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HomeMy WebLinkAboutMiscellaneous - 99 PHEASANT BROOK ROAD 4/30/2018THE COMMONWEALTH OF MASSACHUSETTS fJSCAL YEAR OFFICE OF COLLECTOR OF TAXES N 1998 TOWN OF NORTH ANDOVER YOUR PRELIMINARY TAX FOR THE FISCAL YEAR BEGINNING JULY 1, 1997 AND ENDING JUNE 30, 1998 ON THE PARGELOF REAL ESTATE DESCRIBED BELOW IS AS FOLLOWS: 'N MAIL TO P.O. BOX 124 Map 106B NO. ANDOVER, MA 01845 Block 0228 OFFICE HOURS:(120 MAIN ST.) Lot 00000 TUES TO FRI 8:30AM-4:30PM MONDAYS 8:30AM-7:30PM ASSESSOR'S OFFICE= 688-9566 TREAS-COLL OFFICE= 688-9550 PRIOR YR TAX BAL. NOT INCLUDED Page: 1209 Line: 2 Location: PHEASANT BROOK ROAD THIS FORM IS APPROVED BY THE COMMISSIONER OF REVENUE SEE REVERSE SIDE FOR IMPORTANT INFORMATION Taxpa�7er' s Copy COLLECTOR OF TAXES KEVIN F. MAHONEY VERGADOS, NICHOLAS CONNIE VERGADOS 8 DOUGLAS ROAD CHELMSFORD MA 01824 115 PRELIMINARY REAL ESTATE TAX BILL 2nd Quarter BILL NUMBER 9396 Preliminary Tax: 643.08 1st Pymt Due: 8/01/97 321.54 2nd Pymt Due:11/03/97 321.54 Credits Appl'd -321.54 Past Due: Balance Due: 321.54 Amount Now Due: 321.54 INTEREST RATE OF 14% PER ANNUM WILL ACCRUE ON OVERDUE PAYMENTS FROM THE DUE DATE UNTIL PAYMENT IS MADE. 98 09396000 3 0000032154 9 i SCAL YEAR 1998 98 PRIEr�'I INA tY TAX..: This bill snows the amount of preliminary tax you owe for fiscal year 1998 (,July 1, 1997 -June 3Q, 1998), PREL,t'INARY TAX APviC3',`NT; As a general rule; your oreli€�inary tax will not exceed 50% of your adJuslqr? fiscal year i 99'7'tax (including any betterments; special assessrer t.� and other c^arges ached to the tax). Adjustments are made for any abatement or exemption granted for fiscal year 1397, and any tax increases allowed under 6' R)pos f=on 21 _ in fiscal year 1998. Under certain circumstances, your preliminary tax may exceed 50% of the adjusted arrIount. PAY -MEN t C'. E DAFE.S... INTEREST CHARGES:: If preliminary bills were mailed on or before August 1. 1997, your preliminary tax is payable in, t.Wo equal iristailM nis.Your fist payr„€ ns is due August 1, 1997, or 30 days after iho bills were mailed, whichever is laler.Yot,r second payment is due Novombor 1; 1997. Hov^,ever, if preliminary bills were mailed after August 1, 1997, your preliminary tax is payable in fulfil on November 1, 1997, or 30 days after the bilis were rnailed, whichever is later. li your payments are not made by their due dates, interest at the rate tiwili be charged on the amount of the payment that is i=='1pji d and overdue. If ;are liminary bills were mailed on or before August 1; 1997, interest will be compL.ted on overdue first payments from August 1, 1997, or the payment, due date, vvihiche:ver Is hater, and on overdue second payments frorn November 1, 1997, to the date payment is made. If preliminary bilis were aiailed after August 1, 1997, interest will be computed on overdue payments from November 1; 1897; or the payment due date, whichever is later, to the (late payrrieW is made. You will also be required to pay charges and fees incurred for collection if oaymemts are not: made when due. Pavaienis are considered made v,,he . receivea..by thie Collector, To obtain a receipted bill, enclose a self-addressed stamped envelope and both copies of the bill with your payrner it. f=1SCAL YEAR 1998 ACTUAL l �L,,"1AX BILLS: will receive your actual tax bill for fiscal year 1998 after your community sets its tax rate. Any preliminary tax payrnen s (rode will! )e crodited t , vard roayment of your fiscal yea,r1998 tax. Your actual tax bill will provide you with more detailed inforrnation on payment die dates, ABATEMENTrEYEEMPTiON APPLICATIONS: Your right to seek an abatement of or exomption from your fiscal year 1998 'tax is not prejudiced by the