I
DRYER
FIREPLACE
FRYOLATOR
FURNACE ^ - -- I
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT
OVEN
POOL HEATER
ROOM / SPACE HEATER
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEATER,—r �_.
WATER HEATER
OTHER
INSURANCE COVERAGE
1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES __I NO
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF �OV.ERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY j— OTHER TYPE INDEMNITY ( BOND
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws, and that my signature on this permit application waives this requirement.
CHECK ONE ONLY: OWNER (� AGENT �I
SIGNATURE OF OWNER OR AGENT
1 hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to th best of my knowledge
and that all plumbing work and installations performed under the permit issued for this application will bei pliance ith all Pertine provision of the
���
Massachusetts State Plumbing Code and Chapter 142 of the General Laws. , -
PLUMBER-GASFITTER NAME a _ -* -I _ LICENSE # 31351 SIGN URE
MP ED MGF JP 0 JGF L] -j LPG] 0 CORPORATION N# ( PARTNERSHIP 0I(#[ LLC I#
COMPANY NAME: DDRESS �-V "�
CITY STATE `-JZIP dS�TEL t' _
FAX ELL! AIL
MAIL'W�'S
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
°www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
Address: \N��
City/State/Zip %-S Phone #:
re you an employer? Check the appropriate box:
1. I am a employer with C'�
4. ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. ❑ 1 am a sole proprietor or partner-
listed on the attached sheet. t
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3. ❑ 1 am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] t
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. ❑ Remodeling
8. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11.❑ Plumbing repairs or additions
1Roof repairs
13. Other C( -
*Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information.
f Ho;reovvners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I am an employer that is providing workers' col ensation insurance for my employees. Below is the policy and job site
information.
Insurance Comnanv Name:
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: �� — - ``�'C S� ��\OC
City/State/Zi�
Attach a copy of the workers' compensation policy dec aration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
t do here i y ung r the ins r d penalties of perjury that the information provided aboy is true and correct.
Si nature:,
Date:
Of use only. Do not write in this area, to be completed by city or town official.
City or Town:
Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector
6. Other
Contact Person:
Phone #:
r
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 "...every person in the service of another under any contract of hire,
express or implied, 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 including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments 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 be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of 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 work 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited 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 may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event 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/license applications in any 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 licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.) said person is NOT required 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 of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax # 617-727-7749
www,mass.gov/dia
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Date ..6/!rt?�/ t .......
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that X : zl... �,q1 07-4. !° �! . !`?...... .
has permission for gas installation
in the buildings of . r`%. .�. I./94. y!'. I .. ... .
at.7.5� ...F-ell&t�5... k9t. 144, aNqrth ver Mass.
Fee�,AQ•Lic. No.. r0 4.(,. ./ u.. .. .
GAS INSPECTOR
Check # / L) / (r,
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ew•r� mre.
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING
City/Town:` °, /f/,J V V-04- , MA. Date: Permit#
Building Location: V-S,e /2d Owners Name: `AA V ftZ -i
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential
New: ❑ Alteration: ❑ Renovation: ❑ Replacement: [j�- Plans Submitted: Yes ❑ No ❑
ew•r� mre.
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SUB
SUB BSMT.
