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HomeMy WebLinkAboutMiscellaneous - 87 BELMONT STREET 4/30/2018N) North Andover MIMAP April 23, 2012 3.0 N008.0-1112 " 013 02 .Lawrence 013 03 013 04 01 05 013.0-0006 013.0-0034 013.0-0007 1�6 008.0-0003 013.0-0025 CONDO \fly �� 013.0-0027 CCC` 003.0-0004 �t o13.a0029 _ . 12� U013.0-0031 013.x0033 003.0-0005 Rail Lineal Wetlands Zoning Interstales0 Exempt Lands — In - Busine D Busine s 1 (R-1) s 2 (R-2) Horizontal Datum: MA Slaleplane Coordinate System, Datum NAD63, — Major Roads d Busine O Busine s 3 (R-3) s 4 (R-0) NORTH Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of - Roads L Easements Q Genera O Planne Business (G B'Of Commercial Dev «ac q0- < �a O 'e North Andover. Additional data provided by the Executive Once of Environmental Affairs/MassGIS. The information depicted on this ma is Pi P r ❑ MVPC Boundary "` Induslri Induslri I 1 (1-1) 12 (1-2) j e� O 3 L O 10 0' 9 for planning purposes only. It may not be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER L3 Municipal Boundary W 12 Induslri D Induslri 13 (1-3) I S MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING Zoning Overlay Reside (I -S) ce 1 (R-1) t 1{ THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY B Atlell Entertainment - - Reside ce 2 (R-2) • i ,^, y 1► o'0- OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT ❑ Downtown Overlay District Historic District i2 Reside ce 3 (R-3) �� I 'rl ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION ®Water Protection 97 Reside 0 Reside ce 4 (R�) 5 °�+rxu����'� 'SSS O Parcels i R—ide ce (R-5) ce 6 (R-6) A CMU S�< 13 Hydrographic Featuresge '� esidential (VR) Streams 1" = 74 ft a .ge ommercial (VC) i Printi=ng Property Ownerl BEL MONT STREET NOMINEE TRUST Owner2 C/O JOHN BODDY Address 87 BELMONT STREET Map/Lot 013.0-0034-0000.0 Lot Size 16988.4 S Fiscal Year 2010 Land Use Code 401 Last Sale Date 04/17/1990 Book/Page 3095 Total Valuation $456900 Building Type Year Built Finished Area 8736 sq. ft. Assessor Map NorthAndoverAssessorMapl3_26x36.pdf Page 1 of 1 Print http://maps.mvpc.orgINorthAndovennimaplldentify.aspx?datatab=ParcelBasic&id=013.0-0034-0000.0 4/23/2012 y - - Date. .................. A' TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . `.r ..:........... '.... ......... .. . his permission for gas installation ..f . f/ ........... . in the buildings of .i ... -'� ". ! .................. at .. .. .: , North Andover, Mass. FeeLic. NoA4:': GAS INSPECTOR Check # t 4037 "N JMASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FI=G or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations Permit g 1/03 Amount S r Owner's Name J-, New 0 Renovation ❑ Replacement ❑ Plans Submitted ❑ CY (Print or type) Name Address I. LACL , B4siness Telephone fti- 11— S5114-- ���MP dame of Licensed Plumber or Gats Fitter J F Check one: Certirig � t�lin<_ Company o.J Corp. ((�� ❑ Partner. FFirm;Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent_ Yes Q NO If you have checked ves_ please indicate the type coverage by checking the appropriate box. Liability insurance policy z 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 vldss. 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 herebv certifv 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 a d installations pertormed under Pe it Issued for this application will be in compliance with all pertinent provisions ofthe Vlassa husetts Stye Gas de and Ch it VfYe Gene; -al Laws. By: Title Ciry/Town APPf,O`"ED(OFrig;- utiF !)NI.Y) S�nature of Licensed Plumber Or Gas Fine,- r7 itter❑ Plumber M3 4YO Gas Fitter icense ;,iumoer Master ❑ )oumeyman I Date..._. . S.. el.2 ..... r TOWN OF NORTH ANDOVER a PERMIT FOR GAS INSTALLATION This certifies that . ��✓?t l �' .`" ...... . has permission for gas installation .. � .. b-. : / ........ in the buildings of 4(�./6c C. .r ........................ at .. . �........ ` ...... f .............. . North Andover, Mass. r `�Fee.Lic. No........... ......: .......... GAS INSPECTOR Check # 3910 L� MA%ACWSLT1S UNDDRM AMUCATON FOR PERNVIfI' TO DO GAS G (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 97 GrL117ep- / 5T Permit # .3 �l Al n C Amount $ � Owner's Name New ❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ + or typeCheck Certificate Iu�stalngCompany Nameott/4/f/k l,(-di"D-_l/r �Cor (� Address c /3 &L iL, 0 N -T S ❑ Partner. lk./1 O UIE- 7Z /`SAS S Business Te ep one 9 )--3 ' ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter :__(0L—! C -AL1 /-) h1 -4A, INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑'� No ❑ If you have checked }_es, please indwate the type coverage by checking the appropriate box. Liability insurance policy I 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 certily that all 01 the details and mtormation 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 Massact yisetts,StatetiGas„C,,odp and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) ature of Licensed Plumber Or Gas Fitter ober , 5 tf Lil Fitter License Nurnoer Journeyman x 14 w rA z C) Z W co�z W cn FCn z 0 rj) AgoE. wz 0 W� Wx Wx � 99 En {"i O w A c' -s' a 0 A aF FF O SUB -BA SEM ENT B AS EM E N T 1ST. FLOOR 2ND. F L O O R 3 R D. F L O O R 4TH. FLOOR all 5TH. FLOOR 6 T H. F L O O R I I I -film l____F_1_l I I I 7TH. FLOOR 8 T H. F L O O R + or typeCheck Certificate Iu�stalngCompany Nameott/4/f/k l,(-di"D-_l/r �Cor (� Address c /3 &L iL, 0 N -T S ❑ Partner. lk./1 O UIE- 7Z /`SAS S Business Te ep one 9 )--3 ' ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter :__(0L—! C -AL1 /-) h1 -4A, INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑'� No ❑ If you have checked }_es, please indwate the type coverage by checking the appropriate box. Liability insurance policy I 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 certily that all 01 the details and mtormation 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 Massact yisetts,StatetiGas„C,,odp and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) ature of Licensed Plumber Or Gas Fitter ober , 5 tf Lil Fitter License Nurnoer Journeyman n N22209 ................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that � ...... .. ............................................................ has permission to perform.r'::..:::...::;...... ....... Z ..................... wiring in the building .................... ................................ ...... ................. . North Andover, Mass. Feel,)(76........ Lic. ... ................................... ............. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer '�"` (..ccommonwsa�lh o�cc�ad�acitwe�l 1JsParfntsrrt o`..tiis �srvicas BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. rjai� / Occupancy and Fee Checked ,A4 (j G, 00 Rev. 11/99] heave blank) # $,S APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (XIE )Y52 CNIR 12.00 (PLL•.ISEPRINTLV INK OR TYPEALL hVr-01,L I770N) Date: a � 0 City or Town of: 4k • Ain O/o ,' e r- To the Inspector of Wires: 13y this application the undersigned gives notice of his or her intention to perfomt the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with n building permit? Purpose of Building Existing Sct•vice Amps / Volts New Service Anips / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Yes ❑ No Utility Overhead ❑ Overhead ❑ (Check Appropriate Box) Jiou No. Undurd ElNo. of Meters. Undgrd ❑ No. of Meters ' ' Conrnletion of the followine table nrav be waived by the lnsoccior- of (Vires No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans N o. of I,otal Transformers KVA No. of Lighting Outlets No. of Ilot Tubs Generators KVA No. of Lighting Fixtures A oveIn- Swimming Pool %rnd. ❑ rnd. ❑ t o. o Emergency tg tang Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARD•IS No. of Zoites No. of Switches No. of Gas Burners etection and No. Init ating Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Eieat Pump NT i _ . KW No. of Self -Contained No. of Waste Dis osers P Totals: --_umber _ -ons Detection/Alertinx Devices No. of Dishwashers Space/Area Heating KW Local ❑ Iutttetpa ❑ Other Connection No. of Dryers Heating Appliances KW ecurity vstents: No. of Devices or E uivalelit iso. of Water KW of No. of Ballasts Data Wiring: Heaters Sighs Signs No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total i1P 'Telecommunications x firing: No. of Devices or Equivalent OTHER: . - ...