issuance of preliminai,y tar. bills. Once the actual tax bills are issued, you will be able to apply for an abatement or exemption. The deadline for fling your abatement or exerrrp ion applicaVon will be (measured from the date the actual tax bills are mailed, not the date preliminary tax bills were rnailed. Your actual tax bill wi l provide you :asitia more d :=taled information on application procedures and deadlines. INQUIRIES: S: If voi,r have cuesVons on hair your preliminary tax was determined, you should contact the Board of Assessors. If you have questions on pnymeats, yo i should contact the Collector's Office. T T ;F 1 z�N DOVE M. A5 A R K S E 1VIS�(_X-J OF PUBLIC 'VV' GEORGE PERNA . t*t�-� 1. ,7S A WJE C H DRIVEWAY PERMIT Date: LOCATION: BUILDER: phone: Telephone (508) 685-0950 Fax (508) 688-9573 OWNER: phone: 7oe:> 9 The North Andover Superintendent of Highway Utilities & Operations MUST be notified of the grade and set -back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Remarks: Approval: c��, E&t'"w}''y.s.'`„�aCy;7.,pfe!k�'.,`�. � '�'rv-ettitS.W"_'+�+w.r•+'+�'�".._.+.^'ti���s--,.�..``.,---rw.��^"r� . r Date. . cam"..." !!� '*-NI` 3939 ftNORT: , TOWN OF NORTH ANDOVER O «ao 1h Oc PERMIT FOR PLUMBING SSACNus� ' This certifies that .'�'--' '�. ............... has permission to perform . 61 .................. ,A plumbing in the. -buildings of ... ......... ............... at ...i . /..... ? `.. ; North Apdoyer, Mass. PLUMBING INSPECTOR 02/16/99 12:10. 300.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PER IT TO DO PLUMBING (Print of Typo) ,�,7—, Mass. Date ✓ 19� Permit # 3 �'. Binding Location � .,,t ,. 1 . � wner's Name Type of Occupancy New Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name �/'���/��R Check one: Certificate Address Z� r�C�jiR-7,r lr�e�oLra. l�,! ,[� 3G3 i2(Corporation Q e [3 Partnership Business Telephone G 63 -3 eb 3 ❑ Firm/Co. Name of Ucensed Plumber L L4 INSURANCE COVERAGE: I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yea k No ❑ If you have checked yn, please indicate the type coverage by checking the appropriate box. A liability Insurance policy K- 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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted for entered) in above application are true and accurate to the best of my knowiedge and that all plumbing work and installations parlorunder Ne permit is- u for this application will be in compliance with all pertinent provisions of the Massachusetts State, Plumbing e, Chapter of lha rat Laws By gnature of 1.1cansadPlumber Title Type of License: Master [j,-' Journeyman ❑ City/Town L License Number Z N � f Yf J N Z O Y Z = W W W in Y J 1A T U < N O 0 V ¢ ¢ O — W ►- W ¢ _ ¢ — _ — z r- ¢— LW _ 0 = pZ W U < > I F- 3 0 a � S �� Y Z D. O p p N Z .Z 4 W W f LL O Y U W S A 3 Y J m y O O J 3 = ! w LL V < 3 ¢ Ol O SUB—BSMT. BASEMENT / IST FLOOR IND FLOOR 2RO FLOOR 4TH FLOOR 5TH FLOOR I aTNFLOOR 7TNFLOOR 8TNFLOOR Installing Company Name �/'���/��R Check one: Certificate Address Z� r�C�jiR-7,r lr�e�oLra. l�,! ,[� 3G3 i2(Corporation Q e [3 Partnership Business Telephone G 63 -3 eb 3 ❑ Firm/Co. Name of Ucensed Plumber L L4 INSURANCE COVERAGE: I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yea k No ❑ If you have checked yn, please indicate the type coverage by checking the appropriate box. A liability Insurance policy K- 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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted for entered) in above application are true and accurate to the best of my knowiedge and that all plumbing work and installations parlorunder Ne permit is- u for this application will be in compliance with all pertinent provisions of the Massachusetts