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Miscellaneous - 805 FOREST STREET 4/30/2018 (2)
Date.... ..... .................................. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION - This certifies that has permission for gas installation ....... /V /�'"'S `..................................... �7 inthe buildings of .................................................................................................... at ..... . ............................................................................................ . North Andover, Mass. FeeAQ ........... Lic. No/?//..P .......... ..................................................................... GASINSPECTOR Check # C;,/-/ 7.31 m (j 3 Vi MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK GOWNER TYPE OR PRINT CLEARLY CITY /�e���l Ati / vtr MA DATE /:2 .2 PERMIT # 6 JOBSITE ADDRESS ��•f fob-eur 5-r" OWNER'S NAME ADDRESS 151e 1W L TEL XM -Y7,9 -A?? FAX OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL NEW: ❑ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NO APPLIANCES -1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER U VENTED ROOM HEATER WATER HEATER CTHER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES Q NO ❑ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q 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 F-1SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and a curate to the best ormm7vovvledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance th all Pertinent vi 'on o the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Peter G. Viens LICENSE # 12116 SIGNATURE MP ® MGF ❑ JP ❑ JGF ❑ LPGI ❑ CORPORATION ® # 3631C PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME Merrimack Valley Corp ADDRESS 15 Aegean Drive Unit # 3 CITY Methuen STATE MA ZIP 01844 TEL 978 689-0224 FAX CELL EMAIL viens mvalle co .corn — N /\ \i \'z Vy—_ (j 3 Vi w F O z z o� U W (, 0. `O z Q M z w J 0 G ❑ Z z N i- ❑ W � ~ W aO U w z a � � 3 cn z a W a. o w x GTi W Q W N QZO 0. 4 Q rte. V J F„ a a a � Cii 2 W H LL. W F O z z 0 F U W a z z rA d t� s c� 0 a �5 b i Office of In vestigations 600 Washington Street Bostor,M4 02111 �+ Y6rww.mass.gov1dia Workers, Compensation.- Insur2race Affidavit~. Budde;rs/Ceratractors/Electriciarrs/Piurnbelrs Please IPa-jR )t..egjh➢y Name (Bus iness/organizat ion/]ndividual): j%; r "Al j i — Address: Ce -.Vf City/State/Zip: Phone #: 6' Are you art employer? Check the appropriate box: ]. I am a employer with 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. ship and have no employees These sub -contractors have working for me in any capacity,. employees and have workers' [No workers comp. insurance comp. insurance.+ required.] 5. [_1 We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. fNo workers' comp. right of exemption per MGL insurance required.] 1 c. 152; §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13. them �'siK,eC�S 'Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicaritg such. (Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing worriers' compensation insurance for my employees. Below is the po/icy farad job site information. Insurance Company Name: Policy 4 or Self ins. Lic. hExpiration Date:�� Job Site Address: City/State/Zip: ,A&Ak Attach a copti of the workers' compensation policy declaration 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 itp to 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of STOP WORK ORDER and a fine of tip to 5250.00 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. Ido b certiJ aarader the pains and pen allies ofperjury that the information provided above is true and correct. t e: /..Z– /.2 / // Phone 4: Official uL e only. Ido not write in this area, to be completed by city or town ofjcia1. Cit,, or Town: Perm itlLicense # Issising Autf m-ity (circle ore): 1. Board of 4lealth 2. Building Department . City/Toevn Clerlt 4. Electrical inspector 5. Plumbing Inspector 6. Other --- --- Contact Person _ ---- ---- --- Phone 4: i COMMONWEALTH OF MASSAICHusurs I R 3 11 -R BOAM 0W PLUMBERS A*10 6ASF I TTERS N ISSUES THE FOLLOW N -G' LfCENSE-74) LI CINSER. kS, A JOURNEYMAN PLUKBE--,K-IX PETER G VIENS 4 9 BLUEBIRD LANE W 'ATXfNSON MH 03811-2302 21 213586 { �aEwl�w A71.. LLC Peter Viens Cert # 1023121001-12 Expires: 10/2312015 Certification N.F.P.A. 99-2012 ed. ASSE 6010 Installer & ASME IX 13'razer State of Ne' W,Hampshire GAS FITTERS LICENSE NAME: PETER MENS ENDORSEMENTS: STN, STP DATE ISSUED: 10/1512013 DATE EXPIRES: 1113012015 LICENSE #: IS FE0700587 OSHA 600316337 0 U.S. Deparlment of Labor Occupational Safety and Health Administration Peter Viens has SuOcesslully COmpleled a '30 -hour Occupational Safety and Heafth Training Course in Consbudion Safety & Health cr2Wr q rice-6bW73-- --7M/2QAS–)— a -,COMMONWEALTH OF MASSACHUSETTS bjrj-Mj#j tla 11:412 44*1 Ifl 0 T-111111111111 [Sig FE -111111:1 WARD OF PLUMBE'A$ A140 CASFITTERS ISSUES THE FOLLOWIUG LICENS ;LI,C-ffISE'b AS A MASTER PLUMBER PETER G VIENS 9 BLUEBIRD LANE ATKINSON 141 03811-2302 1211.6 05/01/16 213585 Commonwealth of Massachusetts Department of Public Safety Hoisting Engineer Ao� License: HE -110323 AW *I,' PETER G VIEN$` 9 BLUEBIRD LN ATVJNSON NR 03A 11 Expiration: Commissioner 11/1312015 State of New Hamtishire MECHANICAL IDENTIFICATION NAME: PETER MENS LICENSE/REGISTRATION #: SERVICE GFE0700587 MASTER 3249 Commonwealth of Massachusetts Department of Public Safety License: PMU-001086• Pipefitter Unrestricted Master Peter G Viens 9 BLUEBIRD LANE Atkinson NH 03811 Expiration: 11t1312016 Commissioner 740S," Date... �`.� �? ��....... MOtt TM pf ao ,°,ti0 o? ' TOWN OF NORTH ANDOVER F D PERMIT FOR GAS INSTALLATION This certifies that .......... .... 'C.-° ......... has permission for gas installation ... ��t'i....... . in the buildings of yy,% y 0.��_....................... . at .. North Andover, -.Mass,. Fee , ✓� Lic. No.. 7 j . .... /Z!J G�S INSPECTOR Check # j a 513 IV MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER ,Mass. Date SEPT. 29, 2010 permit it Building Location 805 FOREST ST. Owner Tel# 978-470-1021 New W1 Renovation❑ Owner's Name FARID BENAYOUD Type of Occupancy RESIDENTIAL Replacement Plan Submitted: Yet No[] FIXTURES Installing Company Name Eastern Propane & Oil, Inc Address 131 Water Street Danvers, MA 01923 Business Telephone # 800-322-6628 Name of Licensed Plumber or Gas Fitter MATT BERNIER Check one: Certificate ZCorporation Partnership Firm/Co. INSURANCE COVERAGE: I have acur liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ✓ No c3If you have c ecked ,yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Fvl 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ 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 ml, ru wwituyu anu ina[ aii piumoing work ana installations performed under the permit issued for this application will be in com lianceth II Title City/Town APPROVED (OFFICE USE ONLY) p vv� a State Gas Code and Chapter 142 of the General Type /f License: vlumber Signature of Licensed Plumber or Gas Fitter •Gas fitter 3 o 7 7 • -Master License Number • -Journeyman Date.... 6..' Z -T,07 .................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 24 ............... ....................................... ..... has permission to perform ..... ...... S. ..... wiring in the building of .................... ve-ti.6 ........ ... .... ...... ... .............................. .t .......... ..�°! E.......... ............... . North Andover, Mass. 1—�33 C IS. 966 Fee.��44-7.. Lic. No . ......... 7 ........................... . ELE j INSPECTOR Check# c� 41740 7 ;J 7 4�'6 //�� Qe// // Official Use Only ]7 Permit No. 2cc�� epart`menf o15im SerViee9 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC) 527 CM 12.00 (PLEASE PRINT WINK OJ� P?E ALL WFORNATION) Date:lam71res: '77 ft'" City or Town o&t1A-- /-4� X17 [/elle. To the Inspector of By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) ho T 1--02eS7 s-7- Owner T Owner or Tenant O U b Telephone No. 9 7019' a Vf 7 g/) Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Buildin Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters N c w Seru!ce Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:y g �-� (` Ci` t c� a Secur t d r Ft m 14 La r-rJ S Li STPm Completion ofthe following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Sus Paddle Fans p ( ) o. o Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above Ej In- Swimming Pool rnd. grnd. El o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners cti o. o eteng D an Initiating Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers HeatFU—M—PT,Number Totals: -� ...................... ons o. oSelf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Munic al ❑Other Local onnec No. of Dryers Heating Appliances KW curl evices or Equivalent' No. o aterKW o. o o. o Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommunicationsWiring: No. of Devices or Equivalent OTHER: / 9 % --a 1 3 7U Attach additional detail ifdesired, or as required by tie Inspector of Wires. Estimated Value of Electrical Work: dZ �• (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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenatties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: / 53 3 (Z- Licensee:1-1-&- n ' /.