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Miscellaneous - 990 FOREST STREET 4/30/2018 (2)
,\a N_ O .4�jl,i Date.. ........ ............... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION Tkis certifies that ....... 1"*** .... ****'*****'*'* - --" *. / ...... . .. f ..... .... ..................... has permission for gas installation ........ �1I ............................ . ........................... inthe buildings of. .............................................................................. C-1 � C) at .......................................... **'**"*** Sk .......... * ................. . North Andover, Mass. Fee.... Lic. No.106% ..... M.tr .................................................. 7 GAS INSPECTOR Check # =OM b, G TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY ~ V MA DATE JPERMIT# 741 l Y JOBSITE ADDRESSG.�� OWNER'S NAME �....��.....,�. OWNERADDRESS TELIFAXLL�= OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL E] RESIDENTIAL NEW: d/ RENOVATION:[] REPLACEMENT: APPLIANCES -1 FLOORS BSM BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER ` DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER PLANSSUBMITTED: YES[] NDE] INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES [Ij NO L] I - VOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY >Ej OTHER TYPE INDEMNITY D BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER Ej AGENT 1 hereby certify that all of the details and information I have submitted or entered regarding this application and that all plumbing work and installations performed under the permit issued for this application will be in Massachusetts State Plumbing Code and Chapter 142 of the General Laws. asI or my Known provision of the PLUMBER-GASFITTER NAME Stephen Hogan LICENSE # 1080 \J V SIGNATU E MP [Lj MGF Lj JP ® JGF [j LPGI 0 CORPORATION J# 3403 PARTNERSHIP O#L�—= LLC D# COMPANY NAME: -Atlas Glen -mor ADDRESS 295 Eastern Ave CITY I ChelseaSTATEMA ZIP102150 TEL 617-887-7300, FAX 617-887-7330 CELL 617-721-6059 EMAILF 3� '`'� �® CERTIFICATE OF LIABILITY INSURANCE DATE/2013 /YYIY) 10/01/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. 1166 Avenue of the Americas New York, NY 10036 Attn: NewYork-certs@Marsh.com CONTACT NAME: HO AHCNNo Ext : FAIC No)7 E-MAIL ADDRESS: LIMITS A INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Commerce And Industry Ins Co 19410 073389-PETRO-ACORD-13-14 INSURED PETRO HOLDINGS INSURER B ; New Hampshire Insurance Co 23641 INSURER C: NIA NIA DBA ATLAS GLENMOR 295 EASTERN AVE CHELSEA, MA 02150 INSURER D: NIA NIA INSURER E: NIA NIA INSURER F: '3602506 (NY) COVERAGES CERTIFICATE NUMBER: NYC -006482864-06 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADDL LTR TYPE OF INSURANCE INSR SUBR WVQ POLICY NUMBER POLICY EFF MMIDD I POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY '360-25-05 (AOS) 10101/2013 10/012014EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY '3602506 (NY) 101012013 101012014 DAMAGERENTED 100000 PREMISESS(RENTED occurrence$ CLAIMS P1 5,000 -MADE OCCUR MED EXP (Any one person) $ X XCU PERSONAL & ADV INJURY S 1,000.000 X Contractual GENERAL AGGREGATE S 5,000.000 GEN.L AGGREGATE LIMIT APPLIES PER: -I PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- T LOC $ A AUTOMOBILE UAS107 '720A6-98 (AOS) 101012013 101012014 COMBINED SINGLE LIMIT 2,000,000 Ea accident $ A X ANY AUTO '720-46-97 (MA) 1010112013 10/012014 BODILY INJURY (Per person) S A ALL OOWNED SAUT�ULED OS '19495-31(VA) 101012013 101012014 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATION `258-89-049(MA,ND,OH,WA,WY) 1010112013 10/012014X WC sTATU- OTH- B AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN '012948291(CT,MD,NY,RI,SC) 10!01/2013 10/012014 RY IT R 1,000.000 OFFICER/MEMBER a N / A E.L. EACH ACCIDENT $ A EXCLUDED? (Mandatory in NH) '012948299 (NY,ND,OH, WA, WY) 101012013 101012014 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 B If yes, describe under DESCRIPTION OF OPERATIONS below '059901256 (NJ, PA) 101012013 101012014 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B WORKERS COMP. CONTINUED '059901257 (VA) 101012013 10/012014 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) EVIDENCE OF COVERAGE Town of NORTH ANDOVER l.FAV4k CLLAI JUIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Michael Matinale CEJ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD COMMONWEALTH OF MASSACHUSETTS :L1tPIN- PLUMBERS AND GASFITTERS LICENSED AS A JOURNEYMAN PLUNl�,ER ISSUES THE ABOVE LICENSE TO: STEPHEN G HOGAN 109 BURROUGHS RD BRAINTREE MA 02184-1517 19523 05/01/14 15384 COMMONWEALTH OF MASSACHUSETTS -1 e I° , •1 .' - el�j-'T-91c1,`P•YRYWI•��E�.'}If1e1�F l�'1`lFle a PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMBER ISSUES THE ABOVE LICENSE TO: STEPHUN G HOGAN ?C tl9 BU.,'ROUGHS RD B lAINTRF•E MA 021.84-35`: 10.808 05/01/14 153825 COMMONWEALTH OF MASSACHUSETTS !°JF'/! fl•1,`N°l�:l:lrla� , 11°1E�f_Y�i41K�EiyYl:f.�ep•t_:i�lfsl� PLUMBERS AtiD GASFITTERS. ` REGISTERED ASA —PLUMBING CORP ISSUES THE ABOVE LICENSE TO: A:. STEPHEN G HOGAN PETRO HOLDINGS aNC 109.BURROUGHS RD BRAINTREE MA a, s a 02184 3403 05/01/14 153823 ys The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print. Legibly Name(Business/oiganizatiordlndividual): i�T s GLEN -MO Address: 295EASTERN. AVE City/SfateJZip:, CHELSEA; MA 02150 Pbone #: 800-433-1616: Are you an employer. Check the appropriate box: Type. of project (required) I : I ami a employer with i 20 4. [� I. am :a general contractor and I employees * have hired the sub contractors 6= .� New construction p yees (fulland%r part-time). . . 2..E I am a sole. proprietor or partner listed on the attached sheet 7. [� Remodeling ship and have no employees These sub -contractors have g Q Demolition working. for me in any capacity..: employees and have workers' [No workers' comp. insurance comp. insurance.; 9 D Building addition required.] 5. El We are a corporation and its 10.0 Electrical repairs or additions 3. El I am a homeowner doing all work officers have exercised their 11.© Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL .12 -El -Roof repairs insurance required.] t c. 152, § 1(4), and, we have no employees. [No workers' 13_❑ Other comp: insurance required_) *Any applicant thatchccks box #1 must also fill out the section below showing their worikers'-compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.. $Contractors that check this box must attached ani additional sheet showing the name of.the sub -contractors and state whether or not.those entities have employees. lf.the sub -contractors have employees; they must provide their workers', comp_ policy number. I am an employer tliat is providing workers' compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: NEW HAMPSHIRE INSURANCE COMPANY Policy # or Self -ins. Lic. #: 258-89-049 10/1/14 Expiration Date: Job Site Address:. City/State/Zip: Attach a copy of.the workers' compensation policy declaration page (showing the policy and expiration:date). Failure to secure. coverage as required under Section 25A of MGL c. T52 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 maybe forwarded to the Office of . Investigations of the DIA for insurance coverage verification. 7 do hereby cert d :e pains and 7. enalties fperjury that the information provided abov is tr a and correct.' Si ature: / d Date t J� Phone #. e 1 i Official use only. Do not write in tris area, to be completed by city or town official ff City or Town: TermidLicense # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk '4. Electrical. Inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: 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. ZONING BOARD OF APPEALS Community Development Division Notice of Decision Year 2006 R�:CL.:Iq�F"asfan►P T 0 W1-1' CII FR 'S ,Fr -0r �, � .� Cir ;t,:.. 2006 MAY 22 PSH 4: 17 -� - :�i�TI.I 40A7 § 17 Pro at: 990 Forest Street NAME: Michael Forast6 HEARING(S): April 11 & May 10, 2006 ADDRESS: 990 Forest Street PETITION: 2006-008 North Andover, MA 01845 TYPING DATE: May 15, 2006 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 Wednesday, May 10, 2006 at 7:30 PM upon the application of Michael ForastC 990 Forest Street (Map 105.1), Parcel 2), North Andover requesting a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of the rear setback in order to build a proposed deck. Said premise affected is property with frontage on the North side of Forest Street within the R-1 zoning district. Legal notices were sent to all names on the abutter's list and were published in the Eagle -Tribune, a newspaper of general circulation in the Town of North Andover, on March 27 & April 3, 2006. The following voting members were present: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R. Webster, and Daniel S. Braese. The following non-vO ing member was present: Thomas D. Ippolito. Upon a motion by Joseph D. LaGrasse and 2nd by Richard J. Byers the Board voted to GRANT a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of 15.9' from the rear setback in order to constrict a proposed 1 -story garage and enclosed breezeway per: Site: 990 Forest Street 105.1) Parcel 2), North Andover, MA 10845 Site Plan Title: Permit Site Plan for 990 Forest St., North Andover, Massachusetts 01845, prepared for: KerryForaste, Michael Foraste Date & Revised Dates): 3/9/06 Registered Professional William M. Damour, P.L.S. #31307, Wm. M. Damour, P.L.S., Burlington, Architect/Land Surveyor MA With the following condition: 1. Either the existing shed shall be moved within the 30' sidetrear setback or the existing shed shall be submitted to the Zoning Board of Appeals for a Variance from the 30' side/rear setback requirements of 7.3 & Table 2 for structures in the Residential 1 zoning district in order to receive the final building inspection signature. Voting in favor: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R- Webster, and Daniel S. Braese. Page 1 of 2 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9541 Fax 918.688.9542 Web www.townofnorthandover.com ZONING BOARD OF APPEALS Community Development Division 1?1 .(J k Time Stamp lest 2006 MAY 22 P14 G-. 17 :llIC v N 0 R T H i{Ll0'%.!r-i': MASSACHU.3 _:T) v The Board finds that owing to circumstances relating to the soil conditions the shape of 990 Forest Street (Map 105.1) Parcel 2), and the single-family dwelling's existing location on the parcel, especially affects this land and stricture but does not affect generally the Residential 1 zoning district in which it is located, a literal enforcement Of the provisions of paragraph 7.3 & Table 2 would involve substantial financial hardship to the petitioner if the variance were not granted. The Board finds that the 100' Conservation Commission Buffer Zone bisects the existing dwelling and that the 50' No -Build Zone bisects the parcel to the right of the dwelling, requiring the applicant to obtain the Conservation Commission's Abbreviated Order of Condition 242-1323. The Board finds that the existing attached garage is 30' (+-) from the left side setback. The Board finds that the applicant would need to raze the existing attached garage in order for the proposed deck to avoid both zoning and conservation seftd s. The Board finds that the left side abutter, Derrick Paul Davies, 980 Forest Street, wrote a letter dated March 26, 2006 in support of the variance for the deck, and that there was no written or spoken opposition. The Board finds that desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the North Andover Bylaw. Note: 1. This decision shall not be in effect un it a copy of this decision is recorded at the Essex County Registry of Deeds, Northern District at the applicant's expense. 2. 