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Building Permit #915 - 120 CRICKET LANE 6/20/2012
A pORTH BUILDING PERMIT o�tt�e "tio TOWN OF NORTH ANDOVER ?~d`° _ .``." .'6 op APPLICATION FOR PLAN EXAMINATION H C—C Permit NO: Date Received L �'qs R,T.o SACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION �•fLU CX�v�T� �.G� N l.� [U-, u}A�Gov�2- Print PROPERTY OWNER L1 (J•efi2 Print _ 'MAP NO: -?0 /�PARCEL;�ONING DISTRICT: Historic District yes no, Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family a Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other - Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE P EFORMED: I.2 -C �c.�C S 457T,-�(2 5 l ho" Identification Please Type or Print Clearly) OWNER: Name: Zoo.t U -e-Lr?- Phone: 2(y 71� 2y QS Address: CC) CrLk C�-PIT ��^' 2 i�: CONTRACTOR Name; Si tw u [wC-. Phone: Address: gl C-0wona C4�w.5 V- Supervisor's Construction License: 16 L4q ?� Exp. Date: g' 2 S Home Improvement License: (1 �-� Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ g, bOd. FEE: $ 3�1 a3 n �II1I3S'1 Check No.:17�— Receipt No.: (Q� '� NOTE: Persons contracting with unregistered contractors do not have access to the guaren/tyyfund Signature of Agent/Owner Signature of contractor Location k D G �•T �!r� No. Date0. 0� • - TOWN OF NORTH ANDOVER • k Certificate of Occupancy Building/Frame Permit Fee $ a3''� r s � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#� 25435 Building Inspector t 7/.- No �' O Date..... : ,/ .�... .. + �aORTF� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �ss�cr+usE� This certifies that ...... �. ......E 1\C F F t c` ` ....................................................................... has permission to perform �U , "N ................................................ ..�. ........................ wiring in the building of J a at... ..:":. ...C ytt.7.. ....L�r.......... .......... .North Andovvf, Mass. ..� / //!. Fee..... )C �.. Lic.No. 11 . .�/ y ..... .. ............ ..... . /ELECTRICALINSPECTOR C E� �5-C'j() WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site 1 M THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on 1 D ' Signature COMMENTS S T.- � (Oo cz-xy 1t.1/ 7— HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I Conservation Decision: Comments I Water & Sewer Connection/Signature&Date Drivewav Permit DPW Town Engineer: Signature: Located 384 Osgood Street _FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire'Department signature/date COMMENTS i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) -12 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. 1 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 ❑ Engineering Affidavits for Engineered products F NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 DEPARTMENT:BPFORM07 Revised 2.2008 O/B/O S.1.�-�S✓�irSS '...�'3.fOd�r *a�+�ns o �l�73t�1f' iY?'I'/ 77 � ,aptSSgy "� � r•� w 7 777 b 43 y c ��9 03z dp ' � S.�n .g�Goo_S'z�„ »�'r'd.{fiirnivwop rw»iYi Jrma�fr�+ C/ •r_star' oirr2l ab+o� ',W.VJ"9ml 9AU 4'/0.1hv7 .YOB /ViMi'�'O sv�✓si awir��+�s.4-t.Z xt AxOKd r" ys►tr��►�s. �-�w�.tri r1�vrlr�►nur� s.�►�ti►,t�s' OWAMP saw -��°%// ' :�': .�. ,�.; _,..� ,�y1 .�'��j'/ '• SAta1r�D.7V' v�r�2 x.��noNd'oi✓� nNr^o� .�N1 Nl/.tf N'�fJy/yt7� tJb01/1/!✓1 OiYY AtMoM�t'sw app Jwd /YO 4�1I�.71�7 r//+Ya<�'4�npj JN1 1I1Y1.Y/Yr�1N1 CZL N/ o/Yr.YaY�s/Yi <�1 .ar,� ae .crrlrs� .tv ,�iY .r, /Yb'7v 1 O 7c� l ✓` • �,S'i'b/_�y ny t• 9# .407 bb G I 1i \ l • r•V 1I, • u Q . b i i • j L .fT t?G j;ec � N — mom PL Z Xt o 13Qj*Pl-1 Z x g Ja sT r � I � 's ./� � NORTIy Town o _ Andover 0 �� .ti•. to No. t - I Y* O LAN! h ver, Mass, �d • 2 COC"Ic"tWICN Q�R^TEO PQP��S S U BOARD OF HEALTH Food/Kitchen PERM -IT T LD Septic System THIS CERTIFIES THAT ........` Wt �. BUILDING INSPECTOR �.�. .�............. .�`. .. ......................................... ...... Foundation has permission to erect .. ................ buildings on .�,.....�.� .�.. I�e ...... Q�:•`� Rough to be occupied as .............. ... .. ... .........Ac....fe ............ ...� ...":.....:..� ............... Chimney provided that the person accepting this permit shall in every resct confor to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR o431, UNLESS CONSTRUC7f0N TS Rough ' Service ........... ................................