(,�� Signature � r �--�� LIC. NO.: (If applicable, enter "e. ern t" in the licede a num4�er line.) I H/4 Bus. Tel. No.: 5Q� Address: i T C? L- l im 10-- /[l5 , k%H ��p Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CC D U 7' 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 11 owner's anent. Owner/Agent PERMIT FEE. $ Signature Telephone No. IN Irk C) W W LL c W _j to a. r, 0) 0 LL 0 w L) (D C) WC/) 0) C) w cn C) r CD u =1 z t x w a) < w (D z Z o 0 F-0 Z u) F - Z ainieu6is Z W Z Z IL w W C14 D 04 M u -4 V) .2 ZU0 co < w1- W -4 LIJ C) (L u z > w Otf LLJ Zj C4 UV) m LLJ > -j V) w LU D) LD z ;< LU cf 0 Ln z 0 LL LIJ U) C:) w LL LLJ a -j Q) LLJ Z. P --q CD Z IL z LU LU cc se K'' IN Irk C) W W LL c W _j to a. r, 0) 0 LL 0 w L) (D C) WC/) 0) C) w cn C) r CD u =1 z t x w a) < w (D z Z o 0 F-0 Z u) F - Z Z W Z IL w W C14 D 04 M IN Irk Location �No. �8 Date 0 /9j - TOWN OF NORTH ANDOVER • c 9 Certificate of Occupancy $ '�b''••°''<�' Building/Frame /Frame Permit Fee $ �Ss.�....sE 9 Foundation Permit Fee $ Other Permit Fee mD $ �Sr TOTAL $ Check # w ` o� Building Inspector nl - U c 3 a H y s U z a o a = cn z O i L/1 W h W c w F z O W - p U _ A d z F•a A 1 H z � k p w O O A J a N C F--1 z L4 y w e w q r w r w O L r O c <1 c F O a C U ❑ Z U Z a ZZ o 0 ❑ a O O z O w Z O Z. y O �'" O O O J U z C7 z U Z 0-0ti U `n O v. =� k, cn C;; r a. C .p.7 ❑ W O W Z W w W FM vai a a q in c i C) z O n V H H O � V w W 1 �a z � L �l 'Is W O F z r= w < Li O Z F w � W � C "� U z U Z U Z O _.t ..� ca ❑ FFNy'.iy _ < y _ O - U c 3 a H y s U z a o a = O i W h W c w F z O W - p U _ 3 a H w U a 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 SECTION*********************** APPLICANT5;.,(f4aeS - arrC , n PHON / @-- 6? 1 q- t LOCATION: Assessor's Map Number ID7 PARCEL�C� SUBDIVISION _ LOT (S) STREET ±e- S ST. NUMBER *******************************OFFICIAL USE ONLY*********************************** ` D �'c rho e y15�/AlJ RECOMMENDATIONS OF TOWN AGENTS: dig M � � IA -0a- CONSERVATION ADMINISTRATOR DATE APPROVED IZ- Z til COMMENTS ZOWN"P COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH DATE. REJECTED DATE APPROVED DATE REJECTED_ DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED_ COMMENTS %j%Q - /��i-s f7�(l /EJQS�/YJ Z�%I %y� Cf /G - 22ax, BOOMS-D.r' 41 PUBLIC WORKS - SEWERIWATER CONNECTIONS _ DRIVEWAY PERMIT MU) � z7-99 FIRE DEPARTMEN-CP,0(Dv,z-S RECEIVED BY BUILDING INSPECTOR Revised 9197 jm DATE Town of North Andover NORTH OFFICE OF 32 Oy t e D , e 1�OOL COMMUNITY DEVELOPMENT AND SERVICES ° . A . - 27 Charles Street : ; North Andover, Massachusetts 01845 �9 pD4�TEDrv�PP'�(`J WILLIAM J. SCOTT SSACHUgE Director DEMOLITION OF BUILDING AFFIDAVIT (978) 688-9531 Fax (978) 688 29542 DATEl� lqq OWNER'S NAME & ADDRESS JCrllG1 e -S Aarc k d ✓_e/„ LOCATION OF PROPERTY TO DEMOLISH (%5— �s f ` -fie eJ- DESCRIPTION CONTRACTOR'S NAME & ADDRE; !L e SS r,7 = DEPARTMENT SIGN -OFFS DEPT. OF PUBLIC WORKS - WATER: SEWER: EXTERMINATOR DUMPSTER - ON/OFF STREET DIG SAFE NUMBER 19V 7 d? 0 DATE REC'D BLDG. INSPECTOR BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with.the provisions, of MGL c 40 S 54, a condition of Building Permit Number C-6 P Is that the debris resulting form this work shall be disposed of in a properly licensed solid wastedisposalfacility as defined by MGL c 11, S 150A The debris will be disposed of in: MtJ AAN + Location of Facility ermit Applicant licant licant hq Date NOTE: Demolition permi . t from the Town of North Andover must be obtained for this project through the Office of the Building Inspector x w ° Ll a V) V) z C O °Ur E V " c u V °°U ° 4 C/5 w x o u a z C4 ro w z d w W m� 6' cn v Qo(I cn n- � o o c 2�L O N a c W O m C � O fig=.N O 1 �a • L _ D O_ w o n. N • o m c CM 0 0 I m C m m L I y m C m S m N Ca �+.E IVol CDor I !' C. • � c 8* o a C3 C = t m � 3 I O : a O LJJ C Ow�� y '_ A C L= E C3 = c V m p m e C h CL Co.— 'o o H . = e . a,- Cc O '':q C/) ' N H c �T� ijd OO U Es CD C/) os c w m P-4 L cm C* LN c �C N m 20�; z mono w O aJ O Q 5 ai Ell 1 U6 O 2 PVA •ria 6 w Ma .CD L CL CD C O CD 0 m CL CA O CL O C#2 O V O C _m d 0 L O V co CL CO W CM C O co O � m m LU 0 U) U) W W crW LIJ CO TOWN OF NORTH ANDOVER p PERMIT FOR GAS INSTALLATION • Vis. ..-....., _ ^ This certifies that ... ...: �" �....:.:'. :. �... ......... has permission for gas installation... ........ ...... ..... . in the buildings of ................. 1 at .. ���,5...?.�:: f ........... North Andover, Mass. Fee...... Lic. Noll:!/.........�..,� t�.2., ........ GAS INSPECTOR %r /� WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ra, 146 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or T) &W e(_ MA DateLf Receipt# Permit# v 7 4 G l c � Building Location �� �ie S^F S+ OwneesName 0-�d Map: /� Lot: Zone: Type of Occupancy CdZ New /� � Renovation ❑ Replacement Plans Submitted: Yes (3No [3 4 Installing Company Name kAJFrrn 3?t-r pc n� (�AA5 ir)C- Address 13 i- W 41� r `3 t; � a n v F_t- 3 Yr -1 tit 0 1 Ct EstimateValueof Work: Business Telephone 1- '?on- -- � Name of Licensed Plumber orGas Fitter INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy W� 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: 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 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 Gas Code and Chapter 142 of the General Laws. By Type of License:�� Plumber SigInature of Licensed Plumber or Gas Fitter Title Gasfitter Master License Number City /Town Journeyman APPROVED (OFFICE USE ONLY) Checkone: Certificate IN Corporation ❑ Partnership ❑ Firm /Co. L m c3 Ll INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy W� 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: 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 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 Gas Code and Chapter 142 of the General Laws. By Type of License:�� Plumber SigInature of Licensed Plumber or Gas Fitter Title Gasfitter Master License Number City /Town Journeyman APPROVED (OFFICE USE ONLY) VV z O r v W O N z_ N N W ¢ 0 O ccIL 19 W W W ni y M e BO N m� ny J Ay1 Om W O N Sn �D W J �g 0 0 r D �m q $c N 10 5 vii (509 f) r NOI1tlON00i 9Nuslxa �Y ,29E Ziy - oz ~D A O� 2� � 0 m o oD Hm o6 A v m,5 n 4 N m Z7 my Zo C) n o dm D rn 0 n °1z N O A l >. ru N Z O O z0 m D 0 z O >>0 N, T rr o CO) N z r- O 0 a \'•;, z J�n M e BO N J ' W O N 0 W J � y D 0 r D N q 10 5 vii (509 f) r NOI1tlON00i 9Nuslxa N ,29E J ' 0 N i a.• a 1 5 .LI'9Z .a IS O�fA S 10 5 vii 133�i1S { 1ce N° 214 4 Date....�,/�............... °:t TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �•r This certifies that .........-4.!.................( x.'1.:1.?.....f.2:..................................... has permission to perform Z r ................................ wiring in the building of ......G.!Z. :.�!. 4.`.' ................................................... Tr 5` ;���. Psi,,,, � : , North Andover, Mass. 41 Lic. No. %�� ,r�. �!!.............. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TMC0MM0NWE,4LTH0FM4SSAMrSEM Office Use only 4 DEPARTAfENT0FPUBLJC&4= Permit No. �( / /�, BOARD 0FFIREPREYEN770NREG UT10A SV7CMR 1210 UVA4 Occupancy &Fees Checked PPUCATTONFOR Pf RMITTO PERFORMaECTRICAL 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 oZ " 7,0 6 Town of North Andover The undersigned applies for a permit to perform the electrical work described below Location (Street & Number) '-Z,< Q �51 Owner or Tenant _J —,+a Q U is S Owner's Address 11.7 C VVI?C� Is this permit in conjunction with a building permit: Purpose of Building �j,{/G-Z,y_ A;? -I- 77 ;? -Y 77 fi-1�2e .4-4-n/ Exi ' g Service /� Amps Volti Amps,�V /,?/*Volts Number of Feeders and Ampacity Yes [E3' No To the Inspector of Wires: (Cheek Appropriate Box) O v Utility Authorization N Overhead M Underground M No. of Meters Overhead Underground M No. of Meters Location and Nature of Proposed Electrical Work _ -7-Zrn .Q "59 9 !!! CE -,If No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total 1 KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ED ground 17 No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total - Total Pum sTons KW Wtiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Locala Municipal Connections Other No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Signs Bailasis Hydro Massage Tubs No. of Motors Total HP .1=f hsL=%eCoA=r- Laws IhmeaaBatLmbkyhumxPd ymdtcfffgCaq)i CmeaWcrtsabi3tde;u,YES IhaembmiWdvalidpmfofsa e1othe0)�YES � f}whawiedmdYESpeaa*hetMxcfwmaFbNyOd -edagdx F1 'r�MURAl ®- BOND ❑ MfER a - Expir�oatL?a� WadctDSh�t 0�1K��-4„�� hspaCsrnDaDeReclt�>e,Bad RoughFmW Est¢r�ItadVahtec# Wodc $ SignedundwTr 44W. FIRMNAM'E-j'� Lk=NTa Lioasea �)�'/YLS�� ► 1 ti= , Signoure Licet>seNo /' &&m Td Na Arm % �t�.mR=?�y G�/1. !