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. Furthermore, 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 Spacial permit granted under the provisions contained herein shall be deemed to have lapsed atter 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 atter notice, and a new hearing. Town of North Andover APpas, /7 7 Ellen P. McIntyre, Chau Decision 2006-008. M105.DPI Page 2 of 2 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9541 Fax 978.688.9542 Web www.towoofnorthandover.com „OOT” �•- Zoning Bylaw Denial t Town Of North Andover Building Department . + = qpp Osgood St North Andover MA. 01845 Phone 87545 Fax 876411118-8542 Street: Michae deck a Date; 1 3-10-06 Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning R-1 Variance Site Plan Review Special Permit X hem Notes Access other than Frontage Special Permit hem Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit A Lot Area Variance for Sion F Frontage 1 Lot area Insufficient Planned Residential Special Permit 1 Fro age Insufficient 2 Lot Area Preexists yes 2 Fro a Com res 3 Lot Area Complies 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information 5 No access over Frontage B Use 1 fAllowed G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting yes 2 CoMiplies 4 Special Permit Required 3 Preexisting CBA e s 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Hi M Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height y e s 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient for deck I Building Coverage 6 Preexists setbacks 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Compiles D Watershed 3 Coverage Preexisting yes 1 Not in Watershed yes 4 Insufficient Information 2 In Watershed j Sign 3 Lot pri2r to 10/24/94 1 sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district yes 2 Parking Complies 3 Insufficient Information 1 3 insuffident Information 4 Pre-existing Parking yes, n�..�...�.. t-.. &a.- -tom.— :- -6-16-A bun& W. RQrrraY 1%x YAC aYNVW we a.l.a..wv.. vs...... Item # 3 ial Permits Planning Board Item / Variance Site Plan Review Special Permit X Setback Variance Access other than Frontage Special Permit Parkina Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sion Continuing Care Retirement Speaai Permit Independent Elderly Housing Special Permit Special Permits Zoning Board S Permit Non-Conformina Use ZBA Large Estate Condo Special Permit Planned Development District Special Permit t Earth Removal S I Permit ZBA Special Permit Use not Listed but Similar Planned Residential Special Permit SP2921 Permit for Sign R-6 Densft Special Permit S I Permitpreexisting nonconforming Watershed Special Permit The above renew and altarired er1planation of such Is based on the pl r e snot infarrrMfion submiltad. No definitive review and or advice shah be basad an verbal maps— IN m I by the a *kW t nor dal such verbal erOWW"M by Urs applicant serve to provide defsdtive answers b Ua above reaear for DENIAL. Any taccuac", rrrelsading irrlomMtion, ar atlrar aubaequerK CIO nger to Ua 2 dbi n w submMad by Ua applcrtt dal be gmwWs for this rsvMw to be voided at the diacrdbn d the guiding Depw n w t, The waded doaarmrt tN ed low Rwtsw NwrWW "be atlactad & W to and mwpaalad herr► by reference. Thr but ft dWw h -w wfl slain al phrM and doornMr*WW far Ua above ffk. You rust Ilea naw WMding permit application lam and been the penift prooeas v/ ire_ Building Department Official ig ure Application Received v Ap kation Denied Denial Sent: If Faxed Phone Number/Dee: Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: loom FAmWW fW Da1" ANe1r110esetback on the proposed. dec C-5 as only ' sill remain where 30' is required per Zoning Bylaw Section 7.3 & Table 2. Referred To: Fire Health Police X Zoning Board X Conservation Deparhned of Public Works Planning Historical Commission Other BUILDING DEPT TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH� A ONE OR T WO FAMILY DWELLING lhit A BU,MDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner for of Buildi Date SECTION 1- SITE INFORMATION 1.1 Propedy Address: 7�t 0 s -s remit 1.2Assessors Map 10, _ Number and Pared Number 274 Parol Number sr 1Map o V TZoning 1.3 InfomsatiJ m: r _ Zoeim Distrsd RwoscdUse 1.4 Property Dim=ions: o f Lot Area M F ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Provided 'red Provided - o Raw 1.7 Waaa SepplyM.G.GC. 34 a •3. Flood Zaee mform+tioa: ru61w 0 pdvae zone Outside Hood zone ❑ mmkipat 7.tt Senenge Disposal syskm: a on site mpoml S SECTION 2 - PROPERTY OWNERSWIAUTHORIZED AGENT 2.1 Owner of Record ter,- F 9 9 o Name(Printla" ` Address for Service: I�/o�, f� 4n�V,2-rj -57 (�,..�', �. to Signature Telephone 2.2 Owner of R000rd: Name Print Address for Service: S' tune Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor. M.- _ Licensed Construction Supervisor. Z / S/d L Cl d�7 Address /0 7 /C � X03 s'- i6 90 Telephone Not Applicable ❑ LicenseNumbet / Z/oS z-od i Expiration Date 3.2 Registered Home Improvement Contractor /y1vr�%1� rof�r ohfrct.c�� 1 -LL Not Applicable G JC/� ��G' Company Name /' /' Zi�S7jyn�tpgS%r �,`r� `� %t�y/y11�+tt� /✓ 1`� B3a'77 Registration Number %0�Z..f/O7 Address Expiration Date i Te hone V M a_ Z 0 v m O Z M 00 O r M r Z a d - WORKERS COMPENSATION (M.G.L C 152 § 2546) npensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition ❑ Accessory Bldg. 0 Demolition ❑ Other Specify Brief Description of Proposed Work: f/ 61.14Sfrve- kONUt_ �I✓%G:earA .r/Z� Ye fyrr► �tC.�C o+�t of %owe e., I SRMnN K. TtCTTMATF.D f:nNCTRiDMnN MS" . I item Estimated Cost (Dollar) to be Com leted b it brant OFFiCUL USE_014LY 1. Building 1.7 i �n0. �Ot (a) Building Multiplier );(o tl aY-D 2 Electrical (b) Estimated Cost of Cs 3 Plumbin Building Permit fee t.) : (b) (7(- 1(71- 4 Mechanical HVAC 5 5 Fire Protection 6 Total 1+2+3+4+5 1 . 00 Check *lumber SSGT1U]47aUWl4EHAUi31UKtLAllUri 14Ulil;l:VWLtc1LVWH r4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L 'v 1 �C�'�Z 1��n —' ���"J 1 as Owner/Authorized Agent of subject property Hereby auth ee I Vl I CiE'� i� 4� IF � U (l o� l to act on I, behalf all utters re five to word authorized by this building pernfit application Date 1, Al t. r "41"") as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and actuate, to the best of my knowledge and belief 1�f, 'c� / /— Yy4e Prin _ _ -� /11 e:.... 'r�...., OF PROPOSAL �- • •�,�: w'.�r+..1 �`'�'_ r � �;:.� 7' PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT:- NAME T: NAME r ADDRESS PHONE NO. ADDRESS._, _ v Y �• F i DATE OF PLANS ARCHITECT We hereby propose to furnish the materials and perform the labor necessary for the completion of ....vT+:., /: ♦' C y 4 i_ � �.,; � r � �ts' '{: ` fi"y s i� i�.." .� <f 4 ,� . r � �• . �r / 1f r i €e . C; L r S Ier / t a ,! -a.i .�.,c,. h.� t s.c.+ :, t.• 4'�i '• )�,._ 1 f ,j �f r , +., <4*- ti-7 - f �f ✓•,.x ...,v„ f , - l _ { _ All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations submitted for above work and completed in a substantial workmanlike manner for the sum of Dollars ($ + !� with payments to be made as follows.,/),,,,, J- Respectfully submitted - - Any alteration or deviation from above specifications involving extra costs ^ will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents, or delays beyond our control. Note —This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted, You are authorized to do the work as specified. Payments will be made as outlined above. Signature Date : "' Signature NC 381850 PROPOSAL MADE IN USA FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION************************** APPLICANT H !C[�hCL �12-AST) �a PHONE—&?S -S-4-08 LOCATION: Assessor's Map Number 105- D PARCEL L&r 2A SUBDIVISION LOT (S) 24- STREET 'T1 9X'5i_ ST. NUMBER 99 D ************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS Uri 17,111;t"4 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH ".' ` ' "'`. A APPROVED. .DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTION DRIVEWAY PERMIT; FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197jm NOV-03-2005 THU 01:15 PM FAX NO, 9784750303 P, 01 Cilso t' 12828 AQWD. CERTIFICATE OF LIABI I Doherty Insurance Agency, inc. P.O. seal 1885 21 Elm Mmt Andover, MA 01610 1 Murphy Orothers Contrild1mg, LLC 28 sumbpost Circle RoymonlL, KH 03077 THE eI S OF INGAMANM LISMO MOW HAVE MEN 18550 TO THE F Amy CONTRAGT OR OTHER MAY THE IM'9URANCE RDEDOBYTHE POLICIES DESCRIBM POt ta% AGCMGATE UWT$ SHONM MAY HAVE BEFM REDUCED BY PN A UAW.QTY SAL GENERAL UABUTY CLAM MAM M O=kw CEWL A00 EGAT L LWV AMAS PER: POLICY LOC lJAi41" AM AM ALL OVRJED AUTOS ACHSWaDAUT03 HrWM AUTOS NDND AUTOS UAMUTY AMY AUTO OOCUR L_j CLAIMS MADE DEDUMLE AfTENr10N f Vg&Vpj coW%9"*W Atm DVLpYM LIAVA. TY ANY AO FICiARJfMeBERtDfCLUDF3Yl curia LITY INSURANGt: ;i THis CERTIFICATE IS ISSUED AS A UATMR &UNWORMAVION ONLY AND CONFERS No RIGHT8 UPON THS CERTIFICATE HOWM THIS CERT1MATE DOES NOT AMPM, EXTEND OR ALTER THE COVERAGE AFFORDED BV TH13 POLICIES BELOW. INGURER8 AFFORDING COVERAGE MAIC 0 PMJM A st PauVrrovolers IM31�tER A: Palo R C: *gPJRER Ik pV817RER �: D MAIAED ABOVE FOR TM POLICY PFRIOO INDICATFD. NDTMTHWANDINt -:W PATH RESPECT TO MMICH THt8 CEMK'ATE MAY BE MWED OR is SUBJECT TO All THE TERM, EXCLUSIONS AND CONOtTKM OF SUCH c 0610110s 105101106 DSI OF OlsEtiATi0Si31 Ldf.ATIOk91 VEMtG1.JS0 ! t7tCi338WMS ADDED tiT E1t�Raasewr + Lowas Companies, Inc w*o any and all subaldhAn Is listen as an add4lonsl Insured for Ilability arising out or tate gwro0ons Murphy Brothers Contracting, LLC... 4 LMR! EAGI OCCUMEM M 6 000 M,>< fa 0 000 Mw ow w+Y PWPW—) $5 ,000 PMONAL aAM NAM 61,000,000 dEwsi L An"ZoATe $2000 00 T92CTs . SOMME AQG $2,000,000 Com 3mo wNOLE LIM = 3 0=6Y a0my INJURY f pwA I {PKOAMAtiE f OWV-FA ACC=NT I f -AM OT hII TW W *AAW It AUTQ QMLr. A[36 f EACH OCCURW-WE f At30REOA f f f i v►c x A 0 H. E.L EACH ACCIDENT f EL DIMLM6 - PA f LL • POUCY f ;ERT TE HOIMER I CANCELLATION OHO= AMI' OF TME ARM MURIDFO POLR'IE. i tM CAMCEI.1 BEFM THv 00MATON L4Wa! Clirnpanit�, lrlC / DATE TWAcor, T"e mama IMSURM VA$. L E MAVOR TO BAIL –31L DAYS MIR"TO Attn:191N9L1itAiiCE tMP� V I tilCi TO THE t: T1irCATP MOl1tEA 1}A4�tt'A 7O TME > J'FT, BUT FA&Lltfl TO OD: ef1AlJ. P.O. 19 11111 wrasa No cow—mu an UAR=V 6P AMY TM! Wgumm rre AGFJff$ trR Nom womboro 28M, NC RiPAEitPJ1TA AUTiiORM RE PITA , L Acl=126 WIZI !) l of 2 019215 i a A OAPORATlON ,Use i NOV 03,2005 13:13 DOHERTY,INS AGE 9784750303 page 1 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The -- debris will be disposed of in: Zman. PrT 2ay?,? ova' Al 6� T wn Divi (Location of Facility, 00 of Applicant 2/0 �la ( Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 11,. �•J.�»+NJ,n,r..n1/h •/ l�. w(ryJJ.o(I BOARD OF BUILDING REGULATIONS Lirmn%e: CONSTRUCTION SUPERVISOR WIN Number: CS 088039 Birthdate: 12105/1975 Expired: 12/05/2007 Tr. no: 88039 Restricted: 00 MICI IASL F MURPHY 102 A WEST BROADWAY f 4 DERRY, NH 03038 GJ Commissioner �„\ . ��e i' r•»r.m..n�(,rvr�/%r r�i . �/�r;:.rrrqulr'�ll yl .p x Board of Building'Repletinn% and Stsndards HCR0 imPROVEMENT CONTRACTOR Regh&atlon: 1487130 Expiration: 10125!2007 Typo: Ltd Liability Corporation MURPHY BROTHERS CONTRACTING, LLC MICHAEL MURPHY 26 STONEPOST CIRCLE RAYMOND. NH 03077 Adminhitrator License or registration valid for individul use onh- before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ms. 02108 w•rthout signature Y Location YJI & No. e Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ iBuilding/Frame Permit Fee $ 1� 1 �'�s'•�"''t�' Foundation Permit Fee $ �4CMUSt Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ -� 1/ Building Inspector u , �106MM 090 3'OO PAID Div. Public Works ro -n 7 C ro > en ro rn m Zi Zrm m iNV p h cn m � r -I C M rA C ' nr cn rn ?cn n W rn C Z to > C C ^' y C/)> to [*f V to cn (1 z z n m cn a z t Ci n c r C C a > C cn C O C _ c � c �� m n > - cn y > o C ai '✓ C I Z C A C: c k.Ar > r L �" C� �e n O !Z- n O z n z O r o n c o c c CA C O 0 O Otz rA c — n n c O O i la cn b� m en �'i a+ H> c- n ? v +Zt7 p p p C Z Z Z Z n C G] Z C C F cn O n t- cn C C c G1 H m m *i O ro C Clcn C "y C y C C/1 Q J '"• C — tTtCA -- a > S O z O z to r r CA LA CP CD � Z G h PN C O = � c N •� C z Ml Irl o � Ta � I G _ r C/) m m m VJ Cl) 0 y .p C, z CD O CL r .7 rF cl. aC0 .p O o p a� cr CD O CO) co0 0 F—J CO) CO) n� C O CO2 ML c� CD 0 CD CDa y. CD CO) I V A' _C O CD W-- p C•y O =r N —1 = G w Q Q Om o 4` G p� O � m 0 m R. m C7 m Z y' t c VJ O G x M �C r 1--I ~� z cn a0 � (D b O O °�" nto r : CL n c �o m H O Cm/d CD > > m y 0 2>4 O .► fop 0 oZH'cw, � V, >w C2, CO �a C=D m m H :� cc m 'COD C_ d O CO) O O d H ' CO) G Q Cca HCD "~ CD: l : N H C = o O m Cp C'1 cli c R 0 =r CDo CO) 0 C m D 0 S Q :0 H CD m C r IW W: n's Cl) C-) no: a c o �C C O rD d rt �. o „� G ��y Iv z ►Z'3 G w O G 4` G p� O G a r y O 7 O G a- ' r y � O pF,, O G x O G a 0 �C r 1--I ~� z cn a0 � (D b O O °�" nto r : O O x y y 0 r INSTRUCTIONS HO's TO OBTAIN PERMIT . FOR ADDITION/DECK 1. Fill out Building Permit application completely, date and sign 3. Submit a copy of the contractors Home Improvement Contractors Registration number (HIC). 4. A form U -Verification form must be signed by Conservation, and Board of Health (if on septic system). 5. Assessors map and parcel must be on permit application and on U -Form. F Gill 1NnrkPrS' (fin �t:� 7.