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,- express or implied,oral or written" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shallnot because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25CM states`Weither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)andphonenumber(s)along with their certfficate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)withnoemployees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,apolicy isrequired. Be advised that this affidavit maybe submitted to the Department ofIndustrial Accidents fox confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of In dustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department atthe number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit Indicating current Policy information(ifnecessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license o permit not related to any business or commercial venture (i.e.a dog license orpermit to burn leaves etc)said person is NOTxequired to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. Tho Gozx onwoaith o ssarhv.:sPits - Dep.a ent offhdustxial Acoldonts Clf ee ofIuvestigatiom 6�()'U�asla%izgtax�Stzeet Boston?M A.0211 x 'del,#617-72,7-4900 QA.405 or 1-877:MSSARE Revised 5-26-05 Fax#617"727-774. The Commonwealth ofMassachusetts Department offndustrialAccidents Office of fnvestigations UV 600 Washington Street .Boston,.MA 02111 www.mass gov/dia Worker'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Ap-plicant Information Please Print Ledbly Name(Business/OrganizatiorAndividual): ;A jC, !j 1/y we- --Q U(OV Address: 8 l Ca PjcA 2 T City/State/Zip: Gk^e`115 FW Phone#: q 7 3 —(21 — 0? Z Are you an employer?Check the appropriate box: Type ofproject(required): 1.❑ I am a employer with�_ 4. ❑ I'am a general contractor and I 6. ❑New construction employees(full and/orpart-time).* have liked the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.x 7• El Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp,insurance 5. ❑ We are a corporation and its required.1 officers have exercised their 10.[]Electrical repairs or additions 3.❑I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp, c.152,§1(4),and wehave no 12.❑Roofrepairs insurance required.]i employees.[No workers' COMP.insurance requlred j 13.[:1 Other "Any applicant that checks box#1 must also fill out the section below showingtheir workers'compensation policy information. T Homeowners who submit this affidavit indicating they Ere doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation znsuYance for my employees Below is thepplicy ancZ,job site information. Insurance Company Name:. Policy#or S elf-ins.Lic.#: Expiration Date: Job Site Address; 12,0 C 2I C k c 7r' L4"e City/State/Zip: PJ 1q Aqo v-Prz Attach a copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civilpenalties 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. Ido hereby cern under thVains andpenalties ofperjury that the informationprovided above is true and correct - i afore: �� Date: q 6"?2- Official Official use only. Do not write in this area,to he completed by cloy or town official. City or Town permitucense# Issuing Authority(circle one): 1.Board of Health 2.PuildingAepartment 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: r� Office of Consumer Affairs&B sines Regulation _ HOME IMPROVEMENT CONTRACTOR Type: Registration:,.;171290 Corporation ' Expiration: L512014 SIDI G GUY INC ------ JOE ,-JOE WINK = �� 181 CONCORD RD', CHELMSFORD,MA 01824 Undersecretary ,_• 1lassachu�ctts tai inrcnt of Pull lic SJON ! board of guildin'�Rc~ervisorLicensOns and e tldat(!s \ Construction Sup License: CS 102092 Restricted to: 00 j JOE WINK j 32 CONCORD RD + BILLERICA, MA 01821 Expiration: 812812012 102092 ('a uun i�siunc r � t o-- i 5-An�h- 1- d /yam �ow iM{r�M � fl DATE ACOR - CERTIFICATE OF LIABILITY INSURANCE I 4/24j201�) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JAMES SULLIVAN INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 885 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Tewksbury, MA 01876 (978) 851-9600 INSURERS AFFORDING COVERAGE NAIL# INSUREDThe Siding Guy Inc. WSURER A: Scottsda a Insurance