/C/G-77� ,%%%/r AItTdNa 2 y V 9 OWNER'SII}SURANMWAIVEP,Ianawaetha drLioazs dlmnat ett»eitnuaneoaea�oril�sE9a alectrivalatastagtmadbylvfassads>seltsGateralLaws aod�atrtrysignattaeon�petmitappftt�ottwai�esthis tec�artettL - (Please check one) Owner a Agent fr. \ Telephone No. PERMIT FEE V , t� THEC0MV0AW F.4LTHOFMASS40RN S Office Use onlcy� DFPARTMENTOFPUBLICSAFM Permit No. BOARD 0FMEPREVEM70NRWM4T10AN970MR 12.00 Occupancy & Fees Checked APPLICATION FOR PERNIIT TO PERFORM ELEC MCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 /Ido (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 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) 4,j O FOP gs7r Owner or TenantT-A-e- n I) Yid A4-07 14,4A) D Owner's Address 136 ( M41 Is this permit in conjunction with a building permit: Yes [U'No E:] (Check Appropriate Box) Purpose of Building SIAJ (sd.t hhyll 4 2)W fZ-G-1A1,G- Utility Authorization ciwar Existing Service Amps�l Volts Overhead M Underground M No. of Meters New Service d O Amps(5;)0 / -;210 Volts Overhead E1 Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 76 w2477-77 7,q7, /77 - OGt)z✓��/n'/G- No. of Lighting Outlets y 4,© No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA and ground _ Nr . of Receptacle Outlets f No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets 41 No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Totall� - Tons r No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW / No. of Self Contained Detection/Sounding Devices Local � Municipal Connections r7 Other No. of Dryers ` / Heating Devices KW No. of Water Heaters KW- No. of No. of Signs Bailasis No. I'Jydro Massage Tubs No. of Motors Total HP OTItER Irs==Comage Laws L. -J IhmeamautLra*hr�t&=Pchym&&gCaTide Co&agFa�skkFWeWivA t YES NO Ihmesttt nftdvalidptoofofsametofCOffM YES r7 If}puha%edv*WYES,plea9eitxlcwt cNxofmwrWbydmckrgthe INSURANCE r7KBONDo OUiERo ?kmeSpmifiy)ExpirW Ddle Estim*dVo W ahCrk $$ �OOo WakbStat lrgecfimD*ReWm d Rao � �o�� Feral &J /G P FIRM NANIE _ J I�oaseNa O ! I Lioa�sae Sigrn�ae IiarmeNo fr Bts¢t�sTd Na 7?/ 302 /7/-5— AdIm, iZ f� l � i`Yl AUCTC,< S'T �/Y1'/it/G lith t� 01 W %� Alt dNa 9= Egg' i` 74� % OWMR'SBqRJRANCEWAIVER,IammmtrttcLmwdomnott 1hemw=amVanllsstksWMl eWhalatasret#WbyMmdxsMGenaalLaws and fat my sern this p� eppficatiai waives this tagtrQertg�. (Please check one) Owner a Agent a Telephone No. PERMIT FEE 2 2 ` /2 0 Date .... � TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... 36-At.f.A, .......M �it tf. ................................. has permission to perform ........ w ....... U.ou S ..... -C ....................................... wiring in the building of.. �!!�.a,'.<.C.�'�.. 4'i :. .................................................. at ....... �,- ()-�- F0 1 .11 ................. v ...... at:l ............... /,,North Andov,6r,.Miv/ F"2vv Lic. No.,r:j-.J� ............... 2� ....................... LEcrRicAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer C-- 3— e�;� Date..`/ .......... N 6 7 3 0 TO W N OF NORTH ANDOVER TO FOR PLUMBING This certifies that ;A has permission to perform � 0 plumbing in the buildings of at ..... North Andover, Mass. Fee.. . . Lic. No..........-' .?............ . 4 Z A WHITE: Applicant PLUMBI/NeINS�PECTOR CANARY: Building Dept. PINK: Treasurer Date. ,7 - / 3.-. C G N° TOWN OF NORTH ANDOVER .�.0 PERMIT FOR PLUMBING This certifies that ..r��� f. !?tea .l ` ...%� 'Z. ...... . has permission to perform ... ........ . plumbing in the buildings of ..!'.�N`. !? /fit �� . at .. 67... North Andover, Mass. Fee. k.�—i Lic. No.. :........�..... !..:.:fer�.a...... . PLUMBING INSPECTbR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 01, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date i 0 C i� , �� Building Location LZ Owners Name 7 � � Permit # Res Amount 2V 3 45e� Type of Occupancy New IN Renovation Replacement 1:1 Plans Submitted Yes E] No FIXTURES (Print or type) rr Check one: Certificate Installing Company Named �� w�.�-ins 11 Corp. Address ?'C) ` (�0X 2:L0 Partner. Business Telephone Q cA 51 'Co 2'Lu ® Firm/Co- Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate boic Liability insurance policy Other type of indemnity E] Bond Insurance Waiver. L the undersigned, have been made aware that the licensee of this application does nothave any one of the above three insurance Signature Owner 0 Agent E] 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 W�chuse State PTtnbing Code d Cam hfe 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY Type ofPlumbing License icense um err Master. E9 Journeyman M 3367 Date . ..0....... 'ORTM TOWN OF NORTH ANDOVER p -141 PERMIT FOR GAS INSTALLATION This certifies that .zx .���f �... /.� �/........ . . has permission for gas installation ... �� �' �t :: in the buildings of ... �� :����:!?!'.`� ..................... at ..:,.` G .)..... L :: ! . ....�... , North -Andover, Mass. Fee.. Lic. No.. ...... . GAS INSPECTOR V WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 10, 3 ' MASSA�=t APP CATON FOR PER UT TO GAS FITTING Type or print) PARCEL -te NORTH ANDD Building Locations �o5 l �e,7 s7 Permit,1 3 7 Owner's Name New M Renovation 11Replacement ❑ Amount S yJ" .— jftl-�X& mkkadx� Plans Submitted ❑ or ` ' �v� ` \e Q` lane C vj Check one: Certificate Installing Company Name S ❑ Corp. Address ?-0 • % x Z•-ZLD TeQ31LS \-)w , A-YCA o t kp Business T Name of Licensed Plumber or Gas Fitter l2vCk k(6 4= ❑ Partner. 13 Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No ❑ If you have checked yes, please iodic a type coverage by checking the appropriate box. Liability insurance policy 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Check one: ❑ Owner ❑ Agent I hereby certify that all of the details and information 1 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 vlas�ate Gas Code and Chapter 142 of the General Laws. By: Title . CityiTown APPROVED (OFFICF USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber License [''Gas Fitter icense (Numoer C" 1G�aster ❑ Joumeyman LAW OFFICE OF MARK B. JOHNSON 12 Chestnut Street Andover, Massachusetts 01810-3706 (978)475-4488 Telecopier: (978) 475-6703 MARK B. JOHNSON (MA, NH, DC) LINDA A. O'CONNELL (MA, NH, RI) DONALD F. BORENSTEIN (MA, ME) CYNTHIA R. GLACY (MA, NY) November 5, 1999 Hand Delivered Robert Nicetta, Building Commissioner Town of North Andover 27 Charles Street North Andover, MA 01845 Re: 805 Forest Street, North Andover, Massachusetts Dear Mr. Nicetta: Paralegals KATHRYN M. MORIN JEAN A. SHEEHAN LIANNE CRISTALDI By my letter to you of June 24, 1999, I provided you with certain information concerning the legal title to 805 Forest Street in North Andover. It is my understanding that you have requested additional information as to the legal title to this lot and surrounding properties in connection with your determination as to whether this lot is "grandfathered" under Section 6 of the Zoning Act, G.L. c.40A. It is my intention to provide you with this additional information by this letter. The lot in question was divided from a large parcel of land owned by Anna M. Gilbert. That large parcel was conveyed to Anna M. Gilbert and her husband, Roscoe A. Gilbert, as the second parcel in a Deed recorded at Book 779, Page 303. A copy of that Deed is attached hereto as Exhibit 1. The lot comprising 805 Forest Street was conveyed by Mr. and Mrs. Gilbert to Gayle C. Belair, by a Deed dated February 19, 1960, and recorded at Book 920, Page 185. By that conveyance, 805 Forest Street was separated in ownership from the surrounding land owned by Mr. and Mrs. Gilbert. Ms. Belair conveyed the property to the current owners, William J. Hamel and Deana J. Hamel, by a Deed dated May 11, 1978, recorded at Book 1338, Page 76. A copy of those Deeds are attached hereto as Exhibits 2 and 3 respectively. The property abutting the northern boundary of 805 Forest Street was conveyed by Anna M. Gilbert to't I 70"T N E1�Fa�ti ENTI Robert Nicetta, Building Commissioner ' November 5, 1999 Page 2 the property, Linda M. Emro, Trustee of Pine Hollow Trust, by a Deed dated February 5, 1993, recorded at Book 3657, Page 232. A copy of that Deed is attached hereto as Exhibit 4. The property abutting the western boundary of 805 Forest Street was conveyed by Anna M. Gilbert to Mary Elizabeth Koontz by a Deed recorded on April 30, 1991 at Book 3247, Page 137. The property conveyed to Ms. Koontz is shown as Lot 6 on Plan No. 11810, dated April, 1990. A copy of a portion of Plan No. 11810 is attached hereto as Exhibit 5. A portion of Plan No. 6757 showing the northern boundary of the 805 Forest Street lot is attached hereto as Exhibit 6. Thus, since the conveyance of 805 Forest Street to Gayle C. Belair from Roscoe and Anna Gilbert on February 19, 1960, the property at 805 Forest Street has been held in separate ownership from abutting properties. Accordingly, it appears that this lot should qualify as a "grandfathered" lot under the protection afforded to isolated residential lots at G.L. c.40A, §6. If I can provide you with any further information or documentation concerning this matter, please do not hesitate to contact me. Very truly yours, LAW OFFICE OF MARK B. JOHNSON C�/ Donald F. Borenstein DFB—klb F:\NEW-DOCS\WELCH\HAMEL\Nicetta-Ltrl.doc I I.J Wet George W. Lord and Ruth g• T+od�rh�haaa��ad..wlfejlt,both of North Andover, f.'•''1'i #'.�,;'> ' t ,`ytiF`{{�s�.,�!��;� �AI(l9� Cpyaty,Ms�sgchuscua L7mCDtOfD1DCDf�![iur:uusidcratinn a'td,6�r�ntto R ag09 °4 � (}ilbert`'.and Apna'}M. (117bertt husband and wife, as �I I tenan�so,�nQ4�,.not as ,tenants in common nor as tenants by the entirety: both �, of!ly :e t i A ; said Cq{uilty of Essex, "ith quiidsttn =12smtac two certain parcels of Tandy ivlAh the bUlldinge •thereon, situated in said North Andover. (Description and enettmbr,lptcet ti any) ;pry • ., , , FIRST PARCEL, Bounded and deserib and Easter y by Forest Street sev Southerly two hundred ninety-two" hundred thirty-four and 77/100 f Lord at u:; and Westerly so u"" e of Frederick Rabs et al four h d Said land is shown on a p em -or 1B' -F19'51- ',filed in the recorded with NoM Essex Regi-s.tr BOOK 779 PAGE 303 Yortherlyt Northeasterly �y-throe and 35/100 feet; aadgPouthwepterly one D formerly of George -W. rly .t~►y :land now or formerly '4n4;.!