-FtM7M=f�pvs r i� 8. Fill Homeowner License Exemption Form if applicable. N FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************APPLICANT FILLS OUT THIS SECTION APPLICANT Si-ep1'jr-C" \J LOCATION: Assessor's Map Number SUBDIVISION STREET ******** *****************OFFICIAL USE ONLY********************** ****** RECOMMENDATIONS OF TOWN AGENTS: _---- PHONE q t PARCEL LOT (S) ST. NUMBER 190 CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS FOOD INSPEroTOR-HEALTH ECTOR-HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS e-- /< -7L PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9197 jm DATE Ar i Lp a Ar i a LOT IA X IST f3ul- E TANI BOX 1� - TOP OF FOUND4=/03.62 - SEPTIC AS -BUILT ELEVATIONS INV. OUT HSE. =101.23 IN TANK =100.63 OUT LOT 2A �7164/ S.F. TANK =100.43 IN D. BOX /00.26 441.10 y� OUT D.BOX = /Op 0813 END PIPE= 99.68// it 99.80/2 = 99.68/3 SEPTIC AS -BUILT NOANDOVER.,IVIA. -FOR- COL ONIA L VIL Qn L . DEQ/. 9/ 28/., °:� SCALE i �{ .x17 O' DA TE. '9126 SCOTT L. GILES ✓T`' �oNO. A NDOVER , MA n F?, . - pRfVlrWAy 6t,. LIFILIT'y - GAs�>sf EN7 r�RE3 JOHN S. LAURETANI # 34311 iA9�FESS���I UjL u. GPSGNILNT- r—arL L177, 7J�'4r, ST R E ET G�MI"bfQ U,ICA MAss, AC,kUS 6, -YS Scale: J" S. LAVH ANI A PROFESSIONAL LAND SURVEYOR,tilt AMERICAN SURVEYING COMPANY DO HEREBY CERTIFY THAT THE ABOVE MORTGAGE INSPECTION 77 Rumford Avenue, Waltham, MA 02154 (617) 893.6477 PLAN WAq PREPARED FOR A,.f 1�)0�/1264.Nk< IN CONNECTION Mortgage Inspection Plan INTENDED AND IS NOT INTENDED OR REPRE• NOT OR SENTED TO BE A LAND OR PROPERTY LINE SURVEY. NO CORNERS WERE THE LOCATION OF THE ORIGINAL ESSa�x RECORDED AT COUNTY REGISTRY OF DEEDS SET. IT CANNOT BE USED FOR ES- DWELLING SHOWN HEREON EITHER BOOK PAGE L.C. Cert. # ---- TABLISHING FENCE, HEDGE OR WAS IN COMPLIANCE WITH THE LOCAL PLAN REFERENCE:..?LAh11 .1Z-lbI BUILDING LINES, THE LAND ASSHOWN APPLICABLE ZONING BYLAWS IN EF- DRAWN PER TOWN OF ASSESSOR'S HEREON is BASED ON CLIENT FUR- FECT WHEN CONSTRUCTED WITH RE- MAP # _ PARCEL # DATED NISHED INFORMATION AND MAY 86 SPECT TO HORIZONTAL DIMENSIONAL ADDRESS; LC i LA E" SUBJECT TO FURTHER OUT -SALES, AEOUIREMENTS ONLY), OR IS EXEMPT IN) Q'w.T`A AL t)OVEQ_ , T-ek - TAKINGS, EASEMENTSANDRIGHTSOF FROM VIOLATION ENFORCEMENT AC- BORROWER; WAY. NO RESPONSIBILITY IS EX- TION UNDER MASS. G.L. TITLE VII, CHAP. TENDED HEREIN TO THE LAND OWNER 40A, SEC. 7, UNLESS OTHERWISE SUBJECT DWELLING LIES IN FLOOD ZONE OR OCCUPANT, IT IS NOT INTENDED NOTED OR SHOWN HEREON. A CON- AS SHOWN ON NATIONAL FLOOD INSURANCE PROGRAM FLOOD TO BE RECORDED. FIRMATORY INSTRUMENT SURVEY INSURANCE RATE MAP DATED Sut-jL' I5 11;) 93 I D "Z`i�9.5 IS ADVISED WHEN STRUCTURES ARE COMMUNITY_ PANEL # 2R 0,77 7' DATE SHOWN TO BE 1' OR LESS FROM CLIENT C��T'��- PROPERTY OR REQUIRED ZONING FIELDED I DRAFTED I CHECKED CLIENT nAin'i n Y R: En,,# SETBACK LINES. BY DAT1= i F R. S00Y PrF k i-4. TO/T0'd OSGST8980ST Ol I Nd0Id3Wd WOaJ 80:bT S66T-TO-AON Town of North Andover Ot AORTh , OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845�sISSncHusa�c WILLIAM J. SCOTT Director (978) 688-9531 Fax (978) 688-9542 HOMEOWNER LICENSE E.YENIPTION Please print. DATE —9/3 11,q -7 JOB LOCATION ??C> s/ _ e� LA - Number Street address Section of town "HOMEO�VNFER„ S`i��Ql r.J �� Ps�y �`�—(� g �' �t '� –=t a>1 Cj'� 'I -7L Name Home phone Work phone PRESENT MAILINvG ADDRESS "t /q O F2SLcs i SIQC-e--t_ lib /L?�/ N �p vCyL /V,#- City/Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 Sec- tion 109.1.1) DEFINITION OF HOMECI rVNER: 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 to six: family dwelling, attached or detached structures ac- cessory to such use and/or farm strictures. A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Offfcial, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he./she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with 'said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICL-�L Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. BOARD OF APPEALS 688-9541 BUILDNG 683-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Date..r :..�:.� ......... 40RTN TOWN OF NORTH ANDOVER pf .ao ,^,ti0 PERMIT FOR GAS INSTALLATION r This certifies that .. ... ...0-:. ' . r ................ . i f has permission for gas installation ....... in the buildings of.....:.:..; ............................... . at ...`. .`::<..../C !' ... ................. North Andover, Mass. c Fee..:..'.... Lic. No.. ........ GAS INSPECTOR J WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN (Print or Type) /U(3 NpDc��c , Mass. Date /21a0 19_Y_Z Permit* 3 Building Location / / 0 r' S7 �%- Owner's Name S? --6-Y6 Type of Occu cy New ❑ Renovation A— Replacement p P ns Submitted: Yesp No ❑ Installing Company Name VA,,.l k ff G4 --S Check one: CertNicate Address �f C %%// �7L Corporation �% 1 lei✓'✓ / ❑ Partnership Business Telephone 9 7k - 7 7 5/" 2 760 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter /"? /ert(/�d "YS6 J INSURANCE COVERAGE: I have a curr liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy P(-, Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 1 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 ' , for this n will all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Laws. A By. T of License: Plumber Signature of Lrcen umber or Gas Fitter fitter ster license Number City/Town Fl Journeyman APPRUVED O S O I� I y • tm���������������r��■uttr�����■ ©. .. ■�t�t����f���ft�n�MENNEN E��t�������t����t�t�i��■ MEN' ME Installing Company Name VA,,.l k ff G4 --S Check one: CertNicate Address �f C %%// �7L Corporation �% 1 lei✓'✓ / ❑ Partnership Business Telephone 9 7k - 7 7 5/" 2 760 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter /"? /ert(/�d "YS6 J INSURANCE COVERAGE: I have a curr liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy P(-, Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 1 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 ' , for this n will all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Laws. A By. T of License: Plumber Signature of Lrcen umber or Gas Fitter fitter ster license Number City/Town Fl Journeyman APPRUVED O S O NoDate.... ' L TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING 4L This certifies that ........... . ...... .// .................. haspermission to perform ............... .......... E.:?.. 1............... wiring in the building of ..........4Z ........................................................... at .......... 726-. ....... ............ ........... ... ,North Andover, Mass, Fee!�LK!{L Lic. No..///.�? ............. ........ / ...... ............. ELECTRICAL INSkCTOR (1-7 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THE09MM0NWE4LTH0FM S&4a&SEM Office936141 DEPARTMF.NTOFPUBLICSAFM Permit No. BOARD 0FFIREPREVEM70NRWULATI0AS5270MR 12:00 ' Occupancy &Fees Checked APPLICATION FOR PERMITTO PERFORMUECMCAL 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) Dat Z 9% Town of North Andover To the Ins ecttor of Wires: The undersigned applies for a permit to perform the electrical work described below. MAP �U 7 Location (Street & Number) r t1" t7 Owner or Tenant f Owner's Address f>1Z£Sr Is this permit in conjunction with a building permit: Yes ® No (Check Appropriate Box) Purpose of Building 'Ft itso SA.Scne,NT 1"�L�y t2oc> �•• Utility Authorization No. Existing Service -2— 040� Amps Volts Overhead Underground No, of Meters New Service I Amps Volts Overhead Underground No. of Meters Number of Feeders and Ampacity 7 Location and Nature of Proposed Electrical Work 7r0� 4�d No. of Lighting Outlets / No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures 7 Swimming Pool Above Below Generators KVA / C.• and 0 ground No. of Receptacle Outlets / No. of -Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets �V 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 16 Detection/Sounding Devices Local Municipal Oth;r- No. of Dryers Heating Devices KW to a Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP ` e- &-J Lr %1A.fGl C� Av+,EtAk �ove j 2 3c -'"'s t v iksCMG,+ Instra =CuRrageGernalLaws Ihawaa>natLiabtldyh-&m=PobymdtdrgCmVW CotewagecritsakstFrialegivalatt YES ED NO E] 1hawwbrni vandpoof6fsane1othe0ffio,- YES rJ NO r-1 If}Doha,.etjiac WYES, pkwemdic*thetypeofomWbydwckFgttte INSURANCE BOND ODER M ftmeSpe y) EVilatim Date Estimated ValuedElectriral Wak $ WaictDSlart �Jj1EP/iy �e � himDRec}esad Rtxr✓Z1.0 — /2/j"Z Fecal SigttedunJxTr ofpauy. FIRM NAME LieerneNo Licat9ae Sigiragae LiMMISJo BtSimTdNo. AddesS.....��-■-- .. — ._.. AIL TeLNa OWNER'SiNRRANCEWAIVER,IamawxethattheLi=nse t thehummwmaporitsabftWe#valartasc *iWbyh4mmdn&CmedLam aodtha[mysigtratueonthsparr*�.ayanvvai�ihisragtrQar�att. `� (Please check one) Owner Agent Telephone No. y� �-�� yid / PERMIT FEEU v Location 99 U i b.2 -IT ST No. 4�i.r� Date - qS TOWN OF NORTH ANDOVER • L inwilSIAL p Certificate of Occupancy $ ""— > Building/Frame Permit Fee $ "SA IM„5 <� Foundation Permit Fee $ 0 Other Permit Fee Sewer Connection Fee Water Connection Fee TOTAL r'945040.00 PAID $ -- 0- Q v Building Inspector Div. Public Works (ICAU TOZE-LT �:-7 Location No. � U�O Date • 4. �r 4 NpR7" TOWN OF NORTH ANDOVER A Certificate of Occupancy $ V Building/Frame Permit Fee $ g Foundation Permit Fee $ t Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector N l Div. Public Works TOTAL � $ �uflldi Insnectori .� y ^ Div. P4611prWorks Z/ ---I Location No. /+ �:'�0 Date . � TOWN OF NORTH ANDOVER 5 •'`t o .'ti� f 0 c= Certificate of Occupancy $ Building/Frame Permit Fee $ �AtNUS Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ ' Water Connection Fee $ _r TOTAL � $ �uflldi Insnectori .� y ^ Div. P4611prWorks . - I Mum NO. MAP j-40 • APPLICATION FOR PERMIT TO BUILD _ - J ZONE LOT NORTH AN. MASS. / . .L SUB DIV. LOT NO 2 RECORD pF LOCATION a OWNERSI-Ilp PAGE 1 �fpDATE (BOOK `h3�'YNER'S NAME n ►' OWNER'S ADDR Cr P RU POAGE SE OF BUILDING / I-�- ESS AR HITECT'S O C No. OF STORIES NAME troll Q S• BASEMENT OR SLAB SIZE ^ 0 �+ BUILDER'S Nq ME ,/,/�� a ' t SIZE OFF `�osao ��ti DISTANCE TO NEAREST pUILDING LOOR TIMBERS • �'L �S SPAN IST � 1� fO 2ND 'd�10 DISTANCE FROM STREET / JC 3RD DISTANCE FROM LOT LINES - x5D DIMENSIONS OF SILLS SIDES �— XXb AREA OF LOT 3' /�� POSTS - REAR 3/ N IS BUILDING NEW �•O� ACTe S FRONTAGE DERS Y. S Q, HEIGHT OF FOUNDATION IS BUILDING ADDITION IS BUILDING ALTERATION /:.iU SIZE OF FOOTING THICKNESS MATERIAL /f X WILL BUILDING CONFORM TO RNO OF CHIMNEY BOARD OF AppEALS ACTION. CUIREMENTS pF IS BUILDING ON SOLID p SGN p - CODE R FILLED LAND IF ANY IS BUILDING CONNECTED TO TpyyN Sat/ IS BUILDINGW ITER CONNECTE IS BUILDD TO TOWN SEWER a ING CONNECTED TO N v INSTRUCTIONS NATURAL GAS SEE BOTH LINE SEE SIDES PERMIT FOR FOUNDATION pi, 1 3 INFORMATION PAGE f FILL OUT SECTIONS REGULATED BY DATION ONLY LAND COBT PAGE 2 FILL OUT SECTIONS , 12 PARA. 114.E-5. B C. EST. BLDG. COST 86 i'll �fs� B.C. EST. BLDG. COST PER S -`+ ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING N DATE 8 [qr ' Q. FT. FEE PAID �� C,1 EST. BLDG. COST PER ROOM ATTACHED GARAGES MUST CONFORM TO d / /r //�� SEPTIC PERMIT O. STAT� E FIRE REGULATIONS ✓vv PLANS MUST BE FILED AND APPROVED BY 4 BUILDING INBpECTOR APPROVED BY DATE FILED SIGNATURE OF FEE PERMIT GRANTED 19 —DATE- 4-7�qcFEE PAI v �p� s� • OWNER TEL. # IF 6� CONTR. TEL. X - 6a8/ CONTR. LIC. # Q.z H.I.C. # 81 Z 2 c6L4 — bs�g— BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES B'M'T APARTMENTS ELECTRIC _ CONSTRUCTION 2 FOUNDATION _ _ 8 INTERIOR FINISH CONCRETE PINE d 1 �/ 2 I3 ✓ CONCRETE BL K. BRICK OR STONE HARDW D _ Y 600, _ PIERS PLASTER DRY WALL _ UNFIN 3 BASEMENT AREA FULL '/, 1/2 V. NO B M FIN. B TAREA FIN. ATTIC AREA FIRE PLACES HEAD ROOM MODERN KITCHEN folo 4 WALLS I 9 FLOORS CLAPBOARDS / B 1 2 �_ 3 DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY _ HARDW D COMMCN _ _ ASPH. TILE STUCCO ON FRAME BRICK 6NMASONRY BRICK. ON FRAME _ ATTIC STRS. & FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR(POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. 12 flX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES wO LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR zol TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM _ STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA. RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. �` • "" '' „' -"y' � B'M'T 2nd 13rd I ELECTRIC "� •rte• r•f�. lst NO HEATING`. l.'.^,r.?. c � 'C d 'v O CD 0 Z CO) C-1, O CL r C O0-► O CO) O C v CD Q O Q CD CD O CD P. C CD C*,) CD CZ O y O I COD F v y O 10 Z CD oCD 0 c CD 0 E 0 zrm Cn n \1J O 0 m O O m 0 CO CD m c d O N cm0 CD H N c 0 0� rn y z �. ? N — � .► 6,0 C O _ dO�m y C C y O m CD CD n Go Go G m ._.