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Home My WebLink AboutBuilding Permit #Exception - 194 GRAY STREET 5/27/2005ir 0 Permit No#: BUILDING PERMIT TOWN OF NORTH ANDOVER 0.410 APPLICATION FOR PLAN EXAMINATION. NA Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building -g One family El Addition D Two or more family 0 Industrial )KAIteration No. of units: 0 Commercial 0 Repair,, replacement Li Assessory Bldg El Others: D D "" lition D Other 10D. I PCv Wei El Weir fi6t-'. ffrghi�d Isi a -8- WIO' nr:Qr'P1DT1r)M r)r: Wr)RK TO RE PERFORMED: OWNER: Name. I Address:—tzy - Please Type or Print Clearly 57�� IV, dAi1C'-e,1- P'M &C 7 F- 7/4 -ne- qof� Ndf Rh A u E cpuptfubtlibr-i C WV '��T. 75 8t ha" �1' (-1 4'�2,3 ARCHITECTIENGINEER IV A Phone - Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: $1Z00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. I ost: $ 00 FEE: $ .-__,rotal ProOGt C Check No.: Receipt No,,- 4 NOTE: Persons contraefing witIz unregistered contractors do noaave.- access to t1ze guarantyfund A i ke OWNER: Name. I Address:—tzy - Please Type or Print Clearly 57�� IV, dAi1C'-e,1- P'M &C 7 F- 7/4 -ne- qof� Ndf Rh A u E cpuptfubtlibr-i C WV '��T. 75 8t ha" �1' (-1 4'�2,3 ARCHITECTIENGINEER IV A Phone - Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: $1Z00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. I ost: $ 00 FEE: $ .-__,rotal ProOGt C Check No.: Receipt No,,- 4 NOTE: Persons contraefing witIz unregistered contractors do noaave.- access to t1ze guarantyfund A 0 Plans Submitted .j. - Plans Waived Certified Plot Plan Stamped Plans 0 F SEWI 131 F SEWERAGE DISPOSAL yp� rPublUic Sewer TanningtMassage/Body Art Swimming Pools well El Tobacco Sales El Food Packaging/Sales El Private (septic tank etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On . . Signature_ CONSERVATION Reviewed on 8iqnature I COMMENTS EALTH Reviewed on Siqnatu .-1- 11 1 COMMENTS �4-0?A 4" +-1-b, -� -Tljjp � po-e,� plool- J��Vs if Pljoifq S -1d 6�f 0 Zoning Board of Appeals: Variance, Petition No: Zonina Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Go n n ectio nfSi-q nature & Date DrivewaV Permit DPW Town Engineer: Signature: I Located 384 Osgood Street FIRE DEPARTMENT' -.Tem� Dumpstor on site yes Loeated -at 124 Main Street Fire Department signatureldate COMMENTS no �� - C'�� 12/29/2016 194 Gray St, North Andover, MA 018451 MLS #72043737 1 Zillow CONTACT AGENT Q SAVE 0 HIDE SHARE MORE - 21 EXPAND X CLOSE Public View Owner View 194 Gray St, North Andover, MA 01845 4 beds - 4 baths 3,733 sqft FOR SALE $749,000 Price cut: - $50,000 (12/4) Est. Mortgage $2,962/mo Get pre- qualified Barbara Grasso AGENT (0) 1 Recent sales Coldwell Banker Residential Brokerage - Andover (978) 502-6242 urName 1k. Phone 30 R.14 E m a i I I am interested in 194 Gray St, North Andover, MA 01845. Contact Agent IENERGY PRICED!! Exceptional Home with Exceptional Privacy! This is the perfect home for an extended family with I Learn how to appear as the agent above wonderful living space everywhere! The 1 st floor features a formal L.R. and Formal D.R., an oversized eat -in -kitchen w/granite, SS appliances, a center island and tons of cabinets, a nice sized laundry room, a family room w/Oversized Windows 'A,vww.zillow.com/homes/for-sale/194-Gray-ST-N-Andover-MA-01845-rb/VomHomePage=true&shouldFireSellPagelmplicitClaimGA=false&fromHome It All Location No. 170 cf Date 40RTol TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check# YY - Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT M!Mj RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING sell" 1AW BUU,DING PERNUT NUMBER: DATE ISSUED: SIGNATURE:', Building