%7/l00 feet. "A", Billow, E..' -da -teal y oP"portion of which is 36. SECOND PARCEL, Containing about"14 acresQ�,e'ttboWI40diand 'described as &.1hl, hs, follows: Beginning at the Northeasterly cornt�jZ6ji th6�.rpremisee on the Road at the first parcel hereinabove described;''thence the°;]line runs Southerly on �Y'•�`G� �� said Road to land now or . formerly of F1oroAco :Ayerill�., hence Westerly by i� • 1,� r/ -, the wall by said Averill land to land now yr forkerly pf Julius Bode; thence Northerly by land of said ,Bode to land now oyprq�ery,,ol,yFrede�rick Rabs et Ill thence Easterly by said Rabe land to the'fir...st.t.panoplyhereinabove described; thence Southeasterly and, Eastoily.;byk?q ,d S s;ts,paFcel to the point of beginning. , , .ti',�: Being the same a, i«" premi es conveyed to us by Thooas;Margerison at ux by deed dated rob%ber "16,1951 recorded with )1orthl,,Eq. 4zu.R.egistry of Deeds, Book 756, Page -246 Title to the first parcel above describedy'is coriflrmed in our names by decree of the Land Court (Case No. 23383) dated Jui%o!.x3,•1952,' recorded with said Registry of Deeds on June �5, 1952. U. S. Federal Revenue Stamps hlassachusntts Deed Exciyo S;amps t in stun of S 4 , i 0.... in sum of S... A3.5 offixe.l an-] cancelled un this nVixed and cancelled oq'thlp - inatrutnent. instrument. 31: CIZI.I:M . ...the...said.._...... gorsa...._............._..._.._. rcicasc to said grantee all rights of tenancy by the curtesy and other interests therein, dower and homestead Agititess Our . hands and scats this_... thirteenth...dayof.......... A.uB.u.ft............... alae fQatntnautueattlf ui S'Nattattclft:artfs Essex, Si..A_ugutst 1�,_......._ 19.53 Ill -it pr,,ra,ally appeared the above-named. - - - - - - - - - George W. Lord and Ruth E. Lord- - - - - - - - - amt a. l:uu%%lcdgcd the iurcgoing instrument to be_....th9J r ___iree act and deed, before me •' �!>���8�e�� "_"_-' Nle ZKK Essex,ss. Recorded Aug. 13, 1953 at 4m past,3P-M. Loc ,A S �cax We, Roscoe A. Gilbert and Anna M. Gilbert, husband and wife, both 9' 2 a of North Andover, Essex (county, Massachusetts, UXgY> for consideration paid, grant to Gayl C. Belair, PAGE of said North Andover, with Ruttriatm morxlanta E bhcAzrmkimx a certain parcel of land situated in said North Andover, bounded and (Description and encumb=o%, if any)' described as follows: Easterly by Forest Street, one hundred fifty feet; Southerly by land now or formerly of one Wysocki, two hundred ninety-five feet; Westerly by land retained by the grantors, one hundred fifty feet; and Northerly by land retained by the grantors, two hundred ninety-five feet. Being the Southerly portion of the Second Parcel conveyed to us by George W. Lord et ux by deed dated l', 3953; recorded with North Essex Registry of Deeds, Book 779, Page 303. Said premises are conveyed subject to the taxes for the current municipal year which the grantee herein assumes and agrees to pay. U. S federal 1Z(-'Vel1ue Stc1111ps in afCi�:cd wid caiicelleri on this - ' - - instrument. We, the said grantors, X)jm& ( � xxfx curtesy release to said grantee all rights of do ver tenancy by homestead stead and other interests therein. itl>en. our.....hands and seal s this.... ninteenth day of... Cbrua /y, Y 19 60 ................................................................................ ` 'CA�•.7t.....,'~��. Y i�l............. .... .... .... S 4 ......................................................... (//// �L/ N �. .....................................................................................................................................:.......................... (Tilr (gaulu>i.utaturalt4 .af fflaultr4uaetfa Essex, ss. February 19, 1960. Then personally appeared the above namedx nna M. Gilbert and acknowledged the foregoing instrument to be herr free act and deed, beforeme ....................... Notary Public — 1r XX*X ta"X xlccrucix�wxasx xxpgXX E;ssex,ss. Recorded Aug. 5, 1960 at 1m past 3y' -M- 1179 (• Individual — Joint Tenants •--Tenants in Common --Tenuttb by the Entirety.) 232 I, Anna M. Gilbert of Salem, Rockingham County, New Hampshire R for the full consideration of $1.00 grant to �,ida M ATO, Trustee of Pine Hollow Trust under a Declaration"Of�: s��� -�yApril 6, 1992 recordedwithEseex North District Registry of Deeds in Book 3531, 9 of 781 Forest Street, North Andover, MA 01845 xith Quitclaim Covenants th A certain parcel of land known as n „lannof°rLand in No. Essex County, Massachusetts and shown on Stiles Survey Andover prepared for Roscoe Gilbert dated sry o Deeds as plan Co." and recorded with the North Essex Reg No. 6757. Said Lot containing 44,250 square feet as shown on said plan. of the premises Meaning and intending to convey a portion deeded to the Grantor and her deceased husband, 1953 and °recordedlwith by George W. Lord et ux dated August Page 303. The said Roscoe A. said Registry of Deeds in Book 779, 9 in North Andover, Massachusetts on Gilbertd [' Deed meant to cgrrect andconfirm This deed is a Confirmatory a prior deed recorded with Essex North District of of Deedseds ich din ook escribedSas�Lotg5 due to a 144 in hscrivenersherror. property da of February, 1993 Executed as a sealed instrument this VY Anna M. G lbert The Commonvealth of Massaohusotts February 1993 Essex, Be. Then personally appeared the above named Anna H. Gilbert and trument to b® her free act and deed, acknowledged the foregoing ins Before me 9 l /tary Publ c *;JW.Zjrre .-No/9910/14 sion expires! L 0 AH D K 13 3 8 L Gayl C. B�',Ialr of North Ando ver~. UBsez Count -Y. Maughusett% firing xttarttnird, for cowidarjktioa pa!_� and in full cm3ld.-rati)n of Forty-five Thousand Dollars ($45,000.00) grants IQ Witham J. MkM41 6d Uvans T. winel, tenanu of 605 Forest Street, North Andover, Msesschusette, with 4MIS1111M Im"?=aft *xt=db A certain parcel of land with the buildings thereon situated in said North Andover, bounded and described as follows- ELL—cripl;un and t"wobumcs. if sm) Easterly by Forest Street, one hundred fifty feet; Southerly by land now or formerly of one Wysocki, two hundred ninety-five feet; Westerly by land now or formerly of Gilbert, one hundred fifty feet; and Northerly by said land now or formerly of Gilbert, two hundred ninety-five Being the same premises conveyed to me by deed of Roscoe A. GMert' at ux, dateA-PebftMrlIP, recorded In North Favez Registry of Deeds, Bibok 920, Pap AL -- E CANCELL_ • , •.• •. •~t•~. •r. soy;:. � _ /Oja. too Mass.. MY.'.- head and sal M ASM -01h, day of M4Y____ 19.TL_ Gay Bemr alp MMM"Orw* Ad filamdwsirffs Essex AL may 11. 1978 Then personally sppetred the above asawd Gayl C. Belair and jd=wledVd the foregoing ksmuna to he her free act and decd; before me J.., S. 'Trombl" PAI]c Recorded. May 12,1978 at 9:7AM #4193 MY —Ini- -pion October 3, 1980 el "Cal 4 'Q Q \ 12 Q r vs v \ !1 I ' r �1V Zd Wd6S:80 6661 0Z .unr 00IS 989 8L6 'ON 9NOHd '0NI'SlN0i7nSNO3 63nOQNo WONU Ed WH6S:8O 666T OT 'unr OOTS 989 $u K �I D'SJL . IN LAW OFFICE OF MARK B. JOHNSON 12 Chestnut Street Andover, Massachusetts 01810-3706 (978)475-4488 Telecopier: (978) 475-6703 MARK B. JOHNSON (MA, NH, DC) LINDA A. O'CONNELL (MA, NH, RI) DONALD F. BORENSTEIN (MA, ME) CYNTHIA R. GLACY (MA, NY) June 24, 1999 Building Inspector Town of North Andover Municipal Building 120 Main Street North Andover, MA 01845 Re: 805 Forest Street North Andover Massachusetts Dear Mr. Nicetta: Paralegals KATHRYN M. MORIN JEAN A. SHEERAN LIANNE CRISTALDI This office has been asked to render an opinion relative to certain aspects of the title to 805 Forest Street in North Andover. The Lot is shown on Assessors Map 105D, Lot 18. The current owners of the Lot are William J. Hamel and Deana J. Hamel by Deed of Gayl C. Blair date May 11, 1978 and recorded with the Essex North District Registry of Deeds at Book 1338, Page 76. The preceding Deed in the chain of title is dated February 19, 1960 and runs from Rosco A. Gilbert and Anna A. Gilbert to Gayl C. Blair. It is the 1960 deed which separated this lot from common ownership with abutting land. The Hamel lot has not been held in common ownership with any abutting land since that time. Accordingly, this lot enjoys the isolated lot brand -fathering protection ut' G. L. c. 40A, § 6. Please call me if you have any questions. Very truly yours, LAW OFFICE OF MARK B. JOHNSON Donald F. Borenstein � DFB*kag cc: GE Welch, Inc. FANEW-DOCS\WELCH\HAMEL\Building Inpector-Hamel.doc rima ID 2- � Z F c; - QMH c z C � J c F C c c� z d INI F L/ 3 Q � a w F Z Z U U U = � G Cn � N � O O O v F z_ W � i NN�Z 143 �C •c z F C C L Z Z - c wl wl V J F LJ r5 _ VI 71 y F lV p F� �.7 Z :n •� C i- C U Z O _ w z C O C C O E.., p w O U _ p Fk7 z cc z z O w O w -c z z Z Z "' O W �N O z ID 2- � Z F c; - QMH c z C � J c F C c 1-3 z d INI F L/ 3 Q � a w F Z Z U U U = � U � L C � O O r F z_ W � i NN�Z �C •c w F C C L Z Z - c wl wl V J F LJ z U z c P c; - QMH c z J c C c z CC- INI