► C •O•► 0 T C a?m O o o CO) O O ?m O yIE = O ca n .CD CD O .. Zen O h n CD -0 =rN 9. CL o CD CD coo �0 C"� n CD h O co, KIM = d C r = t� CD CM $ m ca H CD m m H ^ �y D n O H COD m CD y T m 1`w CD d b 4 o bo cis o . _ •• Z � � O �. t , V • r � a H 0 9 0 P=h r v cn c O (D zK/tz CD "� 6,0 C O w < C l/ p� C y C C rD T1 O n ry�w 1.x.1 n d �- z r z C Ej CD o d y � y z ril o a 4( b3 O C FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *************`***Applicant fills out.this section***************** APPLICANT: lam? ,� � �rr?��� p�y� . e!�-)X/J Phone 6rZ 2-326) LOCATION: Assessor's Map Number Parcel Z Subdivision ja `f ��� Lot (s) 2,11 Street ir�ae9, S�, St. Number `lam ************************Official Use Only************************ RECOMMENDATION OF OWN GENTS: Date Approved v S Conservation Administrator Date Rejected Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Date Rejected Date Approved Date Rejected Date Approved 611;71q5— Date Rejected Public Works - sewer/water connections X1.0 - driveway perm' Fire Department Received by Building Inspector Date j, -kto O �: r ac4, *% rn tb Vtomw, t.IA_l n�7 1 v1C/Ot I �•\ � / �1► -� � �\ \ w� � oaf/// �i ub N� Jr g �E \• X i J � � a v1 � I! �z J � �� �-2. f 2 t��ttm,o3E I i to p r s±woo 4k a o N U `, `�,•,`Ni N ,N �� �'9 , 0313'130109 410 uti � Aj' 0j C LA BA _.cpA z d O ao y i i a c 0 n took l 4v a4�` 1 Z ! o r7- 110 _� Lh e w titi�ti j wo " oyti Otis ti -4 Z `$ /• ftp ��•, � � t s4.i• 6z• 91t0 S Z,60• o A o � LO rn O I rn OCN3 rV-�C L�7 Z C.� O Q J � � 0 o 0 � Op � o o rm oe � o � LO rn O I rn OCN3 rV-�C L�7 O V V � 0 o 0 � Op � o o rm oe � r t � 1 I v o P : p D O - v0 C n D Cr o xp ► A o ccoo 0 D f7 c N a \ 0 rn N IEZ N _ s 7 TI o (D -gyp c (n 0 fs CL r4- II -q Oo CD X 0 0 0 ► .0- -'7IE O I 0 0 o cn LO � 1 co n. � d x r 00 O ► 1 Q 77 N Nn W N x M I x ' 00 ®Z N x 4%. 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N n W N x M 1 x -pt OD F N .06 Cs rn 00fi I • C=) 9- 0 m � 0- O ®\—I� p 1 �y S N :*E O p cm " 5 oo�•N f N C 0a a- a A. a. o " o �' �' n 1— � o t� x c EF . - �• ao O O NNr 1 O< N W �v x 7 'o i a �c o I to o ® o 0 -4 x�. rn O 'mO b o CD N y N� CC) > oD rn O 0''2 G-) o CL t� s N N O O E LO N 0 x c O . a: C C13 o_ 0 ~' a a La m (D M ,-.- 1 4 MI W m M W/�.� E VJ O O o m � z � g { � � x U O s O rn X 00 x PI) o xLL N O I N N � b N o O � u m c� R c O m � X 4 E • • X N N r' d L� rr_ I L tD X O N ` O x N s0 • aEi I E m a � aEi E a ao OM t— N II 0 D 7 MC ? I X0-5 = o x n O0 0rN O Q ,N+D rn Ea N W G7 x \ ton CD ®fO7 g< O C% oYV rn O - \ No_ II 0 _ N x O X O-P 0 cn rn = n x p C- ° I N X o 0 c° 0 O Oco ()C) Do KL o T m O Z \ N II 0 = x f7 CD CD CD Co CD XNTSl CD � LO \WO> Nx O <O .� rn O 0 CD a- cn 0 0 0 -4, t0 0 N N ►v_+ I I x \ I U) co N NN O Q CD d 1 1 x (� Ocr `< .p N to T 0 0 C . r CD m RC m O CD —Z-I TO /V p �N 00 o 5. N y 0 _0 N 0 O x -*x 5' �� to D < Cj oo • O a cn 0 + N N N0 D N a 0 cD Ily IlYLA :3 to CD _ C)-' _cso - s O v ^r J O � I I ^ Oo O ► 00 N N ooxx • oon C z �0 O�•N rnrn x A OCT CD U) Z =CD �, o L„ �a o�� a co z Ln, 00 o ► N 0 p ' 0 O O co I r Location �r aa C:oz�� No. ' �� Date NaRTM TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ Building/Frame Permit Fee $ `' ZSACNUSEt� F undation Permit Fee $ ��irtiev er It F e $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector Div. Public Works 0 IiaENN H.P. NELSON " ; _ - 4r --Town of "cc`o, NORTH ANDOVER BUILDI\G CONSERVATION DWWON OF PLA HEALTH NNINc; PLANNING & CONi MUNITY DEVELOPMENT PL:I CHIMNEY APPLICATION AND PERMIT DATE ��e ,� ) C► LOCATION OWNER'S NAi•1E BUILDER'S NAME MASON'S NAME EN iv U � � t f 120 Main Street 01845 (508) 682-6483 - PERMIT 14!- MAS0141 S ADDRESS alb 6 rAW V 1 / / MASON I S TELEPHONE J, 0 3Q MATERIAL OF CHI?PIE' -�Jr/ c �-- INTERIOR CHI14NEY EYTERIOR C:-tI �.NEY NUMBER AND SIZE OF TTTTrC PYi�, TH;C_,aTESS OF HEARTH �� 1 Wil'_ chimnev or f_renlace co..for- to requirements of the code an have rules and recu'_at-c:.s bee:: received: UA Dt t.r /J/ SIGNATURE OF MASON CO"TR. LIC. 1 ry / R5;'^ _ CCNSTRUCTION CLS i .' C0 : l ,CT' PFcICE PER14IT GRAPiTED ROBERT NICETTA, BU7-D-"- 11 INSPECTED REMARKS FEE G 00 ��- OR ..^ _ C { REQUIRED THIS PERMIT IMUS T BE DISPLAYED ON THE PREi-IISES ' 10-04-1905 2 : 1 1 PA � 00H COLUPJ I AL 'v I LLAGF SOS 682 2:397 P. 2 09-27-1995 'Y' T — S c-- 9P x4.42 215001331 1111 TJBEAMA Jackson Lumber Company 215 Marke* Street Lawrence, MA 01843 USA Phone: 508-696-4141 -------------------------------- ------------- ------------------------------------------------- Name: bark Torrisi Project NaL- it Village Page Title: lot 1 Forest street File Name: COL Based on Allowable Stress Desim: (ASi, 60CA building code for TJM products available through Distribution Application........ Floor- Res. Deflection Criteria ( R) Member Use ................. BEAM Load Classification....... Floor Li Defl TL Defl Member Top Slope(in/ft)... 0,000 Load Duration Factor....... 1.00 Span 1 L 360 L/240 Roof Slope(in/ft)......... 0.000 Live Load(psf)............. 70.0 Floor Decking.. ... ........ H/A Dead Load (psf)............. 30.0 Repetitive Member Use....... N/A Tributary Width('-").., 14- 0.00 Reinforced Overhangs........ N/A 4 Pcs of 1.75" x 18" Microllam(TM) ES LVL 2.OE 21'- 0.00" " ------------------------------------- S 1 2 E A N A L Y S I S - A S D ----------------------------------------- This analysis for TJM products only! Substitution voids this analysis. IMPORTANT! The analysis presented below is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of its products by this software will be accomplished in accordance with TJM product design criteria and code accepted design values. The specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not been reviewed by a TJM Associate. The maximum unbraced length(s) shown are based on the controlling compressive forces on either the top or bottom edges of the member. Lateral bracing needs to be properly attached and positioned to achieve stability. Note: See Residential Products Reference Guide for multiple ply connection. Maximum Design Allowable Control Shear(lb) 15065 12913 < 23317 181% LT. end Span 1 under Floor loading Moment(ft-lb) 79093 79093 < 87194 110% MID Span 1 under Floor loading Live Defl.(in) 0.680 < 0.700 L/371 MID Span I under Floor loading Total Defl.(in) 0.995 < 1.050 L/253 MID Span 1 under Floor loading Span 1 Max. Reaction Total(lb) 15065 15065 Live(lb) qL 10290 ;Required Brg. Length(i 5.06 W) 5.06(0) -Max. Unbraced Length(in 32 OCT 5 Copyright (c) 1995 by Trus Joist MacMillan, a limited partnership, Boise, Idaho. Microllam(TM) and TJ-Beam(TM) are trademarks of Trus Joist MacMillan. 0 5083723960 ` 91.6 �•dD.S�Do� M4 EASEMENT i o EXIST.FND. , LOT -2A AM -2.0/ AC.i DRIVEWAY & urUlrl' l _ _1£XCLUS/VE USE EASEMENT EASEMENT 0 Akre EXCLUSIVE USE EASEMENT FOUNDATION LOCATION PLAN CLIENT: COLONIAL VILLAGE DEV. CORP. THIS CERMICArroN IS MADE AND LIMITED TO THE ABOVE CLIENT. LOCATION: LMA FOREST ST.,NO.ANDOVER,MA. SCALE:1 r 100' DA M-8125195 CHRISTIANSEN &SERGI s IAO SWAM Sr. IiMtRNL4 W. OraW TEL sae-J7J-Wr0 Q im or amoriANsm t s[1IIID/ W. P03 I cin" nar rra' r=Nffr srmxrwr[ SNOD'N COMM ro na HaYla M?AL WWCA' MUMrMM ar nrW L UCM APPiACAKE JUNM Or' -LAWS ar ERECT *XN omr rMXjM OW CEApFR GnW ODE'S Nor OMI M ANY onN'M Ai'SfWNM such As C1MUMrs,lYl7IANWASMNTx owanK or oomp"W n c.) TM DMWMro 9MU Nor K (W BY rW C" FOR ANr PURPME anAEQ TMW TNAr OUMMED AsovICAMPr MW "W MWEN PERNESADN OF CNMSIUM i R SM MC RM"PAM l ITIS DRAW= IS TW COMMON/ MkVq tlr Or CNA' IWIStN • SPW AAS AND ANY UNAUINOWW WE 6 PNOrAMYnMONWUNWX M SUM TARES AV NESPUASMHAr rM YW iMfAUIOXWP U!f Or IM AR WM W ANY MMAI, MAWN COAfMAM /LAMM DWC. NO.: 94003017 cn -v CD T m � z z �Tdd S Cj C o ncz Chi C1 ? 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N J o o a L n0LL>G V- IL 0) m a 13 G J moao�>0 O m a m m m a 0 (1) Z aE Q J W J J h0 O v o ON O O aF-NtJ Um is e me 0 aQ DO � UVuc'_� E o(D X .... a 0 �m w U O=WN & o W ko J c� t Q . '� tI4 N W 0 Q OZ I- W 0 00 g oO Z a 02 MCO O� Q J tq o Y ag , O O 0 LL a0 ui Z W= W� O J W Qd W� O O UO3~> p Q WO wZ —� a L- Q ccU1W U AMU) O= f X00 Loo o 01Z a oLLaQ N N fQ C 0 a 0 80 a A v of cc rn N U ..o CA 00 .J.. r_ P � e0 0 Z"a O� oo rflow z ma ZN� > ° O f Z, O o� F C W % Z aE c c a Z a lzO W J J O v o ON � C FVQ Z `a'$ Q� U.Uva Z me MM Zoo C4 M . DO � F :7 Q if ! I' Z CoCc y ,' U O=WN & o W ko J c� t >mm . '� tI4 N W 0 Q m 2 CA Q I- W 0 00 g O Z a 02 MCO 4 000 4/ CD U , J '- o a o U ~aW c F� O F- = m z to O � U a.. o a in N N fQ r r M r A i0 a m m.. N e wum0 m : >-a>> co _J -a m Eco E Z Q E 7 W U U w N U o'"v� Q12LLCh w209900!P O V- V- N O g 001 0 a-� N �����- me a..�.. d 4) ;5a LL Z cQ`QEa�p LL CLIA. CLL. m`� a -U 0 LL -p c m O W U C1'C O U �7)Q�L- w>~c9Ua� Z W N W W cco Li: *W, ., wLL__ UUP mt C6 mU rn _ 8000°Tm MY E EU O 7l0 X(a.SSC w co ►-m Lt_=wmYW coCo N z UNC9LL U LLL0� 0 i= o o (D = 2�F- F- - m �o� m c W U)cn12wMLL 1:U -U -U cn C 0 SK 8820 PG 3020 DEED a We STEPHEN G. DALY and MAUREEN A. DALY of North Andover, Massachusetts 0 ra a in consideration of Five Hundred fifty -One Thousand Fibre Il undred and 00/100 4 {$551,500.00} Dollars ra 0 z - grant to MICHAEL C. FORASTE and KERRY E-. kORASTE as -husband -and wife vtenants by the entirety, both of 990 Forest Street, North Andover, Massachusetts 01845 aU W 4J with QUITCLAIM COVENANTS, m 0A certain parcel of land with buildings thoreon, in North Andover, Essex County, Massachusetts, being shown as Lot- 2A inclusive of Parcel A on plan of land recorded v with the Essex North District Registry of Deeds as Plan #12523, dated Dwerriber 30, 1994, to which Plan reference is made for a more particular description of said Lot 2A :. } .. and Parcel A. See also plans recorded with said Registry of Deeds as Plan #12663 and Plan#12701. /m 14 Said Lot 2A and Parcel A contain 87,641 squarc feet all as referenced in said Plan. 4J Subject to and with the benefit of restrictions, easements, conditions, rights of Way of 4) record, if any, insofar as the same may be in force and applicable. 04-- 0 a For our title sed Deed. of Colonial Village Devsloprtierit Corporafto r, darted December 1, 1995, and recorded with said Registry of Deeds in Book 4395, Page 241. 4 Witness our hands and seals this 25th day of May, 2004 � 1� or' b'? STEPHEN � :Y 0 - w` o M Ti,;0M / A w MALTREEN A. DAL ,., P Bw r,� M m io w M �O MM � 4 U 2 O �� • M tp O O Oji Ln U OJ [Tl ti o^ ro O t REF pL•a = N h? o O ° h C RI Z M W Q I. cx-, 1 11Z Lu 0 \ 4 Cr to O Wca cn V ZQL oo 0 / 4 Lot" Z V 00 � , ZC 4°y iQ 02 OWE v Q QVh o Z � 3 ►T. H ti02 o T W ti�9• E' p // � � h H W H 51689 99 �' ro a p of �C PL goy o°Q.'' •y�c�^ryo � Z i i � oP � O I � W N C", �y�o2 t ooy, � •� � UA N °c�ak �• >1� W tiR 3QaQ�'K o?oW g1 �(ij �zN `� I N 3Q Za3>oi� titnair �� 18� 39�w N Biu aNI� �i°3x¢v ?243 N 0303 <! ¢�Q ^ f W�`x^��3� 'lW��i V'U� m tow 161 a �+ tnoc QO WO h N 2h �ppOo3 "ass v, cQ,�'`�o �00 mp O a >WW�ytii��'32 w. ZY 3� �� WQ a cwi�W3p 4 I'm �Q m $� �iiw nk iW"ic�i ,ti1-Zoww � ti�QyQ N z Permit NO: 9 511" Date TOWN OF NORTH ANDOVE APPLICATION FOR PLAN EXAMINA ON BUILDING PEkMIT APPLICATION Date Received:L _;0' 0? " IMPORTANT: Applicant must complete all items on this naize I LOCATION / rl Q Fa ra. d S�rtr / Print PROPERTY OWNER Pl,' -d Ao"ra. Sf2 MAP NO.: 169,D PARCEL: a Print ZONING DISTRICT: TYPE AND USE OF BUTI,DING IIICTORIC. DKTRICT VFC F1 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building PSAddition ❑ Alteration ❑ One family ❑ Two or more family No. of units: ❑ Industrial ❑ Repair, replacement ❑ Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving relocation ,Other ❑ Others: ❑ Foundation onl DESCRIPTION OF WORK TO BE PREFORMED c&A rt ,,r I 9,o raX 11 � // 3 c�Gc� W ��i .5'� �� I Z To %vrM n /C � r 0-f 49K%e„ Iden ica on PleAse Tyve or Print Clearly) OWNER: Name: _ i( Phone: 1*7 ci�3 Address: 4\4& DLYLt CONTRACTOR Name: 14 vr,0%y droAt cr Wr6kct l G Phone-� G3)-�� "/6 f 0 Address: /°O i3 CSX P 7 /I2� y, ,� ti / Supervisor's Construction License: 0-,F90317 Exp. Date: 17- o1—/a 7 Home Improvement License: P/9 %d 0 Exp. Date: 101 -?