State, Plumbing e, Chapter of lha rat Laws By gnature of 1.1cansadPlumber Title Type of License: Master [j,-' Journeyman ❑ City/Town L License Number ti V r a r � a G c n z > y � A r a c m a > m z � S m O P O z w v O m m C T � r -I tq O O I 2 V r a r � O G c n z > m O m a C m z � O 0 � O � O O L C T � r -� tq O O C 2 o m O A a � G n O r m � O � � O � O O L T � n -� tq O C to o m O o � z r c � L m z P Date ... ; . • ; 1 .. . TOWN OF NORTH ANDOVER g PERMIT FOR GAS INSTALLATION Id This certifies that ... - ..................... • • • • • • • ��• z . Cu has permission for gas installation —A :. ............... . in the buildings of. T!"....' ••.•••••••••••••••:�•• at ...%� 1'•�'': '•`4, North Andover, Mss. / `�• Fee. `�..... Lic. No.f�%kll .. .... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS, UNIFORM APPLICATION FOR PERMIT TO DO GA FITTING (Print or ype) P 9J d Mass. Date l . 19Permit # l ` Building Location % % ;0hC4�r'�L �t' wner's Name Type of Occupancy G New Renovation ❑ Replacement ❑ Plans Submitted: Yes(-) No ❑ Installing Company Names �b ` + Check one: Certificate Address %� Z� � % 4w, ,j, IV 4/ dAoy v� Corporation ❑ Partnership Business Telephone 6 Q 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �� ! TSL I� INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9, No ❑ If you have checked yes, please ,Indicate the type coverage by checking the appropriate box. A liability insurance policy K' 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: Owner❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ra laws. n By TrMaster t License: 1y� umber gnature o LicensedPlumber or s ltter Title asfitter License Number City/Town urneyman N C N W Y Z 2 N N N U N G N C O N S F- W W J C O W U p� 1 = 0 0 z 0 C < W a C r C z O Z O o t: = uCi W Q m ill W 1- y W < 0 1 A y C O > Q y W Z Z = W W 0 F ~ W W W N J Q = S C W C W > U. W F U W J h 5 W 2 < W J > C < C W 7 ~ 1" y N z < Q Q m Q z O O 0 z W E O O W S r1 F- Q < W = O C7 2 LL 7 C 0 J U C > O d N 0 SUB—BSMT. BASEMENT 1ST FLOOR / _ 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6THFLOOR 7TH FLOOR STH FLOOR Installing Company Names �b ` + Check one: Certificate Address %� Z� � % 4w, ,j, IV 4/ dAoy v� Corporation ❑ Partnership Business Telephone 6 Q 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �� ! TSL I� INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9, No ❑ If you have checked yes, please ,Indicate the type coverage by checking the appropriate box. A liability insurance policy K' 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: Owner❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ra laws. n By TrMaster t License: 1y� umber gnature o LicensedPlumber or s ltter Title asfitter License Number City/Town urneyman v' a 0 G1 a m N N 2 N V m n -4 0 z N X m n x m N T m m D V '9 r A po s m -4 r o O z � T T O O a a m � T '^ a A m 4 4 C O N m 0 o 0 z p r D '< N T z p v' a 0 G1 a m N N 2 N V m n -4 0 z N2 A 728 .4 ". 11 -;� Date.... . TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that.... i(C4.04A .... Co. 12.�.................. has permission to perform .... -4V wiring in the building of .... ................................................ A ............................... -9r CU P .. . ...... fif .... !fN�rth Andover. M�Ss.8 at ..... ........................... Fee.35...'().O.. Lic. No.1177C. ELECTRICAINSPECTOR C� WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ThECUWONWF•4LTHOFAL4yS4CHL7SE77'S' Office Use only 7A8. DEPART712FJYTOFPiIBLICS4FElY Permit No. BOARD 0FFIREPREVLV70NRWUT4TI0A S527G�M 12:00 --�' Occupancy & Fees Checked 116-UVPPLICATIONFOR PEST TO PE PERFORM ELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MAssACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date !