BASEMENT
1 FLOOR
2 FLOOR
3 FLOOR
4 TH FLOOR
5 FLOOR
6 FLOOR
T"—FLOOR
8TH FLOOR
Installing Company Name: _f�r 6�i�/��i�n�
�rL%�
Check One Only Certificate #
Address:- /City/Town:% �"
Q .!fJ&A-----gtate•
',k
El Corporation
[I Partnership
Business Tel:17 Flo F*?, —10 Lfjib
Fax:
S
Ur Firm/Company
Name of Licensed Plumber/Gas Fitter:
v
„ys
,e -
INSURANCE COVERAGE:
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes 92- No ❑
If you have checked Yes, please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy 9"' 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
_Signature of Owner or Owner's Agent Owner El Agent E]
By checking this box ❑, I hereby certify that all of the details and information I have submitted (or entered) regarding this aoolication are true and
.•.. •� •••� �Vo w: Illy "IjW WIeuye anu uJac au pwmomg worK ana installations performed under the permit issued for this application will be in
-- - -- •••• �•• • F—VNOIWII V: NIC 11114, JZN lIu56LL5 mace riurr�g u:oae an cnapter 142 of the General Laws
Type of License:
By &Vlumber �'� /Y
Title ❑ Gas Fitter ignature of Li sed Plumber/Gas Fitter
R'Master
City/Town ❑Journeyman
License Number:
APPROVED OFFICE USE ONLY ❑ LP Installer e�
Location, 7`5 Sc 7TL,�-�-e,
No. Date ? 114IT7
TOWN OF NORTH ANDOVER
p
Certificate of Occupancy
Building/Frame Permit Fee
$
$
;7s 'Argo '��'
s�CHU
Foundation Permit Fee
$
Other Permit Fee
$
/
Al , 12-56
Sewer Connection Fee
$
a 75'5-
Water Connection Fee
$
TOTAL
$
Build' s tor*
N2 10165 Div. 136blk Works
Uhe &mmonw alth of ifluuousrm P.r,,,� ����
i9cPmttntttt of Public *afttq Oocupfutty 6 Fie CMdtedl"%�'
BOARD OF FIRE PREVENTION REGULATIONS 527 UIR 12:00
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
1- �•-9K
Q*or Town of NORTH ANDOV .R To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant 1 t �• L-62�16 of p' -"_4't e-•� i C4-)
Owner's Address _ 16 -!�) V1 C.i -/ I -Y
Is this permit in conjunction with a building permit: Yes ✓ No C (Check Appropriate Box)
Purpose of Building -6--_" {-[��,,v� �,r� Utility Authorization No. S'O I Or S _
Existing Service Amps _J Volts Overhead Undgrnd C]No. of Meters �,_ •
New Service 'ZOO Amps Volts Overhead Unogma lY No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work __ C() 7c,-(—?7E� L) f i.ytv�
No. of Lignting Outlets I No. of Hot '-cs I No. of Transformers Total
KVA
No. of Lighting FixturesAbc
Swimming Pcoi ve n-
— r—.
grro. _ grna. _ I Generators KVA
No. of R•ceotacis Outlets b0 No. or Oil corners No. of Emergency LightingBattery Units
No. of Switch Outlets Q
I No. of Gas _utters 2—
FIRE ALARMS No. Of Zdn•a
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Soft Contained
0olection/Sounofng Devices
Local — Municipal ^Other
Connection
No. of Ranges
I No. Cf Air Czr..c. oia' /
:Cris
NO. 01 Disposals
I No.of Heat o:ai -otai
?urnz;s :ons K%V
No. of Dishwashers
I SoacerArea r♦eatir.q i(%•/
No. of Dryers I Heating Cevices KW
No. of Water Heaters KW _ 100
No. of
I Signs as ias:s
Low voltage
Wiring
No. Hyoro Massage Tubs
I No. of Moicrs Total HSP
OTHER:
INSURANCE COVERAGE. Pursuant :o the reouvements at r.tassacnusers ;eneral Laws
I have a current Liability Insurance Policy inducing Ccmc:et Cera lions Coverage or its substantial eduivaient. YES ANO 1
have suominea valid proof of same to the Office. YES v0 = If you nave checxeo YES. Please inoicate the type of covereq@ by 4
cnecking the appp its Dox.
INSURANCE v BOND = OTHER Z (Please Scec:"�)
Estimated Valt E!Electrical Works ow L (Excitation oatel
Work to Start 4— 7 Insoec:ion Date Race es:ec: Rough Foal
Signed uno•r • e Penalties of penury:
FIRM NAME /\' M rz�G ill
ICC �C 4 F Jtil J tic. NO. K7- 7
M
Licensee
S g^azure 1 LIC. NO.