L/ 3 Q � a w F Z Z U U U = � U � L C � O O r F z_ W � i NN�Z �C c w F C C L Z Z - c wl wl V z U z c P v c; - c z J c C c CC- INI L/ Q � a w F Z Z U U U = � 1\ r F z_ U � i �C F C C L M J F LJ 71 y v Ma c J c C c CC- INI L/ a N � a C Z Z U U U = v c J c C c Z � 1\ r L n U � i �C c a I — 1 bi'E4 - 20 UL) VU. ya ek A W o0 ' W iN N V C M 0 1 l i oiIn rJ ^: i W Q Pn o Z CO k 0 o J � c L � J � 0 40 W r K f o pjLAJ ci 14 \ o Z N t Q� 0 � 2 w ox, ta �v Z N u W 1s /S3y,p�, Q x 2 4 4 'l N k 0\ Z s N � OQ W q Z Z �1 N MM M , NO QeS6 94£ - S i� _ ,,- ,SZ .SB Qi pa 1 rs, 688" O r s o -4- 91-S o o 3 i 18993 40�� I kpOO 31' 0�` . S. c a LAW OFFICE OF MARK B. JOHNSON 12 Chestnut Street Andover, Massachusetts 01810-3706 (978)475-4488 Telecopier: (978) 475-6703 MARK B. JOHNSON (MA, NH, DC) LINDA A. O'CONNELL (MA, NH, RI) DONALD F. BORENSTEIN (MA, ME) CYNTHIA R. GLACY (MA, NY) June 24, 1999 Building Inspector Town of North Andover Municipal Building 120 Main Street North Andover, MA 01845 Re: 805 Forest Street, North Andover Massachusetts Dear Mr. Nicetta: Paralegals KATHRYN M. MORIN JEAN A. SHEEHAN LIANNE CRISTALDI This office has been asked to render an opinion relative to certain aspects of the title to 805 Forest Street in North Andover. The Lot is shown on Assessors Map 105D, Lot 18. The current owners of the Lot are William J. Hamel and Deana J. Hamel by Deed of Gayl C. Blair date May 11, 1978 and recorded with the Essex North District Registry of Deeds at Book 1338, Page 76. The preceding Deed in the chain of title is dated February 19, 1960 and runs from Rosco A. Gilbert and Anna A. Gilbert to Gayl C. Blair. It is the 1960 deed which separated this lot from common ownership with abutting land. The Hamel lot has not been held in common ownership with any abutting land since that time. Accordingly, this lot enjoys the isolated lot grand -fathering protection of G. L. c. 40A, § 6. Please call me if you have any questions. Very truly yours, LAW OFFICE OF MARK B. JOHNSON Donald F. Borenstein DFB*kag cc: GE Welch, Inc. RECEIVED F:\NEW-DOCS\WELCH\HAMEL\Building Inpector-Hamel.doc JUN 2 8 1999 BUILDING DEPT. 2-'2a Date.................................. 03;- ,"`° . "a TOWN OF NORTH ANDOVER n• ...• ' °L p PERMIT FOR WIRING This certifies that ... !................. .............. . has permission to perform::� .. ...:.: - :- wiring in the building of.......................................... a...;r...:................................ . North Andover, Mass. Lic. No `5���� a ELECTRICAL INSPECTOR C Check # 49.3 4 Official Use Only Permit'No._ C-5 Pj Occupancy & Fee Checked —3-S�-- BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 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) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number F5C)!�- &f"e 5� Owner or Tenant ,11„� N► I%(k AG1� Owner's Address A.M Date To the iiwpcva � of a 'ii cS: Is this permit in conjunction with a building permit Yes to No 0 (Check Appropriate Box) io Purpose of Building Yw /it 0c Utility Authorization No. Existing Service Amps Voits Overhead 0 Undgmd 0 No. of Meters New Service Amps Voits Overhead 0 Undgmd 0 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO - If you have checked YES indicate the INSURANCE - BOND - OTHER . (Please Specify) -r/-G N ! Pace / °f gOveraae by checking the appropriate box. Estimated Value of. El riC ( irat on Dval ork$�' �� Work to Start 2 C Inspection Date Resquested Rough Final underSigned the en tties perjury: FIRM NAME LIC. NO. 5215 �a— �i f f' , �� �!i- C- I c}( -, It Tel No. C�'% _fir 1'�_T? 3� Address T� S p .p � h Alt Tel. No. OWNER'S i S RANCE WAIVER: 1 am aware that the Litenses does not ave the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner agent (Please Check one) PERMIT FEE W L� (Signature of Owner or Agent) Telephone No. � 1 Total No. of LWhting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In a No. of Lighting Findures (V Swimming Pool gmd 0 gmd 0 Generators KVA No. of Emergengtaghting No. of Receptacles Outlets No. of Oil Burners Baltery Units No. of Switch Outlets No of Gas Bumers FIRE ALARMS W. of Zone No. of Detection and. Total No. of Ranges No of Air Cond Tons Initiating Devices ��- Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices Not of Self Contained No. of Dishwashers SpacelArea Heating KW DetectiomGoundeg Devices 0 Municipal 0 Other Local Connection No. of Dryers / Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW / S' ns Bailases Wiri No. Hydro Massage Tuds /" No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO - If you have checked YES indicate the INSURANCE - BOND - OTHER . (Please Specify) -r/-G N ! Pace / °f gOveraae by checking the appropriate box. Estimated Value of. El riC ( irat on Dval ork$�' �� Work to Start 2 C Inspection Date Resquested Rough Final underSigned the en tties perjury: FIRM NAME LIC. NO. 5215 �a— �i f f' , �� �!i- C- I c}( -, It Tel No. C�'% _fir 1'�_T? 3� Address T� S p .p � h Alt Tel. No. OWNER'S i S RANCE WAIVER: 1 am aware that the Litenses does not ave the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner agent (Please Check one) PERMIT FEE W L� (Signature of Owner or Agent) Telephone No. � 1 HORTN 0 9 ,SSACMUS� Date. .,�.- m 0 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... �'. `�'. F ....?.�. ..................... . has permission to perform .. .13. A �� �`� �'+ �� plumbing in the buildings of .�:.►'i. t �. /a .0 .................. . at ...F.� .. r `' S{...... , North,,Andover, Mass. ................. Fee..iXA(.(. G . PLUMBING NSPECTOR Check .N 5;42 1' .1 I MASSACHUSETTS UNIFORM (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location Owners of Renovation Replacement TION FOR PERMIT TO DO PLUMBIN( Date 23— i '4 Permit # Amount �33 Plans Submitted Yesa No ❑ (Print or type) _ Check one: Certificate Installing Company Name *T , -{ e�}}-��j ❑ Corp. Address w' Partner. Business Te ep one ��l - 233-\5�3 \ ` , Firm/Co. Name of Licensed Plumber: Wk\QNZ, M Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity ❑ Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent T 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 Massachusetts S 1 mg Co and Chapter 142 of the General Laws. By ignaur Typ V Plumbing License Title I3SZ-- City/Town tense INUMDer Master Journeyman ❑ APPROVED (OFFICE USE ONLY 11 Location ' 80--5 No. is Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ /0761 -- Foundation 076' -- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ /� Building Inspector a.. VOREST t N M.,zl S£ S0 S ,96'01 24.11' 44•%8 5 0?5646" w 38.2' STS T 5 Z 5 01° 32' 12" F- 01 r EX►STWG FOC*8N 0) 5 149.98. un un F o10 to Io N lD co L` OD R LO O 0 z Q 0 L O a V) C) SQ V) WQ o `` = z ao J m'1o o� ty Wa a z �? w �o Of W 0a (n U 30 J z CL (J)4 �o �¢ O z 0 F og V)0 cX �0 U Z O N W La F-� LL ON z� 0z W Q � U �`I O� OY W W Ix Y a Q L N P W a' W U O } F- mN c W ='O W z O` U O O Z O N < ,u p[ 2 N Z 4- uw F—a W in � Q �- Q Q ooc p oQ O cn �= a 41 oDi Q - = W U 0 z Q U V) L O a V) C) SQ V) WQ o `` = z ao J m'1o o� ty Wa a z �? w �o Of W 0a (n U 30 J z CL (J)4 �o �¢ O z 0 F og V)0 cX �0 U Z O N W La F-� LL ON z� 0z W Q � U �`I O� OY W W Ix Y a Q L N P W a' W U O } F- mN c W ='O W z O` U Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 OF tkORTF1 ti O o 4 'p_ COL MI[ tWKK APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS ,)0'> LOT DATE REQUEST FILED %,''� (),:J DATE READY FOR INSPECTION / l l J O /U b FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE/�TRUCTURE DOES NOT MEET ,64L APPLICABLE CODES. SIGNATURE ROUTING CONSERVATION **************************************************** DATE I-blialm CvV PLANNING �x D.P.W. - WATER TER �^ �� �� DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR T j TJIE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHORIZATION 4 N° 5 9 Dater.`"J.... z.. . n�.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that �r "� .Z -t � ............................................................................................. r_ has permission to perform ...... �t..................'`=^' ......................................... wiring in the building of z at ............................................................................... ,North Andover, Mass. Fee .- .......... Lic. No. ........ ..... ` ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer L1 TBE co 11101V T-4LTHoF11 Ay&v-.t1II:��TIS' Office Use only DEPARTMENTOFPUBLIC.S4MY Permit No. P v BOARD 0FMEPREVEW0NREGUl 4TI0AS5V0V 12-M � Occupancy &Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 y � (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Datg _ (J UUU Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) �� L Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes M No M Purpose of Building To the Inspector of Wires: (Check Appropriate Box) Utility Authorization No. Existing Service Amps/ Volts Overhead Underground Q No. of Meters New Service Amps �� Volts Overhead Underground r --J No. of Meters �— Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA 01o. 