HomeMy WebLinkAboutMiscellaneous - 61 ABBOTT STREET 8/25/2015 (2) NORTH
Town of North Andover 1"60 ,b111 0
OFFICE OF 0
COMMUNITY DFVELOpMENT AND SERVICES
146 Main Street A OATIO
North Andover, Massachusetts 01845 C U
WILLIAM J.scoTr
Director
Memorandum
To: Robert Nicetta, Building Commissioner
Sandra Starr, Health Director
From: William J. Scott, Community Development Director--
Date: October 21, 1996
Oct 7, 1996
William I Scott, Director
Community Development & Services
Town of North Andover
146 Main St.
North Andover, MA 01845
Re: 61 Abbott St., North Andover, MA 01845
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[IT No. APPLICATION FOR PER TO BUILD — NORTH ANDOVER, MASS. DATE BO/ � _i 7
2 RECORD OF OWNERSHIP i I &� I !7
LOT NO. q/tc � ------ 2 3 2�'�
MAP dJO. _�21L� (�ju�wr..5 IA+� c tF'--
'-ONE —�j StJB DIV. LOT NO. New �,.4C ..
PURPOSE OF BUILDING
SIZE 3�i ZYO W lyt 1{j�a G
LOCATION �I7 e ' �� NO. OF STORIES
OWNER'S NAME �ZIGI: •�i.11i.01/Ih uG �F�V� BASEMENT OR SLAB �A(,&A
6j(� CC1C SIZE OF'FLOOR 1ST �l Y.('L 2ND 3RD ZK/D
OWNER'S ADDRESS Gq've (/
ARCHITECT'S NAM<5,+jk+ ,,J CZ— SPAN
BUILDER'S NAME —j3iZILr (�j.Ji(�O tNS I N c DIMENSIONS OF SI LS
DISTANCE TO NEAREST BUILDING (00 �— POSTS
DISTANCE FROM STREET a6U } GIRDERS u��y(�
!/
REAR D
_ THICKNESS
DISTANCE FROM LOT LINES—SIDES yj O �� FRONTAGE OI�v HEIGHT OF FOUNDATION y(
AREA OF LOT I��{ 315py1% SIZE OF FOOTING
IS BUILDING NEW y(. / MATERIAL OF CHIMNEY ( av,
IS BUILDING ADDITION IS BUILDING ON SOLID OR FILLED LAND 6')(,Iq
IS BUILDING ALTERATION tt-- IS BUILDING CONNECTED TO TOWN WATER N(�
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ��7 (�
IS BUILDING CONNECTED TO TOWN SEWER
rn NATURAL GAS LINE 1✓
BUILDING RECORD
OCCUPANCY 12
LE FAMILY s oR1E5 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
'I. FAMILY OFFICE$ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
-.TMEN I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
FOUNDATION B INTERIOR FINISH
'RETE
;RETE BL K. PINE
ONE
OR ST HARDW D
PLASTER-
DRY WALL _
UNFIN.
BASEMENT
FULL fIN. B M'T AREA
'1 fIN. ATTIC AREA
MT FIRE PLACES
ROOM MODERN KITCHEN .�
WALLS II 9 FLOORS I
II I�� 2
SIDING J
IDING --""""II CONCRETE
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FORK U ® LOT RELEASE FORK
that all necessary
This form is used to varrif having jurisdiction
INSTRUCTIONS: ards and Departments and/or
approvals/permits from Bo or state law,
have been obtained. This does not relieve the
h compliance with any applicable
landowner from complrements.
regulations or requirements.
****************Applicant fills out this section -7 q y o -7 3Y
Phone
"APPLICANT: >Z
� tercel
Assessor' s Map Number _Z
�,-�pCATION" .___Lot(s)
Subdivision — --St. Number
'Street Use Only************************
************************Official
RECOE ATI NS OFJ O AGENTS: 6 g�
/ Date Approved
666 Date Rejected
�y
Conservation Administrator
Comments
j Date Approved
w e6UV68✓
- - Department of•Industrial Accidents
Am"-- - f/ ®®S
' — 600 Washingion Street
_ Boston,Mass• 02111
Workers' Compensation Insurance Affidavit
am C / 73
t l�G h e# 7g
erforming all work myself.