Commissioner/lEsj!Edor—of 136ildings Date SECTION I- SITE INFORMATION 1.1 Property, Address; 1.2 Assessors MV and Parcel Number Lot #9 (194 Gray Street) 107D 10 Map Number Parcel Number 1.3 Zoning Information: I 1.4 Property Dimensions: R2 — , Single Family House 131,462 51 Zoning District Proposed Use Lot Area (sf) Frontage (ft) 1.6 BUMDING SETBACKS (ft) Front Yard Side Yard Rear Yard LeqTred Provide �,�red Prmided Required Provided ^TT 4U Ju 1.7 Water Supply M.G.L,C.1400.1 54) 1.5. Flood Zone Infonnation: 1.8 Sewerage Disposal System - Public 5 Privaft 0 zoac Outside Flood Zone . Municipal 0 On Site Disposal System X9 SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT ni c- t: "'Ib 3 NO 2.1 Ownerof Record I Litchfield Co: Anc. 26 Ray Ave..Burlington, MA 01803 Name (Print) Address for Service: A �4 781-270-6859 'k Signatmoe' Telephone 2.2 Owner of Record:' Name'Print Address for Service: Signature e ep one SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Joe Currier Licensed Construction rvisor: 1�t��on, License Number MA 26 Ray AV14' Bur.1 01803 yyg Address 617-839-2362 Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Compafii Name Registration Number Address Expiration Date Signature Telephone 4 SECTION 4 - WORKERS COMPENSATION (MLG.L C 152 § 25 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will resulf in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... 3 No ....... 0 SECTION 5 Description of Proposed Work (check al app&able) New Construction 0 1 Existing Building 0 1 Repair(s) 0 Alterations(s) 0 Addition 0 Accessory Bldg. 0 1 Demolition 0 1 Other 0 Specify Brief Description of Proposed Work: New Construction - Single Family Rome 4 Bed, 2 1/2 bath, colonial 5 /34th,�, 3 St&// vpde v -- Z.4 eA Y'C - qRCTTON 6 - RSTTMATRn r0NV.TR1TrTTnN VnQT.4Z Itern Estimated Cost (Dollar) to be C2�!p ete b� permit applicant OMCL46L USE ONLY . I Building $40,000 (a) Building Permit Fee Multiplier 2 Electrical $10,000 (b) Estimated Total Cost of Construction OP 0 3 Plumbing $12,000 Building Permit fee (a) x (b) 4 Mechanical (HVAC) $12.000 5 Fire Protection 6 Total (1+2+3+4+5) t7L - non Check Number IV UK UUMPLE'J'EV WHEN OWNERS AGENT OR CONTRACTOR APPLILES FOR BURDING PERNUT 1, Gary Litchfield_ 72 as Owner/Amtlmriz�eff of subject property Herebv autho ' Ao e,.Puy r i e r , // - o act o My be!h:al V,rq n-::2��e to= ed by this building permit application. *Wv&&e to 6 X �p I -AA510- X Sigii�ture ot?6wnT1,-" ' - Date SECTION 7b OWNERJAUTHORIZED AGENT DECLARATION 1, Tc!e I �Z as Owner/Authorized Agent of subject property k Hereby declare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge and belief Print Name Signature.of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS I b7 2'4u 3 FJ) SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DaENSIONS OF GIRDERS HEIGIHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FELLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I "e " L FORM U - LOT RELEASE FORM -M 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 th 6 applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION . toommit, I — APPLICANT__2— �' LOCATION: Assessor's Map Number Zd2 C, SUBDIVISION PHONE 9,5?- -.2 ;ZO - PARCEk 16 LOT ST, NUMBER I **1*i******i* - -k** OFFICIAL USE ON TOWN I FOOD TH DATE APPROVED DATE REJECTED DATE AP'—PR—O%I&—D DATE REJECTED DATEAPPROVED ---------------- DATE REJECTED DATEAPPROVE6 DATE REJFCTi:n PUBLIC WORKS - SEWER/WATER CONNECTIONS i DRIVEWAY PERMIT FIRE DEPARTMENT 1-7 d r1,9-11 kej RECEIVED By BUILDI NGINSPECTOR RevIeW vW jM U4/1'1/;! 05 TUE 16:40 FAY. 17812709406 Litchfield Company NO, ANDOVER TRAILER 2001/001 BOARb OF 0,UIL003 REOULATMNS CTIGN SUMAMSOR Lkense: CONSTRIJ 066839 Sir L ". P01M Tr. no: 6738.0 .