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 Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local f7-1 Municipal a Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER . -- lnstranoeCo►aage PtmattbatheceglffianallsotlViass&hEWsGataalLaws limcaaaatLiabkykm==PcbcymhdrtgCan CovwdWcrissikkFfde*uva YES a NO lha%esubmadvdbdptoofofsmmlotheOf m YES M NO ifyouhased JWYES,picasegdc*thetAvofwmaWbydakirgthe INSURANCE M BOND GIA (Pl mSpadfy) E ddVakrdEe *xdWok $ Wdk1DSkVt hgxEfiwD&eRegtlested Signedunde &Pa>aidescfpajtay: - F)RMNAME Rough I Final Licensee Sig� Lio lseNo Eusi>essTdNo. A+F-M A1tTdNa OWNDVSDs&JRANCEWAIVER;Ianawa< dAtheLdmna the instra=w=ForirssxWntatapwlatasre*m dbyMasxhzi isCkrgrAUNG aodtl�tmyaearthspasn�aiv�rarv� thistagt>aanat. (Please check one) Owner Agent 1.....3 Telephone No. PERMIT FEE $ Location QS Aa�"'S� S No. F Date a 7 TOWN OF NORTH ANDOVER Certificate of Occupancy $ N Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Check # G `% 2— Building Inspector [J a4,4:3 4 a !p Cr o � h O En a w uFi OU F � z G G w G a C > C c. z 4 rn � ti w z F W a Z Z C O 0 > a Zr w . v pOG w C G a H a j ^ �n (✓i N �cn w ? O p F Z O � Z U U O O A E C O U A Z U p � W z w z ¢ z v J FO- 0 i ti O z U ¢ U IA 0 w b 4. O a U° z u z Z O C Z Z r►", 40 O V U [J a a4,4:3 �° d a !p Cr o � h O a w � O a w uFi OU F � z G G w G a C > C c. z 4 rn � ti w z F W a Z Z C O 0 > a Zr w . v pOG w C G a H a j ^ �n (✓i N �cn w ? O p F Z O � Z U U O O A E C O U A Z U p � W z w z ¢ z v J FO- 0 i ti O z U ¢ U IA 0 w b 4. O a U° z u z Z O C Z Z r►", _ O V U U U � w O O w wN O Z Z w W v w w L� r C A _ ¢ 14 4 14 GOG�A a O w z O - 0-4 a a4,4:3 �° d a !p Cr o � h O a w � O a w uFi OU F � C G G w G a C > C c. z 4 rn � ti w z F W a Z Z C O 0 a Zr w . v pOG w C G a j ^ �n (✓i �7 F w ? O Z O � yy z ¢ z v J FO- 0 i ti O z U ¢ U a E c UUu 14 z z u z Z O C q A o r►", _ V � � N � F F F N_ m c n c v C C r C A _ ¢ 14 4 14 LIS 11 min C2 �° d a o � h O a w � O a w uFi OU F � C F U w G a C > C c. z 4 rn � ti w z F W a Z Z C O 0 a w . v C C2 z o � F m � r w C a O U a � CL O k' a C. C a W A F 0 z z C C u a. 26. m U F z F W a Z Z C O U .. a w C2 r 1 � r � F w m U F O Z Z C O U .. r 1 lk z o ---I J f ccJJ C� F U � U a � � x lk W a z o ---I J f ccJJ a F U � U w � � x w Q A F m z a O x w " Z O F U C W G C C O A � � 0. V] Cy v C C rn �• UUr. L cil x � A z o -- O z w_ (� Z E,y X .z7 a ®� 1 W a z o ---I J f ccJJ a F U � U w � z w Q A F m z a O O w " Z O F U C W G C C ¢ 0. V] Cy v C C rn �• UUr. L cil \+ z O z w_ (� Z .z7 a ®� 1 U W z w o -3e k W o z C ^ C C a n C C q O H O U M� W C Z n o C F z 7 ¢ 7 ¢ C"• A C z p N y C v W ti W U W U zf, W U z�.' w C C A .a .zr, ^ c 14 0 F o z ai �n z G a d x o 0 0 0 u uF u 2 z U U U vFi O V A L p, C7 A cCit 0. C G O A d `n O 0. L u q z u L: `w O z z z z z z A z m I^ m h m F c: G d L c^ w O p m n C O w O w O w C a. O b �. U w z O O U O U O U a w w w n O ct O ti p Z O rn 'Aw OO p w O O U G C7 A C7 A V U �.y O w a O w LGa w C Z z w z w cA z W F C7 w w A 5 \ wOv�� �S W a z o J f ccJJ a F U � U w � z w Q A F m z a O O w " Z O F U C W G C C ¢ 0. V] Cy v C C rn �• UUr. L cil \+ z O z w_ (� Z .z7 a ®� 1 U W z w o W o z C ^ 40 y 0 C C O H O U M� W C Z n O C F z 7 ¢ 7 � V 'O 0 0 h a fi + ►�� a � Q� z o J f ccJJ a F U � U w � z w Q A F m z a O O w " Z O F U C W G C C ¢ 0. V] Cy v C C rn �• UUr. L cil \+ z z w_ (� Z .z7 a ®� 1 U W w W o z C ^ 40 y 0 C C O ¢ O U M� W C Z n O C F z 7 ¢ 7 ¢ C"• A C z p N y C v W ti W U W U zf, W U z�.' w C C A .zr, ^ c 14 En " c. C J f a F U � U w � z Q Q A F m z a O O w " Z O F U C W G C C F r� z zz r O v w U z F c = ¢ 0. V] Cy v C C rn �• UUr. L cil En " c. C a F w U z z a O O En " c. C 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 SECTION******************** * APPLICANT ales CFTC t n PHON ? 01__ X363 s� LOCATION: Assessor's Map Number D PARCEL_ SUBDIVISION LOT LOT (S) STREETf i��l'Q 5 � V ST. NUMBER 005- 1A1 USE ONLY******************************* C ple m 0 E �f(W"' T t RgIA-C, RECOMMENDATIONS OF TOWN AGENTS: �Itw CONSERVATION ADMINISTRATOR COMMENT TOWN COMMENTS DATE APPROVED I z nATF RF_IFC_Ti=n FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS Z10 /0Q5em 60Z ddr Q � 6_ - /'-aX , PUBLIC WORKS - SEWER/WATER CONNECTIONS zo_-2? -9i � DRIVEWAY PERMIT FIRE DEPARTMENTc� t �+ c� ��.��L�� c�eT. F� ►�,,. i`T._ �� 7 - 5' `1� RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print I I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone #: Insurance Co Policy # Company name: Address City Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as .well.as civil penalties in the form of a STOP WORK ORDER.and a fine of (.$100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify er the pains and penalties of perjury 7 t the in ation provided above is true and correct. / Signature Date l0! a Print nam a Phone # 7 r Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept ❑Check if immediate response is required p Licensing Board p Selectman's Office Contact person: Phone #: ❑ Health Department 0 Other Growth Management Bylaw Exemption Statement Town of North Andover Building Department This fort shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit (below) Address of Property for Permit (be!ow) J�aeue Map and Parcel !TD IS Purpose of Application (check below) Phan Numb r of AAp licant: • Z Single Family Two Family 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 an 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. VThe 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 andlor represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior•' shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40416 permanent reauction in density, (buildable tots), 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 an the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By 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 I understand 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 knowledge or not, is grounds for refusal by the B iding Department to issue a Building Permit. /.47 /51 ture of wner or Author ed Agent wno signed he Attacned Budding Permit Date s form 4fust be attached to the Building Permi upon application for such permit WARD OF O_IIILDINGREGULATIdNS,` UCSnsS: C0NSTkUCTi0N SUPEi21/IS0i2 I NVMtber, k 007864 8i G a ' 0461.8%1 t�h[d t@. 954 :, irAa 04/18/2000 Tr. no: 3625 1 ;, �iestricted To:.,00 +. PARD E WELCi N _ i 61 MAIN ST �� 4 i DING; MA.,91867 Administratgr • I I I i i � r v BOISE CASCADE - BC CALC*d 99 DESIGN REPORT TRIPLE -1 314" x 9112" V -L SP 2900 lob Name - 9906147 Cumomer Address LOT 4 ASPEN LN Specifier 10 0oacriptim Load Type Ref, Stant Designer CiV. Staoa, Zip - STONEHAM, MA Company: Cod. Reports - iC80 5512. BOCA 88.52, S8CC19162 Mist: Member Diagram $0 15.0400- 10D Member Type. today August 27, 1999 08:01 File ham. 2b2.bca - GERALD WELCH INC, - BA Wakar - National Lumber SECOND FLOOR BEAM —notal Horizmtal Long h-11104.00.--.—.� Gonna) Data Lotaed Summary — &us Unit Foevinches 10 0oacriptim Load Type Ref, Stant End Lira Dead Trio. Dur. S Staandsrd UnfArea Wed Left 00-00.00 1304 -DO 30 $0 15.0400- 10D Member Type. - Fbofseem t Unf.t-in,Load Left 00 -00 -DD 1344-M 0 65 nh too Nurnbsr of Spans - t Lan CWWIO,.W - No Controls Summary Right Contrlaver - No Conflel Type Valga % ADowabM Duration Loodamw Spee Location Moment 15019 ft-Ibs 17.0% 0100% 2 1 - In18m81 Slope (inM -0,00 End Sheat 39x9 Ds 41.4% 8100% 2 t - Lafl Tributary (it) - 1540.00 Total Don, V 248 (O.e441n) 96.0% 2 1 Repetitive - n/a Live DOE L/ 374 (0.4271n) 9610% 2 1 Construction Type - n/0- Live Load (psf) .30 Dead Load (paf) - 10 NOTES: Psrtltlon Load (pat) - 0 Damon Reels Code minimum (L/24D) Total bad deflection criteria. DwaYon ft - 100 Design meets Code minanum (6/860) Live load defladlon Criteria. Minimum End bearing length is 1.5 in. CNSCtq�ur� The cormnpletwou and at:ouracy of the Input must be vwMad by anyone who would rely on the oaW as evidence of sultwmy rot a pavkxdw aWkstim, The output above is - 'upon bWk tnp cod14140111 d dsaign pro WOOS and anafyala nMthods. huunstbn of ®cies Cascade engineered woo products must be in aocardenoe wits► cite currant Instatldbn Grinds and the apptOW buftng codes. To obtain an haat kftn Guide or if you lava any questions, plass all (80-0)232.0788 before beginning product itetallation. BCO and Vera* -Lamb are registered trademarks of Bolsa Cascade Corp. Za'd L9LZ 0SZ 8L6 d(rl!' tiS:SL 666ti-8Z-1�0 BOISE CASCADE • BC CALCm 99 DESIGN REPORT DOUBLE -131411 x 9112,' V -L SP 2900 Job Name 9908147 Customer Addtaila LOT 4 ASPEN LN Sl flasidner City. Stets. Zip - STONEMM, MA Campeny' Coda Reports )CBO 5912.9= 9832, SOCCI 8852 Vise: M*mber Diagram 041111,10MI Data Bass UrM FaetJlnchas member Type: Floor Sam Number of Spans - 1 Left Camteavar - mb Right Cantilever - No $laps (in" -0.00 Tribtl" (fl) - 07.00 -DO Repauve - Ma Camtrudon Type - nfa Live toad (pal • 30 Dead Lead (Pei) -10 P■rtitw Lead (pet} - 0 Duravon (%) -100 umdoeure The completeness and accuracy of the input must be veriled by anyarve who would raly on the Pt4ut as euldspce at LedmbiRty far a Psitcular apphos1w. The autPut above Is based sport building oode-ampted design properties and artalyase rnethada. Ntatailation of Base Cascade angineered wood pmduea must be in socol me wllh ft owi nt tnstaKnW Cutch and the appillcablit buihfmg Popes To obtain an hvilatlaGon Guide or if you have, any 9mbona, please call (800)132.0746 before boon" product itilmNation. BCM® and Versa -Lam® are registered trademedlts of Bolas Cascada Corp. 00 ' d T9L2 0Si? 8L6 - t» -a -OD Friday, August 27, 1999 05;00 