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Home My WebLink AboutBuilding Permit #487 - 131 CRICKET LANE 1/6/2006 r ' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING :. :, ,c z w;.-j+C? ��: �-p ,.,.."- :,n, ,.: ..: ,�. �a .,.�� ter•' < u,�,.. � a �.,.a... BUILDING PERMIT NUMBER: DATE ISSUED. rn � 7 / a O46 3 SIGNATURE: O` ��Y C-- Building Commissioner/1r of Buildings Date Z SECTION 1-SITE INFORMATION s O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 131 Gr�c t L"e- MaP Number Parcel Number 1.3 Zoning Information: IA- Property Dimensions: y C s aC-f-e- p Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS(ft) IFront Yard Side Yard Rear Yard RegWred. Provide Reqdred Provided ReqWred Provided 1.7 Water Supply AGI-C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: v Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record Name(Print) Address for Service: /\ Signature Telephone 2.2 Owner of Record: Name Print.- ! R Address for Service: O �S Si slurs Telephone v SECTION 3-CONSTRUCTION SERVICES 90 4 3.1 Licensed Construction Supervisor: Not Applicable ❑ f_�4 rr Licensed Construction Supervisor: t✓✓ a 7a I F7 O License Number Mn 1/�ti.9 .fes' !1 ,ri✓oe�i'•c �/�. Address g — Q. ZP' ;2a7 Expiration bate ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 /j Cr�I�l�.riJ 4-all 7l,IV7-10.✓ 124 v V3 /0 / Company Name / 7 ,/0 9 rn q Registration Number r Address _ /4EO f Z 7� i '��7 Expiration to i ature Telephone SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other Y Specify � ,/�!fr< N111,1' �"i'••i J'H Brief Description of Proposed Work: ��-� tv9lfl'. Gd,✓.f i �✓ r J3io>�,�,�ra� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be '0MCI1AL USE ONLY Completed by permit applicant 1. Building 41,5 3Gn (a) Building Permit Fee 1 Multiplier 2 Electrical (b) Estimated Total Cost of C 1. Construction 3 Plumbing Awl. Building Permit fee(a)x(b) 4 Mechanical(HVAC) �3 60 5 Fire Protection 6 Total 1+2+3+4+5 Check Number 6 SECTION 7a OWNER AUTHORIZ TION TO BE COMPLETED WREN p OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My ehalf, * ll matt s relative to work aut orize by this building application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name i Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1ST 2 N15 3 RD SPAN DIN ENSIONS OF SILLS DIN ENSIONS OF POSTS DINvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH Town of Andover No. �`y ori 0 _ L A 1 1 dower, Mass. ' T - ^ I� COCMICHEWICK V 7�ADRATED P'? S BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR P T T D THIS CERTIFIES THAT........ . . ....... .................................... Foundation has permission to erect......................... ....... buildings on .............. ... 1 ./..� .. . �/�� Rough to be occupied as �s �/ � ............................ Chimney`/�/ .r ........................................... 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 Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTIO TARTS ELECTRICAL INSPECTOR Rough OleService LD GINS 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street two. SEE REVERSE SIDE Smoke Det. 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 x �� eVIE�- P14J F-4`+ PH0NE -710�D — / LOCATION: Assessor's Map Number --0`o 3K•D`032-5-Won© PARCEL x SUBDIVISION �"�v�N�.�{- tZ�`d�j� LOT(S) ' STREET Gj^�I GKT L/�1v�i ST. NUMBER 3 OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOO SPECTeR-HE T DATE APPROVED A\\ DATE REJECTED SEP C INSPECTO -HEAL H DATE APPROVED 0-0 DATE REJECTED /7 / COMMENTS l PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE 91te eqmwwww" Board of Building FZegulat ons and Standards One Ashburton Place -Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 143109 Type: Private Corporation Expiration: 6/18/2006 DESMOND CONST. INC. MATTHEW DESMOND 19 UPLAND ST N. ANDOVER, MA 01845 Update Address and return card.Mark reason for chang DPS-CAI is 60M-04/04-G101216 Address [] Renewal [:] Employment Lost Card •. ✓1ze Vanvnzom�� a��czooac�tuoeG7a Board of Building Regulations and Standards License or registration valid for individul use only _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 143109 Expiration: 6/11112006One AshburtoiPPlace Rm 1301 Boston,Ma.02108 Type: Private Corporation DESMOND CONST.INC. MATTHEW DESMOND 19 UPLAND ST _� � ,� N.ANDOVER,MA 01845 Administrator of4withotignature �uSOR J License: C0 07248? Numbet CS 1960 Birthd?' `� Tr.no: 19206 ;t Exp►�'""��2??20� `� 4 _ t aestriccea:10_ #r EW F pEgQ110NQy- C m Doer1 Mp,TTH �..'. pctln9 19 V�VERTNW 01845 NAN RE F.I%Ii--D 2 � �• JAN 0 3 2005 Ir Ili �H� -- 33dc1—� cy 4Q S'SI X a £S d c1H ati)J-1-4 as T \ The Commonwealth of Massachusetts Department of Industrial Accidents L Office of Investigations 600 Washington Street Boston, ,VIA 02111 �� -;_•� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly maple (l3nsiness/()h•Lant%ttion/Individual): �i'Lff�dN� GO,✓S/,t06-1 ? Address: Z F fi- -- City/State/Zip: ,Al/� ,41yoo1,tr., !f-t/', D/fi y� Phone #: Are you an employer?Check the appropriate box: Type of project(required): I.;0 I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 7.6. F] New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. '+ ❑ Remodeling ship and have no employees These sttb-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. q. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13.,N]Other comp. insurance required.] *Any applicant that checks box#l must also till out the section below showing their workers'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 an additional sheet showing the name of the sub-contractors and their workers'comp.policy inhumation. 1 um an employer that is providing workers'compensation insurance fir my employees. Below is the policy and job site information. Insurance Company Name:��Y��./f Policy 4 or Self-ins. Lic. it: --� O J ,� Q �-• Expiration Date:_ Q _ Job Site Address: e:e icy,✓ ,/ l.A,✓a( City/State/Zip:________ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties ora 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 line of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the p d s rad penalties of'perjury that the information provided above is true and correct. Si mature: Date: /2 Q� Phone_'__' — Ullic•ial use only. Do not write in this area,to be completed hp city or town olliciad. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Hcalth 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: 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 at: 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. Also, note Permits are required under Fire Prevention laws'Chapter 148 Section 10A. The debris will be disposed of in: %GG'wznle'�J (Location of Facility) ignature of Permit Applicant Fire Department Sign off: �/t-, 1 Dumpster Permit _ Date PROPOSAL Desmond Construction, Inc. P. 0. Box 41 North Andover, MA. 01845 (978)682-2279 Date: 11/30/05 Page 1 of 2 TO: Job Site: Mr. and Mrs. Pajela same 131 Cricket Lane North Andover, MA 01845 978-685-2595 DESCRIPTION TOTAL BAS MENT FINISH y Item 1 Sub-Floor Installation Install 2'x 2'Dri-Cor subflooring on concrete. Material and labor. Item 2 Frame Frame walls with 2"x 4"including shelf along outside walls. Frame all soffits with 2"x 3". Labor and Material. Item 3 Plumbing Install pipe and drains for kitchen sink, bathroom sink, toilet and shower. Install finish lumbin rovided by Homeowner. Item 4 Electric Install electric base board heat with thermostat. Install recessed lights, receptacles and switches. Cable for television and computer line. Fan/ light combination for bath. Detailed list to be provided. Item 5 Vacuum Outlets Install 2 central vacuum outlets. Item 6 Sprinkler System Drop 12 existing sprinkler heads to be flush with ceiling. Item 7 Insulation Install R-13 insulation in exterior walls. Item 8 Board and Plaster Install 1/2"blue board on interior and exterior frame and ceiling-soffits. Apply 1/8" laster skim coat. Smooth finish. Item 9 Finish Carpent Install 1 Anderson 400 Series window to match 1st floor existing. Install 1 french door to office area. Install 2 double closet doors,4 single doors.All doors 6 panef solid core masonite facin . Install door/window casinq and base board trim to match existin . \a \ r M Desmond Construction, Inc. PROPOSAL Date: 11/30/05 Page 2 of 2 T0: Mr. and Mrs. Pajela Job Site: same 131 Cricket Lane North Andover, MA 01845 DESCRIPTION TOTAL ~ Item 10 Ceiling Install 2'x 2'dune the with 3/4"track. Item 11 Support Columns Frame and wrap columns with pine trim. Item 12 Tile Install bathroom and kitchen floor tile. Homeowner to provide material. Item 13 Paint Paint wall and wood work. Walls one coat of primer, 2 coats finish. Wood work re rimed, 2 coats finish. NOTE 1 Finish on shelving TBD per selection of finish material and possible wains coating. 