Address "► !J �CO� �- `j ��w �tfq Sus. Tel. No. J�11 3 ZD % Y
..1 Alt. .el. No,
OWNER'S INSU ANCF. WAIVER: I am aware that the Ucensee toes moi nave ins insurance coverage or its substantial equivalent as re-
duireo by Massacnusens General Laws, ono that my signature an ^is --ermit aopucation waives this reouuernent. Owner Agent
(Please cnecK onel•
eieonone No. PERMIT FEE S
-- ISignatun at Owner or Agsnti
i
Date ..........
No .. . .......
a j4oRT#j
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that / ..............................................
has permission to perform .............
wiring in the building of ............. . ....... ...... :� ............................................
at ...... ............ ...../.... .. ........ . ......... . North Andover, Mass.
Fee.... ............ Lic. No(. . ................ ** *** **........................... *** **' **R"'
ALINSPECTOR
WHITE: AppIicanP2/18/99A*AP: 13.11ding16400 PAMNK Treasurer
PER111T NO
APPLICATION FOR PERMIT TO . BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP x�0.
LOT NO.
',
2 RECORD OF OWNERSHIP 1DATE
BOOK 'PAGE
.
6f.
I
SEPTIC PERMIT NO. IA -1
t
ZONE -
SUS -DIV. LOT NO
LOCATION , 1
PURPOSE OF BUILDING (�
a
S
OWNER'S NAME
NO. OF STORIES SIZE q
OWNER'S ADDRESS
BASEMENT OR SLAB
ARCHITECT'S NAMEe,f �,
'+
SIZE OF FLOOR TIMBERS IST 72ND f 3RD
'J
BUILDER'S NAME1 f
Vt��
SPAN .��t /L ,/ 6+.Q
�! —
DISTANCE TO NEAREST BUILDING �/
-
DIMENSIONS OF SILLS ( ,
�- #.._
DISTANCE FROM STREETPOSTS
z�J�.
DISTANCE FROM LOT LINES — SIDES + L
REAR /4,
GIRDERS
AFEA OF LOT -7 7 e) R-S7S 1'^
i'
FRONTAGE O-YQ
HEIGHT OF. FOUNDATION - !u/ THICKNESS
']
IS BUILDING NEW
SIZE OF FOOTING '� X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
✓
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
!J
IS BUILDING CONNECTED TO TOWN WATER \1
BOARD OF APPEALS ACTION. IF ANY i /
IS BUILDING CONNECTED TO TOWN SEWER )-e l
IS BUILDING CONNECTED TO NATURAL GAS LINE
1
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST,BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED F A 3
S
OR
FEE
PERMIT GRANTED
FiR Hi�ii Imo_
19
F J l FU& 1 3 1997
WILDING ®EPARTMr-1
S
.I+'
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST S U
e"-) -'
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST S U
e"-) -'
EST. BLDG. COST PER SQ. FT.
.
6f.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO. IA -1
t
4 APPROVED BY
BUILDING INSPECTOR
OWNER TEL.# (r�� ��-" S
#CONTR. TEL.
b,F' % Z
CONTR. LIC. # S '
3 77 H.I.C. #
BUILDING RECORD
1 OCCUPANCY 12
INGLE FAMILY
MULTI. FAMILY
STORIES
OFFICES
APARTMENTS
_
CONSTRUCTION
2 FOUNDATION
8 INTERIOR FINISH
3 1 2 ( 3
PINE
CONCRETE
CONCRETE BL K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WAIL
_
UNFIN.
3 BASEMENT
AREA FULL
FIN. B'M'TAREA
_
14 1/t %
FIN. ATTIC AREA
NO B M'T
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
CONCRETE
EARTH
B
_
I
2
�_
3
_
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
HARDtr✓'D
COMMCN
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK N MAS NRY
BRICK ON FRAME
ATTIC STRS. & FLOOR_J_
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
_
STONE ON FRAME
SUPERIORPOOR _
ADEQUATE I 'NONE
5 ROOF
10 PLUMBING
GABLE
GAMBREL
I
BATH 13 FIX.)