File Norrie: 2b 1.bcc - GERALD WELCH INC, Wl WOW Nationai Lumber OVER FIRST FLOOR SAY $117# Lead Summary W DerlartpCon Lead typo Ret. Start End Live Dead Trib. Dur, S Steward UmfAmsload 1.0 00-00-00 Og-D"O 30 10 07.00-00 100 1 unf.lin. Load lett 00.00-00 09-04-00 0 100 n/a 100 2 UntAmLoad lett 00.00.00 09.04.00 20 10 07-OUD 1t10 3 TraowMal Left 00.00-00 35 10 n/4- 115 3 Trapazoidal Left 03040 525 200 Na 115 CanbWs Summery cafltrpl Type Value 7r. Allowable Duration Loadca" Span Locillibn 'Moment 13779 ft-fbs 71.5 oils 3 1- internal End Spear 3995 lbs 541% 115% 3 1 - night 'Total Defefl. V 332 (0.331in) 72.2% 3 Live Defl. U 519 (D.216in) 89.3% 3 1 NOTES: Design meats Code minimum (L/240) Total bad defloeborn v teria. Design meets Cods minimum (LM) Live load dalleWon criteria. Minimum End beari,gletglh is 1,73 in. d('1t TS : ST 666T -8Z-140 BOISE CASCADE - SC CAL.CTM 99 DESIGN REPORT TRIPLE -1 31404 x 9112" V -L SP 2900 Job Nerve 9948147 CdAtWMr Addless - LOT 4 ASPEN LN 3penuier Designer City, State, Zip STONEHAM, MA Company. Ob Code Rsporta - IC60 5512, BOCA 6x-52, S6CC19652 AAise., Member Moratn Friday, August 27, 1209 08,04 Fite Noma: X21cc GERALD WELCH INC. Bill Walker • NOW* i_urnber UNDER FRONT GABLE Germ" Dater peon Unit Fostnnd+es Member Type: - Floor basrn Number of 81parw - 1 Loftc," leoor - No Riprt CaMitevsr - No Slope (Inlft) • 0.00 Tributary (ft) - W" Repetitive - rVa Cenabudion type - rua Lin Load (pat) - 20 Deed Load (pef) - 10 Partition Load (pat) - 0 Duration (%) - 100 Diedwwo The conv*Wness ane accuracy of ttw Input must be veritled by anyone who would nety on itte cuout as w4donoe of sultablrty for a axwe isparticular application. t WW rn argapia�nwobukungdesf prolplawm anIneaftilon Of 8011A Castaea enginoerad woad products must be M accordanaa With the rumen lastalftoi t Guide and tM appricabla bLftvq Cedes. To obtain an Inslaliatior►Guide or 0 you have any puesliona, please tail (800)232.0701 before beginning product instahtlon. BCI® and Vente'Larn® am registered Vaderaeft of Eloise Cascade Cole. DsocrWdon Standard 1 COMMIR summetV Load Type Ref- Unf.Areo Load Left thsfAma Load Loft Control Type Vacuo % ANWA* to lrorrent 14062 ft-ibt 52.4% End Sheer 4374 Ibs 39.4% Total DO. U 323 (0.4001a) 74.2% Live Dell. U 438 (0.301 in) 9211% bloat End Live bead TOW Dar. 00.0040 11-00-44 20 1D 08-80.00 100 00-00 11.00.00 35 t0 15.0000 115 Duman Loadcase Spm Location S 11516 3 1- Inler821 0115% 3 1 -Left 3 1 3 1 NOTES: Design meats Coda minmum (U240) Toted bad defllection criteria. Design moot& Code mlr+imum (LWI) We load deftebon cede w Minimum End bearing length 161.5 in. b0'd T9LZ ©SZ 8L6 dmf ZS:ST 6662-8Z-100 y BOISE CASCADE - BC CALCTV 99 DESON REPORT DOUBLE -1 314" x 9113" V -L SP 2900 Job Name 990x147 Customer Address 1.014 ASPEN LN Specifier Designer City, State, Zip - STONEHAM, MA Company: Code Reports - IC80 5612, BOCA 9862, SBCCI 9852 Mies. Manbdw Diagram friday, August 27. 1999 M03 Fite Nano: 3151.hce - GERALD WELCH INC. - Bill Welker - National Lumbar ATM FLOOR BEAM ' _ „o�'o°-°° . , �. -�— - ------------• -- . ii -40••00. ,_.�._ _..... ...,�... - -- _- - Total mwi zontal L4000 - 20-00.00 Sass Unit Ftetdnches k%w4w Typa! - F)W Sham Number of Spans -2 Left Cantilever - No RightCantilaver - No slope Onift) -0.00 Tributary (ft) - 154XHM Rrvstill" - rja COnetPUCrion Type - Na Lige Load (pat) -20 Mad Load (po 10 P"tiort Load (pef) .0 Durebon (%) -100 D"Daws The canptaf#ness and accuracy of the V" must be ver*W by anyarn ev�idenncce of r" an wjw u partioulaf appMa&m. The output above is based upon btdk mq code-ac-capted design pmpairties Ind 0114"ls Irtlthede. Insiallatwn of D056 Cescade engineeted wood prod must to In evowdsm a wHh twe current Iftewlederw Guide and the appficabk bMirg Dodos, To obtain an InatskWei Guide or If YOU have any questions, pfeaff cao (800)232.0788 botm beginning product Installation. 9126 and Verne-LaenBl are ragisteted trademarks of Boise Cescade Corp. Load Sutrmury to faee " ioe load Type W. Start End Lw Dead Tilb. Out. S Standard ElnfArsa load Left 00.0000 20,00.00 20 10 1500-00 10D Centro" SUMMry Cetl001 TYjte Valu. Moatefd 7282 ft -lbs End Shear 2111 be Cont. Shear 3183 be Uw -391 U Total Defl. U444 (0.3S1in) Lire Mn. U 657 (0.2371n) Toth Nay, Defl. -0.056 in !L Allowable Duration 55.8% 0100% 32.8% 8100% 49.5% (11100% 54.0% 54.7% .0.5 in The found at span 1 - Left, moats Code minirru fn (L/240) total lead da% ton criteria. mcata Colt minimum (1=) Live (ped d0ec*w cd*fia. M End boating length is 1.5 in, ro Continuous bearing length is 3 in. loadesaa Span Loeafbn 2 1 - Right 5 2. Right 2 2 - Left S 1 -Left S 2 5 2 S 1 Said L9LZ ®SZ 8L6 dmf, ZS:SZ 666T -W-100 90' d -1Ui01 t BOISE CASCADE - BC CALC'rk 99 DESIGN REPORT SINGLE .9 112- SCI 45S SP -OSS Address - LOOT 44ASPEN LN spot ietr Designer Cly, Stats, Zip - STONEMAM, til► CornPany: Gods Raperts - tCaO 5208, SOCA98-18. SBCCI 9844 Mid Member Diagram Friday. August 27, t899 07:88 FNB Name: lj1.bcc • GERALD WELCH INC. • Bill Walker National Lumber TYPICAL FLOOR JOIST Total NOr12ontal Ln-tn G na oral Data Base Unit Festpnches Load Santtaary ID OesctiptioA Load Type Raf, Mart End Lira Diad O)CS (in) Our. g Sy,ndard U nf.Atea Load Left 00.00-00 30 -DO -00 40 12 18" 100 MarnbsrType; Joist Nurtiber of Spans - 2 Left CmMavw - No Controls SummatY contra)" Valve A Yowabla Wrratton Loadcase 8psn Location Rpht Cantilever - No Moment 1916 ft -lbs 601% 0100% 2 1 • Right End Reaction 46966 41.7% 10100% 5 2 • Right Si" (lr1tA} - 0.00 Int. Reaction 1306 lbs 52.9% 0100% 2 1 • Right 0C Spacing (in) 15• Coen• Shear 670 Ibs 45.2% t0100% 2 2 - Left Repetitive • Yes Total Deck. U 578 (0.832in) 41.50A 5 2 Construction Type • Glued L{vs 00fl. U 701 (0.2741n) 51.3% 5 2 Total Nag. Deft. -0.09 in -D.5 in 5 1 Live Load (pa!) 40 SpanrDspth 20,2 Dead Losd (psf) - 12 Partition Load (psf) - 0 ouratm (16) • 100 NGTSS: Design meets coda minimum (Ll240) Total load de1)edian criteria. Dlet:i num Do*" moots Code minimurn (U360) Live RW deflection aireris, The compMenen and acovrwy of Minimum End bearing length it;1.T5". the input must be vertfied by anyone Minimum Continuous towing length is 3.5". Who would rely on the aUOA as e ilwaa of WAWMNht for a padiculat application. The output above is be upon buWinp coda -accepted design ompertiea and analysis methods. lnstaAation of Bolae Cascade engineered wood products must be In aoWrdancs with the cannot installation Guide and n1e spplicabie bulift codes. To obtain an Mateipation Guide or if you have any questions. phase arm {800)232-0788 before bonntag product installation. SCA and Varsa•LamO aro moistamd trademarks of Boise Cnade Corp. 90'd t 9L2 05'32 BL6 dmf 2S:SL 666ti-8Z-130 MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 10-22-1999 DATE OF PLANS: 7/22/99 TITLE: THE SUGARBUSH PROJECT INFORMATION: 805 FOREST ST N.ANDOVER, MA. COMPANY INFORMATION: GERARD E. WELCH, INC. 1361 MAIN ST. READING, MA COMPLIANCE: PASSES Required UA = 433 Your Home = 402 I I I I I Permit # I I I I I I Checked by/Date I I Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 1473 30.0 0.0 52 WALLS: Wood Frame, 16" O.C. 2400 13.0 0.0 197 GLAZING: Windows or Doors 265 0.310 82 FLOORS: Over Unconditioned Space 1473 19.0 0.0 70 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined in the applicable Standard Design Conditions found in the Code. ThegACipment s t d to heat orcool the building shall be no greate125% th d s' n oad as s cified in Sections 780CMR 13J . Builder/Designer Date ❑ / 0 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 THE SUGARBUSH DATE: 10-22-1999 Bldg.1 Dept.1 Use I I CEILINGS: f J I 1. R-30 I Comments/Location I I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-13 I Comments/Location I I WINDOWS AND GLASS DOORS: [ J I 1. U -value: 0.31 I For windows without labeled U -values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 I Comments/Location I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: I ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R -values and glazing U -values must be clearly I marked on the building plans or specifications. i I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. I t I DUCT CONSTRUCTION: I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.): I PIPE SIZES (in.) i HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT LATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): I PIPE SIZES (in.) I NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED LATER TEMP (F): RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 1 170-180 0.5 1 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 1 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only) ------------------------- V 0 LAW OFFICE OF MARK B. JOHNSON 12 Chestnut Street Andover, Massachusetts 01810-3706 (978)475-4488 Telecopier: (978) 475-6703 MARK B. JOHNSON (MA, NH, DC) LINDA A. O'CONNELL (MA, NH, RI) DONALD F. BORENSTEIN (MA, ME) CYNTHIA R. GLACY (MA, NY) June 24, 1999 Building Inspector Town of North Andover Municipal Building 120 Main Street North Andover, MA 01845 Re: 805 Forest Street North Andover Massachusetts Dear Mr. Nicetta: Paralegals KATHRYN M. MORIN JEAN A. SHEEHAN LIANNE CRISTALDI This office has been asked to render an opinion relative to certain aspects of the title to 805 Forest Street in North Andover. The Lot is shown on Assessors Map 105D, Lot 18. The current owners of the Lot are William J. Hamel and Deana J. Hamel by Deed of Gayl C. Blair date May 11, 1978 and recorded with the Essex North District Registry of Deeds at Book 1338, Page 76. The preceding Deed in the chain of title is dated February 19, 1960 and runs from Rosco A. Gilbert and Anna A. Gilbert to Gayl C. Blair. It is the 1960 deed which separated this lot from common ownership with abutting land. The Hamel lot has not been held in common ownership with any abutting land since that time. Accordingly, this lot enjoys the isolated lot grand -fathering protection of G. L. c. 40A, § 6. Please call me if you have any questions. Very truly yours, LAW OFFICE OF MARK B. JOHNSON DFB*kag Donald F. Borenstein cc: GE Welch, Inc. F:\NEW-DOCS\WELCH\HAMEL\Building Inpector-Hamel.doc 0(ZIG,_wkl wl w z`dump' o O ® Q CIS cl �- -Z o w o � Of alow o 11 1 :s -- ai 0 47 pi LL ro 42 O �Q� `NG..