Company . INSURER B: AIG Insurance Company 181 Concord Road INSURER C: Pilgrim Insurance Company Chelmsford, MA 01824 INSURER D, INSURER E I COVERAGES 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 SUBJECTTO ALL THE TERMS,EXCLUSIONS AND CONDn-IONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOUL POLICY EFFECTIVE POLICY;XPIRATION LTR .rNSRO E OF INSURANCE POLICY NUMBER DATE'MM/D DATE M.'DOM( LIMITS LIABILITY EACH OCCURRENCE S 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Eaocau0. $ 50 ,000 �GENERAL CLAIMSIVADE EXOCCUR MED EXP(Any aneperson) $ 5,000 A CLS-1198503 03/22/12 03/22/13 PERSONAL BADVINJURY S 1,000 000 j GENERAL AGGREGATE S 2,00 000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS-CONP.'OPAGG S 2,000,000 :1 POLICY PECa F7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 1,000,000 ANY AUTO fEa accident) ALLOWNEDAUTOS BCDILYINJURY $ I fP-De—) X SCHEDULED AUTOS C ;HIREOAUTOS PGC10009664632 09/21/11 09/21/12 BODRYINJURY NON-0bNNEDAUTOS ;Peraxidenl} $ PROPERTY DAMAGE S 100,000 ;Peracddard) GARAGE LIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO OTHER THAN EAACC i$ AUTOONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ -I OCCUR F CLAIMSMADE i AGGREGATE $ I DEDUCTIBLE 1 $ I RETENTION S $ A 'NORKERSCOMPENSATFONAND X;T FTYLIMITS ER EMPLOYERS'LIABILITY WC 895-88-38 04/10/12 04/10/13 . E.LEACH ACCIDENT $ 100,000 AMY PROPR:ETORTARTNEMEXEM7WE B OFFICEFVMELI E EXCLUDED? E.L DISEASE-EA EMPLOYE S 100,0 00 Imes,de=iba u nder SPECIRLPROVISIONSbelow E.LDISEASE-POLICY LIMIT $ 500 00 L OTHER :RIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSION S ADDED BY EN DO RSEMENT t SPECIAL PROVISIONS Joseph Wink is covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION The Siding Guy SHOULD ANY OF THE ABOVE DESCRISEO POLICIES BE CANCELLED BEFORE THE EXPIRATION The Siding Rodd DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MA10 DAYS WRITTEN Chelmsford, Road 01824 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHOR! ESENTATIVE ACOR025(2001/08) ©ACORD CORPORATION 1988 6-d Aoua6V eouBJnsul UBAiIInS d00:Z6 Z6 VZ AV t�,� Name Company Name Lai Ut" SIDING GUY, INC. Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name 1,2_0 C ic4-Ir Joe Wink 978-621-0729 City/Town State Zip Code Business Address(must include a street address) 0 AA14Vp-2 PVV4 181 Concord Road Daytime Phone Evening Phone City/Town State Zip Code 'Z l L - 7 l 6 2,L( R Chelmsford, MA 01824 Mailing Address(It different from above) Fax 978-256-0606 1 Federal Employer ID or S.S.Number 043502484 Home Improvement Contractor Reg.Number Expiration date Law requires that most home S' improvement contractors have 294377 V-1 a valid registration number I� �� 0 / The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessarv.) Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contract 's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) L'i,�k R I t e 2 STa'M T Py 0� Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule I (� Q A (*) The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum o£ b U Payments will be made according to the following schedule: / $ 3 AT START $ by / / HALFWAY $ /y upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ U to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of (a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty being provided by the contractor? ❑No 52Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Siding Guy work,guaranteed as long as we're in business Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. , DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! -_" Two identical copies of the contract must cco leted and signed. One copy should go to the homeowner. The okt should be kept by the contractor. y Homeowner's Signature Date C tractor's Signature Date INVERT ELEVATIONS BUILDING TIES 4" PIPE @ FDTN. = 200.95 BUILDING CORNER A B SEPTIC TANK IN = 200.47 SEPTIC TANK 16.2' 23' SEPTIC TANK OUT = 200.36 PUMP TANK — _ PUMP TANK IN _ — DIST. BOX 25.0' 25.0' PUMP TANK OUT — CORN. LEACH FIELD 01 28.021 .5' DIST. BOX IN = 200.12 CORN. LEACH FIELD #2 88.5' 80.0' DIST. BOX OUT = 199.92 1 = 199.44 CORN. LEACH FIELD 3 87.3' 82.7' END LEACH LINE END LEACH LINE #2 = 199.44 CORN. LEACH FIELD #4 25.0' 31 .0' END LEACH LINE 3 = — END LEACH LINE43D/V = — ROOF DRAIN \ ��C/NgGEkDRAIN FNDTN. LEACH PIT �E ESSOUTLET \ v INV=188.0± LOT #8 ' 46,884 S.F. ��/ �� G � DECK \ 31.8 41 2-112 5 STORY W.F.D. 4 BORM. B.M. TOP FNDN.