/� — �g Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. /� Location (Street & Number) _ 22 �� oL/� ± (aL z2 Owner or Tenant Owner's Address 'A Is this permit in conjunction with a building permit: Yes No :0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ® Underground ® No. of Meters New Service Amps / Volts Overhead ® Underground ® No. of Meters e� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA and round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of A Si s Bailasis No. Hydro Massage Tubs No. of Motors Total HP hstrwxC wrage. Ptrsuar>t�lhere�atlarisofMassadasdlsC�ataalLam Iha,,eaaxmlLihltyhnra=PobyuaLdgCanpk!e Covet-agecritssttslargiale#alat YES NO I tow stibxrtiuedvatidxdafsanetDtheOffioe YES F1 NO ® Ifj uhmduicedYES pleaseirdc*thetypeofwo wr bydi-dmrgthe WSURANCEBOND ® 01I-iER ® (P1taseSpeu(y) _ Ex a6w Dae EMnaled VahredEl &Aml Work $ WodctoStart e _ ��� � hspection *R d Rough Final FIRM NAME 1 — (/Yl Ct7 n n LicaseNa �/�j� � C.. Lroasee r� i,�Lll®_ '64 Sign. r L seNO , Jg V BiTa Na 47 1?s 2 -NSA' C j Alt Tel Na OWNER'SNSL�WANER;lama%Nmbldr dmm ethe irsuraaxe oritsshr>bal e4ovallatasz*urdby C,kneniLmNs and 8rtmyWmftnrn$aspmnit tv4aiymt)zM4 X*aT (Please check one) Owner Agent ED Telephone No. PERMIT FEE OEfice Use only 7 The Commonwealth of Massachusetts D , Permit �o /,3�( apartment of Publlc.Safety „an Occupancy & Fee Checked " BOARD OF FIRE PREVENTION REGULATIONS 527.CMR 1200 .3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ,ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527: CMR 12:00 (PLEASE PRINT INh INK OR TYPE ALL INFORMATION)ry ie14 17if City or Town of PSL=A e of =11"-- To the Inspector ol Wires: The undersigned applies for A permit to perform the electrical work described -below. Location Owner or (Street & Number) 1 �h•��( Irl ✓Tf Gryo �o+- �' j TenantAhch o ias- 5 Owner's Address Is this permit in conjunction with a building; permit: Yes, ❑ Purpose of Building Utility No ❑ (Check Appropriate Box) �- '> Authorization NO. h Existing Service Amps / Volts Overhead ❑ .Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and'Ampacity 03 -770 Location and Nature of Proposed Electrical Work : e" kA.e0eA Q,U S g_ a Lx Cie (an 4. No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures g g Above In- Swimming Pool, grnd. ❑ grnd. ❑ Generators':. KVA No. of Receptacle Outlets No. of Oil Burners No sof Emergency Lighting Batter• Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local 0Municipal ❑Other Connection No. of Ranges Total No. of Air Cond. tons No. of Disposals No. of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW Nosf Ballasts No. of Low Voltage ng No. Hydro Massage Tubs No. of Motors Total HP. OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts GeneralLaws / I have a current Li ilit Insurance. Policy including Completed Operations Coverage or ids Substantial equivalent. YES NO I have submitted valid proof of same .to this..office. ,..YES,_ NO ❑ If you have ch ked YES; please indicate the type of coverage by checking'the'appiopriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Electrical Work $ Work to Start Inspection Date,Required: Rough Final Signed un FIRM NAME Licensee —�j 'Yaai� Address '� P �i D�� a / S 6��'`/�... � r. Z� Dye�_� Alt., Tel. No� .�S� SS 0 SS OWNER'S INSURANCE.WAIVER- I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General •Laws,.and that my :signature on this permit application waives this r uirement. Owner Agent (Please check one) Telephone No. PERMIT FEE Sienature of er or Aeent I# Mr 15 41 Date.... 4 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies th6............... ... ................................... has permission to perform -.0 ..... . ................................. - , 42'—'A:� : ........................ wiring in the building of ..... ......................... at .......... North Andover, Mass. .... Lic. No�./ . .............................................................. ELECTRICAL INSPECTOR 04/22/98 15:08 3.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer December 21, 1998 Mr. Michael McGuire Building Inspector Town of North Andover 27 Charles Street, 2 d Floor North Andover, Massachusetts 01843 Re: 99 Pheasant Brook Road Structural Review Dear Mr. McGuire: Per your request, H.H. Morant & Company, Inc. performed a visual structural inspection at the above referenced residence on December 12, 1998. The inspection was performed to determine the structural condition of the Trus Joist MacMillan, Micollam LVL beams, Parallam columns, TH joists and CDX exterior sheathing. During our inspection we noted the following structural information: 1. The "Trus Joist MacMillan" TH joists showed no structural signs of moisture and/or delamination of the product. The Til joists at the exterior sills of first, second and ceiling joist framing which would show the greatest amount of weathering all appear to be structurally adequate. 2. LVL beams and Parallam columns show no structural deficiencies due to moisture damage and/or water penetration. Connections at all joining points of members also appear to be unaffected by their limited exposure to the weather. 3. Exterior CDX wall sheathing although showing signs of discoloring does not display any structural and/or material failure. Although it would be advised that prior to installation of house wrap, plywood should have at least 3 days exposed to dry weather, to remove any top moisture on sheathing. In conclusion, it is our opinion, following completion of the above noted recommendations, that the residence is structurally sound. If you need additional information, please advise. SWL/99pbrl K. H. Morant 0 Co., Inc. P.O. Box 4485 (Salem, M&BsachusettcS 01970 978.744.5354 Fax 978.740.9161 Email: hhm@Uac.net UTown Of North AndoverProject: 99 Pheasant Brook RD Building Department 146 Main St. Town Hail Annex 508-688-9545 DATE: September 20, 1997 APPLICANT: Nicholas Vergados RE:_ 99 Pheasant Brook Rd. Title of Plans and Documents: Building Permit Application & Drawings by Wm. Balkus Associates Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following reasons: P inUse not allowed in DistrictViolation of Hei ht Limitations Violation of Setback Front Side Rear Not in conformance with Phased Developmer Sign exceeds r uirements Insufficient Lot Area Violation of Building Coverage Insufficient O en 5 ace Use r uires perm rior to Buildin Permit Si n r uires ermits rior to Buildin Permit Form U not complete b other de artmen Not in conformance with Growth B -Law Other Remed for the above is checked below. gSecial Permit for Watershed Review Dimensional Variance .S ecial Permit for Site Plan Review... Permit for si n Com lete Form U si n -offs Recorded VarianceInformation indicatin Non-conformin status f Recorded Special Permit OtheOther Plan Review The plans and documentation submitted have the following inadequacies: 1. Information Is not provided, 2. Requires additional information, ._. _�_._......,.., .o in,n rP!'t 5. All of the above. - Administration The documentation submitted has the following inadequacies: 1. Information Is not provided. 2. Requires additional �informic 4ionr t. 5. All of the above. The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons or DENIAL. �Any be nds inaccfor uracies, reviewmisleading sle to bevadedinformation, or ot ration er subsequent t Bent changes to the information submitted by the app licant Building Department. The attached document titled "Plan Review Narrative' shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. You must file a new building pit application form and begin the permitting process. 