�, O ,C 0 Ln A O 1cu 0 aF c O " OC C �-. - O E O O roLn u Q. m 'r o = _ n Ln O. _aj Ln om �Q O : O � O 3 D1 u m :� O C a u O v) E a Q ~ x c �a F- 0 O O C OC1 O W = H V O O O m _ ro O y 0. r c v C .� U a a�0N �° a r a = 0 s o o Q O Z �A `• ° cu u ® g =° X_- in c.� 6 Li 9 O z o m _j= u LO °' �' y n ° U Q -� m o m L2 O s pO t CO C w U w W Oa iCs x p U z ¢ p roC z w A a w C z U) v v O (n C O O N O C.) C.3 d O p� C 0 sco � ? N IL �Ea CD G �. o m c s: 0 CMa 4=3 C +. S: N a C t: y CD 3 N Qf � C � m C � _ m N A 'C y !�► 'E cD CD 0 V; c o a O;= N _�• V h O A 0 '� Z c � o H c m = m m :s 3 !— 0COO N � � � W G , LL � •N .Q t O C N w E 0.0 CO, C.) oCO) CL m o�� c CA a.,., m 8 0 z 0 W W DLI LO O as dwo dow 6 n_ ., M71 CD O E MM co 4i. O Z O D C#* CD LA .CD L CL CO s C O co v raj L O V CD CL y C CD Q, C CD O .0 D� m m s: C T� i Aloft rdMFWAD—b' 1 LLJ0 W Ir LLJ LLI cc LdW CO T ST ' y 6 0 s� xa -,-0, �m iso �s a 50 o. 3o x�6 r)),4) IL) 080 &S, D a D a Y) �( t3 o N cin Fc) 63L M14 IA) IDoD 65-1 D a 0 0 x/I as 13 o -��� / � 9D • moi" Ila Bd* 02 S7�a �� lJ/v X12 Bq C> o / a� b ZY,CAvA-7'idN 1-Fo vN /d A-) I � 1 S BBDO ftp- 8 q5 I a a /S� so.o� WELL DATABASE ADDRESS: s Ds- AGE OF WELL : WELL DRILLER: WELL PERllyIIT T: WELL LOCATION: WELL PERMIT DATE: DEPTH OF WEE'l. TYPE OF WELL: a.. DRILLED b. DUG UNKNOWN TYPE OF WATER BEARING ROCK. WATER ANALYSIS DATE: HIGH MANGANESE: Y HIGH IRON: Y N OTHER CONTA dE TAM'S. Y N WELL DATABASE ADDRESS: AGE OF WELL: WELL D LER: WELL PERMIT 0: WELL L CATION: WELL PERMIT DATE: DEPTH OF WELL: TYPE OF WELL: a.. DRILLED b. DUG c. UNKNOWN TYPE OF WATER BEARING ROCK: WATER ANALYSIS DATE: HIGH NfAINGANESE: Y HIGH IRON: - Y N OTHER CONTANfINAINTS: Y N N N s Date... .. !..f�...v- TOWN OF NORTH ANDOVER PERMIT FOR WIRING 'T,.� �is certifies -that ............................... -5�7�............ �.�5................. As permission to perform .................... .... .... .................... wiring,in the building of ��. �� a a ......... .. ' .......... at ........... ... 5�.... .................. orth Ando S �c.0�................... N..... ELECTRICAL INSPECTOR Check # 11 Commonwealth of Massachusetts Official Use Only Permit No. 4�V7-) Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 27 C R 12.00 (PLEASE PRINT WINK OR T P A A L INORMATION) Date: p� City or Town of: To the Inspec or of Wires: By this application the undersign hives note of is or her intention to perform the electrical work described below. Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No Telephone 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 No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table mav be waived hv the Ins ector o 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 Fixtures Swimming Pool Above In- rnd. E]rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o Detection and Initiatin Devices ,No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Merting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Kit Security Systems: No. of Devices or E uivalen No. of Water Heaters KW . Noo No. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 ❑ BOND F1 OTHER ❑ (Specify:) Estimated Value of El trical Work: (When required by municipal policy.) (Expiration Date) Iy&Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: HolLIC. NO.: 1 S q 3C Licensee: John S. Bassett Signature LIC. NO.: 1533C (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 603 594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Li*see see 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: $ 500 , t r Location q C� _St Siryid No. Date TOWN OF NORTH ANDOVER o '. Certificate of Occupancy $ �'7S'�•° E<� Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 6;'2-4 Building Inspectdf 3 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPUCAT10N TO CONSTRUCT REP RENOVAT OR DEMOLi58 A ONE OR TWO FAMMY DWELLING 117X-1�7 Saw BUILDING PERMIT NUMBER: 2 DATE ISSUED: _ V 7-p3 SIGNATURE: Building Commiss►oner r of BuildingsDate SECTION 1- SITE INFORMATION 1.1 Property Address: -fu" _ r S7R cT 1.2 Assessors Map and Parol Number �/os-p o0Numbw �18 Muldher NQ> A �s�VE_, MAVIS 13 ZoningbrformaGm: Zaoio District PrMosed the 1.4 Propmyl)immsions Lot Area Frarta @ 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required ProvidedRe 'red pi Provided l.lwettrSupplyhLO.M40. 54) M. FloodZasetafomdon: 1.8 Sew-VDisWWSyaem: P146C 0 P&MO 0 Zane OnoddeFloodZDae a MaakW 11 On SiteD'uposd System 0 SECTION 2 - PROPERTY OWNERSMAUTHORIZED AGENT 2.1 Owner of Record r s r .5 , r .Asy&Ae- Nance (Print) Address for Service: 19-0 tkg Si Telephone 2.2 Owner of Record: _-6r--- L t' ST2C T N „ Name Print Address for Service: ' S' Tel e SIRMON 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 Su eture Telephone V Z O INI O rn O Z M 00 O r v M r r z 0 13 SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 4 25e(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 buil ' permit S' ed affidavit Attached Yes ...... V No ....... 0 SECTION 5 Dticrintlon ofProposed Wormehtc&k b1e New Construction 0 Existing Building 0 Repair(s) 0 Alterations(s) Y I Addition 0 Accessory Bldg, (3 Demolition 0 Other 0 Specify Brief Description of Proposed Work. i'l1viS1� n ALL) tAzM In1 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant *; OFFIGL{bSEQ�mJLY' °:`tc'a" Y 1. Building -- (a) Building Permit Fee Multiplier 2 Electrical ,— _ (b) Estimated Total Cost of Construction 3 Plumbing p 0 Building Permit fee (a) x (t,) 4 Mechanical AC_'.4000 5 Fire Protection 6 Total 1+2+3+4+5 ` . et, Check Number SECTION 7a OWNER AUTHORMATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR MELDING PERMIT t 9l' as Owner/Authorized Agent of subject property Hereby authorize J to act on ' My be f, in I ma relative to authorized by this building permit application. / Si tore of Owner Date SECTION 7b OWNER/AUTHORLZED AGENT DECLARATION I, 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 Print Name Si ture of Owner/Agent Date N0.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TAMERS ] eD 3 RD SPAN DDAENSIONS OF SII.I,S MENSIONS OF POSTS MENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING g MATERIAL OF CH ANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE O ' Town of North Andover Building Department ',q.�;--•. qT10 rPi'(i 27 Charles Street 9SSACHUSE North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE 16117 1,:iV03 JOB LOCATION YOJS -EPZfir 79-9—� Number Street Address Section of Tc "HOMEOWNER 2b5 97 Number Home Phone Work Pho PRESENT MAILING ADDRESS S-74CEe7— City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of 1 or 2 units 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 HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which of two there is, or is intended to be, a one family dwelling, attached or detached structures accessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) The undersigned "homeowner" assumes responsibility for compliance 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 No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir men HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. Revised 4.30.03 Home owner Exemptions Form North Andover Building Department 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: �--4 S r S �J ' (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector FORM U - LOT RELEASE FORM h 3 n INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fr, Boards and Departments having jurisdiction have been obtained. This does not retie the applicant and/or landowner from compliance with any applicableor requirements. ***********APPLICANT FILLS OUT THIS SECTION APPLICANT -RC's (' PHONE ?7—/ LOCATION: Assessor's Map Number S PARCEL- SUBDIVISION. ARCELSUBDIVISION A44- LOT (S) STREET -ice P T SSP j ST. NUMBER *'-OFFICIAL USE ONLY*"*—**"*""***** ,t* RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS s� TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED. DATE -REJECTED , COMMENTS_ Ic-- r' i� °l<? T' < <512-.__ ,. � CJt�'. � , P•� . C F��'r PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING 1NSPECTO Revised 9197 jm DATE V In Imst'-4. z I x o O uo uu o g w CL cn 04 o 004 z 01- w to y .0 U G w a o t � a� C O � ci x a 0 w Cf) w W a�' cn is w o U z O tov a�' m U. a w H cq z ' cn Q 0 cn co O CD Z 0 H 03CIO O CL O co O ey y 0 CL. 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