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. &COLS.
STEAM
STEEL BMS. 3 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 12nd I cri
tst 3rd
ELECTRIC
NO HEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
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 local or state lawn
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: r!) Phone
LOCATION: Assessor's Map Number G.1 Parcel
Subdivision it l rs i Lot(s)
Street rs AT St. Number 7
*********** ******* ****Official Use Only************************
RECO DA I NS T AGENTS:
�✓ Date Approved
Conservation Adm nistiatop
,r%Q�te Re
jected
Comments
C
la4ffier
Health Agent
Comments
c=�
Date Approved>
Date
/�Rejected
'tom I /r -t -Qg l �i /,Y(�I .5r, cC-P) l�f
lic Works - sewer/water connections
- dr-iveway permit
re Department "L
ceived by Building Inspector
Date Approved
Date Rejected
Li
l 1�7
7 7-L-
Date
b
1� 4T 5
PR4Pd�i�1� 5►rE PLAN
/,LASE I" = ya
+oo io+oo ' —
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.� N
Tara Leigh Development Corp. w,
185 Hickory Hill Rd.
N. Andover, .MA 01845
LA
-
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irp' �A
27, o®S 5.j:.
1.
JL
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/ \ 'no
AW 1 3 1997
L GILDING DEPARTIV EN'i
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t FORM U -.LOT RELEASE FORM
INStRUCTIONS: This form is used to' verify that -all necessary
. approvals/permits from boards!
and Departments havin
P g jurisdiction i•
have been obtained.
This -does not relieve the applicant and/or
` landowner firom compliance -with
regulations oany applicable local or state lam;
r requirements..
****************Applicant fills
*'rout this section*****************
APPI,YCANT:
Phone
�y_ I
LOCATION: Ass.essor'"s Map* Number 6.l Parcel ,
Subdivision' r,T
Lot(s)
Street St. Numbdr
****Official Use Only************************
cd
' A I ISS T ' '
AGENTS : =
Date Approved
r° Conservation Adm nistdto ip to Rejected
f
� Comments
• Date Approved I
► 01 ner Date Rejected i
comm is
Health A gent Date Approved 1I1
g Date Rejected
' Comments
Public Works - sewer/water connections
driveway permit i•�ll�
Fire De rtment '
�, l�; �, G�Tur�GCX •
�.a. Received by Building Inspector Date
SETTLERS KI-r> Ab E
I I
LqT 5
PRdPd�i`�]7 ` IrE FLAN
o
too 10+00
Tara Leigh Development Corp. jy,
185 Hickory Hill Rd.
N: Andover, MA 01,845
r
IS AO %
10
✓ 27
P
LOT 5
Ui
AvX00
j ,x'90
gORTH
Ot,�y�o '�y0
0: oA RECEiy'E
t JOYCE BRADSIHAW
> TOWN CLERK
NORTH ANDOVER'
� 'SSAcsWSE< OCT 16 221 ISM '91
TOWN OF' NORTH ANDOVER
Any appeal shall be flied : MASSACHUSETTS
within (20) days afte
date of fiiing of this Notice
in the Office of the Town BOARD OF APPEALS ATTEST;
A tae Copy
Clark, 1d&44A4W-
Thiz is to certify that twent! (2()c : 7bWn Clerk
havaelapwfrom date;otdecisio:, : t NOTICE OF/DECISION
►rithout filing of an appeal,
Dal le
Joyce A.6rad,,natq —Property: 75 & 30 Settlers Ridge Rd., Lot 5 and 11
TOM C:�;*
NAME: Tara Lei h Develo ment Colr . DATE: 10/15/97 i
ADDRESS: 75 8< 30 Settlers Ride PETITION: 027-97
North Andover, MA 01845 HEARING: 10/14/97
The Board of appeals held. a regular meeting on Tuesday 19vening, October 14, 1997 upon the
application of Tara Leigh Development Corp., (Thomas Zahoruiko), requesting a Variance from the
requirements of Section 4:2, paragraph 1, from the Phase' Development Bylaw as a party aggrieved.