- o 7 ARCHITECT/ENGINEER ,_,JCn;ej ,1 parfw A 2A Name: Phone: Address: /3'r,-Jf4', jM(,,, Reg. No. FEE SCHEDULE: BULDINGPE IT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S. F. / . �-a Total Project Cost :$ �' % / / P x10.00=FEE:$ Check No.: Receipt No.: /0 L, NpRTS p,ND M�AT1pN TO*S pF POPLAN EX ATT L1CATlON R pate Received Tete all items on this p' Pen,,;tN�� ust comp pate ed' pRT ANT :Applicant iTi Issu INIl � m e )eels. LOCATION/ PRGPERTY OWNER P MA BUILDIl`1G OF NT TYPE A� PROVEME point DISTRICT print ZOISVSG YES TpRIC DISTRICT AIS z C),R- Res- Demolitto►► o BE PREFORMED � NM ovin (relocation) T dation onlypF W O DESCR1PTlON Identification 'Please Type or Print Clearly) 0 1 `60 96 O\ e� �i i OBER Narne:............. Address: CONTRACTOR Name: Exp Date: Date: Address: Exp r' stctton License' Super iso s Con Name: Ph°ne: ent License � 00 PERS M . F Home ImprO`iem ON $125 N EER Reg' No. si BASEn 1jECTIE G1N To ESTIAFEEco ARCH E x10 •p4 $10 p0 PER $1000.p0 OF TH Address: � PERMIT ReceiptN° ' BVLDfN FE tat P C Cost T� CheckN°"----------------- - Pale �Of 4 I TypE OF SE Public Sewer W ARGE pI SPpSAC Well L te(septic tank, etc. E' Persons ea Signature of ^ rn ❑ Tanning/M _ ❑ To assage/godY Art Tobacco Sales ❑ ❑ Permanent pumPster on Site Department swimming Pools Pon,, r Building ropriate permit to be e uired forms to be flied out for the app The following is a list Of the rq obtained.Interior Roofing, Siding, Interior Rehabilitation P Permit Application ❑ Building perm Workers Comp Affidavit C.S.L.Licenses A ❑ of H.I.C. AndlOr . ❑ Photo o Contract • ❑ Copy f proposed Interior Work _ ❑ Floor Plan Or Prop Q Addition Or Decks Cpl ❑ Building Permit Application ❑ surveyed Pomp Affidavit ❑ Workers COMP I.C. And C.S.L. Licenses Ian And Photo COPYork With Sprinkler P HEAL1 ❑ Copy Of Contract Elevation Plan Of Proposed W c3Floor/Crossectlo� If Applicable) licable) �MMEr Hydraulic Calculatiocsompliance Report (If App ❑ Mass check Energy ction (Single and TWO Family) Zonin- Zoning De New Constru cisioni. it Application Planning Board pe ❑ Building Perm ❑ Certified Proposed Plot Plan la Licenses Conservation photo Of"-' C. And C.S.L. rinkley plan Ar. pec�sic ❑ Affidavit to Include Sp Water &Sew One To Be Returned) Sewer ❑ Workers Comp plans Te nne� ❑ Two Sets of Building (If Applicable) mp pumpster on site Hydraulic Calculations ❑ Copy Of Contract Energy Compliance Report check the de Registry of ❑ mass Town Clerks office must stamp require the et this recordede or at the Reg special permit was req applicant must then get application B all cases If Appeals that the appeal period is over. The app Board of App recording must be submitted with the building app One copy and proof of Doc: INSPECTIONAL SERVICES DEPARTMENT:8PFoRM05 page 4 of 4 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this paE LOCATION PROPERTY OWN MAP NO.: PARCEL: ♦ - YTIIY71 i%V 1)7777 7'IiT�T&- Print Print ZONING DISTRICT: ATCT"'Pli DNTRICT VFC Fl TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition L3 Two or more family 11 Industrial ❑ Alteration No. of units: ❑ Assessory Bldg ❑ Repair, replacement ❑ Commercial ❑ Demolition ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO 13E P-I(EPUE-MtV, Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ x10.00=FEE:$ Check No.: Receipt No.: Page I of 4 a Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks o Building Permit Application o Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DF.PARTMENTMFORM05 Page 4 of 4 TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art E]g Swimming Pools ❑ ' Public Sewer ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private ❑ Permanent Dumpster on Site ❑ (septic tank, etc. Electric Meter location to project NOTE: Persons contracting with unregister d actors do not have access to the guaranty fund 4. Signature of Agent/Own Signature of contr ctor Plans Submitted ❑ lans aived ❑ Certified Plot Plan ❑St ped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS ATE REJECTED DATE APPROVED CONSERVATIO COMMENTS DATE REJECTED DATE PROVED HEALTH ❑ ❑ 71--3/L OMMENTS Lonmg Board ot-Appeals: Variance, Petition Zoning Decision/receipt submitted yes Planning Board Decision: Comm Conservation Decisi Comments Water & Sewer connection/Signature & Date Drivewav Permit Temp Dumpster on site yes—no— Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required I Provided DIMENSION Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. NOTES and DATA — (For department use Page 3 of 4 Doc: INSPECTIONAL SERVICES DEPARTMENT BPFORM05 Created JMC. Jan.2006 Location % NO. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ sACNUS t Building/Frame Permit Fee $ Z21 Foundation Permit Fee $ � Check # 0 "-- Other Permit Fee $ TOTAL $ f C - uilding Inspector m m m m m y mm v y d C •C O Cos CD Z y CD O n• O CL = y c v `D CD o CLQ "cdCD CD cm C CCD y Q, v y O co C 0 b 51 l „ cn 2 N a O cn t 0 0 as my 0 m� 0. n yogic m 0mOglo y � m o m _ omo �o�� o 0 Zs n o a y 0 CL '* " goy\" �n CD a Cl V1 d y :o W— a 1 m O y yam: m O 'O co .N C0� mo: � O 'D O O m y co co 0, . 0 0d: CL 0 0 n1 n}, .i o : �a 4K V OITA% s O .a o 2r�� O mD 1 0 c IN, . / ' i `t:*sc:of�Deeds } ` ' - ' .� 381 Common- Streer . Lawrence, Massachusetts 01840 ' ! � ` ' . ` ! 0x3x06 .� ` ruRAST E KD ^ ./ DOC. �121,2283 C. P. 20.00 ' R. D. 5. 00 #�'51 "29 Ce -t. Copies 4, 00 '^ ` ^ otal .,' _ � 77. 00 . ` � -�--��-77. `00- ^ THANK YOU! Thomas J. Burke frk Time Stamp F'ir,L" CE� ,xtf k_ ppir'q nc-cnr •" 2006 JUN 27 PM 4: ! 0 WN 101 IF ZONING BOARD OF APPEALS NO H AN Dr` iMASSACHUSET Community Development Division The Board finds that owing to circumstances relating to the soil conditions the shape of 990 Forest Street (Map 105.D Parcel 2), and the single-family dwelling's existing location on the parcel, especially affects this land and structure but does not affect generally the Residential 1 zoning district in which it is located, a literal enforcement of the provisions of Paragraph 7.3 & Table 2 would involve substantial financial hardship to the petitioner if the variance were not granted. The Board finds that the 100' Conservation Commission Buffer Zone bisects the existing dwelling and that the 50' No -Build Zone bisects the parcel to the right of the dwelling, requiring the applicant to obtain the Conservation Commission's Abbreviated Order of Condition 242-1323. The Board finds that the existing attached garage is 30' (+-) from the left side setback. The Board finds that the applicant would need to raze the existing attached garage in order for the proposed deck to avoid both zoning and conservation setbacks. The Board finds that the left side abutter, Derrick Paul Davies, 980 Forest Street, wrote a letter dated March 26, 2006 in support of the variance for the deck, and that there was no written or spoken opposition. The Board finds that desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the North Andover Bylaw. Note: 1. This decision shall not be in effect until a copy of this decision is recorded at the Essex County Registry of Deeds, Northern District at the applicant's expense. 2. 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. Furthermom, 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. own ,of North Andover of Appeals, A �* � #Y.4 75.41 Ellen . McIntyre, C Decision 2006-008. M105.DP2. Page 2 of 2 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9541 Fax 918.688.9542 Web www.townofnorthandover.com .V* 0 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. 0 a� ZONING BOARD OF APPEALS Community Development Division Notice of Decision Year 2006 ED1ime Stamp R E CTf lnV TuNIN, CLERK'S ^`"FICE 2006 JUN 27 Ply 4: 15 t Vt"T:i u NORTH H ^. -j-HVER MASSACFC30 -;'S 40A, §17 Proat: 990 Forest Street NAME: Michael Foraste HEARING(S): April it & May 10, 2006 ADDRESS: 990 Forest Street PETITION: 2006-008 North Andover, MA 01845 TYPING DATE: May 15, 2006 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 Wednesday, May 10, 2006 at 7:30 PM upon the application of Michael Forast6, 990 Forest Street (Map 105.1), Parcel 2), North Andover requesting a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of the rear setback in order to build a proposed deck. Said premise affected is property with frontage on the North side of Forest Street within the R 1 zoning district. Legal notices were sent to all names on the abutter's list and were published in the Eagle -Tribune, a newspaper of general circulation in the Town of North . Andover, on March 27 & April 3, 2006. The following voting members were present: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, 10 David R. Webster, and Daniel S. Braese. The following non-voting member was present: Thomas D. Ippolito. Upon a motion by Richard J. Byers and 2°a by David R. Webster, the Board voted to GRANT a dimensional Variance from Section 7, Paragraph 7.3 and Table 2 of the Zoning Bylaw for relief of 15.9' from the rear setback in order to construct a proposed deck per: Site: 990 Forest Street Map 105.1) Parcel 2), North Andover, MA 10845 Site Plan Title: Permit Site Plan for 990 Forest St., North Andover, Massachusetts 01845, prepared for: Kerry Foraste, Michael Foraste Date (& Revised Dates): 3/9/06 Registered Professional Architect/Land Surveyor William M. Damour, P.L.S. #31307, Wm. M. Damour, P.L.S., Burlington, MA With the following condition: 1. Either the existing shed shall be moved within the 30' sidelrear setback or the existing shed shall be submitted to the Zoning Board of Appeals for a Variance from the 30' side/rear setback requirements of 7.3 & Table 2 for stmctures in the Residential 1 zoning district in order to receive the final building inspection signature. CD ry ry kv CIO W Voting in favor: Ellen P. McIntyre, Richard J. Byers, Albert P. Manzi, III, David R- Webster, and Daniel S. Braese. ATTEST. A True Copy Page 1 of 2r g7 Q 4,w4A",,- Towrt Clerk 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 918.688.9541 Fax 918.688.9542 Web www.townofnorthandover.com ' "K 9824 PG I Massachusetts Department of Environmental Protection Bureau of Resource Proteatlon - Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.L. c.131, §40 .4b&eev1,*r-e6 A. General Information Imports! ,Fn�m: North Andover When filling1. Conservation Commission out forms on Q. Zip Co&& the computer, 2. This Issuance is for (check one): ® Order of Conditions ❑ Amended Order of Conditions use only the tab key to 3. To: Applicant: move your b. Csylrownrn cursor- do not Michael Foraste use the return a. First Name b. Last Name C. Company key, 990 Forest Street d. Malling Address ou North Andover MA. 01845 a. Cltyrrown f. Stub g. Zip Code 4. Property Owner (if different from applicant): Sarno rn a. First Noma - b. UM Norm O. Company Gry s. 6. Y. S. d. e. Cbyrrown Project Location: 990 Forest Street a. Strom Address Map 1050 a Assessors MaWat Number Latitude and Longitude, if known (note: electronic filers will dick for GIS locator): d. ParteUl.ot Number a. Lo tude f. Longhudo Prope=rty recorded at the Registry of Deeds for (attach additional Informatlon If more than one pard: Essex North w a. County b. CortiAaate (V molatsred land) 4396 241 C. Book d. Page 7/1105 Q Dates: a. Data Nodo of Intent Filed b. DOW Public Hoeft Closed C' Date of Issuance Final Approved Plans and Other Documents (attach additional plan or document references as needed): Permit Site Pian foo 990 F a. Plan Title Hancock Associates John Gilbert Dioks'I , i..S _, b. Prepared By C. Signed and Stomped by 6!23105 1" - 20' d. Final Rovislon Dais e. Scab f. Additional Plan or Document We 9. Date 9. Total WPA Fee Paid: $ 215.00 .$42.50 $172.50 a. TOW Fee Paid b. Stats Fee Paid a. CWrmn Fee paid wpdmn&dm- MV. amos wpoo I ora .» f. state Q. Zip Co&& North Andover b. Csylrownrn Parcel 2 ( 6+ 2 A N d. ParteUl.ot Number a. Lo tude f. Longhudo Prope=rty recorded at the Registry of Deeds for (attach additional Informatlon If more than one pard: Essex North w a. County b. CortiAaate (V molatsred land) 4396 241 C. Book d. Page 7/1105 Q Dates: a. Data Nodo of Intent Filed b. DOW Public Hoeft Closed C' Date of Issuance Final Approved Plans and Other Documents (attach additional plan or document references as needed): Permit Site Pian foo 990 F a. Plan Title Hancock Associates John Gilbert Dioks'I , i..S _, b. Prepared By C. Signed and Stomped by 6!23105 1" - 20' d. Final Rovislon Dais e. Scab f. Additional Plan or Document We 9. Date 9. Total WPA Fee Paid: $ 215.00 .$42.50 $172.50 a. TOW Fee Paid b. Stats Fee Paid a. CWrmn Fee paid wpdmn&dm- MV. amos wpoo I ora K 9824 PG 2 Massachusetts Department of Environmental Protection r�� DEP File Numb Bureau o1` Resource Protection -Wetlands er. �bb L) WPA Form 5 �- Order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above -referenced Notice of Intent and based on the Information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed Is significant to the foilawing interests of the Wetlands Protection Act Check all that apply: a. ® Public Water Supply d. ® Private Water Supply b. ❑ Land Containing Shellfish a ® Prevention of Pollution e. ❑ Fisheries t. ® Protection of Wildlife Habitat tr ® Groundwater Supply h. 0 Storm Damage Prevention L ® Flood Control z. This Commission hereby finds the project, as proposed, I& (check one of the fokwAng boxes) Approved subject to: ® the following conditions which are necessary in accordance with the performance standards set brth In the wetlands regulations. This Commission orders that all work shalt be perk med In accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shill control. Denied because: ❑ the proposed work cannot be conditioned to reset the performance standards set forth in the welland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Invent is submitted which provides measures which are adequate to protect these interests, and a final Oilier of Conditions is issued. A descriptlon of the par1W=ncs standards whi tt the proposed work cannot moat Is attached to this Order. ❑ the information submitted by the applicant is not sufficlent to describe the site, the work, or the effect of the work on the interests Identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions Is issued. A description of the specific Information which is lacking and why It Is necessary is attached to this Order as per 310 CMR 10.011(8)(c). Inland Resource Area Impacts., Check all that apply below. (For Approvals Only) ❑ Buffer Zona Impacts: Shortest distance between limit of project disturbance and wetland boundary (if available) linwfaet Resources Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 3. ❑ Bank aa. Omar feetfeet b. linear Iter a bow few d. linear fast 4. ❑ Bordering Vegetated Wetland 2,$guar* feint b. square testiest c. rquwro feet d. square feet 8. ❑ Land Under a. square test b. square W a square teatteat d. square feet Waterrbodles and Waterways a. cu.yd drafted t cu.ya dmd>�eddradW vpd0 m&doe • nv. 3nra6 Pap 2 d e wpoftnUce• rwr.3MM PpN3de BK 9824 PG 3 Massachusetts Department of Environmental Protection -- Bureau of Resource Protection - Wetlands AUrw4 DEP File Number. WPA Form 5 -- Order of Conditions 2,Q-1U3 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 S. Findings (cant.) Resource Ares Proposed Penrnitted Proposed Permitted Alteration Alteration Replacement Replacement e ❑ Bordering Land Subject to Flooding a. square /bet b. square fleet a square fest d. square /bet Cubic Feet Flood Storage e. rublecuble feet tt cubic feet 0. cubic fast h. cubic feet 7. ❑ Isolated land Subject to Flooding _ a. square foo b. square teat Cubic Feet Flood storage _ a cu ice Leet i7aft hufast ae. arbla testiest L comic teat a. ❑ Riverfront area a. total sq. fast b. total sq. fast Sq ft within 100 ft e. square fest d. square het V. square fed. t, square ibat Sq It between 100-200 ft p. square feet t square feet e, square hat t square het Contac Resouncs Area Impala: Check all that apply below. (For Approvals Only) g' ❑ Designated Pon AreasIndicate size under Land Under the Ocean, below 10. ❑ Land Under the Ocean a. square iset b. sgwnefeet e cu.yd dredged d. cu.yd dredged 11. ❑ Senior Beeches Indicate size under Coastal Beaches and/or Coastal Dunes below 12. ❑ Coastal Beaches a. square feet bb. square testiest o ey nrriaarnt d. sly rrourlahmr. 13. 0 Coastal Dunes a. square tent bb. squarefeet a ay rwuriehrrrt. d. cy nouriehmt 14. ❑ Coasbd Ranks -- a. Amar feet bb.A-- nw �et 16. ❑ Rocky tnterddal Shores a. square het b. square fest is. [] Soft Mathes a. square feet b. square fast r~ square feel d. square feet 17. [] Land Under Salt Ponds a. square feet b. square fW a cu.yd dredged dd. cu.yd dredged 1s. ❑ Land Containing Shellfish a. square feet b. square feu c. square feet d. square feet tg. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, land Under the Ocean, and/or Inland Land Under Waterbodles and Waterways, above a. Myd dredged b. cu.yd dredged 20. ❑ Land Subject to Coastal Storm Flowage a, square fast b. square feu wpoftnUce• rwr.3MM PpN3de L I SK 9824 PG Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands AArevi a-4 DEP File Number: WPA Form 5 -- Order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.L. c. 131, X44 C. General Conditlons Ander Massachusetts Wetlands Protection Act (only applicable to approved proles) I. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Opfer. 2. The Order does not grant any prop" rights or any exclusive privileges; It does not authorize any injury to private properly or invasion of private rights. 3. This Order does not relieve the permifte or any other person of the necessityr of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Omer. 6. Any fill used in connection with this project shall be clean Till. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, piaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded In the Registry of Deeds or the Land Court for tate district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted In the Registry's Grantor index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered lend, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording informabon shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or mon than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" for, OMA DEPT 'File Number 242-1323- - - -- wpaaom%da - mv. 311= Pap 4 d G BK 9824 PG 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP pile Number WPA Form 5 - order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.I. c. 131, §40 C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection Is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. • 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form SA) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to Inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and Inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Deportment for that evaluation. 15. This Order of Conditions shalt apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person perfomrtng work conditioned by this Order. 16. Prior to the start of work, and If the project involves work adjacent to a Bordering Vegetated W aftnd, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once In place, the wetland boundary markere shall be maintained until a Certificate of Compliance has been Issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited In a wetland or water body. During construction, the applicant or his/her designee shall Inspect the erosion controls on a daily basis and shalt remove accumulated sediments as needed. The applicant shall Immediately control any erosion problems that occur at the site and shall also Immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. 18. All worts associated with this Order is required to comply with the Massachusetts Stormwater Policy Standards. If you need mora space for addWanW cond1bris, select box to attach a text document Special Conditions: See attached wp*rmLdn i rev. SMO pap bae BK 9824 PG 6 LlMassachusetts Department of Environmental Protept1lonl E � ! Bureau of Resource Protection - Wetlands j{ e d DEP File Number: WPA Form 5 --Order of Conditions 242-1323 Massachusetts Wetlands Protection Act.M.O.L. c. 131, §40 D. Findings Under Municipal Wetlands Bylaw or ordinance t. Is a municipal wetlands bylaw or ordinance applicable? 0 Yes ❑ No 2. The North Andover hereby finds (check one that applies): conservation commission 3. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: a. Munkipat ondinanco or Byte* b. Citation Therefore, work on this project may not go forward unless and until a revised Notice of intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. s. ® that the foiloaring additional conditions are necessary to comply with a municipal ordinance or bylaw: North Andover Wetland Protection Bylaw Chapter 178 a. Municdpal ordinance or Bylaw b. citation The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submittled with the Notice of Intent, the conditions shall control. tf you need more c. The special conditions relating th municipal ordinance or bylaw are as follows: Space for additional See attached conditions, select boot to attach a text wpdem&dm- my, IIl n Pop$d• DEP FILE * 242 -1323 9824 PG 7 Therefore, the North Andover Conservation Commission (hereafter the "NACC") hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the State Regulations, the local Bylaw and Regulations, to protect those interests noted above. The NACC orders that all work shall be performed in accordance with said conditions and with the Abbreviated Notice of Intent referenced below. To whe extent At ft foll c nditi m or MU frout the pko, s tions or oth owls submitted with the Notice ofIV n# c2aftm shd control. GENERAL CONDiI'1'IONS 18. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 19. This Order does not grant any properly rights or any exclusive privileges; it does not authorize any injury to private property or invasion of property rights. However, the NACC, agent of the NACC or the Department of Environmental Protection (DEP) reserves the right to enter and inspect the property at all reasonable times until a Certificate of Compliance is issued, to evaluate compliance with this Order of Conditions, the Act (310 CMR 10.00), the North Andover Wetland Bylaw and Regulations, and may require any information, measurements, photographs, observations, and/or materials, or may require the submittal of any data or information deemed necessary by the NACC for that evaluation Further, work shall be halted on the site if the NACC, agent or DEP determines that any of the work is not in compliance with this Order of Conditions. Work shall not resume until the NACC is satisfied that the work will comply and has so notified the applicant in writing. 20. This Order dogs not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. 21. The work authorized hereunder shall be completed within three yews from the date of this order. 22. This Order may be extended by the issuing authority for one or more periods of up to one year each upon application to the issuing authority at least thirty days (30) prior to the expiration date of the Order Mxftr to Section 8.3 (p.37) of the North Andover Wetland Regulations). 23. The NACC reserves the right to amend this Girder of Conditions after a legally advertised public hearing if plans or circumstances are changed or if new conditions or information so warrant. c:\WJU"rM0C1990ForMSbwLdoc NACC 7/M005 DEP FILE * 242 -1323 BK 9824 P6 24. Where the Department of Environmental Protection (DEP) is requested to make a determination and to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before the Department. 25. This Order of Conditions is issued under File No. 242-1323. 26. The conditions of this decision shall apply to, and be binding upon, the applicant, owner, its employees and all successors and assigns in interest or control. These obligations shall be expressed in covenants in all deeds to succeeding owners of portions of the property. 27. The term "Applicant" as used in this Order of Conditions shall refer to the owner, any successor in interest or successor in control of the property referenced in the Notice of Intent, supporting documents and this Order of Conditions. The NACC shall be notified in writing within 30 days of all transfers of title of any portion of property that takes place prior to the issuance of a Certificate of Compliance. 28. The proposed work includes: The construction of a 16'x22' deck to an eluting single- family dwelling within the Buffer Zone to Bordering Vegetated Wetlands (BVW). 29. The work shall conform to the following (except as noted in the remainder of this document where revisions may be required): Abbreviated Notice of Intent filed by: Site Flans and ANOI prepared by: Michael Foraste (Applicant) 990 Forest Street North Andover, MA 0x845 Hancock Associates, entitled, "Permit Site Plait for 990 Forest Street", dated June 23, 2005. Stamped & signed by John Gilbert Dick, R.L.S. 30. The following wetland resource areas are affected by the proposed work: Buffer Zone to Bordering Vegetated Wetlands (BVW). These resource areas are significant to the interests of the Act and Town Bylaw as noted above and therein. The applicant has not attempted to overcome the presumption of significance of these resource areas to the identified interests. 31. The NACC agrees with the applicant's deliAeation of the wetland resource areas on the site as shown on the plans dated referenced herein. 32. The NACC finds that the intensive use of the upland areas, Buffer Zone, and Riverfront Resource Area proposed on this site will cause further alteration of the wetland resource areas. In order to prevent any alteration of wetland resource areas a twenty-five foot (257 No -Disturbance Zone and a fifty_ foot (507 No -Construction Zone shall be established from the edge of the adjacent wetland resource area (BVW). The Conservation Administrator and/or other agents of the NACC do not have the authority 2 NACC 7/26/'M DEP FELE # 242 -1323 BK 9824 PG to waive these setbacks as established under the local bylaw. No disturbance of existing grade, soils or vegetation is permitted in the No -Disturbance zone. (See Section 3.4 & Appendix F of the local Regulations). 33. There shalt be no increase in the post development discharges from the storm drainage system or any other changes in post development conditions that alter the post development watershed boundaries as currently depicted in the Abbreviated Notice of Intent and approved by this Order of Conditions, unless specifically approved in writing by the Commission 34. This document shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors, and other personnel performing the permitting work are fully aware of the permits terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order resulting from failure to comply with its conditions. 35. The owners of the project and their successors in title, in the event they proceed to alter areas subject to the Commission's jurisdiction under the order, agree that the Order does not in itself impose upon the Town any responsibility to maintain the proposed drainage system and that said Town shall not be liable for any damage in the event of failure. By acceptance of this Order, the owners agree to indeauiify and hold harmless to the Town and its residents for any damage attributable to alterations undertaken on this property pursuant to the Order, issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. 36. Issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. PRIOR TO CONSTRUCTION 37. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been .filed, until all proceedings before the Department or Court have been completed. 38. This Order shall be recorded by the applicant at the Reghtry of Tweeds immediately after the expiration of all appeal periods. No work shall be undertakenuntil the Final Order has been recorded in the Registry of Deeds or the nand Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In. the cage of registered land, the Final Order shall also be noted on the Land Court Certificate of Title CAWhmWd%00K19WPor=Mtr=Ld9c 3 NACC ?/MOOS DEP FILE # 242 -1323 BK 9824 PS 10 of the owner of the land upon which the proposed work is to be done. The recording Information shall be submitted to the North Andover Conservation Commission on the forst at the end of this Order prior two commencement of the work. Any Order not recorded by the applicant before work commences may be recorded by the NACC at the applicant's expense. 39. A sign shall be displayed at the site not less than two square feet or more than three square Beet in size bearing the words "Massachusetts DEP, File Number 242.1329.,, 40. Any changes in the submitted plans caused by the applicant, another Board's decision Or resulting from this Order of Conditions must be submitted to the NACC for approval prior to implementation If the NACC finds said changes to be significant, the NACC will call for another public hearing (at the expense of the applicant). Within 21 days of the close of said public hearing the NACC will issue an amended or new Order of Conditions. Any errors found in the plans or information submitted by the applicant shall be considered as changes. The proposed project nay be still under review by other local or state boards or agencies. This may result in changes to the project plans or wetland impacts. If any such changes occur a revised plan and an explanation of the revisions shall be submitted to the NACC for review and approval prior to the start of constriction. No work shall begin on a project until written approval has been granted by the NACC. 41. It is the responsibility of the applicant, owner, and/or successor(s) to ensure that all conditions of this Order of Conditions are complied with. The project engineer and contractors are to be provided with a copy of this Girder of Conditions and referenced documents before commencement of construction. 42. Prior to any work commencing onsite, the applicant shall submit to the NACC for approval, a detailed sequence of const action, including the construction of compensation and retention areas, installation of sedimentation/erosion control devices and re -vegetation to be completed before other work begins on-site. 43. Wetland flagging shall be checked prior to start of construction and shall be re- established where missing: All wetland flagging shall remain visible and enumerated per the approved plan(s) throughout the life of the project and until a Certificate of Compliance is issued so that erosion control measures can be properly placed and wetland impacts can be monitored. The proposed limit of work shall be shall be clearly marked with stakes or flags and shall be confirmed by the NACC. Such markers shall be checked and replaced as necessary and shall be maintained until all construction is complete. Workers should be informed that no use of machinery, storage of machinery or materials, stockpiling of soil, or construction.activity is to occur beyond this line at any time. All flags used for the above purposes shall be of a color different from other flagging used on the site. C.-ViewordltNxa1"Opamtstmot.doe 4 NACC 7/MOOS DEP FILE N U2 -1323 BK 9824 PG 11 44. Since the deck sonotubes will be hand dui, erosion controls are not required. However, the NACC reserves the right to impose the use of erosion control (hay bales & silt fence) if the site exhibits erosion, or any noticeable degradation of surface water quality discharging from the site. Should the erosion control be required by the NACC or the Conservation Department, they shall be installed within 48 hours of the request. The erosion control barrier will be properly installed (trenched 4 - 6 -inches into the ground, backed by double -staked hay bales) and shall be inspected and approved by the Conservation Department. These temporary erosion control measures shall remain intact until all disturbed areas have been permanently stabilized to prevent erosion. All erosion prevention and sedimentation protection measures found necessary during construction shall be implemented at the direction of the Department or the NACC. 45. A check payable to the Town of North Andover shall be provided in the amount of $5500, which shall be in all respects satisfactory to Town Counsel, Town Treasurer, and. the NACC, and shall be posted with the North Andover Town Treasurer through the NACC before commencement of work. Said deposit of money shall be conditioned on the completion of all conditions hereof, shall be signed by a party or parties satisfactory to the NACC, and Town Counsel, and shall be released after completion of the project, provided that provisions, satisfactory to the NACC, have been made for performance of any conditions which are of continuing nature. The applicant may propose a monetary release schedule keyed to completion of specific portions of the project for the NACCs review and approval. This condition is issued under the authority of the local Bylaw. 46. Prior to construction, the applicant shall permanently mark the edge of the 28' no - disturbance zone or existing tree line with six (6) markers evenly spaced every Meet incorporating the following text: "Protected Wetland Resource Area". This will designate their sensitivity and assure no further inadvertent encroachment into the wetland. These markers can be purchased at the Conservation Department for $2,00 per marker. These permanent markers are subject to review and approval by the NACC. The applicant shall instruct all agents to explain these markers to buyers/lessees/landscapers and all persons taking over the property from the applicant. 47. The applicant and/or the legal owner of that portion of land upon which these Orders of Conditions have been placed shall provide to the NACC prior to tranaferrirtg, or assigning any portion of said land to another patty, subject to said Orders of Conditions, the "Compliance Certification Form Affidavit" attached via "Appendix A" signed under the pains and penalties of perjury, stating that said applicant and/or owner has read these Orders of Conditions and is in compliance with each and every condition. This document shall apply to each of the conditions referenced herein and shall be provided to the Conservation Department at least five (5) business days prior to the closing of said land transaction. 48. Once these above mentioned pre -construction requirements are complete, the applicant shall contact the Conservation Office prior to site preparation or construction and shall arrange an on-site conference with an NACC representative, the contractor, the engineer, wetland scientist and the applicant to ensure that all of the Conditions of this CAW{nw0rd10W990F0T"t8bVCLd0c S NACC 7/24/2005 BK 9824 PG 1 DTP FILE # 242 -1323 Order are understood. This Order shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors and other personnel performing the permitted work are fully aware of the permit's terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order of Conditions resulting from failure to comply with its conditions. The applicant or contractor shall notify the NACC in writing of the identity of the on-site construction supervisor hired to coordinate construction and to ensure compliance with this Order. A reasonable period of time shall be provided as notice of the pre. construction meeting (e.g. 72 hours). DURING CONSTRUG110N 44. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 50. There shall be no increase in the post development discharges from the storm drainage system or any other changes in post development conditions that alter the post development watershed boundaries as currently depicted in the Abbreviated Notice of lntentand approved by this Order of Conditions, unless specifically approved in writing by the Commission. 51. Water quality of the adjacent BVW shall not differ significantly following completion of the project from the pre -development conditions. There shall be no sedimentation into wetlands or water bodies from discharge pipes or surface runoff leaving the site. 52. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts on any of the foregoing. 53. No exposed area shall remain unfinished for more than thirty (30) days, unless approved by the NACC. N soils are left to idle greater than thirty days, all areas shaD be seeded with rye seed to provide immediate stabilization. 54. The contractor will take all steps necessary to control dust onsite so that adverse effects on adjacent resource areas and / or habitat do not occur. 55. No re -grading in the buffer zone shall have a slope steeper than 2-1 (horizontal: vertical). Slopes of steeper grade shall be rip -rapped or biodegradable erosion controls to provide permanent stabilization. 56. There shall be no stockpiling of soil or other materials within fifty (50) feet of any resource area. CAWinwMiA0 "0F0rMtSftftt 40C b NACC MAM005 DEP FILE # 242 -1323 BK 9824 P 57. Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage system, or wetland resource area. 58. All waste generated by, or assodated with, the construction activity shall be contained within the construction area, and away from any wetland resource area. There shall be no burying of spent construction materials or disposal of waste on the site by any other means. The applicant shall maintain; dumpsters (or other. suitable means) at the site for the storage and removal of such spent construction materials off-site. However, no trash duntpstera will be allowed within 30' of areas subject to protection under the Act or local Bylaw. 59. During and after work on this project, there shall be no discharge or spillage of fuel, or other pollutants into any wetland resource area. If there is a spill or discharge of any pollutant during any phase of construction the NACC shall be notified by the applicant within one (1) business day. No construction vehicles are to be stored within 100 feet of wetland resource areas, and no vehicle refueling, equipment lubrication,, or maintenance is to be done within 100 feet of a resource area. AFM CONSTRUCTION 60. No underground storage of fuel oils shall be allowed on any lot within one hundred (100) feet of any wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's Wetland protection Bylaw. 