-• " - ..��--'--' -- -- --- -J 4 -' - '-------•-- -rev:...... AtraCn aaataonac aetaa y arsrrra, ar w rcgiurra by ure m4pruu, 01 •• INSUR. NCE 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. 11te undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specify:) p� d26vo (Expirati Date) Estimated Value of Electrical Work: 3,5'0, 00 (When required by municipal policy.) Work to Start:_ I certify, cinder FI1L•NI NAME: Licensee: �1 (/f applicable, enter " Address:22 OWNER'S 1N! required by law Owner/Agent Sio nature 400 Inspections to be requested in accordance with MEC Rule 10, and upon completion. x ajjd pcua/tics of perjury, that the information on this applicatiotr is true and complete. LIC. NO.: �'_30� 7G Signatur C. NO.: !i pt" in tlrc• licen/se number line.)1L Bus. Tel. No.:C.I: rrl�VEIL �y�� v !C Alt. Tel. No.: .TRANCE WAIVER: I am aw-ire that the Licenseefoes not have the liability insurance coverage normally By :nv signature below, I hereby waive this requircmeut. I atn the (check onc) ❑ owner ❑ owner's anent. Telephone Nu.Pi:R:11IT TLL: S %00, G O `'ration r 7 " t3 Date NpRT1yA TOWN OF NORTH ANDOVER �. �t•ao .a.y� • �L Certificate of Occupancy $-QC) Building/Frame Permit Fee $ 'ssAcMusE`� Foundation Permit Fee $ rimer; �/7J Other PermitTi Fee $ �, 1 REC,EIVEf�e Connection Fee $ OCT 2 water 4?tion Fee $ r d ver� Collectc,r Building Inspector i Div. Public Works i ��t�T no• � v �`��,= - .APPLICATION FOR PERMIT TO BUILD —NORTH ANDOVER, MASS. ✓AGE 1 MAr,rio. LOT NO. I 2 RECORD OF OWNERSHIP DATE (BOOK PAGE ZONE SUB DIV. LOT NO. F i LOCATION 27 " C1-A1001,r PURPOSE OF BUILDING 4/�✓ OWNER'S NAME i /IZj NO. OF STORIES SIZE . ` y� �/Q%v��/lf/T/djjJ OWNER'S ADDRE(SS�f/ 3�Y�f/�,/ C�L�I��% W V '1 /v BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME O /may rrI /_'o Y_7� I) ,5 /J SPAN -- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET " POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDiTION'V/l/v !8s MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES y PAGE 1 FILL OUT SECTIONS 1 - 3 j PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING y` ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FI SIGNATU" OF OWNER OR AU ITDRIZED AGENT I/ FEE l'5�1 �1 { O D !� PERMIT GRAN E 19 r 1-7 OWNER TEL. #4Zpl CONTR. TEL. # CONTR. LIC. 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 461 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPECTOR IL BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION—I 8 INTERIOR FINISH CONCRETE PINE 3 1 1 13 CONCRETE BL K. BRICK OR STONE HARDWD PIERS PLASTER _ _ _ _ DRY WALL _ _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA '/ 1/1 1/ FIN, ATTIC AREA _ N_O B M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B 1 _ 2 3 _ CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HARD",/'D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY _ STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE HIP BATH (3 FIX.) GAMBRELMANSARD 11 TOILET RM. (2 FIX.( FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ _ ROLL ROOFING I I MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING - _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GOA` Lil ELECTRIC I NO HEATING B'M'T 2nd _ I.r 13rd THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. � r 1 FORM,U - LOT RFL EME FORM INSTRUCTIONS: This form is used to verify that all necessary' approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT. Phone LOCATION: Assessor's.Map Number Parcel Subdivision Lot(s) Street St. Number ************************Official Use Only************************ RECOMUMATIONS OF TOWN AGENTS: Conservation Administrator Date Approved Date Rejected Comments Date Approved Town Planner Date Rejected Comments Health Agent Comments Public Works - sewer/water connections driveway permit Fire Departm t vl// Received by Building Inspector Date Approved Date Rejected Date 11 COMMONWEALTH DEPAH 1 Mtn 1 Ut- IMUOUL, *At'k: 1 Y ,\ 1010 COMMONWEALTH AVE. a a OF MASSACHUSETTS BOSTON, MASS. 02215' ENCLOSE CHECK OR MONEY ORDER ' LICENSE FOR REQUIRED FEE, CONSTR. SUPERVISOR EXPIRATION DATE ^ I ' I MADE PAYABLE TO 06/30/1993 `j' RESTRICTIONS 6 EFFECTIVE DATE LIC -NO. 6 I T '' ,1 "C4?MMISS16 ER OFIPUBLI;�_SAFETY" NONE o Ob/30/1991 004435 m (DO NOT SEND CASH). JOHN F B O D D Y I, i 139 WASHINGTON ST SS N 019-42-5649 METHUEN MA 01844 P EASE NOTE FEE INCREASE PHOTO. (BUSTING OPR ONLY) FEE: I )� jI I'• E I FECTIVE !