9/16/97 9/20197 t ulidi g epartmen �idialignature Application Received Application Denied If Faxed 9122/97 Denial Sent 9;: lmmended : Health Zoning Board _ De artment of Public Works Historical Commission cc: William Scott �Chcx� I S+_ 1 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify approvals/permits from Boards and Departments that all necessary have been obtained. This does not relie the havin landowner from compliance with an a 9 jurisdiction , regulations or re Y applicable local t ate la requirements. state law, ****************Applicant fills out this se t• ** APPLICANT: � n � ion *************** 0 � Phone LOCATION: Assessor's Map Number 5(' - 9-,035 Parcel Subdivision ; Street Lot (s) I D ** St- Number Official Use Only************ RECO TIONS 0 TOWN AGENTS: c: Conservation AdminisApproved trator Date A D Date Rejected c Comments , is � `(�,�� _ �S. R7, , I • i - Comments Food In pect r -Health Septic Inspector -Health Comments 3 8A OS�� P lic World -o0 -34 4 d connections riveway permit e Department _ Received by Building� ��� Inspector Date Approved-' "� [ (� I Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date �i Date a L L Y III z 0 H 0 IL z W L O it L U) z 0 u z r g u O Z 3 r m lVA.; �.. "V� � Vlv W j(.•71� �� Vin.; d �k �� �� '� , q` !I 7"ne CominonweaLth of.Vassachuse= CAJ Deparmumt of JndUTxrx;j.-jCCidentS 600 Washingron Strew Boston, .Vain 0:111 Workers' COmPtnsadon Insurance Affidavit 1 2m a homeowner ;erfor.-ninpil wont =vse:-,7 I am a sole 'brocriemr and have no one wc6g :-- 3mv ata 1 soil -roor.etcr, general coatr3c:or. -,,- aome-3vme:- -)nej ana nave nir= :."L* I.onL--C' OrS bc;ow who the -.'011owing workers* compensation poi c= CQMA2nv 01sme! 2ddress- dry. nhane,J- . .. .. ........ Papace Co. .. ..... 2ddzesit city! 2hone if - 7. ..... .. .. : ...... ... ....... . . insur2nco IN' 2ddinons- flet 20ficyil. .... . . Failure 'a jec, re coverage is required under Secnoo ,!.aJf.NLGL L--:- =MCI -CMQ -0 Me IMIDOSIGOIN O(cnaziom penuries of Ila* up to Sjj00.d0-3R­Q-jjF,, :Re .tears' imprisonment as well as civil penalties in tae ror-.* Of a STOP WORX ORDER and a line O(SI00-00 S JSV 3t2idSt Me. I understand that OPY Of :his statement M2i be forwarded to the OMcc of lavesti-2ciams of ne :)LA or coverage wenfication. Idhereby c9rdfi. under the gains and penalties 0f,7C7w7 :AXt :he ZRfor-naxton,7ravided above is .7ut snd corrm Sip 03LC P Print name t-� r) r) Phone* Amcial rise OGIV danot Write i0thin arca tDbteoapieigdbmcin *r=_ *jMCW eity or town: peraio'Ucease 'e "Saitdlns. Department C: contact ifinernediate response is required CUee"ag Mard I CS*Iect an's 01171ce persoo.. phoee 0. CHalth Department ---Z-Otber� WIIllAM J. SCOTT Director Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: (Location of Facility) Signature o Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ` a3 J000 GLS We- h 1 r -P a- / n vn,f "u'n�� r BOARD OF APPEALS 68&9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit (below) Address of Property for Permit (below) -1-5 q 9 (t hews -M k rJ2 o � ppliati Map and Parcel :1O(C6 Purposecon (check below) Phone Number of Applicant: - )�_ Single Family _Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit iq issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. VThe lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6."re met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior' shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. ature of Owner or Authorized Plbent who signed the Attached Building Permit Date form must be attached to thb Building Permit upon application for such permit. • �J 11C 009I7//noJz�nCn��'/ (/Z Restricted To: 00' -I1 DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION SUPERVISOR LICENSE 00 - None J -'- - � Number: Expires: Birthdate: lA - Masonry only •^ _-rte CS 036610 04/04/1998 04/04/1935 1G - 1 & 2 Family Homes Restricted To: 00 Failure to possess a current edition of the Massachusetts State Buiilding Code "'"�` �,r✓ GEORGE PAPAGEORGIOU is cause for revocation of this license. 