Said premises are lots 5 and 11, which is in the R-2 Zoning District.
The following members were present; William Sullivan, Raymond Vivenzio, Robert Ford, John Pallone.
The hearing was advertised in the Lawrence Tribune on 8/26/97 and 9/2/97, and all abutters were
notified by regular mail.
The party aggrieved section of this petition is as follows: Robert Ford made a motion to sustain the
decision of the Building Commissioner with respect to 4.2 and 8.7 to Tara Leigh Development.
Corp. as its2 provisions currently exist in the by-laws Raymond Vivenzio seconded the motion.
Voting was unanimous, William J. Sullivan, Raymond Vivenzio, Robert Ford, -John Pallone..
Upon a motion made by Raymond Vivenzio, and seconded by John Pallone, the Board of Appeals NOV
unanimously voted to GRANT the petition for a Variance from the terms of section 4.2 of the North
Andover Zoning By-law as it applies to the requirement to schedule building permits using the
"anniversary date". As such the petitioner shall be entitled to a development schedule that will be
controlled by section 8.7 of the North Andover Zoning By-law. This variance shall in no way exempt the
petitioner from any other sections of section 8.7 of the North Andover Zoning By -Law. The petitioner is
caused undue hardship by the application of both of the sections of the Zoning By-law 4.2 and 8.7. Such
hardship is directly related to the soils and slope of the land as the petitioner is required to maintain the
sloping site with wetlands over a longer period of time than originally planned by the petitioner. The
Board further finds that the petitioners case is unique. This is the first case under which both by-laws are
required to apply. Voting in favor: William J. Sullivan, Raymond Vivenzio, Robert Ford, John Pallone.
Note:, The granting of the Variance and/or Special Permit as requested by the applicant does not
necessarily ensure the granting of a Building Permit as the applicant must abide by all applicable
local, state and federal building codes and regulatiori„s, prior to the issuance of a building permit
as requested by the Building Commission.
BOARD OF'PP L ,
/decision + William J. S Ilivan, Chairman
10
Ma,
f A f
l 1 -A.A AIr / 11.1 i<JI r'
t
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ESSEX NORTH REGI RY Off' bEE08 .
LAWRENCE.,MASS.
A TRUE COPY: ATTEST:
r
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F
REGISTER OF DEEP
CERTIFICATE OF USE & OCCUPANCY
V
Town of North Andover
{
Building Permit Number 572 Date April 7, 1998:
THIS CERTIFIES THAT s
I 1F.,`
THE BUILDING LOCATED ON 75 Settler Ridge r;
MAY BE OCCUPIED AS single 'Family y Dw 1 1 ; gg IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
CERTIFICATE ISSUED TO Tara�, Leigh Dev 7s::
i
o 185 Hickory Hill Rd
41 ADDRESS
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No. .171 Date
D)5(6
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
-6� Permit Fee $ S�
9315
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
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MASSACHUSETTS URIFORM APPLICATIOWFOR PERMIT, TO-'DOVLun�etry�
(Type or Print) •;...:. ,
NORTH ANDOVER ,Mass.
Building Location �,,� �S elf �tw I& P Perm t
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(Print or Type) Check one: Certificate
Installing Company Name en uL 0?0� � Xe)'% (� Corp.
Address /,� (, f� C06,x , ),(�Partner.
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Business Telephone /,a &? Y2 /**,
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box: •
Liability insurance policy Other type of indemnity Bond Li
Insurance Waiver: I, the undersigned, have been made aware - that the licensee of I
this application does not have any one of the above three insurance coverages. . .
• Signature of owner/agent of property Owner Aged%
I baebr cerdry dial all of Ure derails and in(orntation I loa.c subuniucd (or sniped) in alwa.c Applicadoa irs low 4:214 to dw Oast al u
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By
Title
City Town:
pe of Plumbing License ,,
36•x.