2 Tile in shower walls labor TBD upon size of area. 3 Laminate floor over sub-floor TBD upon selection of material. D.C.I. to acquire building permit. 5 Kitchen cabinets and island intallation TBD upon selection of material — by Homeowner $54,300.00 All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of $54,300.00 with payments to be made as follows: 5% upon signing $2,715.00 20% upon start of project $10,860.00 Remaining upon request per project progress An interest charge of 1.5% per month will be applied to any balance due 30 days after completion of this project. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over an above the estimate.All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance upon above work. Workmen's Compensation and Public Li '' Insurance on the above work to be taken out by DCI. Respectfully submitted y' _ Per Desmond Construction, Inc. NOTE: This proposal may be withdrawn by us if not accepted with 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. Payment will me made as outlined above. Signature: l Date: /1 /BOJ = � -- Signature: Date: / Cr n Customer Service Report ,AME 022'1,9793 9 ENVIRONMENTAL System Owner System Location Pajela Rex Primary Home 131 Crickett Ln 131 Crickett Ln North Andover, MA, 01845 14kth 'Andover, MA, 01945 (978)-685-2595 x home (978)-685-2595 x Pa'ela Rex customer ID: 11"20 Customer Homs Technician �J- T Nr`v 1 2 3 4 5 6 7 8 Systtsm Type Standard FF Taf&Stle iow 22 20 is 16 14 12 12 12 Previfto Service 24—Sep-2003 1250 22 20 is to 16 14 12 12 t• Next See V 1500 24 22 20 20 Is 16 14 14 Dete Of�Sere 29—Sep-2003 CAT 1750 26 24 , 22 24 WIs, 16 16' CeDigging` °�0(per 6 inche 25.0000 $0.00 seanFromTabk . ...Pumping 1001=1500 241.7800 $241 &6haet6f4r"6d"dispesul ' ,': Coupon or Discount -20.0000 20.00) alert.er5Ifsyssaeisew:rlKiitoyaws I Ace s far siewesl use _ Add 5 If symm addMve is used: � Seen: �s Freq envy Less than 5 Every 6 months — Subtotal $221.78 6 to 15 Every Year Payment Type: Amex Expires: Talc $0.00 16 to 23 Every 18 months Credit Cad M Total greater than 24 Every 2 years Teehnidan Consesnts: Tank Observations LQ�e V p L f GIC condition lsaehfisw itunbaek . Riding High(liquid level) Excessive Solids(top/bottom) Vse Ne Powdered Soap Heavy 6reoss Roots i Outlets Baffk M inft i Inlet Baffle MUsshg Wind River Environmental LLC 107 Forest St, Middleton, MA 01949 (978)-562-4500 Tem Pu on Receipt P (7 ; s f i • I Customer .Service Report 0222007q7 ENVIRONMENTAL Work Urder# i Systan Owner System Location j Pajela Rex Primary Home 131 Crickett Ln 131 Crickett Iai +{ North.Andover, MA, 01845 North Andover, NIA, 01845 i (978)-685-2595 x home (978)-685-2595 x Palela. Rex I Customer ID: 1108246 I( Custansr Home Yes is 1,4hP Tedtirician /,/ ��, 1 2 3 4 5 6 7 8 SYS TWO Standard Tack Sias 1000 22 20 's 16 14 12 u u Previous Service 07-Sep-2004 1200 22 20 is is 16 14 12 12 Next Service 1000 24 22 20 20 is 16 14 14 Dans of Service 31-Aug-2005 AM 1700 26 24 22 24 20 is 16 16 Service Code bescription Chart's Sash From Taw. Coupon or Discount L00-10.0000 $(10.00) SL&hu&66PgwtapAgwsd j Pumping 1001-1500 1.00204.7800: $204.78 Fuel Surcharge Residentia 1.00 9.1200 $9.12 3ub*od50sys'wai°"'i"''a"20 i see 8 for SSOM i U" Add s if sysMs adeMw is und: Mar sawn: ---- Scar Frequency _. •__ _` Less than 5 Every 6 months j - r( 1 Subtotal $203.90 6 to 15 Every Year T CheckT 1 x Tax 16 to 23 Every 18 months 1 Payment Type. Expiss:-; �, Credit Card#: ___� Total $203.90 greater than 24 Every 2 years Tediniclen Continents: ;' Tads Observations rcGood Condition �} ! (�, n '• �.._/ P r� , � ) /� '` �i�l �.`�a c J Riding High(liquid leveo J Excessive Solids(top/bottom) Use No Powdered Soap Heavy Greaw i Roots r� Outlets Baffle L Missi n g Inlet Baffle Missing I Wind River Environmental LLC 163 Western Ave., Gloucester, MA 01930 (978)-562-4500 r f Town Due on Receipt i Customer Signature 1 &Sftmar cop/ Date. NOR7M � { r ...•. .��a TOWN.,OF NOi6H ANDOVER PEFtkT FOR PLUMBING TY ,S SACHUS� This certifies that . . . . . 7. . . . . . . . . . . . . . . . has permission to perform . . . P�' .'`. ' �.'` plumbing in the buildings of . . . . .")5. . . . . . . . . . . . . . . . . . . . . . . . at. ./j�. . .C. `^. . . . . . . . ., North Andover, Mass. Fee. Lic. No.. . . 3. l.". . . . . . . 't./'. . . . . . KLUMBING INSPECTOR Check # �¢ G 8 "1 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS _ Building Location i?j C ( Q� lei✓e Owners Name o �( P}9�� Date Permit# G q(/ Type of Occupancy Amount New [3 Renovation El"" Replacement 1:1 Plans Submitted Yes ❑ No IOXTURES Q w z U W o w w x o a xCn d� w w F 3 A d > H 3 x z a o a sL13-FM RA vENr ]Sr HADOR ZD FLOOR 3M FLOOR 4M FLOOR 5M MOOR 6M FLOQ2 7M FLOOR s> i FLOM (Print or type) Check one: Certificate Installing Company Name ❑ Corp. Address _ 0 ?) k Y-,11SS72W /Vl(J gU'y 13 Partner. Business Telephone MFirm/Co. Name of Licensed Plumber: 2 {+� Insurance Coverage: Indicate the!y Pp of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts 2a=inKodr pter 142 of the General Laws. By: Signature ul or Licensco rluuer Title Type of Plumbing License y Cit /Town icense NumDer Master ❑ Journeyman EJ APPROVED(OFFICE USE ONLY i i t i' Location No. Date �O^T►, TOWN OF NORTH ANDOVER i s • i ; , Certificate of Occupancy $ SA US<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee -,. $ 1 TOTAL Check # C Z 7 3 Building Inspector, JJ / I • TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: rn YJ 43-- i3 I SIGNATURE: ..� Building Commissioner/inspector of Buildings Date Z SECTION I-SITE INFORMATION I.1 Property.Address: 1.2 Assessors Map and Parcel Number: O 1D 61W4 30 S` F1 W Map Number Parcel Number 1.3 Zoning Information: `• 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(so Frontage(ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Suppty M.G.L.C.40. 54) 1.5. Flood Zone Information:— 1.8 Sewerage Disposal System: D Public 0 Private ❑ Zone Outsid40I od Zone 0 Municipal 0 On Site Disposal System Z SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Ow of Record 13 � 04'�kJI,04 Name(Print) Address for Service tI SignatureA V,& Telephone�� 2.2 Owner of Record: (a Name Print Address for Service: O _ rn Signature Tel hone SECTION 3-CONSTRUCTION SERVICES 3.1 Lice Construction Supervisor: Not Applicable ❑ Licens ostructi Su isor: ; O O t� �/ZA, Licensee Number �= w 1 "Ilk Addre s 514v(oack ham. fN,314M �/ Expiration Date S n r Telephone /��< r �81•83 ��1� V -< 3.2 Reg red Home Imprbvement C tra or Not Applicable ❑ 0 Company Na /�' c rn �11 ECV �S Registration NumberAd r1 tieU Ilvv r zC0Expiration Date n� Sien ture Telephone I �+' I •SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all a 6cable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ j Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify G jBrief Description of Proposed Work: C6WAIJ lmyA�Vl & i SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 'Y' Completed by permit applicant x � � IT 1. Building '' -1 b/, (a) Building Permit Fee V Multiplier 2 Electrical (b)(b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (b) ' 4 Mechanical HVAC a 31 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENpT� OR CONTRACTOR APPLIES FOR BUELDING PERMIT I, ` v`_ as Owner/Authorized Agent of subject property Hereby authorize_ V, to act on My b �I' n all mat+ relative Ark authorized by this building permit application. i l Z/ Si nature of weer 117 Date SECTION 7bQWNMA%JTHOJZIZED AGENT DECLARATION I, COA as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and bel Print NaV)d,,� 4167 Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TDABERS 1 s1r2ND 3RD SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DW ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHUv1NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ?fid FORM - U - LOT RELEASE FORM Cha, INSTRUCTIONS: This form is used to verify that allnecessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. p a ................ 1.