60 FOURTH AV LOWELL, MA 01854 location: /�h{a 51r.YTf li .If��i� l� /C (J` �U� I� �✓�i�%-0��1 S - ......... _ .._ ................................... _ _._ .......................................... . ................... ........................ . ....................................... . ....................................... jhgne: #, one), and have hired the contractors listed below who have one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature �i —DateU�' Print name W {� Yl l� V(� 5 Phone # ��1_ 5�)— 5-f_�2 official use only do not write in this area to be completed by city or town official city or town: permit/license # check if immediate response is required contact person: phone #; -ised 3/95 PJA) C]Building Department pLicensing Board OSelectmen's Office C]Health Department mother Information-, Instructions Massachusetts General Laws chapter 152 sectiow25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or wtitten:" 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 orbuilding-appurtenant thereto�shall_not:because. of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a Iicense 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, 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. �b„6 /„i /rvz✓i.,��i'i�.,G,.ta„n..�.�„e.'�uoa�or/rw!,r�,:�.Cl�tli, v��r/< ,<.v.<zrw°'u„d *,.�2hY.�e n �<k',Y5_ :"r. R... .,.1'r,:,�.. .t :;:; u.�i„.xaur,.. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law” or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. ✓ .� l y /fd - zzip 3.' x/ �r r YY �.y:.,a ,<y33 < �.. z z s 4` .� ,t`.. MI. Mn. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out m 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. �Szh"�'y%1/.1s4%/i� /. i,fix,%va`k .'`.�scl k"'�°w✓y`rY >s 7 IV ari p' ✓fifes Department'sne The 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ,N0 767 APPLICATION FOR WATER SERVICE CONNECTION S North Andover, Mass. 5e%J 19 �e Application by the undersigned is hereby made to connect with the town water main in 1 v1`��u �l StfeeY subject to the rules and regulations of the Division of Public/Works. n The premises are known as No. 7 tGam-/ Street or subdivision lot no. 1/12 4s — 706>0 Owner Address Contractor if ydel Address Applicant's Signature oZ .0'�7 PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main at r— `/i subject to the rules and regulations of the Division of Public Works. Inspected by _ Date f Street BVarfP lic Works B ` Y c See back for rules and regulations RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES 1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town of North Andover without a valid permit from the Division of Public Works. 2. All water services shall be installed a minimum of five feet below the finish grade. 3. No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964. 4. Service connections shall be 1" type k copper tubing. 5. All fittings shall be brass flange type Mueller or equal H 15202 Corporations H 15212 Curb stops H 15402 Three part unions H 8185 stop and waste valves 6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 41/2 foot rod and brass plug type cover. 4 G 1.0/0- 1 i1 -e Cl 8 13 5a8450- PE -16-1 T I F'A.GE 01 GATT, r. T -E 0 LIA-RUTYINSURANCE TF1 S CERT[6kIS iS - TTER DF MFORMA'TION S U 1: 0, A S 10 A UpoN THE CERTIFIC,WrE OKY AND CONFEFS NC? 