—M. Rai JPS g.PH,P CURR MAO -g7d1z's-/ I MA-W.F.-OR0 �6 BUkLIN6*6N, I�A . . ........... ------- - 04 sa 2 S 0 it '-I I � 11* 11 t 1 i h I img, Rog it hit imus and t ad rd HOMCI OVEMENT CONTRACTOR R '9302 '2007 ioual J -PH P C OSE JOSEPH CUR i ICRAWFOR BURLILNGTONi. rv,,�k f,-,8�!3 Admi aistrator T& wo oi North Andover Plauning Board Thi; form represents the schedule for allowing the following lots to be considered as eligible for WE ding permits under the Town ofNorth Andover Management by-law Section 8.7 of the zoning by-, aw. 6suant to 8.7 this Development Schedule must be Rled in the Regisstty of Deeds and be refi renced on the deed of each of the lots below and be filed with the Planning Board prior to the isst Wee of any building permit or permit for construction. Nw ie and Address of Applicant for lots: Nam of Development! LkIfield Co., Inc 26Asy Ave., Buffmgton, MA Gray & Boston Streets North Andover, MA. Ma and Parcel of Original: 107D, Lots 6 & 10 Dal of Application for Lot(s) Division: March 25,2003 Lot i Covered by this Schedule lar314L51617s8,9p10711J2�14915 (15 total) Tbc Planning Board by their signature below, or a signature of a duly authorizes representative, do her �by establish for the above named development for the following Development Schedule for the pur.)ose. of Section.9.7 of the Growth management By -Law. The applicant, their assignees, suc -essors and or subsequent property owners shall conflum to the following schedule that limits the el� ibility of the following lots for building permits. This form must be filed in the RegWq of Det ds by the property owner or representative and be referred on each deed fDr each of ft foll )wing lots. Such deed references for the deed of each lot shall at minimum reference tho book and page mi which this development Schedule is filed and contain the language; This lot is subject to' aL D welopment Schedule pursuant to the Town ofNoith Andover Zoning By-Lavq, "This lot is sub, ect to a Development Schedule pursuant to the Town afNorth Andover Zoniag By -Law aU ow. ters, representatives, and fiture purchasers should avail themselves of said restriction by rev ewing i,the approved Developmeni Schedule as filed in Book and Pa IN fact that a f�t is eligible for a building pennit is subject to the Umitation of the nmuber of buIding permits per year pursuant to section 8.7.2d of the Zoning By Law." The Planning Board hereby schedule the lot(s) for the above development as follows: I . Number of lots Building Office Us -c igi le ible Efigi Date Lot EH&ilhv Complet.-ly Utilized Building Office USQ Notes Fisi al 04 6 Fis at 05 6 Fis( at 06 2 10/15/2004 FRI 10:17 (JOB NO, 74411 Onni S, gnature 0 a�ng S W1 Lfuuw iNbrth MW 11 t or Authorized Representative Date:4 /)/ e Date: zyklve- COMMONWEALTH OF MASSACHUSETTS w",1,ffYZ-Lw ss $& , 12Q2� �f r -f -- rOle 1henp ersonally appeared Z2� 60 11j,/ as Applicant or his/its authorized agent aud IV, 9s a:knowledged the forego' g to be ; or her free act and deed and the free act and deed 29--,6;7wEt o f the AppEcant, before me. �-Mk f L A MWAL%- .1 X\X /Z lope,, 7Y commission Expires: 1;d1-2wA:-'0-t i0m. E* 0 ACT COMMONWEALTH OF MASSACHUSETTS 11.A - X RY 9\)e SS 20 "hen personally appeared the Planning Board Ch* or his/its i athorized agent and ackmowledgcd the foregoing instrument to be his or her free act and deed and tv free act and deed of the Applicant, before me. Notary Public My Commission Expires: & MARY LEARY4PPOLITO Notoq Public wr-awaft"alth of mossuchuselft MY Cw"j"w bpiru JU rAs 7,2W7 10/15/2004 FRI 10:17 [JOB NO. 74411 MAW OCT -29-2004 04:40PM FROM -MICHAEL T. STELLA SR,P.C. rr 10*191,771 af N.Dith Andover Office Of fb.