=203.86 D.9' B ,. v k'� A PORCH r, cv 4`t "rfo0.1 pis J y,3��sf ��r Y+�y�� �,► Jit t s Popp O O O CONC. VIAL K . ;r . 3 O r .I 1500 GAL. SEPTIC I�•..w ,��i I TANK ® \ \ D—BOX ct \ \ TR #1 TR #2 0.2 LEACHING \ VENT �� I I NG TRENCHES 2'W x 2'D x 62'L •� 2 Cn . 03 WA TER)VAIN ' _ cn CR/CKET L_A_NE' AS- BUILT m OF N SUBSURFACE DISPOSAL SYSTEM LOCATED IN NORTH ANDOVER, MA. J - AS PREPARED FOR �cH o�� OFMgssq�y COPLEY DEVELOPMENT DANIEL N 50 COPLEY DRIVE KCRAVOS M ETH U EN, MA. 01844 -0 9Ncl) 3i�7s2o cn ——. ----. SCALE: 1"=20' � s/sTE� NG 1-11 DATE: MAY 24; 20000') SUBDIVISION SUBDIVISION LOT #8 CRICKET LANE MERRIMACK ENGINEERING SERVICES PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (978) 475-3555• FAX (978) 475-1448 i MIT NO. APPLICATION FOR PERMIT TO BUILPX*******NORTI-I ANDOVER, MA46 G ;(> 8 LOT NO. 2. RECORDOFO1•jvERSInPr; DATE 1100K PAGE SvnDn•.LOTNO- e 141r.&114- ti: LlBd• L G noN K -- Z aNe l7-e2 PURPOSEOF-RIn1.1)11N4; S N /�e R sNANtt: aY1[. NO.OF STORIES SIZE �Z R'S A1)DRF_tiS733 N S SCl TQ A. A. BASEMENTORSIAR e ' , n ► LD ► it A d 1'I'E('"f'S NA�(F: SIZE OF FLOOR TIMBERS 1 N Z�( 2�! Z 1 z x /a~ 3 X /O 407 �4 L SPAN FR'S NAME ge Iv �f G �l00 rL SCF:TO NEAREST 111111.nING DIMENSIONS OF SR.IS ►( �� )� �� NCE FROM STREET DINONSIONS OF POSTS ' �r ►� �� x NVEFROM LOT I-INFS-%II)F.S REAR I11MF.NSH)NSOFGIRDvRs OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKN SS O LDING NEW S Sr/.F.OF FOOTING I I/0If x 2,f/J LM\GADDmoN ./a MATERIAL OF CIIININEY I✓Ge. LDING AI:ERATIONNO 1S BUILDING ON SOLID OR FILLED LAND i BUILDING CONFORM-r0 REQUIREMENTS OF CODE `p S IS BUILDING CONNF,CTF.D TO-i-OWN WATER eS 1)OF APPEALS ACTION,IF ANY IS BUILDING CONNECTED T(1 TOWN SEWER 1S RIMMING CONNECI FT)TO NATIMAL GAS LINE Ye.5 I�(:'CIONS 3.PROPER'.%'liNHO NIA'1.1ON LAND COs'r 120, DOD . Od EST.RI.D(:.COST < F I FIL1 not SF:CTIo\S 1-3 EST.Rr.D(:.COSV PER SQ.FT. � t FST.RLDG.(:OST PFR ROOM rl(U'AI vi rits Nitis-rtl$ON 01I'I'SllIE 01:1111 ILDIING sF.l'I'R'PER M n NO. _ 'JIUDGARAGES NII1ST CON FOR AtTOSFATE FIRE REGULATIONS 4. APPROVIA)III: i NIUSI HE I'll ED AND APPROVED n1•BUll-DING IYSPF(TOU III III DINNG INSPECTOR FILED J 011-%,vRS TE I.# i O S q i U <( -T- u CSC a (ONTR.TEI.# 133 P1 4- oy a 7 q ^'o- A� o"�`.- o TLL`s LTURE OF OWNER OR A1:TIIORIYI-:D AGt:NI CONTR. X-9 r � l ILLC,# L/ 9L-3/ IIT(:RA\TED ryQ t i / 3 19 7/ tl S/5/99 .1111 i FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. **************** a*************APPLICANT FILLS OUT THIS SECTION********** Vi/ ****** APPLICANT ak /\IY;142 0e✓ PHONE 7P-/ �� ��✓`�7 LOCATION: Assessors Map Number8' PARCEL SUBDIVISION Wa/lNc.,. 11F/M/cP— LOT (S)_ STREET C/Z/CIC e, �� r✓It, ST. NUMBER l�0 *****************************************O F F IC IAL USE ONLY**********'**** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED IC l DATE REJECTED I .[ COMMENTS �C_o :�Su��'(oi'15 V TOWN NNER 0-- DATE APPROVED it) ,, ��'I_- /, DATE REJECTED '� COMMENTSJPgZkd CNn (r) 40 [Qq FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED P I ECTOR-HE H DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT �� � � � ,�✓ �C�/EJ 1/� UV�.��(�/ RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Y$ : pa. _ F—rf c nrJrw D s �F I: S 3 E i t �x ft s At , t N2 0727 Date ... a a .°F NORTH TOWN OF NORTH ANDOVER - - RECEIPT ..I ACHUSE C•7Q G { x" This certifies that »l �..0 ......Q 4v...(-ef ,....zLc has paid..............�.... �...�. Z..t. .. G . .... .................. ray % ,� � for...........Y.1....{...I�...pero4l.� ........ .. ....'ZV...Cr l-& y r -.k f'Y'h•=Trow.'"y'�", � :t Received by t i e v. ........... ................................. M Department....................R.°�.l ...................... ...... .................... WHITE: Applicant CANARY:Department PINK:Treasurer n. k r # � � h i� *y i A .s No 9 1 5 - ' APPLICATION-'FOR,WATER SERVICE CONNECTION ,,,,f,-, ,;,:' ,_. =North An ` ` C, f Application by&the undersigned is hereby made:to connect with the town water main m Street, _. subject to the rules and regulations of the Division of Public Works.. - Thepremises•are known as No Street or subdivision'lot h6. -7 �Z5,7 _ ✓ Owner Address w� Contractor ' ,_ dress t. �S.�n,t:..�t s..stn i3z1 'r)cz..-- ` _✓c.�r r —4.t-_-44 i..'.i- ) --vr �,j+. - + , Applicant's Signature -' t n - t , -=PERMIT TO CONNECT-=WITH WATER MAIN .- The AIN .-The Board of Public Works hereby.grants"permission'to t/� :�12v� K� r. _ to make a-connection+with-the water.-main'at� 1 �X Pte' L�� � Hi Street subject to the rules and:regulations,of'the Division_of Public Works. oar :b Pu i Works gy Inspected by Date _ r See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 Telephone(508)685-0950 Fax(508)688-9573 SORTH 3�Ot"Ea ,y'g1,o o m A �9SSACHUSEt�� DRIVEWAY PERMIT Date: PP LOCATION: Zo c✓- I'C_ BUILDER: phone: OWNER: phone: The North Andover Superintendent of Highway Utilities&Operations MUST be notified of the grade and set-back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Remarks: Approval: ORTH Town o �� �:- ��, ..:::..6 Andover ti __ = old ndover, Mass., / q LAKE CoC MICMEWICK ADRATE D PPS\ �C, �SSAC HUS�� IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT .....I A. .��t/..11.7..�....,���.. ......... v!..... .. ....................................... e.P y � �' has permission to excavate and pour foundation at l� .. � .....� �......IC��7 ...X;!�ve. do � S�'.1�� it M� Gvbr��for_the purpose of.19.R.......�...%P A..... j . . ......................8 ......�±.......... ....#if 3 The-person-accepting:this-permit mustretunrto the office f the Building Inspector:a-certified-plot-piartshow of building thereon before Foundation will be inspected. VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. IF ........ .:� c ................................. BUILDING INSPECTOR NORTH Town of Andover No. T O - LA O dover, Mass., COCHIC EWICK ADRATED S 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR e. THIS CERTIFIES THAT... lv ....... /. .. ,........ l 41-e ......••••.•..••• Foundation ..................... buildings on .i.0f..6.. ..f ....1 A�....... ......�� g has permission to erect............... g /0 Rough to be occupied as.... 8.... ���. ..'/�... .0. ......3.... �� //......� C�'� ��� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough rY1 Final 3 $ PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TART IP Rough ............................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises -Do Not Remove Final No Lathing or Dry Wall To Be Done I FIRE DEPARTMENT Until Inspected and Approved by the Building, Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 1 ores Q 1 l I ap o o p_5 4 1 s� o/, x / ,a ,o R -ell k4 r --- - - b�� 3Y 2I dY 0 Location No. ✓ `�? Date NORTH TOWN OF NORTH ANDOVER t • + Certificate of Occupancy $ C U9 <�' Buildin /Frame Permit Fee $ � SSA115E Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check # rg,.Building Inspector Location 4,4 r` /,>-)U (,/?(4---/ No. -S�C2 3 Date / Sy/ NORTH TOWN OF NORTH ANDOVER F? • • Cy Certificate of Occupancy $ Building/Frame Permit Fee $ 3. ,SSACHU Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 9,3 Building Inspector Div. Public Works I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 i111 I i ITDus� ��P� „C,/ Checked by/Date I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 8-25-1999 COMPLIANCE: PASSES Required UA = 764 Your Home = 700 p Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1850 30.0 0.0 65 CEILINGS: Raised Truss 230 30.0 0.0 7 VUkLLS: Wood Frame, 16" O.C. 3060 19.0 0.0 184 GLAZING: Windows or Doors 650 0.470 306 GLAZING: Skylights 5 0.470 2 DOORS 40 0.500 20 FLOORS: Over Unconditioned Space 2430 19.0 0.0 115 HVAC EQUIPMENT: Furnace, 93.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code, The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CIJ2 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 8-25-1999 Bldg. 1 Dept. 1 Use I I I CEILINGS: [ ] 1. R-30 Comments/Location [ l 1 2. Raised Truss, R-30 I Comments/Location I Insulation must achieve full height over the exterior wall. I 1 WALLS: [ ] I 1. Wood Frame, 16" O.C., R-19 I Comments/Location I WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.47 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I SKYLIGHTS: [ l I 1. U-value: 0.47 I For skylights without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I DOORS: [ ] I 1. U-value: 0.5 Comments/Location ` I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 Comments/Location I I HVAC EQUIPMENT: [ ] 1. Furnace, 93.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ l I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I I difference and shall be labeled. I VAPOR RETARDER: ( ] Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ) Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ) Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ l i Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ l SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I I.l I CIRCULATING HOT VVkTER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I I PIPE SIZES (in.) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 I 0.5 1.0 1.5 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- d Town of With Andover Planning Board his form represents the schedule for allowing the following lots to be considered as eligible for building permits under the Town of North Andover Growth Management bar-law Sedan 8.7 of the Zoning by-law. Pursuant to 8.7 .5 this Development Schedule must be filed in the Registry of Deeds and be referenced on the deed of each of the lots below and be filed with the Planning Board prior to the issuance of any building permit or Permit for construction. Name and Address of Applicant for Lots: Name of Development: Marie Pitochelli I Walnut Pjdqe W wenswA of Cnc ,L4 Lane?- Ma and Parcel of Original Lot: Date of Application for Los Division: Odcber 31. 1997 _ Lots Covered "is Schedule: 1 1-110 Cricket Lane The Planning Board by their signature tow, or a signature of a duty authorized representative, do her establish for the above named development the foilowing Ceve4ment Schedule for the purpose of Sec:U=8.7 oL the GcaWL managenlert Sy-Law; The applicant, their assignem successors and or subsequent property owners shall conform to the feilewing schedule that limits the eligibility of the following lots for building permits. This form must be filed in the Registry of Ceeds by the Prnp"owner or r'epreseaative and be ref-crerr,ced an each deed Lar each of the fcllcwing Icts. Such deed reference for the deed of each lot stat)at a minimum reference the book and page in which this Development Schedule is filed and contain the language: "This tot is subject to a 0e,,L=tapmertt Schedute,pursuant to the Town of LVortb:Andover Zaaarg 8Y-taw ad C-rrers, reprasentatfees, acrd AUture Purchasers should avail themselves of said restncbon by re newfrtg rhe approved Oevelaprrrent Schedule as filed in Book and Pace The fact i'at a:ct rs eligible frr a twrldir�g Perrrrd is sc:bjeci to tf'a lim4atcn of the number of building ne�&Per Year frStfant to seetkon a.7.2.d of the.Zoning By-L..aw.- The Planning Board hereby schedules the Ict(s)-for the above development as shown cn the attached=hedule. Signature of?lanni .em ~ cr uthcrized Representative �Y l Signature of Pro uUVMed rRe resentaiwe- 8.7 Growth Management BvLw - �Valnut Ridge • o-i 0 lots = 5 bLu'rding Per=.is per year • �':ar=July 1 to July I • Pits are Given out on a quarterly basis i.e. % eligible lot;would be available in July, October, January, and Aprz? - In the •year that the lots sre created the total number of eligible lots for that vear may be se eduled in the month the decision appeal period expires - Date Eli,aiblc Eligible permits Total permits .Jub 1998 peryearehaible Oct I. 1995 5 I 5 i 10 :5t7 b!C-bbi-JI 4z Lf II -fyt _fJ�vr. Plat ri..t �Jl i ,A CERTIFICATE OF LIABILITY INSURANCE 11-03-1999 PBCOUCfII is CSR 15 ISSUE"A MATTER OF INFORMATION S2iT=!�sv>!v> c>a DIC ONLY ANo CONFERS NO IEGHT8 UPON THE t,'ERTIFICATE HOLDER.THIS CERTIMME DOMES NOT AMMI10,EXTEND OR 522 CNICEMA=0 P= ALTER THE COVERAGE AFFORDED 8Y THE FOUCIE8 SiLOW. A*= AlQ Celt, W% 01645 � INQURM AFFORDING COVERAGE INBYMBD INELPER A. Z33ZX ZA4U2VA = COTQJNT>< 106LWT RIDS DmLesull T tic INSURER e: TRUST A3BORAUCE COB[?ANY _ 13S ?91111m l2xt V=312 l!NSURER C' t ZQION 2DtlGl«AI= COMA= S13S iENSURER D: NOM AMDMR UL 018415- INSURER E: COVERAGISi "POLICIES OF 1NSURANOS LIIrMD SELOW HAVI SiiN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY MCUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13E I$SU[D OR MAY PERTAIN,THS INSURANCE AFFORDIV BY THE POLICIES DE>SORIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGaREMSATs LIMITS SHOWN MAY NAV!SSRN REDUCED BY PND CLr IMS. ""0111 YISOBAMM PaucywMOMBBR EanvEPUTAW&mmLBMTS 411111mm Lilt11111LITY 1ACH OCCVRRlNOE i 11000,000 1► OBNT-RALUARILITY SCD1910 04-05-1999 04-05-2000 FIRE AMAOD(Any ONNIre) I xxmUDIQD CV�MABIIM! ®OCCUR MFDLXPON I XXaMm PER40NALAADVIQURY Ir EXCLom Qj'ARALARORtGATB S 1,000,000 OBN'LAG0Rt0A7tl LWAPPLIGS PGA: PRODUCTS-CCI1P/OP AGG S =X Lunn AYTolI0011.2 UABILM ,CO IIN10 INOLB LmT ANY AUTO ALL OVONBD AUTOS I `BODILY INJURY I 60HEDUADAUTOi (Pr pmw" How AUros I �BODILY INJURY f MX44YOMAUTO3 I{Pr•add�q ! i PROPERTY DAMAGE •_ 064v Orel) I dkMVM LIAMLI Y 1 AUTO OMLY.FA A0010tNT i — 3 ANY AUTO I OTHER THAN GA.ACC I AUTO ONLY: AcG f IBICBBII 1.10AMMY i !EACH OCCURRENOe s OCCUR ©CLAIMS W4K i A0WKrATS f DBDUGnBLG � RETENTION s WONIBNt COMPSUSATMON AMO tMPWVRRAI UASILMY i O TO » IBBUA{D 11-01-1999 11-01-2000 E.L.EACHACCIDBNT i 100,000 CL dJBGABt-GA lWLOYt t 1500,000 E.L.DI P CY T s 100 000 BUIOTNBR 1 LOMRS R18R TXW 1012377 07-12-1999 07-12-2000 WTS 2,1 S 300,000 DESCRIPTION OP OPERAT O MLOCA7X MMAH MCLESME7YCUnNO LS AWED BY ENOONSIMEWISPEC1AL PROVISIONS CEtTACATE HOLDER I IN u Ra CANCELLATION SNOIILD AMY OF THE A00Yf!DESCRIBED POLIC16t BE CANOELLED BEItOR@ THE 87nMRAT1011 zam Cg =�oxela alsauzimerr R� DATE THIMOR TRI 16GUIN01NSURMTR"ILL ENWAVOR 70 MAIL 010 QAYN wftTrr.N a> . l20 1AI31 S'r11>C='t NOTICE-TO TW ctlrRntAlt HOLM NANMBD To 7Nt LBrr,BUT PAILURt TO oo So SHALL IMPOSE NO 7lON OR LIABILITY O}ANY KIND UPON 0.MTS AdBNT!OR MOfk'!'8 Amovim ISI► 01843- REPRE NTA � AT ACORD 2"(rffin OACORD CORPORATION 42U Ut- , �� y 166567 �a 4My n ^r{ DEPARTMENT.:.*.; p HLIC SAFETY 156567 ,, ONE='.`ASH3U.T p. CE RM 1301 i - �'.: _; .. t., s05 8— 1 .,: 0 16 8 LD Na Ak 41 A '..GOtdSTRUCTION SUPERVISOR LICENSE. ? Number... Expires: ii t �. ,042329 02/01/`Z000.. Restricted To: 00 -----� F ;rr m 4 ' b li�.r5 D r1► ;x i l J o; THOMAS D LAUDANT o 733 TURNPIKE ST #20<3 kD N ANDOVER, MA 018�4a ��r,f �,\�d"�! � A Keep top for receipt and change 0) of address notification. m �Tk..., .�-, Vii• ZJ Y:vFi+ ,SIS: Sz t, t r Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of.North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Address of Property for Permit(below) Lxjc n.a f el 4 G .e�� ✓, Z--/-,- .2 c Map and Parcel : Purpose of Application (check below) Phoney Numb ant /Single Family Two Family �0Z — I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit ig issued. Based on section 8.7,6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in exis nce as of the effective date of this by-law,provided that no additional residential unit is created. The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.care met and/or represents Dwelling units for senior residents,where occupanc7 of the units is resthr.ted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior'shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 400,16 permanent reduction in density, (buildable lots),below the density, (buildable lots),permitted under zoning and feasible given the gnvironmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. Signature of Owner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit. ' 1 1 • -71/ � a Qp Aa � 1 \2 \ o � � i�`� mac;y� F-r�s � • 1 J , nV l "c' _ 1 Pent`- -//- .b-c23 � free i3O/ mL or RL.4-ov - s AaMNY MfrifY 7b r,Ke- ;-,,rex�,vfe-~. vp rb rv�r er�ar rri�T rvt-��N�p>.�,���or.�rEo ov /N T/KE coT.�Ct.sr.�an'�✓.I.vo T.wT'/7',00" e4w~w A""MW "M"C W AW".rr.«rrs/"V"u.." p.�gll✓�t/ fO.P •_�i�nKre uesr.�r r r rwxs`wr ."A*W IS,ves cnurro it rr� rsA�,e.� ,gaao .sat.�cto .�.eia+. y 1�1 y #3638 1r" ./IfE.t.�/�I�GIGt'E•�•wL�E•�•��ti .lE•�r/�Et ESS%O G6 /�I'Ce a SURVEY .L✓ODYEZs 8 CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number °� Date 5--31 - 00 THIS CERTIFIES THAT / THE BUILDING LOCATED ON O (041e- MAY e MAY BE OCCUPIED AS g'�O` ° �� '�vS Id--e 00 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. O`,..OR7.1yO CERTIFICATE ISSUED TO p ADDRESS 33 �'34cmu'`` Building In pector Town of North Andover OF NORTH q I.1LEO "6 (. Building Department 3? 9� h..