�X ••VA•�`CIU.................PHONE••�10" ■UL;�•Z51� APPLICANT ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION I LOT NUMBER L STREET �� r\� Y)�, STREET NUMBER. ' OFFICIAL USE ONLY RECOMNIErM ATIONS OWN AGENTS .....00090 ..... ....................................... ... Z. n DATE APPROVED ��✓ j CONSERV IO ADIffl4FRATOR 07u) w �/ do l hpa/srr-consfrvc-Aa• /nsp,-c41u,, he,x{- /� pDATEREJECTED s � COMME'NTS Al/ DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED L'^ �*•S Lst DATE APPROVED SE C INSPECTOR':HEALTH DATE REJECTED COMMENTS �2�- S-e{`1��-c �S `�" l� G /-e- -J S 7 At"t. ii 0 m n PUBLIC WORKS—SEWER/WATER CONNECTIONS DRIVEWAY PERMrr Z UZ_ DATE APPROVED FIRE DtPARTMET DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE 5 ,eLem ,7L, ,n.eo r 17see x 'x °�'� ��:8' ,a { y x 102.02 a x Ism C26 U," ` k 3►� x I" $ Ir - _ J J7 171.11 IMLM WAD ,eae2 PROX. UNDEEPOPou D uam x 1ee37 x uAPP\x Iwo 32 SOLR � es�� ,ase \" X , PR Ox' WA TPR SER Vr C x I177 1a.e4 _' x,Qse Q 87 IV IsLes — xf \ �S // x 100.04 176.00 � '� _ i 8r_ 30 �, 170.40 BOULDER RETAINING WALL - -_ .IL T FENCE 100' — _x ,�,.� )x,ISLnx Imm (TYP.) � ' BUFFER tm.22 x BUFFER 170.27 ( 161.94x 1 . i ZONE x 17L1, _ �s 1M93 — 52-82 ^G tiO BU/�O NO t x 70.02 — ZONE r� v 6 � � nx 61.43 � � rn 0� z °' s�L� - 4 � N 131 G•r �� Lc�� LOT 4 0 �s 45, 574 S. F. 1 rn C, A r� p Jun-14-2001 02:IIPm From-CJ CARTHY INSURANCE AGENCY INC. 9881913 T-589 P.001/001 F-106 CERTIFICATE OF LIABILITY INSU�RANC�b " OATT6/1rDD/14/0 E1�NZ,-4 • 06/ 01 � PR6000ER THIS CERTIFICATE IS ISSU80 AS A MATTEROF INFORMATION lgraowood Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE c/o C.J,XcCatthy Ins.Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR • 229 Andover Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Wilmington MA 01887 COMPANIES AFFORDING COVERAGE Daniel Ippoli to COMPANY Pn N - 7-5100 FerN* 978-658-9195 A' Hartford Insurance iNSuRED COMPANY . B Arbella COMPANY Environmental Pools, Inc. C Occupational Health Underwrite 184R Riverneck Road COMPANY Chelmsford MA 01824-4000 D COVERAGES :.. . THIS 13 TO CERTIFY THAT THE POLICES OF INSURANC9 LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMINT 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, CXCLU31ONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) i LICY DATE(MM/DDNY) LINTS GENERAL LIABILITY GENERAL ACGRGQATQ s2,000,000 A X COMMERCIAL GENERALLIAbILITY 08LTUNSQ9238/01 03/28/01 03/28/02 PRODUCTS-COMP/OP AGO 52,000,000 CWM$MADE a]OCCUR PERSONAL G ADY INJURY 111000,000 OWNERS tCON1AACT0RSPROTEACH OCCURRENCE c 1 1 0-00 000 FIRE DAMAGE(Anyon*fire) S 300,000 MED EXP;Mymeper"N S 10,000 1' AVTOMOBILE LUIBIUTY B ANY AUTO 34993400000/01 03/24/01 03/24/02 COMBIIEDSINGLE LIMIT $ 1,000,000 ____• _ ALL OWNED AUTOS BODILY INJURY 1 IX SC4 YDULGD AUTOG 0161 P--) X HIRED AUTOS BODILY INJURY. X NON-OWNED AVTOS (Per ea)eent) 1 ' PROPERTY DAMAGE i GARAGE LIARUTY AUTO ONLY.GA ACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: 1 EACH ACCIDENT S I AGGREOATG S EACESS LIABILITY EACH OCCURRENCE r UMBRELLA FORM AGGREGATE S CTNER T.!AN UMGRfeLLA FORM 1 WORKS7IS COMPENSATION AND ATU- H• GMPLOYERIT LIABILITY 0 Y MRS GL EACH ACCIDENT $ 500000 `. TME PROPRIETOR! INCL C43187065/01 05/14/01 05/14/02 66D18GA8E-POLICY LIMIT 1500000 PARTNER&EXECUTIVG OFFICERS ARI: GXCL EL DISEASE•EA EMPLOYEE r 500000 OTHER 1 I DESCRIPTION Oft OPERATIONSILOCAMONSNTB•IICLr'rS/SPGCIAL(MMS I CERTIFICATE HOLDER CAN�ELLATI:ON .. , -----1 SHOULD ANY OF"ABOVE DESCRIBED POLICIES BE CANCELLED WORK THG EXPIRATION DATE THEREOF,THE ISSUNG COMPANY WILL ENORAVOR TO MAIL Environmental Pools, Inc. 30 DAYS WMTTCN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, Attn:, Andy $YeT.1Di C]h . BUT FAILURG TO NAIL OUCH NOTICE^•HALL IMPO$G NO OOLIOATION OR LIASLIYY 184A Piverneak Road I Chelmsford MA 01824 OF MN HIND UPON THE COMPANY,RS AGENTS OR REPRESENTATIVES. � . AuTWCWGD RGPR696WATNE I ACORD 2"•(1/96) ORATION 1988 i �x vi►hiNHa t 1 HYDRAULIC&FILTERING SPECIFICATIONS J i 23. Approved deluxe filterSize y. T e '1t�� 1 24Pump and motor: Type ' AWV Size I POOL DECD PRIES _ 25.Hairand Lint Strainer.....................................................................'..................INCL. : SUB-BASE MATERIAL IS NOT INCLUD D. 26.Pressure test all pool piping...........................................................................INCL. f 27.Hook up all water lines from filter to pool.....................................................WCL.- Decking square foots ;Type 28.Non-corrosive PVC plumbing throughout....................................................INCL. 29.Hydrostaticvalve......................: ................. INCL. Other: 30.Provide return inlets for filtered water to pool...... .......... ....................:.......INCL. . .................. 1, 31.Main drain suction line with grate........................... ........................:......INCL. E' 32.Automatic recessed deluxe skimmer....................7.l.................................... INCL. 33.Leaf strainer basket in skimmer....................................................................INCL. , 34.Vacuum fitting outlet in skimmer.....................................................................INCL. PAYMENT !° 35.Freefloating action skimmer weir..................................................................INCL. I 36.Up to 30'of plumbing between filter and skimmer....................................INCL. The Buyer agrees to pay E.A.P.I.the following Contract Amount for 37.Concrete pad for pool equipment..................................................................INCL. E.A.P.I.'s performance of its obligations under this Agreement. 38.13ackwash line...................................................................................................INCL: AUTOMATIC EQUIP ENT PAYMENT l!44 �t! �7 �j t L Contract Amount$ �"v 30%Day of Excavation. j� I/� 39.Automatic pool cleaner: Type �V S L u (� $ �6 1 V 40.Stub plumbing for future pool cleaner. ............ .... .. �..........1:. .... . .....INCL. Mobilization $ 006 40%Day of Gunite Installation 41.Floor recirculation system OVL m 1 ��"lD� $ 42.Automatic chemical feeder...::..................................................:.....................INCL. BALANCE $ i 25%Day of Tile POOL HEATER&UTILITIES i. 5%Day of Interior Finish 43.Deluxe eater: Size_L Make tj\'1 LUQ}( TOTAL $ Indoo utdoo NatfPro Fuel c Ions,heater venting,fuel storage tanks, permit...............BUYER THE BUYER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT,HE OR SHE ENTERS INTO A : 44.Installunderwater light(s),each with 10'conduit.......................................IN L. CONTRACT NTH E.A.P.I.AND THE BUYER CONCERNING E.A.P.USCONSTRUCTION OFA' s 45.Electrical bonding of pool as required by city or town code 1 � SWIMMING POOL,MEETING•THESPECIFICATIONS CONTAINED INTHIS AGREEMENT.ANY CHANGES IN ANY OF THE TERMS OR SPECIFICATIONS OF THE AGREEMENT MUST BE MADE 46.Electrical wiring and connection up to 75 from service panel- ( IN WRITING SIGNED BY E.A.P.I.AND THE BUYER,AND NO VERBAL CHANGES IN THESE TERMS Over 75'at$6.00 per foot AND SPECIFICATIONS ARE PERMITTED. J� HYD 'T Y A AS PART OF ITS OBLIGATIONS UNDER THIS AGREEMENT,E.A.P.I.Is PROVIDING THE BUYER �(P, l(� WRITTEN GUARANTEES REGARDING THE SWIMMING POOL WHICH IT WILL CONSTRUCT PURSUANT TO THIS AGREEMENT.THESE GUARANTEES ARE CONTAINED INASEPARATE 47.Attachedparate Light Blower DOCUMENT WHICH IS PROVIDED.TO THE BUYER. Booster Pump n rol Venturi Aqualink System 0C I THE BUYER HAS THE RIGHT TOCANCEL THIS AGREEMENT ATANYTIME BEFOREMIDNIGHT OF THE THIRD BUSINESS DAYAFTERTHE DATE ON WHICH EITHER THE BUYER OR E.A.P.I.HAS Jet bar on bench #of jets SIGNED HISFO 'HYGIVI ITT aNOTICEOFCANCELtAT10NTO��E.AP.L �;,/• `� e' ENVIRON , .. ACCESSORIES AQUATECH POOLS,INC. _ BUYERBY. '. 48.Deiuxe cleaning tools (18" nylon brush, hand leaf skimmer, thermometer, 4 r, pole,test kit,deluxe vacuum)......................... .........................................INCL. C 49.Diving board: Size Color BUYER. 4 " 50.3-tread S.S. ladder/handrail . 5.1.Pool slide: Size, Color DATE: DATE: Z� 111 52.AII jigs installed by decking contractor or buyer —_ _ --. _ -,sy,�.,_�•.--_. s----_ :•'6r�X.:7771 .:•p•f'ti:::3;3 t,�'3 ...y T.,;�v .-:,c*«�_:e-Y..•l:r-- _ - inn'+-'.. :a-.1s.