I am a homeowner p any capacity
I am a sole proprietor and have no one working em to ees working on this Job.
to er rovidmg workers' compensation for r P Y
laman emp Y P ..
o n a
who have
insu ce and have hired the contractors listed below
I am a sole proprietor,general contractor,or homeowner(circle one)
rs' compensation polices
the following worke
eom n na e.
address•
Information and Instructions
25 requires all employers to provide workers' compensation for their
Massachusetts General Laws chapter X15 n eml to ee is defined as every person m the service of another under any
employees. As quoted from the law , P Y
contract of hire, express or implied, oral or written.
partnership, association, corporation or other legal
eceased employer,oor or more of
An employer is defined as j individual,en P lovin employees. However the
the foregoing engaged in a joint enterprise, and including a association or other legal entity, emp g cu ant of the
g partnership, as
receiver or trustee of an individual ,p
ntenance , construction or repair work on such dwlnng hnce
owner of a dwelling house having not more than three apartments and who resides therein, or the°C an employer.
own to s ersons to do m
loyment be deemed to e
dwelling house of another who employs P
or on the grounds or building appurtenant thereto shall not because of such employment
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
or permit to operate a business or to construct bW th the insurance overagelrequiredy
renewal of a license p
applicant who has not produced acceptable evidence of c cal subdivisions insurance enter requirements of this chapter have
Additionally, neither the com
monwealth nor any of its political subdivisionse hall enter into any contract for the
performance of public work until acceptable evidence of compliance with t
been presented to the contracting authority.
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77 377 V r
Applicants
letely by checking the box that applies to your situation of and
Please fill in the workers' compensation affidavit comp ,, o be sure to sign and date the affidavit. The
anv names, address and phone numbers as all affidavits may be submitted to the a fil
supplying comp - r,,,ation of insurance coverage. A �L_..-r ;t nr license is being requested,
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120 Main Street'01845
co` r ® - (508) 682
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PL ANNIZ G 8. COti�IL'i
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PLAN OF SUBSURFACE
DISPOSAL SYSTEM
IN
NO. 4AIDOVZ OF
AS PREPARED FOR
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; Syse Pumping
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DEp,has provided this form for use by local Boa rds of Health. The S Mt ' Est
be submitted to the.local'Board of Health or other approving authors -•- .m�W
A:. Facility lnforniation
� ..Imgortant
yVheri filUnq out 1 System Location
computer,, ,/
fo the tom✓ e
use � ' "
only the tab key Address
to move your �1
cursor.do not CI /Town — —"-
use the natum tY to Zip Code
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t, 4 1,, ,. , � System Owner, �", ,• ,:,•r .
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Namo
Address(If different from location) "
CltylTown State °
f-
.. Telephone Number
FAX 5083 28434 UERA WELL i_.T P02
130 A I�D 0 I11--,A i�'l 1,1
7
Appl icaVon is h voby made for parmi. 0 co elrUl a wall, ( i . Application is
mode Co in5t:all 4 ! it P-t'mp s f'yr-CTit.
110011 nv Lot
Location : Address 177
�-
Owner 1� �l�c d fry' Ad(3 rc r,�
_
Well Contractor V/rz Thl
v u M P C'0nCraCt0 ddrCSs e
WELL CONTRACTOR ( To be completed ac cime of }m"np test )
Typu� Of Well—„ �`� Well used for.
Du 3Ch of Bed F. cic �
-E _'Depth easing into Bad F:oclt
was Seal Tested?ed? Yes W) NO { ? Late of Testing
�'
De 1Wh ,•�� ray � .�. � �,_.��.__ Well Er'idc',.1 in lJ°nXer,
FAX 5083528434 VIERA WELL CO: P03
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FAN 5083528434 MRA WELL CO-, PO-1
(508)
M LITIL�TUw ROAD Wektrokf7, ada, tliF9�
6�2 4t7 1 •�ceT
1i�ralmt
JIMP10 Tak a At,
sill walwh
252 Arad vor 0 • Lot 5; AbDot dt
ovaegotownIM400 . 01853
s4mple TAM MY'Cli nt ont may
CEKTjPjCxTx or AMYSX6
TOOT PAMNASAI SPX MAX ASSULTO UMITO
Total CalijOrM (P) 0 0 P r 100M1
calcium vo Limit 40.3 MIN
1 . 3 Mgh
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