=a °o 27 Charles Street o North Andover, Massachusetts 01845 (978)688-9545 Fax (978) 688-9542 T O <OL MI[ML K• 1' �9SSACHUS���y APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION Ck,4i� � ADDRESS \90 �.rl. LOT NUMBER* SUBDIVISION W� l2,n�i'�_ DATE REQUEST FILED o O DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE /5 O' ��yh_ OFFICIAL USE ONLY ************************************************************************ ROUTING CONSERVATION U — C DATE 'S 3 L i>O PLANNING DATE D.P.W. -WATER METER � eC Z2-� DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR,T INSPECTION REQUEST DATE. SI NATURE AUTHORIZATION NORTH Andover To-V' : � f J . .O � 4 Sc�3 O LA o dover, Mass., J'I COCHICHEWICK V AD''A T E D P9 4, S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic SystemJ� /] /�•�����3L) O� THIS CERTIFIES THAT...91AIN07.......A.a ..0.........4b.w.0. .4 BUILDING INSPECTOR '• Foundation �j►� has permission to erect.............../..................... buildings on . .9 .. .. ..f Q� ..... ..1 0C Rough �Ic � /4 � , � /� Chimneyb/oto to be occupied as.... .... .............. ../. ............ ....... ...... .... ..... ... ..... C r....... . '' provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Fina✓/ "�v `�3��a this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. bough V( 1(e ftb5��,,'Vyj/oz rY1 ,3 $ PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION TART -.-EL�EC ICAL INSPECTOR ou flopF............................................................. Se ✓-� • BUILDING INSPECTOR Fi �3av c IA Permit Required to Occupy Building v GAS IN'TWtQR Rough Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done FIRE OPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. e CY -l7 SEE REVERSE SIDE Smoke Det) i Office Use On Permit Na `IV 0 �r Gr'�F�'�jLi7li�t!/�.�'�'r,��'��S�r►'Zl-.�C`��i� D Sa�dy Occupancy&Fee Checked BOARf}OF-RRE-PREVENTION-REGULATIONS-527 CMR-12:00-_ _ APPLICATION-FOR PERK f-T TO-PERFORM 9LECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 iRtuase Pririt3rr_ink-or typaati-infonnattan)- Date_, � �(0 To the inspector of Wires: Tk,w1vo€ NAT##Andaver- The undersigned applies for a permit to perform the electrical work described Wow. Logon-(Street-&Number �. Owner or Tenant I �� ` ���J`� / e �. 1 Owner's-Address-- 5!5 IC 2 Is this permit in caniunction with a building:permit- Yes ❑ No- Q (Check Appropriate Box) n Purpose of Building �� IJ�� (�,e(�f.A)� Utility Authorization No. / E>iisting Service- Amps- - Voir Overhead-(:I- - Undgrtid U No.of Meters New Service j,) Amps 11 2x6 Volts Overhead ❑ Undgrnd f No.of Meters Number-of Feeders: a> Ampaotity- AA1 Location and Nature of Proposed Electrical Work Total No.of Ught(Ing Outlets No.of Hot fuse No.of TransformersKVA Atktve ❑ In ❑ No.of Ughting Fixtures Swimming Pool grrfd ❑ gmd ❑ Generators KVA No.of Emergency Lignting No.of Receptacles Outlets No.of Oil Sumers Battery Unit t No.of Switch O-udet- No-of Gas-Bursters- RREALARUSi No,of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons initiating Devices Heat Totau Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices NoJ of Self Containeo No.of Dishwashers SoacelArea Heeling KW Detection/Sounding Cvices ❑ Municipal ❑ Other No-of-Dryers Oeutces-- KW---- Local Connection No.of No.of LAW Voltage No.of-Water Heats, - KW Sicam Barlases- Wiring- No. iri -No.Hydro Massage Tuds No.of Motors Total HP OTHER:- INSURANCE COVERAGE Pursuant to the Massachusetts General laws,, i have Uabiliiy Insurance Policy inctdding mpleted Operations Coverage or it st tisiarttiat eclu NO = h i valid Proof of same to ce-Y = NO = If you have-eheelver!YESpleaseindicate the type of coverage by checking the appropriate box sod Specify)- EsUrnated_Vatue of Electdcal Work$- (Expiration Date) WorkW-3tart 2:�UIQ inspectlan_DataResqueated_ RaugtrlNa C C Final Signed underthe-Penald of perjury: J C� FiRtt#NIiAOE- — LIC.NO. LlCatisee + S Signature LIC.NO. 51�Ire- Sim Tet-Na. �6 EV-6�4 Address. Aft Tel.No. OWNEI .INSURANCEWAi\ :.I am aware that the cense*does not have the insurance coverage or its substantial equivalent as required by Massachusetts -13eneral Laws.And that my signature on this-permitapplicatlon-waivers this mqulnament. Owner Agent{Please Check one) �( Tnlanhnna Nn PFaur r FFF S v/-�O. cv(y/)