„ HEIGHT:STAMPED NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY OR SIGNATURE OF THE COMMISSIONER DOB: 05/22/1952 c D NOT DETACH LICENSE STUB THIS DOCUMENT MUST BE OF LICENSEE SIGN NAME IN FULL -ABOVE SIGNATURE LINE ,r f IJ�� :. CARRIED ON THE PERSON OF THE HOLDER WHEN Et AG ED IN THIS OCCUPATION. COMMISSIONER OTHER $ r:Y•� c )OM 287-8T4 t •w�)�v1f �' NZ � 29 O/V v ��a�� �ryrr�dd • � m 30 e-. L.7 O z w O� Lij z LU LU CC 0 LJ C6 • Z • z O .cc �i _O ZD U LU O O .. J O W W LU dIA d O H L6 z z Z d LU o G V (� Z W o z z i m mt C J L J t V a t m Y c o O L c p C p m C p c E cr U ii OC ii ¢ to ii cr U- to to LJ C6 • Z • z O .cc �i _O ZD U LU a H .y �. (w 4 aw i � C ho a. c a. V Z = Er. CL fl. O V C 3 p m V � m to .� C r� tr Z Location No. Date -� tt TOWN OF NORTH ANDOVER L Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL Check # 28414 Building Inspector Permit NO --5 `q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TMpORTANT• Applicant must complete all items on this page Print E- W ;l -- Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes n Machine Shop Village yes n 5 -hi-►" liv rJ10-e- DESCRIPTION OF WORK TO BE PERFORMED: 1r il; Identification Please Type or Print CIearly) OWNER: Name: Phone: Address: /� Y CONTRACTOR Name: �GJ G/ Phone: Arlilrp-cc- g? �� � � Z o/ Supervisor's Construction License: SS d � ___.Exp. Date: Home Improvement License: 136-77F Exp. Date: P— o /4 ARCHITECT/ENGINEER 4�416� Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $72.00 PFR $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925,00 PER S.F. Total Project Cost: $ `Z Z Yo o '' FEE: $ Check No.: (a 12Z Receipt No.: c;i -[ t NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund V16- nature:of.�AgenfilOwner;,�:;_:.:.:�_.:.°_:_;_:-:.`:::..._�- -------- --- i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ; - NOTE: ❑ Building Permit Application - ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C: And/Or C:S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application - ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses a- Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic, Calculations. (If Applicable), ❑ Mass check Energy Compliance Report (If Applicable) - u Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Now Construction (Single and Two Family) - - ' ❑ Building Permit Application - - -- ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses - ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract - r ❑ Mass check Energy Compliance Report i ❑ Engineering Affidavits for Engineered products _ ®TE: All dumpster permits require sign off from Fire Departm.ent prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals lit the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording st be submitted with the building application Doc- Doc.Building permit Revised 2008mi 9 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq, t.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine Doc:.Building Permit Revised 2008 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ '.Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ' ❑ Tanning/Massage/BodyArt ❑ SwimmiugPools ❑ Well ❑ Tobacco Sales _ ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑' F - i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS ATION `COMMENTS. ._l HEALTH COMMENTS_ Reviewed on Signature Reviewed on _ - Signature-- - a Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments V c.:,onservation Decision: Comments 7 1l Water & Sewer Connection/Sianature Date Driveway Permit jPW ITown. Engineer: Signature: I Located 384 Osgood Street _ FIRE DEPARTMENT - Temp Dempster on site yes no Located at 124 Main Street Fi `re Department signature/date COMMENTS rroposat HIC # 136779 TWOMEY & LEGARE CONTRACTING INC. "Couldn't your home use a little TLC?" Specializing in Residential Additions 87 Belmont Street • North Andover, MA 01845 P:978-685-7447 • F: 978-685-7446 : NAME OF OWNER >I � f `J 1 LIC 0 ADRESS OF JOB 9-7 13GSA ^,rr 5` % TE,. -L? % 6 b,6 - 2i1 ©& DATE: We hereby submit estimates for:�— i oil /%►;,Jw L,(f'S - l Z X 1�- t c��, Z�� etr /" c-,� J /L� �' Xi S¢ i/a1� ul rJ --; c�.s :LLr� �'�1 e✓�— ���i,,�^� Sir 3� r /7� 11�. ��rll�� %%/�% ji✓`� We Propose herby to furnish material and labor - complete in accordance with above specificati7s, for the sum of. dollars ($ 2--2-q Cj . Payment to be made as follows /G-- Authorized Signature NOTE: This proposal may be withdrawn by us if not accepted with in _ days i Acceptance of proposal - The above prices, specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance:�'� / 1 `� `� / , Signature The Commonwealth of Massachusetts Department of Indv_strial Accidents s Office of Investigations . 600 Washington Street Boston, MA 02111 www.rnass gov/dia Workers' Compensation Insurance Affidavit: Bui-lders/Contractors/Electricians/Pl-ambers Apj)licant Ynformation Please Print Y–egibly �CCILc. �3 ..rte L Name (Business/Organization/Iudividual): Address: City/State/Zip: P, IM - - Phone #: 9 2,�' — � ' ' 7 el V 2 Are ypn an employer? Check the- appropriate box: 1. ETI am a employer with 2- 4. ❑ I am a general contractor and I employees (full and/orpart time).* have hired the sub -contractors 2. I 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. workers' comp. insurance. [No workers' -comp. insurance 5. ❑ Weare a corporation and its required.] 3. ❑ I am a hor4eoN�mer doing all work myself. [No workers' comp_ - insurance required.] t officers have exercised their right of exemption per MGL 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. M. Building addition 10.❑ Electrical repairs ox additions 11-0 Plumbing repairs or additions 12.❑ Roof -repairs 13. [:1 Other *Any applicant that checks box #1 must also 511 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 indicating such. -tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing x0o,kers' compensation insurance for my enfployees. Below is the.poliry and job -site information. Insurance Comp any Name:,/ s•��L- er�v� € ��' Policy # or Self -ins. Lic. #: ✓69 -- O i?. 9 b ii'► q'i' c/ J / -L- Expiration Date: p" Job Site Address: ?. cS City/State/Zip: Al� /�✓�. �I�-: Attach a copy of the workers' compensation policy declaration page (showing the policy number and' xpiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminalpenalties of a - fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day agairA Elie violator-.-- Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI -6r insurj4�p cover rification. Ido hereby cerlvify, u,zder ins ��alties of perjury that the information provided above is true and correct; -),f - V7- 7—J-1 12Z Oficial use only. Do not write in this area, to be completed by city,ortonin official City or Town: Permit/License # 7" 1O/ -I'– Issuing Authority (circle ane): 1. Board of Health 2. Building Department 3. City/Town Clerk 4_ Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: J W LL D cc 0 ca O cu v Y Y 'O O LL E 41 vYi to y N to U d CA Z (D zo O m O O y C O LL GA 7 O w T O L U C LL � W y Z ZZ co25 i d HD 7 O w (0 C LL O W N z u G W J W w 7 O K U i v (n N c LL w 0 U a z tw 7 O d' = LL z LY Q W LL N i O CD O z N N �, N N Q O. E N n V - �� W > .A Qc O O °' a C9 �' = Z V E:� OCL N a� r r isyr CD C m O o u 4c Z Ea, _40 c `O C4 V) Go�Q h c•E O .� C.)L O v mm L cc ol °0'`ca� w W O �+N _ U) - > rn N• o Q0 0 av O d.Z 0:55 U) 4) c x O OO O s CL LLI Ego � ~ z y .+e n = o . �, y O � cc Lu 3 c W J Q�a� •� ts N Z V C L ' 0 = p VCL U) v V C F - cc= = O !C — o — = a� ai •� N :�+ F- o N cc Liu Lu 0 LL N d = O CL W �E v 410 D V Q (D� O N J 00 • L- a_ 0 1— t r 0.00 > clle ( eolm'"109"VeC111111 Office of Consumer Affairs& Business Regulation @OME IMPROVEMENT CONTRACTOR egistration: 136779 Type: xpiration8/26/2016-. Partnership TWOMEY + LEGARE CONTRACTING INC. SHAWN TWOMEY 87 BELMONT ST. N. ANDOVER, MA 01845 Undersecretary 30a -a But dCj Reg:I- G -F a -d construction Superiisor. CS -067560 SHAUN M TWOMEY 61 PATROIT ST N ANDOVER MA 01845 10/25/2015 massachusefts - Departimert of ?colic Sa';-ezy Boa—'i of suildinig R-ca-u!r"';Cr's and Construction Supen-kor License: CS -055108 DOUGLAS J LE413ARE 79 GARY AVE HAVERI-11ILL AM 01830 commissioner 09/0212016 rNantfi- 19702 ---- ----vvmcry ACORD- CERTIFICATE OF LIABILITY INSURANCEDATE(MODWYYYY) INSFIrM LTR 11/12/2014 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 1985 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR GENERAL LIABILITY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street 08/22/15 Andover, MA 01810 INSURERS AFFORDING COVERAGE NAIC # 11MMED INSURER A: Arballa Protection Ins Company Twomey & Legere Contracting, Inc. PO BOX 386 INSURER B:INSURER C: North Andover, MA 01845 INSURER D: INSURER E: GOYERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSFIrM LTR TYPE OF INSURANCE POLICY NUMBERFECTNE PODLtCY EXPIRATION i1M1TS A GENERAL LIABILITY 850ON3255 06/22/14 08/22/15 EACH OCCURRENCE $1.000.000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Q OCCUR DAMAGE TO RENTED $100A00 MED EXP (Any om person) $5,000 PERSONAL 8 ADV INJURY S1 000 000 GENERAL AGGREGATE s2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: -1 PRODUCTS - COMPIOP AGG $ 000 000 O LOC FX POLICY PRCT JE AVTOMOD" LIABILITY ANY AUTO COMBINED SINGLE LIMIT S (Ea accidenq BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY S (Per accident) HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S 1 ANY AUTO AUTO ONLY: AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR FiCLAIMSMADE S $ DEDUCTIBLE S RETENTION $ WORKERS COMPENSATION AND NSTATU- OTH- IR EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S EL DISEASE - EA EMPLOYEE S OFFICERIMEMBER EXCLUDED? t yes, describe ruder SPECIAL PROVISIOkS below E.L DISEASE - POLICY LIMIT I S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Covering operations usual to the insured... City of Haverhill City Hall, Rm 100 4 Summer Street Haverhill, MA 01830 ACORD 25 (2001/08) 1 of 2 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF. THE ISSUING ENSURER WILL ENDEAVOR TO MAIL I0_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL W NO OBLIGATION OR LUIBILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR #S31195/M30577 DMl_ 0 ACORD CORPORATION 1988 Z V - C ,44@P 3 4.. • 1' �r'. OL y� h �e BUILDING DEPARTMENT Community Development Division November 25, 2008 Ralph Jannini 8 Marblehead Street North Andover MA 01845 Re: 87 Belmont Street - 2107 Permits Dear Mr. Jannini, Please be advised that we have researched the file for 87 Belmont Street for permit for 2007. We have no documentation that permits were taken out in the year 2007. There is a permit in 1992 for an interior partition and addition of a spa. Additionally, an electrical permit for Mass Electric retrofit lighting in addition to two gas permits in 2002 for 4 infared heater. If you have any questions please call the office during office hours. You are more than welcome to come into the office and look at the files. Sincerely yours, Gerald A Brown, Inspector of Buildings 1600 Osgood Street, Suite 2-36 North Andover, Massachusetts 01845 Phone 978.688.9545 Fax 978.688.9542 Web www.townofnorthandover.com i�'d Mr. Gerald Brown North Andover Building Inspector Town of North Andover 1600 Osgood St North Andover, Ma. 01845 Dear Mr. Brown Would you please provide me, by mail, a response to this inquiry, along with copies of any Permits to Perform Electrical, Plumbing, Building or Alteration Permits that your department may have issued as follows: Filings for work to be performed and inspection thereof at the premises located at 87 Belmont Street, North Andover, during the year 2007. There is enclosed a payment of $5 in cash for any copying expense involved. Thank you for your prompt attention to this request and please send to the address below. t Ralph Jannini 8 Marblehead Street North Andover, Ma 01845 Certified Mail 11-21-2008 #7007 2560 0000 4021 0141