—'' '-n. x+�„� - .. MEMBER ENVIRONMENTAL AQUATECH POOLS,' INC:',_ o 200 Turnpike Road Chelmsford,sford, MA 01824 �- 978.256.0200/800.696.6976 NATIONAL Design Excellence; W['; _ SPA&POOL INSTITUTE T e General TermFs , se Rntations,and Conditions on reverse side are part of this Agreement. NAME (Buyer) Q • (A MAIL ADDRESS CITY STATE ZIP JOB ADDRESS t `� CITY IV } 1 U U+ STATE I ZIP ()7jq N RESIDENCE PHONE �,0 VU ? (� OFFICE PHONE L ll�lY ( lA Environmental Aquatech Pools, Inc. (hereinafter"E.A.P.L")agrees with the buyer or buyers above named(hereafter the"Buyer")to construct a swimming pool and/ or spa in a good and workmanlike manner in accordance with the following terms and specifications. - h DIMENSIONAL SPEC FICAT10NS I - 11nad l�F Width Length Shape �, Depth to /GENERAL CONSTRUCTION SPECIFICATIONS MISCELLANEOUS 1. Structural engineered plans..........................................................................INCL. 53. Raised Bond Beam: Tile Stone 2. Pool layout plans.:......:...:.......................:...........................................:...............INCL. 6" = 12" "' 18" _ 3. Layout pool for Buyers approval......................................................................INCL. 54. Start-up chemicals:25 lbs. D.E.,4 lbs. shock&3 qts. Metal&Scale...........INCL. 4. Set pool elevation for Buyers approval........................................:..................INCL. 55.Provide initial start-up and follow-up instructions.............................................INCL. 5. Perform normal excavation and remove soil on day of excavation only.............INCL. 56. Water Condition - $575.00-20 tons of 1.5" stone 6. Access wall or fence: removed by: V1.0�. Additional stone at$300.00 per load.........................................................:....BUYER \ 57.Clay soil-$375.00............... ...........................BUYER replaced by': !,,V SALES TAX&INSURANCE 7. Trees in access and working area to be cut down so that the stumps do : not exceed 2'in height.... .....................::...:.............................BUYER 58. Payment of all sales tax on pool components and accessories...................INCL. ® loads of: trees, shrubs, stumps, asphalt, 59. Motor vehicle insurance, workers' compensation insurance and general Z.;Remove from site:� ` concrete and other debris liability insurance.......:....................:.....................................`: ...INCL. 9. Hand form and shape pool...............................................................................INCL. 10. Removat'or relocation of cesspool, septic tanks, leaching fields, sewers, A DITIONAL SPECIFICATIONS pipes and utilities(overhead/underground)..............................................BUYER ''tet 1~ f 11. Steel reinforcing per engineered plans.........................................................INCL. 60. � '�1� �1t PI Mt 1�' wt 12. Engineered gunite structure to meet br exceed local or state codes.......INCL. 13. Watercure gunite shell twice dailyfor seven days.........................: hh t� y, / t; �S. \ ..:..,....BUYER 61. �tl .U �G�3'�� 14. Install continuous bond beam around skimmer...........................:........... ..INCL. r 15: One set of shallow end steps with 4'bench... : ..... . ............INCL. 62 - i 16. Sv✓imout or loveseat = _- <_ 17 Install 6",band offro�stprooftile............ . INCL. �4 . .......... 63. t �u" i S9fety grip.copingor bullnosebrrck �U ' ��- a tai'., `�t9 CantilaV2r form for,' eck :z. ha ATL fg 1• ( :. �•�`Pf _ 'i 2�0: hrs:backfilling and rading;deck'ar a o ly.;;. INCL �ry . �: � 21. Pool interiorfinish..........................00.1) .-... . .{ ........` .INCL 65 ' .. - 10G_)_ �r'•�•t,;!4 �, \ .�II/ 1l''/�111I/wrll r/•rrl�� •//,'r.41r1•�./.1i��1 _ IIUMf OPROYMNI GOHIRBCIOR Registration: 101083 _ kPiralion: 01/29/2002 lype: Private Corporalio �•' . CNVIRUNKNIOI POUTS INC. "f,''• Andrew Del Jeigh >I•• � D,j.%',� G�c�•N�f.0 7� �� .1�' 181R River neck Road yr y,•;• AUMINI51NA1011 Chelisford ryp OiRill *; I ' t ' . �:r: . �l✓ c� c C X131 $lO G•.� 0 / f 3' OC L)[>)c?7-/OV A� a,(I tY., �� gyp;;�.'• . r 9 .`. .�� •l 1. � . 'It•r y ii11• • I ?, bbll,. 0 All SURAW.- &.0170 S;'ALL Pelf SIAI1'rr/flx.Ll7dt�O VAA/N Awoor F,emo A004 S• s•' T2� TERMIN POO( , N6 UGNr N/CNf /f SREC/PIED TOP GF QO/VO BEAM " f//N Alfrft MJ J- 4 XASreg f/1IrME A304 /r ' TxgVS/r/GN Ralwr / DIVIAOC 0&4W SA,wZ7rZEDdmf/ L COMM jW.0 GAY COMN — (�DE S'ANGLE 0 .ccsT.oriC MR/N DAA/N itff;cam racvE CdNVE[T D/Rec r w PUMP o REWDEN MIL CONNE RCIAL G"M/A'fLaK i0FF1Y LEDGE - 17 1 36ARS/Z•O.G 4. 6� 1 . •_� •. B�I'f/N GENERAL •COMSTRUC non/ OF BLDG VSA L ESS THAN EI G c .° ` •- avau/r •HEAL TN DEPT CPO. o: e. A L L CDMMERC DES/GN • '•� • TH/S DES/GN BASED V100-1V , EouAurEx L/Nf .' o AND APPR4YE COMM.-orvcr , C X/ND CI-RMPAND TDP Of .5,0 AUTOmgrlc SURFACE SX/MMER s y WILL REOU/RE •' •. 2--3 eRRt IEWI 1C'EN C E __� - � • OlUNE.P rHALL LINOEA WATEx L.1GNr W/Tt0 LOCAL c • GATES TD L3f . p :� .° • ELECrR/CAL PLATF AND LOCAL R o ro I •U LAS G'OC � b O aorw tl/AYC -.0. YO"S ;Mc ' . t Environmental o- REu�F vg4 v6= • a 4 .,,. ( POOLS COL rW Al 7uSEOf REO b) r; Desig Ia��s •Zv •.• � G.�s+re s.tin►v 0 184R Riverneck Road Chelmsford, MA 01824 MAIN oUrc.Fr FAL(_ SPOUT i • �r—j J- Ara QAAS /H QOMo 6EAA • `, ELEYO'D' II J• N G'_ MAz vier. WALL EC fV 2'D• NAMAN A 3 SAa m rr oc Born WA" R aRou�o _ ECEV 3'Q' curnFF ALr ertR I b' — +r.3 BARS SG"CG. car cr A AS NOrEo EL EY S=0' S .4191 S ELEY G-0' s• iN - � UrcFF i9!rE.�aaTE _ z cc EAR !!IM eyes � E1 E_l/71-9"- EL EK 8'O' F T_ le%N/N Tr / bRooR RE/NIC 103 519RS 0/1-ac- QOTH"WRVS TTP, STANDARD 'WALL S'EC'T/ON CONSTR UC TIOW NBT S _REINFOIACINC STEF/,— HALL CONrOXM 7D C/TY DEPT XE/NFO,PC/NG STL�EL SN,9LL CONFO�P/n L' ETY COD �! ST19NDA�PDS: M ,9.S.T.M. DES/GNAT/ONS A -/SFA 3oS NOT PERM/TED ON PDQC S L/9 P.S SNAG L BE A M//V/.'aUi`f OF 7-11 � /T FEET /N DEPTH 197. BD�9,PD. D1,9MFrERS OR /8"Ll///E7F.- SPL/CES APPROY191 RE011/RED FOR aCrUR 74 TYFE POOLS. UN/TE C01YS TRU C Ti0/V 46 GUN/TF S,yylL BE�/yJACH/,t/E/►�/.rf0 AND /APL/ED PN,UW IYN TICAL L Y. M/.r J11,,9Lf BE C'ONF01?t1S TO La CAL CODE AND ONE P//RT CEMf/VT• TO FOUR .9/VD A HALF RF,9SONAQLY LEYEL S/TE RWRTS '5'9/ti'D /.'4Fvz ULT. CO/!7P STi�E/1/GTH NATU.?,9L CZ0L/N0X//TJ>r/N-2 FEET 3A00 PS/ (-v 3S DAYS 'D 6EAJ'9, ANY -YCEP770NS 10 ulgr ?-CEMENT' z97/O sll g L 1,wr ErceffD SUPPL E MEN TR RRY D17911 /DFS/GN -3'/-' GA L-5 L[/RTfR PER SACK OF CE7ffe yr • C//RE GUN/TE BY A L1 GHT LVATER (; vf y PROYIDE FENCING /iY CDOIPL /RNLf Th'XeC rIMFS A OAY FO.P SeVeAol 0.9rs• TY oR rd LUN ORDINi9NCE oL F CLOS/NG e C,9 rCH/NG 'ALL C-dNr-or& TO STATE gwREMEN75 I I W OF MSS I I _ `r9 SARKIS cyc f o ZEROUNIAN m No.29713 y I A I Excellence �sTER :tf,"q i Andrew Everleigh j 2aCouc� President 978-256-0200 1-800-696-6976 Fax 978-256-6620 I - N ilk co OV c i r .9 'd- ,ORT, Town of E dover No. L-A aoo � -COCHIC , dower, Mass., 3 —/� AERATED p`P�`�� '9S H BOARD OF HEALTH Food/Kitchen PERMIT T Septic System c BUILDING INSPECTOR THIS CERTIFIES THAT.... c G V�........ a�.(..`........I a............................................................................... Foundation has permission to erect....o.?O1...X YO/........ buildings on ....../3.�....C 41.�*tle*......4 A Al �- Rough to be occupied as........6W ti!/'r- ...Poo/.......Fm�.....�2�s/��1d/ Us -� Chimney . ........................................... provided that the porson 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. 3 81,3QS- (LC,-/-y) a6-,3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough NO F//( © � PERMIT EXPIRES IN 6 MONTHS Final Poo/ vN N; ELECTRICAL INSPECTOR /0 rmq '),,1,- UNLESS CONSTRUCTION STARTS / Rough eveG A ............................... ........................................... 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burnet Street No. SEE REVERSE SIDE Smoke Det. 3650 Date... NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SS CHUS This certifies that .. ............................................................... haspermission to perform .. .. .................................................................. • wiring in the building of.... ............................................. at... ..... . ........... North Andover,Mass. - t'y Fee,- �5............ Lic.No,1-2 ................ ........................ Cl/ ELECTRICAL INSPECTOR Check # Office Use only 7 W 00MV0NW LTH0FM�C USEM — DEPARTMENTOFPUBLICS9FETY Permit No. (—?kPO BOARD OFFIREPREVEMONRWM770AS527CMR12.00 occupancy&Fees Checked APPUCATTONFOR PERAff TO PERFORM ELECTRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 I O� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 3 C�1(14 �A yvf— Owner or Tenant Q I Owner's Address set W%A Is this permit in conjunction with a building permit: Yes Pq No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Underground M No.of Meters 1 New Service Amps`/ Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work poV n 1 n rov n I No.of Lighting Outlets No.of Hot Tubs 'tr"* No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA and1:1 round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Souriding Devices No.of Self Contained Detection/Sounding Devices r No.of Dryers Heating Devices KW Local Municipal Other ED Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- Laws limeaameitLmb*bn=oePbbcymdudmgCompl* Caa'ageericssksfttiala*i slat YES 12f NO IlmeahnitedvalidpwofofsanelolheOffim YES U NO r7 If}wha%eded®AYES,pleas mdcethetypeofw&aWbyohadmtgthe INSLRANCE r7l BOND r7 alliER r-1 (P1r mSpecfy) /� Vaile�ical Wolk$ WolktoStatt hgxctimD&-Ra pestad Ratgh 000 CA �� Final Signs dutxi�Patakm afpajW G V 3 Z Z tD FIRMNAME Lioei f1TQV Signaltue S_+.