Dat'.'. ?�.���.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
ssACNUS�
This certifies tha .................... , , • ..... . _ .
has permission to perfor,.. ... ..... .
,
'u73 pg in a buildings -o
�� �•_ .... , North Andover, Mass.
...Lic. NA.5 ..... ..............................
PLUMBING INSPECTOR
'/09/98 14:18 190.00 PAID
nlicant CANARY: Building Dept. PINK: Treasurer
MASSA►CHU$ETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITnko
(Print or Type)
FORTH ANDOVER Mass. Date ;
tuilding Location G ,S Permit #c;7.
Owner Namel�q 1p V,
New 7-7.1 Renovation Replacement D Plans Submitted D
FIXT�IO=� ^
(Print or Type)
Installing Company
Address
Name
Check one: Certificate
Q Corp..
Partner. _....,_ ._
-Al, c.�17$)t% f/. h��sCf Firm/Co._
Business Telephone: („ n 3 3d'a���9
Name of Licensed Plumber or Gas Fitter— AJ8)2 � , L9 j.Z,c/� P
Insurance Coverace: Incica:e ,ne :ype of insurance coverage b' heckin� tithe <
appropriate._ box: , ,
- .
Liability -insurance -policy =�Ot;.er type o;
Insurance Waiver: I, the uncersicned, have
this application. does not have ar,v one of the
Signature of-owner/agent of property
indemnity,
been made aware that..,the licensee;,Qir
above three insurance___coyer4ges.
Owner Agent
I haebY K:ti[Y that all o[ the deuds and Wortnadoa 1 hare aabmittcd (or e-itered) in stove application ars true and accurate to the bq**i mr
8nowtcdCa and that all plumbing Wort and lnratlatioes ?aioraicd undcr ftrrait iueed to: this spptleation Trill be in Compliance nitb all PIMUeat
proriaions o[ Ute :Ytassachwetta Slate Cas "a and QAV= !a: c[ tae Cr- e- L w . o `
By ._P= LICZNSE C
� "urger,
Title I Gas
fitter Signature of Lic+pnse
City/Town: Master Plumber Gasfitter
Journeyman &"//-S-Fe
APPROVED (OFFICE use ONLY) License Number
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Business Telephone: („ n 3 3d'a���9
Name of Licensed Plumber or Gas Fitter— AJ8)2 � , L9 j.Z,c/� P
Insurance Coverace: Incica:e ,ne :ype of insurance coverage b' heckin� tithe <
appropriate._ box: , ,
- .
Liability -insurance -policy =�Ot;.er type o;
Insurance Waiver: I, the uncersicned, have
this application. does not have ar,v one of the
Signature of-owner/agent of property
indemnity,
been made aware that..,the licensee;,Qir
above three insurance___coyer4ges.
Owner Agent
I haebY K:ti[Y that all o[ the deuds and Wortnadoa 1 hare aabmittcd (or e-itered) in stove application ars true and accurate to the bq**i mr
8nowtcdCa and that all plumbing Wort and lnratlatioes ?aioraicd undcr ftrrait iueed to: this spptleation Trill be in Compliance nitb all PIMUeat
proriaions o[ Ute :Ytassachwetta Slate Cas "a and QAV= !a: c[ tae Cr- e- L w . o `
By ._P= LICZNSE C
� "urger,
Title I Gas
fitter Signature of Lic+pnse
City/Town: Master Plumber Gasfitter
Journeyman &"//-S-Fe
APPROVED (OFFICE use ONLY) License Number
s
NORTH , TOWN OF NORTH ANDOVER
pf ao ,"ti0
`A PERMIT FOR GAS INSTALLATION
This certifies that- ......� .............. �.
has permission for gas installation ` . h ' �''-r': .. • . • • •
in the buildings of!� t .... -!�� !.... • • . • • • • • • • •�
at �:� ....� -�-' `"` "..��>>••�, North Andover, Mass.
..... O` .
Fee. - .. ' .. Lic. No........... .... GAASS I -.......... .
NSPEECTOCTO R
S
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer