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Miscellaneous - 9 LACONIA CIRCLE 4/30/2018
6 2 4-6 Date ....... . A - ?.e ........ . ......... ,!0 ,OR'rh TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... . .................... ............... .............. I . .............................. has permission to perform ....r:........................................................ wiring; in the building of r ... .. ...... .. ...... ............................ at.. 19. ....... ............ �( .......... . . orth-Andover, Mass. QP- Fee4.,F,6 ........... Lic. No ...... ............... . ...... ...... 6/ ELECTRICAL INIck Check # Ae //,:PC, -.11 Permit No. 6 er! spay 3 Ra Checked �' 0 V APPUCA71ONFOR PERMU70 PERFORM ELECTRICAL WMo ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSS'TS ELECTRICAL CODs, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DaLa�.— Town of Noah Andover To the Inspector of Wires: The undersigned applies for a permit to perforin the electrical work described below. Location (Street 3 Number) `� (.•�yy-�,� �t CcC, , Owner or Tenant E:i-,-, 'AA L7 jooW Owner's Address 4-yV1 ' Is this permit in conjunction with a building permit: Purpose of Building A& 7 e •G A171 y Existing Service Arnps� Volts New Servis� 0 Amp@ I Lt?�/�jlolts No Overhead Overhead Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work (Check Appropriate Boa) q eo '-711 Utility Authorization No. Underground C3 No. of Meters Urt&gpund Ca-�— No. of Meters I Na of Ushdna Outkb Na of Hot Tuba - No. of Tnnaxrnera Told KVA Na of Ugbthtg Fi:tmm Swimming Pod Above Below �� KVA No. of Receptacle OutWe Na at OH Btrroae No. of Emagaeay Ughdng Bwary Unita Na of Switch Oudeu No. d Ona Barran FDtE ALARMS No. of 7m= Na of Bangs Na of Air Codi. Tout Tama Na of Deteedca and Na of Disposals Na of Had Tohi Total Nnys Ton KW Iaideft DrAm No, of Somdmg Device No. of Dishwuben Space And Heating Kw Na of SOK Codahwd Dnica MDetxdad3o�mdgp Leal tWdp al ��• q No. of Drymf Heating Devices Kw � Com wdom � No. of Wats Heaton KW Na of Na of shm Beiluia Na Hydro Manage 7Ww Na of Motor Told HP >rKaarXCPutttatbllere�aetretofMaeacllsertGemlLauta ]h�eaatoetI�ttil�yiatawazRiicyirr�tdr�(brc CdhA*dyilegi*A" YES EZr NO lhtneahT&dtv*p m(d(slrabie0ft YM 140utaned�d�dYB4,pkaird�ftet�Peafaotm�bp A1st1RANCE F�j g= au 1311���11� u a Do M&IDSmtt p� g dValreeflittiodWadr S .9tated= %mMofraiw.. Lia MM. Nl Z C" loam Telephone No. FEE i_ 60 0- r PetmitNo, V- c�PdX& BUARDOFFREPREVFIVIICMNR�i1Gf77g111S5270MIZio , r� r �up�y & Fea Checked � W APPLICAIIONFOR PERMIT TO PERFORMELEcnuCAL WO All, WORK To BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMB 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Da 3j C'` Town of North Andover The undersigned applies for a permit to perforin the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address To the Inspector of Wires: zq� Is this permit in conjunction with a building permit: Yes[3'No (Check Appropriate Boa) Purpose of Buildingv i,-(_ _ ._ Utility Authorization No. Existing Service Ampa�.V olts Overhead Underground No. of Meters New Servicer spa ?�i, oiler Overhead Underground �� No. of Metes Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 7C' 7 Na of Liabdna outlet No. of Hot Tubs M. Of?nodbeomn Total KVA Na of LiahtLy Rattmes Swu mina Pod" Above Below rl Oatenbn KVA Na of RecepUde Oudet No. of Oil Bumen No. of Emaaenry Uandrta Beitery Units Na of Switch Outlet No. of Oes Boman FIRE ALARMS No. of Zones No. of Ranps Na of Air Coat. Toll TOM Na of Delco= and Na of Dlsposds Na of Hat Told Tod Pomp Ton KW IdtlmWy Devi= Na ofSotmdfq DaMoss No. of Dishwashers Space Amer Headaa KW Na of Self CmWnW L d mwcipd Other No. of Dryers Hominy Devices KW D Comrections a No. of Won Heaters Kw Na of Na of S Bdlmi No. Hydro Maasge Tabor Na of Mobs ToW HP i,>sua =CcmV Pt1a�aRblleRr}iarra�afMaa�srKlCiamlLawa IFa eaamWU iSiyYES L NO 1hmestrrkkdv&pWc(9 1Df Cft YMdzftVtCqWjdftb*- cl� ayouhnedt�dedYB4,pkaidc /tehPedao by MLRANCE L j "D O�tm OCAm** WaddDStait c r~ i>9pa1fon11�R�}»d Rail F dVARdac"Wak$ F MNANS y ��. ��- c t-��-c. r��cc s t_ . �(,r=-� i cf'_t LiMaNd — 8usin TdNn (Please check one) Wr FEB /�ekv cr� cq(—, f z -- f- 0--s-- Date. �<< •� :1�, TOWN OF NORTH ANDOVER 10 PERMIT FOR PLUMBING + a This certifies that .... It -r i has permission to perform ... ................ plumbing in the buildings of ..../41 �-:A'9 ./ ................ L at .... �.. r . .'" ...... , North Andover, Mass. rte%... . Fee. .t!2G�." Lic. No.. 2. . )- ? ........ �..�l .,� -! �, - f - t...... PLUMBING INSPECTOR Check # Z( iL,F MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date /Z( 3 Building Location 1_Ct� e�Nt'1¢ /[ Owners Name r► 'e`e- Yi (I R k Permit Type of Occupancyj Amount New renovation 0 Replacement Plans Submitted Yes ❑ No ❑ i (Print or type) Check one: Certificate Installing Company Name _ A -d R f i) Zt' N t S ❑ Co ^� �Corp. Address `-�6 �•-'2 S+ I>0"JV1 Partner. Business Te ep one • ef 3 — 3 S Z — � irm/Co. Name of Licensed Plumber: 'o/— Insurance Coverage: Indicate the type o ance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 11 ❑ 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 11 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 installatio s erformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus ral Laws. By:i ure o' icense um er Title Type ofPlumbing License City/Town � 3 7� icense um er Z.�?� Jou n ❑ APPROVED (OFFICE USE ONLY 1' • i .J • it .r J • , :A• I MM MMMMMMMMMMMMMMM MM . MMMMWWMWMWNMNWMMWM MM WNNWMMWMWMNWMNWMNNN MM MMM MM MNMNMWMWMMMMMMNNMMM MW MNWMMMMNWNMWMMMM NWWNW ■WMMMW■ MMNMMMWWWWMM� NMW0WMMMNMN■ MMMMMMWMMMWM� (Print or type) Check one: Certificate Installing Company Name _ A -d R f i) Zt' N t S ❑ Co ^� �Corp. Address `-�6 �•-'2 S+ I>0"JV1 Partner. Business Te ep one • ef 3 — 3 S Z — � irm/Co. Name of Licensed Plumber: 'o/— Insurance Coverage: Indicate the type o ance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 11 ❑ 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 11 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 installatio s erformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus ral Laws. By:i ure o' icense um er Title Type ofPlumbing License City/Town � 3 7� icense um er Z.�?� Jou n ❑ APPROVED (OFFICE USE ONLY DelleChiaie, Pamela Subject: FW: Michele -Tank and D -Box Inspection Location: 9 Laconia Circle Start: Tue 5/16/2006 12:00 AM End: Wed 5/17/2006 12:00 AM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Required Attendees: Grant, Michele; Sawyer, Susan Can one of you call installer and reschedule this? Let me know when all set. Just don't want to drop the ball, and I know you are busy with all the flood stuff -- just trying to make sure it doesn't fall throught the cracks..... Thanks. -----Original Appointment ----- From: DelleChiaie,-Pamela Sent: Tuesday, May 16, 2006 3:09 PM To: Grant, Michele Subject: Updated: Michele -Tank and D -Box Inspection When: Tuesday, May 16, 2006 12:00 AM to Wednesday, May 17, 2006 12:00 AM (GMT -05:00) Eastern Time (US & Canada). Where: 9 Laconia Circle 5/17/06 - Michele, let me know when you want to reschedule this. Pam 5/10/06 - Michele, I put it in for this date, as it is going to rain through the weekend, and you have pool inspections on Monday. P. Hi Pam, FYI I spoke to Peter Murphy regarding FINAL GRADE. He infact does not need a Final Grade right now due to the fact he has not loomed or seeded. He does however need a tank inspection as well as a D -Box inspection. I will do those two inspections when the weather is a little better. I sure it is very muddy. Then, he will have to call back for his final grade AS WELL AS "Risers need to put on the tank etc... If you could please make a note of that on the inspection form that would be GREAT! Many Thanks to you Michele Date ... L,�... ,......�..L.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING /� , This certifies that ................J,P.PP.v , r` has permission to perform ....... /I "x ... ��� wiring in the building of ......2 C ....?,..'............ 6 ci —:. ............................................. at ..... ...1......�✓.!C...�Y'' 0/rt+,...............................> North Andover, Mass. ................... E\ Fee.::,.4.j..... U.—......... Lic. N.2.036 ... ........... I ........ ..............:... .................................... ELECTRICA..L.. INSPEC....TOR ~ Check # Z % Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. /C�'�<� Occupancy and Fee Checked , BOARD OF FIRE PREVENTION REGULATIONS [Rev. i/07] (leaveblank \ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V\ All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: Y l� City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 01 vcl ( 0 ( ol G C 1 C Owner or Tenant Ron Awd ur► n Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No,�K' (Check Appropriate Box) Purpose of Building Utility Authorization No. - Existing Serviceps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amp----J.Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: I'v J ro; ) V Cmmnletinn nfthe Mllnwinn table may he waived by the Insnector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans v No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above In- ❑IN rnd. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Disposers No. of Waste Dis p Heat Pump Totals: .... ....................._........................... Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Systems:* SecuritNo. o s or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of'Mres. (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 171BOND ❑ OTHER (Specify:) I certify, under the pains and penalties of perjury, that the information n this applicat' n is true and complete. _ FIRM NAME:. i i �rlcG�l'�G LIC.NO.: Licensee: f PC11 zT• M i i Signature LTC. NO.: (f applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 7 12 3a) 3 Address: 13 bt1,l 11 -ern D1) 5t eta Wl, Alt. Tel. No.: =� *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall.be limited as to the time of ongoing construction activity, and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chanter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effector existence" during the qualifying period beginning on August 15, 2008 and extending through August 15, 2012. ❑ Rule 8 — Permit/Date Closed: * Note: Reapply for new permit ❑ ❑ Permit Extension Act — Permit/Date Closed: french lns ection Pass n Failed Inspectors Comments: Re- Inspection Required ($.) El Inspectors Signature: Date: ERVICE INSPECTION: Pass 0 Failed 0 Re- Inspection Required ($.) ❑ nspectors Comments: . Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass]' Failed IN Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed 0 Re- Inspection Required ($.) ❑ Inspectors Comments: Inspectors Signature: Date: 'INAL INSPECTION: Pass 0 Failed 0 Re- Inspection Required ($.) ❑ nspectors Comments: Inspectors Signature: :B WEINHOLD ... TOWN OF MERRIMAC, MA........dweinhold@townofinerrimac.com Date: g The Commonwealth of Massachusetts , Depairtment of Indifstpigl Aceidiie is Office of'Investigations 600 Washington. Street Boston, MA 02111 -www.massgov/dza Workers' Compensation Insurance Affidavit: Pui dert°sfContrt°actors/ElectricianslPlonbexrs Apulieanti Information Please Print Leg I Name (Business/Oxganizaiionllndividual): Oat r w 7 CV) t bzectrz Address: 3 m OV n+ 11-er 11 City/State/Zip: k0 f' Bf&hAl t 11UI I Are you an employer? Check the appropriate box: Type of project (required): 1. [] I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New contraction f employees (full and/or pax- time). have hiredthe sub -contractors 2X1 am a sole proprietor or partner listed on the attached sheet. x 7. El Remodeling ship and°haveno employees These sub -contractors have 8. [] Demolition worldng for me in any capacity. workers' comp. insurance.9. ❑Building addition [Nb workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised.their 10KElectxical repairs or additions 3-E] I am a homeowner doing all work right of exemption per MGL IL[] Plumbing repairs or additions myself. EEO workers' comp. c.152, §1(4), andwehaveno 12.[] Roofrepaks insurance re ed. employees. [No workers' ] 13.❑ Other comp. insurance required.] x.Any applicant that checks box#1 must also fill out the section below showingtheir workers' compensationpolicy information. Homeowners who submitthis affidavit indicatingthey tie doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that checkthis box must attached an additional sheet showingthe name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees .below is the policy and jots site information. Insurance Company an Name:. Pt- f, I C/ U Ln 3 a % oo d o . , Policy # or Self ins. Lic. ExpirationDate: /6 Job Site Address: Cf La coni C1 Gi r e c City/.State/Zip: /(%, A,4d0 �T I ,# Attach a copy of the workers' compensationT oUcy declaration page (showing the policy number and expiration date). Failure to secure coverago as required.under Section 25A of MGL o.152 can lead to the imposition of criminal penalties of a fine up to $1,500,00 and/or one=year imprisonment, as well as civil penalties in the form of a STOR WORK ORDER and a rine of up to $250.00 a day against the violator. Be, advised that a copy of this statement maybe forwarded to the Office of Investigations ofthe�for insuranAo c)#erage verification. I do hereby ce under ae paan a taes ofperjury that the information provided above '?true and correct. Phone #: 771 3_ -/ 3 g 43 Official use only. Do not Write in this area, to be completed by city or town official City or Town: Permif/License # 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 .q Information and Instrnetions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to ibis statute, an employee is defined as "...every person in the service of another under any contract ofhire,- express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a -deceased employer, or the receiver or, trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapterhave beenpresentedto the contracting authority." Applicants Please fill. out the workers' compensaiion affidavit completely, by checking the boxes that apply to your situation and, if n6cessary supply sub -contractors) name(s), addresses) and phone number(s) along with their certifxcate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation. insurance. If an LLC or LLP does have employees,apolicyisrequired. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'the affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a Workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self insurance Incense number on the appropriate line. ` City or Town Officials Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be -sure to fill in the permit/license number which will be used as a reference number, in addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current Policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in . (city or town)." A: copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit -lion, file .for fature permits or licenses. A new affidavit must be :filled out each year. Where a home owner or citizen is obtaining a license or,permit not related to any business or commercial venture (i.e. a dog license orpermit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: Tho Ga ox wealth ofW_Qmarh ett'q - Deparbent ofIndustxial Accldenta Offke of 15mestigAtim 6.0G Washao�xee Bwton, MA 02111 T01 # 6x7-7,27M49QQ oxt 406 or 1-877 VA.SSAFE Revised 5-26-05 Fax # 617-727-7749 Division of Professional Licensure: License Search The Official Website of the Office of Consumer Affairs and Business Regulation (OCABR) Division of Professional Licensure Mass.Gov Home State Agencies A -Z Topics Home > Division of Professional Licensure > Check A Professional License By the Division of Professional Licensure LICENSEE Name:DARREN J. MINI LYNN, MA ..This Licensee has additional Licenses, click here to view them.`" Licensing Board: ELECTRICIANS License Type: MASTER ELECTRICIAN TYPE CLASS: A License Number: 20355 Status: CURRENT Expiration Date: 7/31/2016 Issue Date: 4/13/2006 Exam Date: 4/13/2006 School: NORTHEAST REGIONAL V This web site displays disciplinary actions dating ba This license has had no disciplinary actions taken dur The page above has been generated by the Division of Professional Licensure web server on Tuesday, June 03, 2014 at 4:22:26 PM. © 2007-2011 Commonwealth of Massachusetts Page 1 of 1 Mass.Gov ONLINE SERVICES Check a License Locate a Licensed Professional Online Address Change Contact the Agency More... REFERENCES & RELATED INFO Disclaimer Regarding Website License Searches Glossary of License Status Codes More Site Policies Contact Us http://license.reg. state.ma.us/publiclpubLicenseQ.asp?board_code=EL&type class=_A&Iic... 6/3/2014 s r Location .�a� Date No. TOWN OF NORTH ANDOVER f ,A ' > Certificate of Occupancy $ �'� s'•^� E<� Building/Frame Permit Fee $ AC Nus Foundation Permit Fee $ Other Permit Fee TOTAL Check if �l G Building Inspect6 Date. . . ........ A TOWN OF NORTH ANDOVER ,� • PERMIT FOR GAS INSTALLATION 1r �,SSAC NUSEth 7 k This certifies that ..../ x r? .'.. f ............................ has permission for gas installation ....... in the buildings of ..1!d ?'- !'./? ., : ........................ at 01 e? e? e. a`.'.! ... �. Vii. �.. North Andover, Mass. Fee ... DU' Lic. No.?7 � c L... .... C U. GAS INSPECTO Check # u )- 6 Y 541 5 A MASSACHUSETIS UNIFORM APPUCATON FOR PERNllT TO DO GAS F rrnNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations ,/1 Owner's,Name tom.,.• New Renovation11 ReRiaX, Date Plans Submitted 11 Permit # 7 Amount /j Clte one: Certificate Installing Company Name. or ty�)ALIPI?{v i 2I 'Ili e S f Corp. Address t�CC &tner. usmessTelephone re �— 3 &� —// y� m/Co. Name of Licensed Plumber or Gas Fitter S INSURANCE COVERAGE tnecK ne: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked L, please indicate ype coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 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 13 Agent 13 I hereby certify that all of the details and information t nave suonuttea kor emereu) ,n avavc appncauan a►e uuc auu at,cutatc LV uic 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 Nlassachusetts as Code and Chapter 14 e-G@neral-Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber / 3 %' Gas F�.tteF tcense Number Journeyman MEN /j Clte one: Certificate Installing Company Name. or ty�)ALIPI?{v i 2I 'Ili e S f Corp. Address t�CC &tner. usmessTelephone re �— 3 &� —// y� m/Co. Name of Licensed Plumber or Gas Fitter S INSURANCE COVERAGE tnecK ne: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked L, please indicate ype coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 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 13 Agent 13 I hereby certify that all of the details and information t nave suonuttea kor emereu) ,n avavc appncauan a►e uuc auu at,cutatc LV uic 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 Nlassachusetts as Code and Chapter 14 e-G@neral-Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber / 3 %' Gas F�.tteF tcense Number Journeyman LAWRENCE K OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 ,332.2959 cell 978.302.3921 February 17, 2006 Mr. Peter Murphy fax: 978.,6853523 P.O. Box 734 North Andover, MA. 01845 RE: Murphy Residence, 9 Laconia Circle, North Andover, MA. 01845 Dear Mr, Murphy As you requested I visited the above property to review the Engineered lumber LVLS and Steel Beam you used in the framing of the structure. These are shown on plans sheets A-1 to A-11, dated 9/9/05, scale !/4";-- 1 ft., prepared by Robert M. Connell, 22 North St., Wilmington Ma. These members are installed in the structure as :indicated on the plans, with the exception that the four member LVLS are not bolted together as indicated on the drawings and per Manufacturers recommendation, These four member beams should be bolted together with 2 rows of %" bolts at 24" oc. staggered. I analyzed the loads on these members and verified the design,. I therefore can certify that the LVLS and Steel beam used in the structure are adequate to support the imposed loads. Should you require any additional information please do not hesitate to call. Yours truly, lY wrence H. Ogden P.E. LAWRENCE ,I @GDEt�.r� LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 —352-2858 cell 978-502-5921 February 17, 2006 Mr. Peter Murphy fax: 978-685-3523 P.O. Box 734 North Andover, MA. 01845 RE: Murphy Residence, 9 Laconia Circle, North Andover, MA. 01845 Dear Mr. Murphy As you requested I visited the above property to review the Engineered lumber LVLS and Steel Beam you used in the framing of the structure. These are shown on plans sheets A-1 to A-11, dated 9/9/05, scale %4" =1 ft., prepared by Robert M. Connell, 22 North St., Wilmington Ma. These members are installed in the structure as indicated on the plans, with the exception that the four member LVLS are not bolted together as indicated on the drawings and per Manufacturers recommendation. These four member beams should be bolted together with 2 rows of %" bolts at 24" oc. staggered. I analyzed the loads on these members and verified the design. I therefore can certify that the LVLS and Steel beam used in the structure are adequate to support the imposed loads. Should you require any additional information please do not hesitate to call. Yours truly, dwrence H. Ogden P.E. OF V -'-,/LAWRENCE HAROLD I.JGDI�/ \�65 �4 c STF� �s V1OIV?il Eel t l' o• ti�cwri� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 323 (10/27/2005) Date: July 25, 2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 9 Laconia Circle MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Peter Murphy 9 Laconia Circle North Andover MA 01845 s ltat-l.eA Bui ing lnspector 1 0 z . Is cri O ` C O IN _ C . w O W C3 CLc am o�° Ea E it MAz N N CDm cc CM C m 0 cm C �C N CD L rr 0 Z O g CD t 1 40 CDE LM z Q, O ca Q c I �cm O CO3 O O m m Z O.a �3 O O Q O LM m O a cma co c ev C3 go co c ZCL O V CO) c c c E c y Q s � �J q W O U w cn cn . Is cri O ` C O IN _ C . w O W C3 CLc am o�° Ea E it MAz N N CDm cc CM C m 0 cm C �C N CD L rr 0 Z O g CD t 1 40 CDE LM z Q, O ca Q c I �cm O CO3 O O m m Z O.a �3 O O Q O LM m O a cma co c ev C3 go co c ZCL O V CO) c c c E c y Q APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Buildincl Permit # ADDRESS/LOCATION OF PROPERTY: q b4C071A Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED CO ISIS to- P.VAT10N PLANNING DPW - WATER METER SEWER/WATER CONNECTION /(o (o NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW AA4)0 , W ()(711LQ.1/, Signature File: OC form revised 2006 TOWN OF NORTH ANDOVER - - BUILDING DEPARTMENT APPLI ATION TO CONSTRUCT !MAI& RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUII,DING PE DATE ISSUED: _,....� , ` ER: c%) 'eL SIGNATURE: 9@1di Commission r/I r of Buil Date 1.1 Property Address: LAC()V,A Cres, 1.2 Assessors Map and Parwi Number: 6 q MeP Number Panel Number ki 611 c/ 1.3 Zoning Information: �� Zoning District Proposed Use /f � 1.4 Property Dimensions: / �6) Lot Areas Fronts e fl 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided 1 1.7 Wata supply M.G.L.c.4o. 34) puy NK -W 0 Zone 1.5. Flood Zone Infomution: Outside Flood 7.one 0 1.9 Sew Me Disposal system: Municipal 0 On Site Disposal System 0 .+++.. a ova. r - a a.vi Ln a i v 1�L' Aonarrt�U 1nV1C1L�L' lJ AIsL� 1\ 1 Historic District: Yes No - 2.1 O_2.1 Owner of Record p pe) -C-4, W M Udo,, o 4 c_ Name tint) V k Address for Service Signature Telephone s .72 Owner of Record: Name Print Address for Service: T SECTION 3 - CONSTRUCTION 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: AO AAA, a... Signature Telephone Home Improvement Contractor Company Name Address -- Not Applicable License Number Expiration Date Not Applicable Registration Number Expiration Date • . // C tJit f L _ i /C hlf </ 4A� 1'�>.-;7� �✓ SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 3 SECTION 5 Description of Proposed Work(check nll applicable) New Construction ,NZ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: �^) , /j C n :✓1 i�1 r z A k {P Gtr to J"r 10 (/ tJ re-: V I FN k+w, I CF.CTTON 6 - FSTiMATRD r0NSTRurT10N COSTS I Addition 0 Item Estimated Cost (Dollar Com leted b e ' applicant OFFICIAL USE ONLY 1. Building,' _= 'tu ` 3 (a) Building Permit Fee Multiplier SIZE 4 2 Electrical „ CYIC 1 (b) Estimated Total Cost of Construction SILE OF FLOOR TIN113ERS 1 a lc 3 Plumbing C/" 4� Building Permit fee (a) x (b) 4 Mechanical HVAC); 5 Fire Protection 6 Total (1+2+3+4+5) nn Check Number SECTION 7a OWNER AUTHORIZAIAOlN TO HE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building pen -nit application. Signature of Owner Date cvrgr1rnm,% nWN1:1?/ATfTHnAT71Pn Ar_'riNTng?rT.ARATMN 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 Signature of 0%�ner/,agent Date NO. OF STORIES 41 SIZE 4 BASETA NT OR SLAB ,--}- SILE OF FLOOR TIN113ERS 1 a lc 2140 (3 3RD SPAN 16 TR -,e-+ DINIENSIONS OF SILLS y T DM ENSIONS OF POSTS DIN ENSIONS OF GIRDERS DIGHT OF FOUNDATION It) -{ c,T ' iuw 1 THICKNESS SIZE OF FOOTING / ! X ` MATERIAL OF CIEMNFY - -t i IS BUILDING ON SOLID OR FILLED LAND IS Btal)ING CONNECTED TO NATURAL GAS LINE QA 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 jthe applicant and/or landowner from compliance with any applicable or requirements. r APPLICANT FILLS OUT THIS SECTION APPLICANT !� LOCATION: Assessor's Map Number 0 (0 6 SUBDIVISION STREET %AC60s 14 C i IC's o l 61V lI y J /Ux- OFFICIAL USE ONL T PHONE Z� - R PARCEL LOT (S) I ST. NUMBER CON VRES A ION ADMINISTRATOR DATE APPROVED Z -'t &I DATE REJECTED ) COMMENTS ohn 100 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS F00 I PECT R- SALT TE APPROVED �. / DATE REJECTED - - DATE APPROVE6.L/AWW, 4F DATE j � 1 PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY FIRE DEPARTMENT a� W ''ECEIVED BY BUILDING INSPECTOR DATE Rwlsed 9197 JM Gerald A. Brown Inspector of Buildings Please print TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION DATE: /d- d O "®<�_ Telephone (978) 688-9545 Fax (978)688-9542 JOB LOCATION: 67 2-AC01U;`,4 lec le 06 6 Number Street Address Map/Lot HOMEOWNER _Ni& MLA4,04 Name t Ilome Phone Work Phone PRESENT MAILING ADDRESS PO SGV I '� S tiC44 Q6. J4 DI�A City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures andrequirements and that he/she will comply with said procedures and requirements. 7% . /I HOMEOWNERS SIGNA' APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption 'SO\RDOF-APP1,-.A1,S6X8-9i.I1 CONSERVAFIONbXX`)530 IIC.ALI1108-95.10 PLAN\ING(M-9535 NORTH ANDOVER BUILDING DEPARTMENT DEBRIS DISPOSAL FORM Tel: 978-688-9545 In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 11 A ( if &, 1, is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL I1,S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: (Location of Facili Fire Department Sign off: Dumpster Permit SiAture ff Vermit Applicant a /0 611 / Date Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to cant' workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confinnation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to till out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy infonnation (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future pen -nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5 -26 -OS www.mass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents }' =1 Office of Investigations 600 Washington Street r _ , Boston, MA 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): re -464. W ►vl n n r Address: City/State/Zip: Phone #: 17g -q l S ^ 6i ?ate' Are you an employer? Check the appropriate box: . ❑ I am a employer with 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* 2.�1 am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance 5. ❑ required.] 3. ❑ 1 am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. We are a corporation and its 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. Pe�ew construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 1 I .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # I must also till out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. `Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Job Site Address: Expiration Date: City/State/Zip: Attach a copy 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 up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: . ' ?tiO'CMR`Appandix I Manual Trade-off W6ricstieet i.*;: Builder Name _ :Date Builder Address Site Address Zone ❑12 E313 []14 SubNtted By _ Phone'..: Insulation . x Ne,� Desai tion R=Value U -Value Area Ceiling ;(Table..18.2.2e) 130- 1 t 033 1 �7 Air able . a 1d11a11a W(�w§, @nd = Insulation �esCtletten R.Vart�a Required ... � - • � � .. U Value Permit # ' Checked By Date . _ UA (Table e.2 -2h) x Area UA X _. Required - 1.1 -Value A a= _ UA U -Value x Area - UA WalIS -` eb1e:J.@:2.2b.c, :.., ., . � � 430 Windows : NFRC orTable 11.5.3a)' .-:- .' ; 34 5257 Do0r3 or Table J't•;3.3b ..— 14. . 27t_: . LRC ing'-Graas'Doom RC ai-Ti le J1.5.3a) --- -34: - 7t'fe Heated: Siab . (rable-J6,229L in. t2 =--• 5 1 932, --�► 2-4,0 Total Area Flog[s oundation ... . °_ hsulation insulation xArea of = . irtequtl`ed' Description Depth R -Value U -Value Perimeter UA ' - U.ValUe x Area = UA Floor Over Unconditioned Space J6.2.2e) - _ easement Wail (Tabic J6.2.2i) i / _. r © 7 = . Unhctsted Slab (Table 46.2:2 Heated: Siab . (rable-J6,229L in. t2 fe :Total Proposed UA must be less Total than or equal to Total'(orAdjustedj Required UA proposed UA Statement of Compliance: The.proposed building design represented in these documents Is conslstent with the building plans, specifications, . and other calculations submitted with the Qermit application r..ra...l. ..::� Total.- oR qu/red U, �—+ Adjusted ... -:,R, :gWred UA ; Builder/Designer Company Name Date R0 30�Z l-'®)WOd c C'�l----5 � C, lam % 414-- a��,. V -/,Y-4495 670 93-6 ..::� Total.- oR qu/red U, �—+ Adjusted ... -:,R, :gWred UA ; Builder/Designer Company Name Date R0 30�Z l-'®)WOd c C'�l----5 � C, lam % 414-- a��,. V -/,Y-4495 CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE. I"=40' DATE) 1/18/2005 LAC01VlA R=705.43' L=150.00' 51'+1- E14 XIST. HSE. FND. LOT #14 43,840 S.F. PLAN #7865 N.E.R.D. I CERTIFY THAT THE OFFSETS SHOWN COMPLY WITH THE ZONING BYLAWS OF NORTH ANDOVER WHEN BUILT CIRCLE 33'+/- 40.00' Scott L. Giles R.P.L. S. Frank. S. Giles R. P. L. S. 50 Deer Meadow Road North Andover, Mass. OFFSETS SHOWN ARE FOR THE USE OF THE BUILDING INSPECTOR ONLY AND SUCH USE IS FOR THE DETERMINATION OF ZONING CONFORMITY OR NON -CONFORMITY WHEN CONSTRUCTED. Raymond Santilli, Interim Community Development Director Town of North Andover Town Clerk Time Stamp Community Development and Services DivisiorliECEIVEO Office of the Zoning Board of AppealsTO,V CLERK'S OFFICE 400 Osgood Street North Andover, Massachusetts 01845 7005 SEP 27 PM 4: 19 Any appeal shall be filed within (20) days after the date of filing of this notice in the office of the Town Clerk, per Mass. Gen. L. ch. 40A, §17 Telephone (978) 688-9541 Fax (978) 688-9542 TOWN OF NORTH f�� AND�+'O�V,ER his is to certlf�M1Ys11�1 Q��usors ai3psed from date of decision, filed Notice of Decision toui `tiny of an peal. Date Ia-s' Year 2005 Joyce A. lmdeffaw Town Clerk Property at: Lot 14 Laconia Circle (Mau 106.B• Parcel 119) NAME: Peter W. Murphy, 4 Red Oak Drive, HEARING(S): September 13, 2005 Plaistow, NH ADDRESS: Lot 14 Laconia Circle PETITION: 2005-025 (Ma 106.13, Parcel 119) North Andover, MA 01845 TYPING DATE: September 21, 2005 The North Andover Board of Appeals held a public hearing at its regular meeting in the Town Hall top floor meeting room, 120 Main Street, North Andover, MA on Tuesday, September 13, 2005 at 7:30 PM upon the application of Peter W. Murphy, 4 Red Oak Drive, Plaistow, NH 03865, for premises at: Lot 14 Laconia Circle (Map 106.13, Parcel 119), North Andover requesting a Finding under Section 10, Paragraph .10.4 of the Zoning Bylaw and M.G.L. ch. 40A §8 from the Building Inspector's denial of a building permit under the provisions of Section 7 of the Zoning Bylaw as affected by M. G. L. ch. 40A §6 and a dimensional Variance from Section 7, Paragraph(s) 7.1 & 7.2 and Table 2 of the Zoning Bylaw for relief of lot area and street frontage in order to construct a proposed single family dwelling. Said premises affected is property with frontage on the South side of Laconia Circle within the R-1 zoning district. Legal notices were sent to all abutters and published in the Eagle -Tribune on August 22 & 29, 2005. The following members were present: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R. Webster, and Thomas D. Ippolito. The following non-voting member was present: Daniel S. Braese. Upon a motion by Richard J. Byers and 2"d by David R- Webster, the Board voted to GRANT the Finding under Section 10, Paragraph 10.4 of the Zoning Bylaw and M.G.L. ch. 40A §8 that Map 105.B Parcel 119 is a buildable lot, per Plan of Land in North Andover, Mass., showing "Proposed Lot Development", Lot 14 Laconia Circle, Prepared for Peter Murphy, Applicant: Peter Murphy, P.O. Box 734, North Andover, 01845, Owner: 140 Appleton Street Realty Trust, John & Edith Thompson, Trustees, 1725 Great Pond Road, North Andover, MA 01845 [by] The Neve — Morin Group, Inc., 447 Old Boston Road — U.S. Route 1, Topsfield, Massachusetts, and upon a motion by Richard J. Byers and 2°d by David R Webster, the Board voted to GRANT the applicant's request to WITHDRAW the dimensional Variance WITHOUT PREJUDICE. Voting in favor: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R- Webster, and Thomas D. Ippolito. The Board finds that Lot 14, Laconia Circle (Map 105.B Parcel 119) was established as a legal, conforming lot as shown on the Definitive Plan of Land of Ingalls Crossing, signed by the Planning Board on 7-7-78, and registered as Plan #7865 by the Registry of Deeds, North District Essex County on July 13, 1978. The Board finds that John J. and Edith S. Thompson acquired the property from Olympic Construction, Inc. as unrelated buyers in May 1979 and recorded it at Book 1371 and Page 176; the property was transferred to John Thompson, Trustee, 140 Appleton Street Realty Trust by a related party transaction and recorded at Book 4060 Page 153 in June 1994. The Board finds that the property was not owned in common ownership with any abutting parcel after May 23, 1979. The Board finds that Lot 14 Laconia Circle was created prior to the May 1987 Town Meeting Article 9, changing this area from R-2 (lot area of 43,560 sq. ft., or 1 acre, and street frontage of 150) to R-1. Therefore, the Board finds that M. G. L. ch. 40A §6 applies to this parcel and the request for a dimensional Variance is not required. Page 1 of 2 ATTEST: A True Copy Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planncu g 978-688-9535 Town Clerk E »,� Town of North Andover Town Clerk Time Stamp Community Development and Services Division Office of the Zoning Board of Appeals TOWN RECEIVED NEFICF 400 Osgood Street ' North Andover, Massachusetts 01845 - Raymond Santilli, 2005 SEP Z7 PM t,: 19 Interim Community Telephone (978) 688-9541 Development Director Fax (978) 688-9542 TOWN OF NORTH ANDD V E MASSACHUSETTS Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a building permit as the applicant must abide by all applicable local; state, and federal building codes and regulations, prior to the issuance of a building permit as required by the Building Commissioner. F.urthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. . Town of North Andover Board of Appeals, iD U, P M ell) Ellen P. McIntyre, Chau Decision 2005-025. M106.BP119. Page 2 of 2 Board of Appeals 978- 688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 LP_l-cf0-d0e5 1s:Lta rrom: 10:yf6bbtzd.5 r.d`4 M.0.1. - "iaFrter 40, Section 6 Page 1 of :3 �t C7ENTItAL LAWS OF MASSACHUSETTS PART I'AIi 1'1 M V -RP. AUM1Nts'1RATTON OF THE COVERNMENT T 11'LE Vll. C".TT.I;CS, TOWNS AND DISTRI(7TS CHAPTER 40A. ZONING Chapter 40Ae Section 6 Existing; structures, uses, or permits; certain subdivision plans; application of chapter Section 6, Exccpt as .hefeinai'ter provided,,) zoning oidinanCe or by-law shall nog apply to structures or uses lawfully in existence or iawfuliy begun, or to a building or special permit issued before the first. lnlhlication of 11011cc of the public hearing on such a.rditiance or by-law required by section live, but shall apply to any change or substantial c;xtentiion of srich use, to a building or special permit issued after tlrc first notice of said public livaring, to any reconstruction, exte.11siotl or structural change of such structure and to :env alte.r,ition 0f a struc'tury beguil after the first notice of said public hearing; to provide for its use for a substantially different purpose or for the same pilrliosc ill a substantially different manner or to a substantially greater extent except where alteration, reconstruction, extension or strucatra.l Change to a siltglc or twu-family residential structure does not increase the noneonforrning; nature of said structure. Nrc-existing nonconforming structures or uses may he exiended or alterW, provided, that net such extension or allcration Shall be permitted unless thereis a finding by the permit granting authority or by the special permit granting authority designated by ordinal e or by-law that such Cllitnge, extension or alteration shall not he substantially more detrimental than thu existing; nonconforming use to the Neighborhood. This scctiun shall not apply to ecta.hlislulletlts which display live nudity for their patrons, as defined in section nine A, adult hookstores, adult motion picture theaters, adult. paraphernalia shops, or adult video sures subicct to the provisions of section nine. A. A zoning ofdinaricc or by-law shall provide thilt Co11stfLlCti0lI or itperationr under a building or special permit shall conform to any subsequent amend.t11c11t of thc ordinance or by-law unless the utic or construction is commenced within a period of not more than six months after tttc issuance of the permit and in case~ involving construction, unless such construction is continual through to completion its continuously and expeditiously as is reasonable. .A.:zoning ordinance or by-law may define and rqulatu nonconforming uses and strictures abandoned of 1101 used for a period of two years or more. Ally inCTUk in area, fronta e, width, yarL1, or do th rK uirements of a zonin ordina.ncc orb -law Shall not apply to a ]r►t. for single, and two -fatuity residential use which at the tinic or recordN or elldotscmunt, whichever occurs Bonner was not held in common ownership with an ad'oinill land, conforined to then existing requirements and had less thatl the Pro _sed rec uirement bUt at east tveousan Square cct o art:x an 1�ly eet r)f ftontige, Ali%, iticreasc w area, frcmt,l.ge, width, yard or depth reyurreement o a zonin or'd naiice or �y- aw shalt Wert apply for tt period of five years fi-0111 its effective date or for five years after January first, nineteen hundred and sevcnty- six, whichever is later, to a lot for single and two Family residential use., provided the plan for such lot was rtveorded or endorsed .and Such lot was held in common ownership with any adjoining land httgr:',rwww.lna5;.#;nv/leg;ls%laws/rrt;l/:it1a-G.11trll 10/20/2005 OCT -20-2205 13:31 From: �vt GSI hapter 40, Section 6 t '1\ To:9786853523 P.3/4 Page 2 of 3 and conformed to the, existing, zoning; requirements as of January first, nineteen hundred and seventy-six, and had less area, frontage, width, ,yard or depth requircurLAUS than the newly effective zoning requirements but contained at least seven thousaiid five hundred square feet of area and seventy-five feet of frontage, and provided that said five year period does not commovee prior to January first, nineteen lmttudrM and scvunty-six, and provided further that the provisions of this sentence shall not apply to more than three of such adjoining lots held in cornrnurr owner.,;hip, The provisions of this paragraph shall not be construed to prohibit a lot being built upon, if at the time of the building, building upon such lot is not prohibited by the zoning ordinances or by-laws in effect in a city or town. If a definitive plan, or a preliminary plan followed within seven months by a definitive: plan, i4 ,ubmitted to as phinni.ng board for approval under the subdivision c:otarol law, and written notice of such submission has been given to the city or town clerk before the effective date of ordin.ince or by-law, the land shown on such plan shall he governed by this applicable provkions of the zoning ordinance or by-law, if any, in effect at the. time of the first such submission while such }lull or plans are being processed under the subdivision control law, and, if such definitive plan or an ainenrlrrteiiL thereof is finally approved, for eight years from the date of the endorsement of arch approval, C:xcc.pt in the case where such plan waw, m*n itt. d or subinitted and approved before January first, nineteen hundred and seventy -Six, for,,even years from the date of the endorsctttctit of such approval. Whether such period is cip,ht yca::s or seven years, it shall he extended by a period cquai. 10 the tirrre which a city or town imposes or has imposed upon it by a ~tate, a t'cderal agency or ;t court, a moratorium on construction, the issuance of permits or trtiliry connections. When a plan rcferred to in section eighty-one A of chapter- forty -otic: has bucit submi od to a planning board and writtca aloti(x of such suhmi-m ion has been given to the city or town clerk, the use of the Ishii Shown on such plan shall be guverrted by applicable provisions of the zoning ordirfaurt: or by-law in effectat the time of the submission of such plan while such plan is being proccsscd under the subdivision control law including the time: required to pursue or await the determination of in appeal fefefred to in said Section, and fora period of three year; frons the date of endorsement by the planning; board that approval under the subdivision control law is not rcyuircd, or words of similar import, Disapproval of ar plan ~hath. not serve to terminate any rights which shall have accrued under the provisi0lis Of this section, provided an arpeal from tete decision disapproving said plan is made under applicable, provisions of law. Such appeal shall stay, pending Cithcf (1) (lie Cunclusioll of voluntary mediation proceedings ;:and the filing ol'a written agreement for judgment or stipul4t!on of dismissal, or (2) the entry of on order or deercc of a court of final jurisdiction, the applicability to land shown ou salad plan of the provisions of any zoning ordinance.. or by-law which became effective after the. dat, of submission of the: pian firtit submitted, togetlier with time rcquirecl to comply with any such agreenicrtt or with the tUrrts of any OT(ler or decree cif the court. In the event that any lot shown on a plan endor,.ed by the planning board is the subject matter of ally appeal or.tny litigatioll, the exernpiive provision~ of this section shall he extended for a period equal to that ,from the date of filing of said apixal ur the commencement of litigation, wlmicheve.r is earlier, to the date of final disposition thereof, pfovidcd final adjudication is in favor of the owner of said lot. The record owner of the land shall have the right, at any tithe, by an instrument duly recorded in the reg?i,stry of deeds for the district in which the land lies, to waive. the provisions ol'this Section, in which case the ordinance; or by-law than or thereafter in effect Shaul apply. The submission of an umended pian or of a frirkher subdivision of all or part of the land shall not constitute such a rwaivur, littii://www.iiiass.gcjy/lQgis/laws,/l-ngi/40a-6.htili m 10/?(,tr 2uo5 uL.i dL-dOM 13:32 From: To:5786853523 F'.4%4 M.GI.T.�I�:Vaptcr 40, Suction 6 Page 3 of 3 1 6' nor shall it have the effect of fulthet extending the applicability ol'the ordinance or by-law that was extended by the original suhmission, hut, if accompanied by lhu waiver described above, shall have the of ecl O1 exlelldiTlg, but. only to extent aforesaid, the ordinance or by-law made then applicable by such waiver. Ruturnto. "Next Section. ,Pre.viotiF. Seciiuu',,' Chapter Tahic of Contents" Lefilsiatbe.HomC, l�ngc hnp://wwtiv.marc.env/le�ir/law;'nz l/4Cld-6,htrn 10/20/2005 October 26, 2005 Town of North Andover Health Department Main Street North Andover, MA 01845 Town of North Andover Health Department: This letter is a confirmation of an agreement made with the Town of North Andover Health Department regarding the lot on 9 Laconia Circle. The agreement states that I, Peter Murphy, understand that the Septic Installation Permit for 9 Laconia Circle cannot be obtained until I submit evidence that the deed restriction for this lot has been recorded. Sincerely, Peter Murphy , Massachusetts Department of • FOODBORNE ILLNESS COMPLAINT WORKSHEET Please Complete and Send or Fax to: Questions? Call.• Date: / / MDPH Food Protection Program Food Protection Program: (617) 983-6712 305 South Street, Jamaica Plain, MA 02130 Division of Epidemiology: (617) 983-6800 Fax: (617) 983-6770 Enterics Laboratory: (617) 983-6609 PERSON COMPLETING INFORMATION Name: 2:( ) - Affiliation: ❑ Local BOH (town): ❑ State DPH (division): ❑ Other: REPORTER / COMPLAINANT Name: Affiliation: ❑ Consumer specify: ❑ Laboratory division, ❑ Local BOH facility, ❑ Medical Provider address, ❑ State DPH town, etc. ❑ Other ILLNESS INFORMATION # Persons ill: ❑ Symptoms: (mark if reported for anyone): ❑ Diarrhea ❑ Vomiting ❑ Nausea ❑ Abdominal cramps ❑ Fever ❑ Bloody stool ❑ Headache ❑ Muscle aches ❑ Chills ❑ Loss of appetite ❑ Fatigue ❑ Dizziness ❑ Burning in mouth ❑ Other symptoms: . .............................................................................................................................. Onset: Earliest Date: / / Time: ❑AM ❑PM Latest (if > 2 ill) Date: / / Time: ❑AM ❑PM Duration: ❑ Less than 24 Hours ❑ 24-48 Hours ❑ More than 48 Hours ❑ Ongoing ❑ Unknown III Persons: Age Name Address/Town W (yrs) Occupation Med. Provider/ m^ ❑ same as reporter (above) 2 3 4 Medical attention received (by anyone)? ❑ Yes ❑ No ❑ Unknown if Yes, specify above: T Stool specimens submitted (by anyone)? ❑ Yes ❑ No ❑ Unknown To SLI 17 ❑ Yes ❑ No ❑ Unknown Medical diagnosis reported? FOOD HISTORY Obtain history back 72 hours prior to symptoms, or, if organism identified, b/n min and max incubation periods (see p.2) If > 2 ill, follow above time frame for common meals (foods) only # Restaurant / store where 2 Fxn3 ❑ B ❑ Same (as left) ❑ Nome ❑ Other (specify): ❑ L 0 1 State Laboratory Institute, 305 South St., Jamaica Plain, MA, 02130 - (617) 522-3700 Sept 1999 (99SeptForm.doc) 2 Always record Time if possible; otherwise, choose B=breakfast, L=lunch, D=dinner Discard Previous Versions 3 Total # persons (both ill and well) who consumed indicated food(s) ti -fl,,, i 4i1, 1 State Laboratory Institute, 305 South St., Jamaica Plain, MA, 02130 - (617) 522-3700 Sept 1999 (99SeptForm.doc) 2 Always record Time if possible; otherwise, choose B=breakfast, L=lunch, D=dinner Discard Previous Versions 3 Total # persons (both ill and well) who consumed indicated food(s) IVIDPH Foodborne Illness Complaint Worksheet Page 2 of 2 FOOD HISTORY (continued) # Restaurant / store where Date & Time' EXp3 Food(s) consumed purchased (name, town) Place consumed ❑ B ❑ Same (as left) ❑ Home ❑ Other (specify): 13 0 ❑ B ❑ Same (as left) ❑ Home ❑ Other (specify): 13 13 ❑ B ❑ Same (as left) ❑ Home ❑ Other (specify): 0 0 ❑ B ❑ Same (as left) ❑ Home ❑ Other (specify): 0 0 ❑ B ❑ Same (as left) ❑ Home ❑ Other (specify): 0 0 NOTES FOOD TESTING Food(s) available for testing? ❑ Yes ❑ No ❑ Unknown Sent to SLI '7 ❑ Yes ❑ No ❑ Unknown /f Yes, specify food(s) & sources: Product and Manufacturer Information for Commercially -Processed Food(s) Product name: Code/lot # Expiration date: / / Package size/type: Manufacturer: Address: Incubation Periods for Selected Organisms Min Max Min Max Min Max B. cereus (short) 1 hr 6 hrs E. coli 0157:H7 3 days 8 days Staph. aureus 30 min 8 hrs B. cereus (long) 6 hrs 24 hrs Hepatitis A 15 days 50 days Shigella 12 hrs 96 hrs Campylobacter 1 day 10 days Salmonella (non -typhi) 6 hrs 72 hrs Vibrio cholerae few hrs 5 days Cyclospora 1 day 14 days Salmonella typhi 1 wk 3 wks Viral GI 12 hrs 48 hrs C. perfringens 6 hrs 24 _hrsj Shellfish poisoning minutes few hrs I Yersinia 3 days 7 days 1 State Laboratory Institute, 305 South St., Jamaica Plain, MA, 02130 - (617) 522-3700 Sept 1999 (99SeptForm.doc) 2 Always record Time if possible; otherwise, choose B=breakfast, L=lunch, D=dinner Discard Previous Versions 3 Total # persons (both ill and well) who consumed indicated food(s) m m x m m x CA y v m _vCD, COD 'fl O MZ y CLO O CLS. y aCc d O 0 d� O Cr Er CD O a C CD y� -� a CO y Co O !D F v CA O .0 CD z O CD O O Q m � Cn �. OC� Cn C7\ O z� � Cnz CnC Oq C 0 s omq 0 (nC� rD ro ro X00 � a x