� LioaseNo BlsinmTd.Na goz 250 00(7 7U11.d )� c�t( � l J AII.TeLNa OWNER'SINSURANCEWANER;IamawatethattheLio wdioes�$tem m maot W"s bmrtmleq rAiatasm*zedbyNlmmdmseasCt nealLaws aodthattnysig>i Mmaltbispam#appbmbmwai,mftmequamlcm (Please check one) Owner M Agent a JS Telephone No. PERMIT FEE • a COMMONWEALTH OF ASSACHUSETTS DIVISION . OF ELECTRICIANS AS• A REG JOURNEYMAN ELECTRICIAN . ISSUES THIS LICENSE TO GREGORY A TAYLOR \ im 10 TOLL CROSS CHELMSFORD MA 01824-3122 32268 E 07/31/04 358421 Fold,Then Detach Along All Perforations Date No r, M &ORT" TOWN OF NORTH ANDOVER O�t,�•o ..AtiO ' ° p PERMIT FOR PLUMBING ,SSACMUS� / /This certifies that �.!.�.<. . .�.,�. . . . . . . has permission to perform . . . . A. S- �/` �� . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . North Andover, Mass. . . . . . . . . . . . . . . 2 yf PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS cc Date Building Location 3 J .�� 1 k— Owners Name Permit Amount Type of Occupancy J ��,� New Renovation Replacement Plans Submitted Yes r-1 No FIXTURES ► W -- W H rA F d� d a W En Fa x d E- d Z Q `n Q CC1 SLRB MC c BASEMM I i Z"D R(XR 71 3MRDM 4IH HJDOR 5M FLOQ2 6M HBM 7M HIM SIH FLOQ2 (Print or type) i I n ^ 1 t Check one: Certificate Installing Company Name �q b �l V `Z f C Corp. {�6 Address ��` L -f- ( 7 V 1 Partner. Business Telephone !`j--1�- '>,�� . -(-� t�"Lj Firm/Co. Name of.Licensed Plumber: Insurance Coverage: Indicate thety a of insurance coverage by checking the appropriate box: Liability insurance policy L=.1 Other type of indemnity 11 Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner F� Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed and Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts tate PI bing e d C pter 142 of the General Laws. By: Signature opmeensedmurnoer Type of P u mg License Title City/Town 1 ense IN um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY i J ., J Date... ....'.:...r. ........ .. ,NORTH TOWN OF NORTH ANDOVER pf 4„ao ,".,ti0 3r PERMIT FOR GAS INSTALLATION SACMUS*S This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . .!'�: :. �- �. . .! •. . .: . . . . in the buildings of . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . :.! . . . . :. . . . . . . . . ... . . . . . .'. . . . , North Andover, Mass. Fee. . . . . . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer IMASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING ' Type or print) O Cj — [ NORTH ANDOVER, MASSACHUSETTS Building Locations 1 ` Gf 11(( � \c ,_e Permit# Amount S G Owner's Name IL �\ New Renovation ❑ Replacement ❑ Plans Submitted ❑ w w _ ;4 M =G 'r Y z C Z r C a i- W C Cn cn :n L m _ cn z Cn -( it i Lcl z � Stl B -B ,1SENI ENT ' BASE .v1 E `I 'r IST. F L O O R 2ND . FLOUR 3R D . "FLOG R 4'r 11 .' LOO R 5'r I1 . IFLOG R 6•r H 1FLOO R 7'r ii FLOG R ST If FLOG R ;Print or ) a Check one: Certificate�In,stalling Company Vame �ci �► 6� L_ �orp. C 1U� 4ddress �$;- \IV-7- 2.� 1 ❑ Partner. 3usiness Telephone Lj•-�� _ �(� —L )C�'� ❑ Firm/Co. \lame of Licensed Plumber or Gas Fitter NSURANCE COVERAGE Check one: have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ f you have checked ves,please i tcate the type coverage by checking the appropriate box. _iability insurance policy Other type of indemnity ❑ Bond ❑ )wner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter [42 of the vlass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's,gent Owner ❑ Agent ❑ hereby certify that all of the details and information I have submitted(or entered) in above application are true and accurate to the )est of my knowledge and that all plumbing work and installations performed under Permit Issu for this application will be in :ompliance with all pertinent provisions of the Massachusetts State s Code a hapte 1 _ f the eneral Laws. f Bv: Ignature of Licensed Plumber Or Gas Fr' Title lumber LityiTuwn YZ Fitter Jc nse Ivumoer taste:' -\PPRO'v7ED IUFl--!CF.t1SE ONI.Y) ❑ .Journeyman - n N22' 5 J 2 Date... ......... ,40RTM " TOWN OF NORTH ANDOVER ° "'.. - p PERMIT FOR WIRING . t - , , VSs^cMus� Phis certifies that .............................. ............... ............-.':................ . . has permission to perform ........: :.... ......./, ................................................. r .. wiring in the building of........ ..� -- n at.. �... ... �:-r'..r�?:- .. - -�.r!.�...............North Andover,Mass. Fee4..�........ Lic.No.,��,?? ..............................................................{ / ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer TBECOA'MOAWIE4LTHO A14-S-"CF]USE77S Office Use only IDER4RTAffiNT0FPUBL1CSAF= Permit No. ��^1 _ a BOARDOFF7REPREYFVL70NREGUTA770AS5270MI2760 - - 05 Occupancy&Fees Checked 2iZ� APPLICA TTONFOR PEST TO PERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 67(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 6 _! Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. MAP PARCEL Location(Street&Number) (�j-!' 0 13 l C r--iC4-,0-4I C Owner or Tenant V Owner's Address 3 t.'t^N l Is this permit in conjunction with a building permit:: Yes Ja_JNo (Check Appropriate Box) / Purpose of Building . W�-e1 i/J Utility Authorization No. U U4 3 1c6 Existing Service Amps / Vol Overhead Underground No.of Meters New Service '7,u1) Amps /ZJ/&rt)Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above M Below Generators KVA ground ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burncn No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices a No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local F7 Municipal Other Conncctions No.of Water Rtaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- hstaar>ceCb�aa Ptast>a'ttotbeteW=crtsdNbmd"&Cm allaws a ihawaam=LmbhyhsxmmPohLyid-digCarvieL-OpwA=CowraWcritsa legtrivalag YES rt NO Ihanestrt TnWdmibdprudcfsmwlodvOffi=YES r7 If}Kuhawdrd<edYFS pl mmdc*dre peofwo uaWbyd*cdmIgthe IN& ANCE� BOND OTHER �seSpacmy) ETiratiatD3W p ( VahreotIlec�lical Work$ WodcmStatt o v Z-�7—1�0 hWx imDe,Rec� Rcu i �"'�<< C`` ` Final SignedurlderTi,Ptr ,sof / Li0Pf1909 l�►1/`f S�O/4t 0 r �lr i+GC__ Stgi]ahIIe L1CH19eN0 //�� //,^�A, •• f BummTelNa /40-- a1� t- - 0�( I F ttr�`�`- "k,1A Alt Tel Na OWNER'S INSURANCE WAIVFR;Iamaw&ediatd)eLioase doesmthawtheitmaanoeaneq,arts substfftdecl mia$asmgmedbyMasmdLmttsCxnuaILaws andd-Anysigmkwond ispmi-i waiusdnsratsman (Please check one) Owner F7 Agent a Telephone No. PERMIT FEES N Signature of Owner or Agent BUILDING PERMIT o "O oT bJu �ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 79.0047!0 0xv,. �SSAGHUS�� Date Issued: -q IMPORTANT:Applicant must complete all items on this page LOCATION 131 Cr i L ~F Ir.OLI'�c Print PROPERTY OWNER Re xNie-tc.- Print MAP NO: _!PARCEL:' ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family 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 PREFORMED: S 4rip tend tresh; cw Identifi ation Please Type or Print Clearly) OWNER: Name: Re x- ►�'Aie l a Phone: I-A b jS ark 3 Address: 13 i CriCAe-f Lo.ne- Wy-Ri Arioyeo' YA" 01 Fq.T CONTRACTOR Name: 0-6,s+fl Ca'tP e,:WfinG Phone: 9 )k 482,0" Address: ?,00 J own S+I,+ $v i� 22(0 ►�c t� A r&dye/ rqa Supervisor's Construction License 3S$ Exp. Date: OL - IL-PI-6 i Home Improvement License: L S�(o 9 Exp. Date: 1-C`f J10 t 0 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED 25.00 PER S.F. Total Project Cost: $ jl. d• f1 o FEE: $ Check No.: `y �TC�� ZZ�-u Receipt No.: 2-Z Q— _ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund l Signature of Agent/Owner Signature of contra � ` Plans Submitted Plans Waived- Certified, Plot Plan ��Stamped Plans s TYPE OF SEWERAGE DISPOSAJ Public Sewer Tanning/Massage/Body Art Swim ming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF -*U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION DATE REJECTED DATE APPROVED COMMENTS DATE REJECTED DATE APPROVED HEALTH `` ' ' ` J ^'�: . ?1 COMMENTS .u j' , Zoning Board of Appeals: Variance, Petition No: E Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/si nature Date Located at 384 Osgood Street Drivewa Permit FIRE DEPARTMENT - Temp Dumpster on site yes ti _,_[Located at 124 Main Street no Fire Department signature/date BENTS Revised 2.2007 Dimension 4 Number of Stories: Total square feet of floor area, based on Exterior dimension s. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service dro r Electrical Inspector Yes P equires approval of No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.s100-s1000 fine NO NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc-Building Permit Revised 2007 I i i 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 ❑ Engineering Affidavits for Engineered products 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 2.2007 Location 1 �� + C No. Date MaRT� TOWN OF NORTH ANDOVER f R 9 ° Certificate of Occupancy $ z_ Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22-� 22Lr62 ,t3uilding Inspector DAVID CASTRICONE CASTRICONE ROOFING&SIDING INC. ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-7314 Uwe the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the followmi specificatio tms and conditions,on premises below described: (/ Cl r Owner's Name.......... .. • rh .. . .., A ......................................... ........Tel hone#...... .. ...... ,t.a Job Address......./1.3. m . ........City....,f•jy,:f.0.,...�. ..u..VAt................State.....�/�:....... Specifications: . ...................................................................................................................................................................................................................... &Strip existing shingles,:"1 .Apply new drip edge to all edges. .........................................................................................:.:......... ........................................................................................................ ;Apply feet ice and water shield membrane to bottom edges of house. 3ffeet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. l) 1, end s W C.m"✓�`-i.+,a.- Y Ca rte a..5. ................................................�....................._.................... ........ ... Apply felt paper underlayment Install ridge vent to r. t ::.� n.............. ....... .. a ve.� r #.J 4 r J ...re Iiertwf&sin I shingles with a year warrant L}` },% J� ...................................................................................I....................... l.:.:?:....... Counterflash chimney. New vent pipe flashing. 4.egal disposal of all:debris. ................................ ......... ......................................................... Area(s)to be worked on: .. ............... :U..0 2 /............................................ :.r:C .... ?-.�.... }1. - ..YJA1 ... ..: �7. to .... J .......... .. /..1..............................)�..... ..:. .X2:vt...........C_.% de„j.�,3 ....C, .Q,t rs. ..f•e tv ,,•�;1..�; ..,(..t.;n.....5 L,..z.�!«�.��1 " .....Gb3v �...... ................................................ ............... ...............• ............. Roof board replacement if necessary aC3 / a /sheet or'�y�°/foot ........................ ......................... ....... ...... ......... . ........... .....: ...l.�'.10............. ...... Two Year Workmanship Warranty(Not Transferable) Wanufacturer's Warranty as specified by ufactu or The contractor agrees perform the work and fiinn sh the materials specified above for the SUM of$.... ��` , ..:......... tt 'ayable.... on. w+ .- ..... $-i�r.................--:...on.......... ................:.[/, )alance payable on completion of job Owner.orOwners are not responsible for property Damage or Liability white job ms m operaT — Contractor is not responsible for any damage to the interior of property;including protxistiug conditions(i.e.water stains,crumbling plaster•exposed nails)or conditions resulting from application of materials specified above(i.e.objects coming loose from walls,crumbling plaster,exposed nails,dust in attic or other living spaces).Items in attic may need to be covered by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above work,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid,immediately due and payable. It is agreed that,if permitted by law,contractor shall be paid by the owner(s)all reasonable costs,attorney fees and expenses,in addition to the amount due and unpaid,that. shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the parties.The undersigned warrant(s)that he is(they are) the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their)names(s).There are no representations,guaranties or warranties,except such as may be herein incorporated;if any,nor any agreements collateral hereto,nor is the contrail dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director,Home.Improvement Contractor Registration, One Ashburton Place, Room 1301,Boston,MA 02108 Tel:-617-727-8598 Any and all necessary construction-related permits shall be obtained by the Contractor. Any Owner who secures his own construction- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c.142A. Approximate starting dtite of work............................................... Completion date......... :............ _ Receipt.of a copy�of.this_contact is hgreby acknowledged,.and-it is further_acknowledged by,_the undemigned.that'the foregoing..:. „- ,.., provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Owner has three business days to cancel this conttact.and incur no penalty (sec notice f cancellation). IN WITNESS WHEREOF,the parties have hereunto signed their names this...�.. �.day of...... 20...4.!. r.. , Accepted: .1: Signed .«....... ... Owner Signed «........................ ........».»........................... Owner � aY{ David Castricone,President NORTH ® of o dover, Mass., T Q "KE COCKICKE.CK ADRATED PkC3 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT........ ............................... �1.J...;;:;;--: .C .................................................................................... Foundation has permission to erect........................................ buildings on .....1k.....C.r.►.4ra�T...��....✓......................... Rough to be occupied as.......... ............ .......... ......... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the appiication 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T S 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street rBoston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p �p Please Print Legibly Name(Business/Organization/Individual): DAV 1D CASTl2ICd NE �IQOFIN& I S IDiNG /tic Address: An 6 Su-TTD fc," ST2f-e-rt 50 tT't Z2.(a City/State/Zip: N• Pc�bOVE.R MA 61$4S Phone #: 9 78 (o M3 y 40 Are you an employer? Check the appropriate box: Type of project(required): 1.X I am a employer with It 4. E] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. F1 Remodeling ship and have no employees These sub-contractors have g. E]Demolition working for me in any capacity. employees and have workers' No workers' comp. insurance comp. insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. No workers' com right of exemption per MGL. 4 Y [ P• 12. Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: V it NtA S�TWT$. ?A Policy#or Self-ins. Lic.#: C 5la fir[11 15(0 Expiration Date: q.,Z 3 •� 9 t - Job Site Address: 131 Cr JW h&ry. City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify tin-deer the pains and penalties of perjury that the information provided above is true and correct. Signature: ", Co .,,¢� Date: Phone#: Q (D �p A 3 ,3 400 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Town of North Andover DF �owri7 .Building Departments a 0 27 Charles Street °Q �' . `t �' 9 North Andover, Massachusetts 0184 � 5 T V. (978) 688-9545 Fax (978) 688-9542 L D� rao hP`y.(5 CHLJO DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris resi.,Iting from the work sli ll be disposed of in a properly licensed solid waste disposal facilit; as defined by MGL c11, s150a. The debris will be disposed of in/at: Facility 1c)(,, Gion --- Signature of Applicant Date NO'T'E: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector, N(xSSxrhvm/^ 0r|`xr/moxo[ PuNiC Sx[,t N Board of' BviWix_� Rc-o|xhm/y and 'Sundxrds --`^~ ' --' ---~^ " " Standards ^~.*~.�.." " "." -�— cons�ruction3"porvino, Specia|tyLicons« HOME|MPROVEMENTCONTRACTOR ' License: CS SL 89358 Restricted to: RF,WS Registration: 104569 Expiration: 7n4/2010 Tr# 270265 DAVID CA8TR|CONE Type: Private Corporation 31COURT STREET DAVID CAOTR ` ROOFING, SIDING& NORTH ANDOVER, MA 01845 David C2mNoone uOOSUTTON STSUITE 220 Expiration: 1211e/2011 NORTH ANDOVER,MAo18ws A«nmvuonm, Tr-p- 09358 ` ' ` ' , ` ' ' ' ` ACORD,. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 8/5/2009 PRODUCER Phone: 508-651-7700 Fax: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC -Commercial Lines ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Natick MA 01760 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:The ILisurance Co of State PA David Castricone Roofing & Siding Inc INSURER B:Citation Insurance 40274 200 Sutton St Suite 226 INSURER C: North Andover MA 01845 INSURER D: INSURER E: 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Auu L POLICYEFFEC71VE POLICYEXPIRATION LIMBS POLICYNUMBER GENERAL LIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Eaoccerence $ CLAIMS MADE 7 OCCUR MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-OOMP/OPAGG $ POLICYF_j PRO_ LOC B AUTOMOBILE LIABILITY 09MMBCNGCV 8/1/2009 8/1/2010 COMBINED SINGLE LIMIT $ ANY AUTO (Ea acdclert) ALL OWNE D AUTOS BODILY INJUR Y X SCHEDULEDAUTOS (Per person) $250,000 X HIREDAUTOS BODILY INJURY X NON�OWNEDAUTOS (Pataccklerd) $500,000 PROPERTYDAMAGE $ZOO OOO (Per acciclenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EAACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLALIABILITY EACHOCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WC5877756 9/23/2008 9/23/2009 X I T'&yTAm,h 'EB"- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE $100,000 Ifs trnclDr E6dgsc(lbeSIALPROVISIONSbelow E.LDISEASE-POLICY LIMIT $-500.000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SP ECTAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED David Castricone Roofing & Siding Inc BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER g g WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 200 Sutton St CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO Suite 226 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON North Andover MA 01845 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108) p ACORD CORPORATION 1988 11 Location./p/ y /V No. 9 / Date NORTH TOWN OF NORTH ANDOVER 3?O��t`'o ,•,SOL 41 D + ; , Certificate of Occupancy $ cNuSE` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee l t r' IRC" $ g TOTAL $ ¢� Check # f 1 �' t 37 Building Inspector Town of North Andover NORTH OFFICE OF 3?O`t f o do L COMMUNITY DEVELOPMENT AND SERVICES ' ° . 27 Charles Street North Andover, Massachusetts 01845 `°q• F°'°"`ty WILLIAM J. SCOTT �SSACHUSE� Director (978)688-9531 Fax(978)688-9542 CHIMNEY APPLICATION AND PERMIT DATE PERMIT # / / LOCATION /0 OWNER'S NAME BUILDER'S NAME � --,p^�^' MASON'S NAME ` MASON'S ADDRESS / G /J/1"41,4x_ � 0 MASON'S TELEPHONE MATERIAL OF CHIMNEY L l� INTERIOR CHIMNEY C I -Y EXTERIOR CHIMNEY NUMBER AND SIZE OF FLUES f THICKNESS OF HEARTH � LJ Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE ( Cj z o SIGNATURE OF MASON CONTR. LIC. # EST. CONSTRUCTION COST/CONTRACT PRICE / 3 �� v PERMIT GRANTED FEE-a ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING , V BUILDING PERMIT NUMBER. DATE ISSUED: X SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided RecItfired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: >Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record c2t�� Name(Print) Address for Service Signe , Telephone _ J,Lf�� 2.2 Owner of Record: j V Name Print Address for Service: O Z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 LIC&Ilsed Construction Su or: Not Applicable ❑ /--,—tLlo Z/� Licensed Construction Supervisor: 3a / 7 /� License Number ✓ mn Address f� p D Expiration DateO Signature Telephone P � I 3.2 Registered Home Improvement Contractor Not Applicable ❑ -® Company Name Registration Number e r Address AUG 312" r Expiration Date .. Signature Telephone ^. — �jEC`P vl , � NT I 1 ✓�ia, i�anama�uue�l� a�:�ln.;.urc�ta�ells BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 063277 Birthdate: 01/04/1947 Expires: 01/04/2002 Tr.no: 12656 Restricted To: 00 PETER GIANNI 16 BRADLEY AVE METHUEN, MA 01844 Administrator i i 1 Location `y� (/ l3/ �'�' C �� A— No. / Date 7/00 NaRTM TOWN OF NORTH ANDOVER h A ' Certificate of Occupancy $ �'�s •Eta Building/Frame Permit Fee $ s�cNus Foundation Permit Fee $ (J Other Permit Fee $ _ TOTAL $ Check # a1 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: 7rn 17DATE ISSUED: �� O 0 SIGNATURE: Buildin ommissionerfl for of Buildings Date % JO SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard t Required Provide R red Provided Required Provided 3C--) o 1.7 Water Supply M.G.L.C.40 1 54) 1.5. Flood Zone Infonuation: 1.8 Sewerage Disposal System: _ Public !@0' Private ❑ Zone Outside Flood Zone qeor Municipal 0 On Site Disposal System 16 / SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Recordf r 1 Name(Print) Address for Service: 57 -73 7- S`UO Signature Telephone 2.2 Owner of Record: Name Print Address for Service: o � Z m Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor:l� �S" C`r1y' 47 License Number 3� R.o�e��.� �J�=, , raj `^S�`'•� �� Address n, - aa- 3oo`� � 2U/ I-r, 33J`l'ST U Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name M Registration Number Address r Z Expiration Date p) Signature Telephone Y/ 0 r CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number ! Date THIS CERTIFIES THAT THE BUILDING LOCATED ON b�y I I C'��CK� �AA.) MAYBE OCCUPIED AS /y � `l .� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. MOR*� CERTIFICATE ISSUED TO 14��1�?` �2iy 0 ADDRESS ;' Buildi g Inspector Town of N;1oft ? '' " Andover No. F /ooNorth.Andover, Mass., BOARD OF HEALTH Food/Kitchen Septic System�� Aw v THIS CERTIFIES THATv BUILDING INSPECTOR 6, .to)........................�..... ..�..�.......................... ........ ........ ............. ........ ......... ...... Foundation/ /#� l+ has permission to erect........................................ buildin s on �^« r � Rough !aA � a.. ... 3/.... .. ... ..... .. . ...... ...... .. .... ....... te• Chimneyto be occupied as � �A�� ................ S .......................... PERMIT TO BU -ILD provided that the person accepting thiel permit shall in every respect conform to the terms of the application on file in Finac this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction.of14 � Buildings in the Town of North Andover. P PLUMBING INS CTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. /�•g�� ri jJ7 9F,# ELECTRI E Rough ........... ... ... .. . ........................................................... BUILDING INSPECTOR F GAS INSPECTOR 60 Display in a Conspicuous Place on the Premises Do Not Remove Fire l ti�� No Lathing or Dry Wall To Be Done FIRE PARTMENT Until Inspected and Approved by the Building Inspector. Burner f y . �G '� Street No. �a . ..� BLDG. PERM FEE SEE REVERSE SIDE y. LESS FDA FEE---- ��,� Smoke Det. _ DUE FRAME PEWIT$ �r � NORTH q 6 OL rto �4SSAG HU��y APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS/LOCATION OF PROPERTY :- DATE ROPERTY :_DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: C� ��►-OCD FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK'AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNED ROUTING CONSERVATION PLANNING DPW -WATER METER / co NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO =TALTHE OCCUPANCY/INSPECTION REQUEST DPW Signature File: OC form revised 618198 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. ******************'***********SAP/ . 01PLICyA�NT FILLS OUT THIS SECTION**********************� APPLICANT �✓alAlG6 /F1W6 1- 9V. // C. PHONE ?8 470'P2 5'7 LOCATION: Assessor's Map Number PARCEL '¢il, SUBDIVISION IA4 /iV Gt lei 6e- LOT (S) _ STREET Cf2/C/� la ,,l e. ST. NUMBER ********O F F IC IAL USE ONLY******************************* ** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED �r DATE REJECTED COMMENTS n 1 TO PLANNER VDATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT Z FIRE DEPARTMENT 'J U RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jrn I r MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code f Permit MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistancel DATE: 5-14-1999 ZFY COMPLIANCE: PASSES Required UA = 665 Your Home v 622 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 2232 30.0 0.0 79 WALLS: Wood Frame, 16" O.C. 2720 19.0 0.0 164 GLAZING: Windows or Doors 158 0.320 51 GLAZING: Windows or Doors 64 0.330 21 GLAZING: Windows or Doors 435 0.470 204 DOORS 21 0.320 7 FLOORS: Over Unconditioned Space 2040 19.0 0.0 97 HVAC EQUIPMENT: Furnace, 92.0 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 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 5-14-1999 Bldg.1 Dept. 1 Use I - I I CEILINGS: ( ] 1 1. R-30 I Comments/Location I I WALLS: [ 1 I I. Wood Frame, 16" O.C., R-19 I Comments/Location I I WINDOWS AND GLASS DOORS: { 1 I 1. U-value: 0.32 I For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes { ] No I Comments/Location I ] 1 2. U-value: 0.33 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location [ 1 1 3. 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 DOORS: I 1 I I. U-value: 0.32 l Comments/Location I I FLOORS: 3 1 1. Over Unconditioned Space, R-19 I Comments/Location I I HVAC EQUIPMENT: [ ] 1 1. Furnace, 92.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: { 1 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 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. 