61. Fertilizers utilized for landscaping and lawn care shall be slow release, low -nitrogen types (< 5%), and shall not be used within 25 feet of a resource area. Pesticides and herbicides shall not be used within 100 feet of a wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's W$tland Protection Bylaw and shall remain in perpetuity. 62. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done either by foaming and seeding according to SCS standards. If the latter course is chosen, stabilization will be considered complete once vegetative cover has been achieved. 63. Upon approved site stabilixation by Conservation staff, the erosion controls shall be removed and properly disposed of and all exposed. unvegetated areas shall be seeded. C:lWtawurdl0lx. MF0te aVftIt &CI 7 NACC 7/2612003 DEP FILE # 242 -1323 B 984 PG 14 64. Upon completion of the project the applicant shall submit the following to the Conservation CanustMon as part of a request for a Cerdfkate of Compliance: a. WPA Form 8A - "Request for a Certificate of Compliance." b. A leiter from the applicant requesting a Certificate of Compliance. c. The name and address of the current landowner. d. Signed statements from the individual property owners shall be submitted with the request for a Certificate of Compliance indicating that they read and understood the recorded Order of Conditions prior to purchasing their property. e. The name and address of the individual/trust or corporation to whom the compliance is to be granted. L The street address and assessor's map/parcel number for the project. g. The DEP file number. h. A written statement from a Registered Professional Civil Engineer (and/or Registered PhWessiiosW Land Surveyor) of the Commonwealth certifying that the work has been conducted as shown on the plan(s) and documents referenced above, and as conditioned by the Commission. i. An "As -Built" plan prepared and signed and stamped by a Registered Professional Civil Engineer (and/or Registered Professional Lund Surveyor) of the Commonwealth, for the public record. This plan will include: "As -Built" post -development elevations and grades of all filled or altered wetland resource areas including the encompassing buffer zone, which is regulated as a resource area under the local Wetland Protection Bylaw. Distances from structures to wetland resource areas. Structures include (but are not limited to) septic systems, additions, fences, sheds, stonewalls, pools, retaining walls, subsurface utilities and decks. A A line showing the limit of work and the extent of existing erosion control devices. "Work" includes any disturbance of soils or vegetation. Location of all subsurface utilities entering the property. CAVA wOMOOOMFOre at,v&dor 8 Nncc Vn6n005 DEP C+'iLE # 242 -1323 urig'K d' 8 2 4 P G 15 65. The following special conditions shall survive the issuance of a Certificate of Compliance (COC) for this project: 25' Na -Disturbance Zone, a 50' NorConstruction Zone shall be established from the edge of adjacent wetland resource areas. Future work within 100' of existing wetland resource areas will re+quire a separate filing with the NACC (refer to Section XI (page 18) of the Regulations for performance standards within these zones) The Conservation Administrator and/or other agents of the NACC do not have the authority to waive these setbacks as established under the local Bylaw (Condition # 32); ➢ Discharge or spillage of pollutants (Condition #59); ➢ Prohibition of underground fuels (Condition #60); Lunitations on the use of fertilizers, herbicides, and pesticides (Condition #61). CAWiawomNoQ( "OForcMSUwLdm 9 NACC 7 MOOS DEP ME 0 242 -1323 BK 9824 PG 1 I, APPENDIX A -- AFFMAVff (auttwrlxed agent of applicant and / or owner) l) 1 am the (position with applicant) on oath do hereby depose and state: 7y (applimes name) the applicant upon whom the Order of Conditions have been (DEP or NACC File #) placed upon by the North Andover Conservation Commission (NACC). and / or 2) I am theof (position with owner) (owner) the owner upon whose land Order of Conditions placed upon by the NACC. (DEI' or NACC File #) have been ♦ I hereby affirm and acknowledge that I have received said Order of Conditions and have read the same and understand each and every condition, which has been set forth in said Order of Conditions. ♦ I hereby affirm and acknowledge that on this _ day of ,20--, I inspected said property together with any and all improvements, which have been made to the same and hereby certify that each and every condition set forth in the Order of Conditions are presently in compliance. ♦ I hereby affirm and acknowledge that this document will be relied upon by the NACC, as well as any potential buyers of said property, which is subject to the Order of Conditions. signed under the pain and penalties of perjury this day of . 20 (Authorized agent of applicant or owner) CAWWwwndQW990F0nW t 96Ldoc to NACC'7/26*M BK 9824 PG 17 Massachusetts, Department of Environmental Pro ction Bureau of Resource Protection - Wetlands DEP File Number. WPA Form 5 - Order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.L. c, 131, §40 E. Issuance This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions $4, from the date of Issuance. i. Diie dF MUQOXS Please indicate the number of members who will sign this form: S' This Omer must be signed by a majority of the Conservation Commission. 2. Number of Slonen The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant A copy also must be mailed or hand deflve-nd at the earns time to the appropriate Department of Environmental Protection Regional , if not filing electronically, and the property owner, if different from applicant Signatures: Notary Aaknowtedyement Commonwealth of Massachusetts County of Essex North On this DayA 7 o1D03- Month Year Before me, the undersigned Notary Public, personally appeared Name or Document signer proved to me through satisfactory evidence of identification, which waste Massachusetts License Description of evidence of ideri f leetion to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for tts started purpose. As member of North Andover CityfTown Conservation Commission ti>�M.MIIILIC aer�� Place notary seal andlor any stamp above This Order is issued to the applicant as foiiaws: R(by hand delivery on oats , oy COrtifled mar, return receipt requested, on Date .poft.. 64010 • (OV. am= ra"rao Massachusetts Department of Environmental Protection 9824 PG 1 Bureau of Resource Protection- Wetlands �bbrwlDEP File Number. d WPA Form 5 - Order of Conditions 242-1323 Massachusetts Wetlands Protection Act M.G.L. c.131, §40 F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ton residents of the city or i*wwn In which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to Issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provide! in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, If he/she is not the appellant. Any appellants seeking to appeal the Departments Superseding Order associated with this appeal will be required to demonstro prior participation in the review of this projol Previous participation In the permit prooesding ,means the submission of written information to the Conservation Commission prior to the dose of the public hearing, requesting a Superseding Order or Determination, or providing written Information to the Department prior to Issuance of a Superseding Order or Determination. The request shall state clearly and concisely the objections to the Orden which Is being appealed and how the Order doers not contribute to the protection of the interests identif ed in the Massachusetts Wetlands Protection Act, (MAL. c.131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order Is based on a muniool ordinance or bylaw, and not on the Mon husetts Wetlands Protection Act or regulations, the Deportment has no appellate jurisdiction. Section G, Recording Inf+orrnalion Is available on the following page. %VPWO. a.dw- nv.am= 1 Pwaae The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name:- - A1; r Ad%d Mveo M.l Location:_ 16 Ao r e-s'y x/ Citv A/or �^ fk 4,,d -t r Phone F-1 am a homeowner performing all work myself. 15� 1 am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Companv name: Address City: Phone #: Insurance Co. Policv # Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify ugaer the Print name 1171 of perjury that the information provided above is true and correct. Official use only do not write in this area to be completed by city or town official' F1 Check if immediate response is required Building Dept Contact person: Phone FORM WORKMAN'S COMPENSATION ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other ` 7V� 1m3t%�F •riJ tib -r r / Lwfi,« tl '.. ' pROp()SALs GUBMITTE0 fib: I L�11 f< tv. At,rs WORK TO BE PERFORMED AT: NO. .,.. '' y51 iu-at'G•a.s3W++�s:.re'P.v�-- rstswts.-w.+-ti- .LLA v We hereby propria to furnish the materials and perform the labor necessary _ f �- to �"' �• „� �' '�' c~..o/tis-- Oct, Ade '"' •C'". �rfr'i ;e ..5" -Y' c t" ." . All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations submitted for above work and completed in a substantial workmanlike manner for the sum of Dollars ($ ¢'(00 C } with payments to be made as follows. 'zoo 'rj"f — 40S` "-o f"k 4`r/'O'pRespectfully submitted Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents, or delays beyond our control. Note—This propose( may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL_ The above prices, specifications and conditions are satisfactory and are heret as specified. Payments will be made as outlined above. 'A Signature Date 311,96 Signature NC 3818-50 PROPOSAL MADE IN USA You are authorized to do the work BOARD OF BUILDING REGULATIONS LiCookw CONSTRUCTION SUPERVISOR Number: CS 088039 91rt wIm 12/05/1975 Expires: 1210512007 Tr. no: 88039 Rcatrictod: 00 MIDI MEL F MURPHY 102 A WEST BROADWAY DERRY, NH 03038 Cammisslarw -- — � — - - - - - • ��Ra' � new �+wr,�i� � , l tit.:;��arl.��i Board of 11aiiding R+egolatie►oc and Staadarda HOME OPROVEMENT CONTRACTOR Rughmilion: 148780 '- tli12512007 Tyw Lid Liab ity C0MMI10n MURPHY BROTMF—RS CONTRACTING, LLC MICHAEL MURPHY 28 STONEPOST CIRCLE RAYMOND, NH 03017 Admlaistrator License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Me, 02108 .. �ewvthout signature —� fiI1A?t NTs 41AIDR laid 1 i�rsi:Iv }�a."i'P"k1F OA >A AW CERTIFICATE OF LIABILITY INSURANCE bwav" PR MM11 Doh" insumnts Aijana y, W. P.D. Bax 9 88 29 Elm Sbut Andover, MA 013iD NIS CERTIFICA19 It ISWED AS A MATTER of 1NFOR tATIBN ONLY AND CONFERS NO RIGHTS UPON T449 DERWIDATB Wt3LDrER. THIS CERT TIFICATE DOES NOT AMEND, VMNO OR ALTER THE COVERAGE AWORDED BY M POUCIES DELOW. I10IiREA11 A"O DINd COMRADE NAIL a IKZURW Murphy Brothers Calntracting. LLC 28 Stanspost clitla Raymond. IIIA 0677 FAa, RD34994- 3 IMl&MMA; at Pauill r>avalars IN ERV, uNMER M INMKIII TM: ISS MR. T'M- POLICIES OF INSURASICE USWD BELOW HAVE BEEN ISSUM TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWUNSTANDINU I ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOC%JMFNT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 91J1 MAY PERTAIN, TAE INSURANCE AFFORDED BY THE POLICIES nFSCRaBED HERRIN IS SUBJECT TO AU vi TERMS, EXCLUSIONS AND CONDITIONS OF SUC14 nru umeb Ar nnenvm i am" eunwu usm HLUF WMa RFn1jft;O AV PAID CLAIMS, DtCMPM 0 t1Pa:R:ATaDMI I LWATIDM3 3 VM=n i MCLIr51 M b DIM SY €NDDR3Eaii M I BP XAU PR OVISIMIS Lawn Campanian, Inc and any and ail subsidiaries is llstad as an additiaml ln4urd far )labiilty arlasing aut of the aparrstlans ai Murphy Statham Contracting, LLC... tHMI C ANY CW "it ASM.ACIIIMSED PCL=M SE tAiN681= DUMM THE COMATM TM OF UMMAM POLICY NWMM 3f [GT' a Warm A IMMURO001JUTIONaRUARLMOFAWIONDUPWM §MW4A IMACEMIre04 tt"rnmuAT m 988282182114 coltai F42AL UENV�L41 LMtan (rY Zz�►uT�Ic>z�co Lumoc=xrc.�= ti DDD-nDD :ti1 y�' ° • �. 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ACORD 211 12o ICS) 9 of 2 208471M2M B V !/ MMS `i"> RD CORPORATION 9088 tHMI C ANY CW "it ASM.ACIIIMSED PCL=M SE tAiN681= DUMM THE COMATM Lawn Compania, Int —AIL 6AV1 WRIT= Pith: ISINSilili C tib ) isMMTortmatmraaennIlatMKNIWItr,Irman, MIT rjr To Mac VAUL PA Box Iiii IMMURO001JUTIONaRUARLMOFAWIONDUPWM §MW4A IMACEMIre04 North Wilkesbata 28838, ND Zz�►uT�Ic>z�co ACORD 211 12o ICS) 9 of 2 208471M2M B V !/ MMS `i"> RD CORPORATION 9088