'R GH,r S 04SURANCE AUINCY -$ NOT AMEND, EXTEND OR HOLD* P., THIS CERT!FIGATE 00E- P.O. Brj; sia/ I 4 ALTE r TME COVERAGE AFFOPDED BY THE POLICIES BELOW I , A GE e a COVER R' ;oMp,.NIEs AFFOR A f3L r.ANY GEORGE PAt-AGEORC—TOU I-! AIR "I' TJ A N D -1 HOMAS PAPAG EO RIG 1 OT -7 60 FOURTH ;M LOWELL, M�. 0 18:-54 D THIS I$ TO C5PTIFY TPA -i THE POU(JIES OF INS-L)RAKE U87E[l BELCW4 HAVE SEEN ISSUE[) TO ``-1E r,AIAED ABOVE THE PCI.ICY PEP'OC INDICATED, NQTNITHSTkj,�iNG ANY REQUIREMEN-l', TEW, OR, ONDITION OF AiNlY CQI&4-TRA;-1 '-F�� D7FQ'Ql DOICJ"EN- W!"H TO IPJ�-!CH -wl�-; ;S =i..!3 --T TCj ALI- THE TEW,15 eE ISSIjE,,E) rjR tAA`' �EfAT,'IN, THE 14SURAKE AFFORDED r,,Y THE PPL, C!SS CER' �FICAT� I I - L4!Vw'. -!H i10L JMITIS SHOWN MAY HA` BEEN RED(JCEE, BY PA! D r EXCLU�IONS AND OF; -3 co TV K- OF IR'tt)f;W-'F CC.tjMEF(;,,.- "�J.&AAL L A�7'L ;v . CLA.ms;oot ),^,CUP OM&O'S & LONTRA,- -COS PROT ,-CHEM oa ORE.0 AUFT05 NON-GANCO AITX vo AUTO L4 Y. C F M UAW L trf umanEUA FORM FOAIA W rmoym, UAeture A 70IF P". R;F:X4V INCL EXC-t. KkIcy NWWWAI T B TBD TOWN OF NORTH ANDOVER NORTH ANDOVER, MIA POLJC�'V - rNt-nVE f�OLICY EXNRATIO�' WITT (MMUD?"'I DA I F � WWI) ll!y T� 0/f 1-) 7 1 " 1/9 J IJ/0) I E PIFAE hAED El:Fl 10/0119 10/`0 -;NI r,5 'OYPOV AGG I 1N.)LIPY 'pq' P'xes}in) L A.JT,'),:.-f'J0 - EA, OTHER tt,4%'Xi-I 0 CNL 3 0 C, 10 EACH A,;Ci, V47 1, 1\ AGf--sRECA-, F 1, AG Gn E G A T E y i C 1AIT, OT". TORY LIMI rS r-, R L E A CH A I.: CA P F N T $ .I'19 qL 015TA A PM &F0JL.D ANY OF THASOVE DtSCAUD POLICIES BE CANCELLED SEFOAV ThE EXWIATICIN DATE 7HEF-!!Ot. THE i53IJlmQ C0101PANY WILL ENDCAVOR TO MAI: 10 ;JAYS WPrrTI--m. NOTICE 1.-0 THF CERTIFICATE HOLOEA NAMED Ta THE LEFT, BUY PAILUAR YO WUL SUCH NOTICE SHALL IMPOSE NO 08LICATICLki (7'R I-JAEfLirf W ANY *N10 UPUN THE COMPANY, 175 AGENTS OR REPHESENYAIWES. 7 jwTnat PIRPRE— TATIVE ,- 0 ACC RD &,014P6 ATION 1988 CERTIFICATE OF USE &OCCUPANCY Town of North Andover Building Permit Number 50 7 � Date THnI�S CERTIFIES THAT `� THE BUILDING LOCATED ON `7 C1 le a �� ` ) S A �^ n k ` J , MAY BE OCCUPIED AS S I S ) C A W(11 (A)q IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 9 ROOM s) 3 both%; 3 S all wodv fry, r l o• l "* ; qa CERTIFICATE ISSUED TO ,N1 C r� l A ADDRESS 9 P a AA Building Inspector e. 11 1 •V versa ■ 6YiY CD C2 Z CL ®® �a CL■ a� W ® CD® O ® CD CL �, r C CD CD CD CD CD CL CO) Co CD CO) CD CD z YCD CD �cn Cn 7oC ; ro r R�Cli a w oGG �7 r o 0., CA & gy r � CD C9 �y 7 O CLOeepn� ! .� CO)CD : .► O =r . �p MCo CD d'o n t7 ....�. s � C� ID Ir a. j m L Ann l) � f Y VVV epi �.n.' eeJ'tt) CL � : maeeeyy A� A e. S t _ �\g��..°_��d+ •',ems-CD CD Ra CA �cn Cn 7oC ; ro r R�Cli a w oGG �7 r o 0., CA O r � CD A 7 O .� CO)CD : .► O =r . CD d'o n t7 s � C� .. Ir a. IL �cn Cn 7oC ; ro r Q 00a7 n a w oGG �7 r o 0., r A Gori J m W TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 11/8/00 This is to certify that the individual subsurface disposal system .constructed (X ) or repaired ( ) by Dave Maynard at 99 (Lot 10) Pheasant Brook has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector v The g} bottom of bed; ( ) septic system located at I ZOT f� �iy/�S�it,TUf'OD� , has been inspected and approved on ���d ��/� by Board of Health personnel, and the Health Department has no objection to a construction permit being issued for this lot. Inspector Date MAR � 3 999 �hi� lefi�ei- is �v corr�i�+ "May/�v� - _.ra.�ls w �'�l b� Ola ced o � y5be4 t .4 a. ; �s �5 �{ The ottom of bed; ( ) septic system located at ZD �iy�/�5latiT 0,C604 been inspected and r ,has approved on/Z�% by Board of Health personnel, and the Health Department has no objection to a construction permit being issued for this lot. 01,k Inspector Date fi k'a H 0.