1 2. Type IC rated, in accordance with Standard ASTM E 283, with no I 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 difference and shall be labeled. I VAPOR RETARDER: [ } I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. 1 I MATERIALS IDENTIFICATION: [ } I Materials and equipment must be identified so that compliance can I 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 1 or specifications. 1 1 DUCT INSULATION: [ } I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ 1 I All accessible joints, seams, and connections of supply and return L 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 air and water systems. I I TEMPERATURE CONTROLS: [ 7 I Thermostats are required for each separate HVAC system. A manual I 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: [ ) I Rated output capacity of the heating/cooling system is not greeter than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ) I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. [ } 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 PIPE SIZES (in.) 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 1 COOLING SYSTEMS: I Chilled water or 9055- 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 I [ 1 I CIRCULATING HOT WATER SYSTEMS: r I Insulato circulating hot water pipes to the foll.owir..3 levels (in.) : I I PIPE SIZES (in.) 1 NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 4 1.0 1.5 2.0 1 140-160 0.5 1 0.5 1.0 1.5 I 1.00-130 0.5 i 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- Town of Na th Andover Planning Board �~ ---_- This 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 by-taw Section 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 orior to the issuance of any building permit or permit for construction. Name and Address of Applicant for Lots: Name of Development: I Marie Pitochelli I Walnut Ridge Fa"nsiop of Cri&i Map and Parcel of Anginal Lot: j Date of Applic3tion for Los Division: I October 31. 1997 i Lots Covered by this Schedule: t-to Cricket Lane ; The Planning Board by their signature below, or a signature of a duly authOOZed reiXesentative. do hereby establish for the above named development the following Development Schedule for the purpose of Seciion 8.7 of the Gc kWl:L=maagement By-Law;. Ttsa-apolicard their assignees. successors and or subsequent property-owners shall conform to the folicvAng schedule that limits the eligibility of the foitcwing lots for building permits. This fora must be filed in the Registry of Ceeds by the property owner or representative and be refamnced on each deed for each of the fcllcwing lots. Such deed reference for the deed of each lot shall at a minimum reference the book and page in which this Development Schedule is filed and contain the language: "This lot is subject to a Development Sctwdute,oursuant to the Torero of lllcrtAAndover Zack?q 4-Lame ait owners, reprr9sentatives, and hbtum purchasers should avail themseh(es of sold restric!kn by raviewir=g rhe appraved Oeveicprnent Sci ecu/e as riled in Sock and Page Tr:e fact >~at a:ct is aiigible for a CuJcrrrg perms is s4ecf to tt,0 jimitatbcn of the number ofibuildirg s per oaf Atrrstuarrt Eo-section 3.7.2.d of:he Zoning By-!aw.' The Planning Bcard hereby schedules the tot(s)-for the above development as shown cn the attached schedule. Signature of alanni .em "~ or iuthcrized Representative / �- - cat Signature of Pro vthonzeid-Repfesentative- �� :) Gate 8-7 Growth Nianagcment By - w - Walnut Ridge • 6-'0 Lots=S buird"ing pCrinits per year • Ycar=July 1 to July I • P its Q Wien out on a quarterly basis i.e. Y4 elicrible lots would be available in July, October, January, andAprff - La the Year that the tots are created the total number of eligible lots for that vear may be sc eduled in the month the decision appeal period expires Date Eligible I Eligible permits Total permits .Ju w 1998 ! per r etiQibie Ocr 1, 1998 10 ; N2 1077 Date ...Z— - r►ORTH TOWN OF NORTH ANDOVER RECEIPT S`rACHUs� This certifies that .....v'-.........�J. l�l . l 1. ...1...... oa................................... has paid............................... .. .. .... .... ` �.�.... ` `�!-7 �Gfor .....w ...... ... f....l�7L . � Received by.........................1..1.11Y1 ......(/v.�.! .. l�...................... Department........................I..: .` ....1. ...... ............... WHITE: Applicant CANARY:Department PINK:Treasurer NO 957 APPLICATION FOR WATER SERVICE CONNECTION Fe�� North Andover, Mass. '1�7 Application by the undersigned is hereby made to connect with the town water main in /�G��( /�iri/� Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. /�( ��e� �� Street or subdivision lot no. L(/ til v �/ �r� L l(��n r 2 .'S Owner Address Contractor Address ^� `�, /J pplican,, Signature Vk PERMIT TO CONNECT WITH WATER AIN J� The Board of Public Works hereby grants permission to V Z--L e to make a connection with the water main at Street subject to the rules and regulations of the Division of Public Works. Board of Publ' Works BY Inspected by Date See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 Telephone(508)685-095Q- Fax(508)688-9573 NORTN t,,EO ,6 64' OL 0 m v s �•9.0,�TF SSACHU5ES DRIVEWAY PERMIT Date: �� Z z LOCATION: BUILDER: phone: OWNER: ��v� �� C phone: L��G� - X70 ri 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: . . ✓rte �� a �f��/�,� j BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR Number: CS 074947 Birthdate: 07/22/1967 Expires: 07/22/2003 Tr,no: 74947 Restricted To: 00 RONALD J PITOCCHELLI _ 20 RIDGEWOOD DRIVE ( •.�,�i! ATKINSON, NH 03811 Administrator i W!� The Commonwealth of Massachusetts , > Department of/ndustria"ccrdents Office cf Investigations Boston, Mass. 0�111 Workers' Compensation Insurance Afdavit dame Please Print Name: Lccaticn: CI,-,^L�e-t City VvJC'C��`�`�za�r Phore j-i$' 33- 1- 5-SU o I am a hcmeewrer performing all work myself. 1 am a sole proprietor and have no one we-rking in any czpadty CI am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address Cih!' Phcne T' Insurance Co. PClicv m I Comoanv name' �Ogiwu' �t Address -733 -a rvijoik S} S";fie 1 SSS Cihr a10(1L. RVI 00\61 Phone Y- I. 97$- y70- co, WC soSags33 Insurance Co. ;rvs1' AS%1-,gV ce Polio T T 1^t O 1 0�S?'1 Failure to secure c overage as recuirac unser Sec;icn 25.E cr tiGL 152 can lead to the impesitien er c.iminsl penalties d a rine up to S1.°00.00 ancler one years'impnscnment as•.veil as cmi penalties in the form or a STCP'NCRK CRCER and a fine cf(S100.00)a day against me. I understand that a c y ci;,`tis statement may to fcrvarced to the Office cr Investigations of the CIA for coverage verinczticn. l do hereby certify under the pains and penalties or pe.jury that:he inicrmaticn provided accve is`rt:e and ccrrec:. Sianature f/ Date ;- a8-_0 0 Print name /roe., a-L' ✓e/)' Phone# 275' 33-7•5"s�t7 Of-ic:al use oniy de not waste in this area to to completed ty city cr town crr ciat C:y or Tc+vn P=rmitlLican<_inc � Building Dept ❑cre`x if immediate response is required ❑ Licensing Board [j Selectman's O,lce Contac:,:erscnt Fhcne Health Department Other " TownNORTII of 19Andover No. 7 dover, Mass.,_3 COCHICHEWICK %ADRATED P'?Y' C1 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT....�(i. A.1.N....ut Ri 4 4.4 NOW, AV BUILDING INSPECTOR Foundation has permission to erect..................1................... buildings on -ke..�.q..... I �....r0%.1.4� T ..��l Rough to be occupied as...�....R*VM. Of. S A't�► � �041( V��'�.� S� Ie �0 • Chimney p ..................................... , .........................hr provided that the person accepting th 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. M *3 A? �O f 4 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough R 167 9. w PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ........... ... ... .. ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner BLDG. PERMIT FEE .a� ' Street No. SEE REVERSE SIDE LESS FDA FEE._ i�- Smoke Det. DUE FRAME PERMIT $ ORTH Town o �� .., To . . gAndover 0 9117 C' .r`- LAK o ndover, Mass., COCHICHE WICK �1 A01�ATED PP��S �SACHuse IT FOR EXCAVATION AND FOUNDATION 600 THIS CERTIFIES THAT ....WANW. ............. z .. -.... ...... !.......An...L-1: .......................... has permission to excavate and pour foundation at �. .... ............ ........ for the purpose of. ................ .............. ..... .. / v�� S1, ..... .. � ...�............ ........ ........., The person accepting this permit must return to the office of the Building Inspector a certified plot plan.....show 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. s BLDG. PERI'd IT FEE LESS FDA FEE�R� DUE FRAME PERMIT $gj BUILDING INSPECTOR