� Flaming Depaxtm Cam iwiuni-17 Developmeiit and Service, 27 Charles Street iing Director: NoTdi Andover, Massachusetts 01.84 /,AINVW I townoffiorthandovLrxi wood s@towRo-fnorthandover.cozr T�Venty (20) daYS 'e NOTICE OF DECISION RTIFIED MAJI joyce AJ3. 011iffiv SENT USPS VIA CE RETURN RECEE" REQUESTED # a ocoo 0?q'4 Ic aq §tella, Rt2lty Trust M — Lots 8 and 9 Gray Street Special Peevnif Approval — Frontage Exceptions The public heaemg-, on the above referenced applications were closed by the o Februa7. 13, ^00'. Present werePlanning Board Vice Chair -Alberto AnI Members rFi:.1ipe Schwarz and George White, Associate Member lames Phh Woods, ,w.d Planning Assistant Debbie Wilson. Attorney George Stella and on behalf ofthe petitioner. Nardella wade, and Wbite seconded, a motion to grant the Frontage I accm to propostd Lots 8 anel 9 on Gray Street that do not meet the �required by Section 7.1.7 and 7.2 of the North Andover Zoning Bylaw by the I'Vary Stella Realty Trust 111, 162 Gray Street, North Andover, M excluding, rev;sed documeniation, as cited hereill, WaS filed with the Pin with subsequent s0mitrals on file. The applicant submitted a complete. reviewed in arcordance with 7.22 and 10.3 of the Town of North Andom �40A, Spration 9. The motion to approve was subject to the FME CONDITITNS set forth in Appendix A to this decishm. The Pjauniag.'%OarA voted on the mothon by a vote of 5 in favor t o 0 a'I sFecia,l Pen -i,4 _Wnting authority requires a vow of at least four members �Chapmr 40.A, Secdon_9and Section 10.3(5) of the Town of North Andove A H�Q+`n "'h Q.*_ *M FV UZI A k; an Special Permit is approved with conditions. T-390 P-001/003 F-819 The applicant 19 hereby notified that should theapplicant disagree with this decisi . bn the Applicalit has the right, wader TAGL Chapter 40A, Section 17, to appeal to this decision within ;7e;z days after the i date tbin dlecbioii has been filed with the Town Clerk. I Respevr:&Ily Submitted, Woods, Planning Director for the North Andover Planning Boari': Voted: John Simons, Chairman Y-N-Abst-N/A Alberto Angles, Vice Chairman Y-N-Abst-NIA Pichard Nardella, Clerk Y-N-Abst-N/A George White Y-N-Abst-N/A Felipe Schwam Y-N-Abst-N/A JamesPhinney, Associate Member Y-N-Abst-N/A RIJILDNCTOR-9545 C0N�11:.R\"hTT0N6S3'-9i30 HFd\LTH&R845,ia P.LN4NTNG69$,953.5 c;::) C�6 I OCT -20-2004 04:40H HOM-MICHAEL T. STELLA SR,P.C. T-390 P-002/009 F-eig I M 8 and Jot.0 Gray Street A Special Permit Approval Stella Realty Tr ,. ust III Frontage. Exceptions Febroary 21, ?W0.3 Page 2 of 3 The Plannis-1g, Board makes the following firidings as rcquiTed by the North Andover Zoning Bylaw Scctions 712 & 10-3, FINDINGS OF FACT: 1. Section 7.13 of the North Andover Zonhig Bylaw defines how the lot area is calculated. If the total lot aTea 4, lots'& and 9 are calculated as described thorcin, the lot areas do not rneet this requirement. Howew;r, thc lllanx�ng Board finds that if a waiver is grante:4 from this sections, the lot areas exceed bY thM,' times the minimum area required for that Zoning District (43,5 60 square feet) as Lot 8 contains 3,010 acras and Lot 9 contains 3,001 acres. Accordingly, a waiver from Section 7.1.3 is grAnted and the Board finds that the criteria in Section 7.2.2(a) is satisfied. 2.1 '11-. lots have, a minimum continuous street frontage of not less than fifty (50) feet and a width of not ICSS thul fiftY (50) feet at any point between the street and the existing horne. Lot 8 contains 52-01' Of on Gray Street; Lot 9 contains 50.00 feet of frontage on Gray Stmt. 3, Tlberrc is 110 firontaga oxception lot with contiguous frontage with another frontage exception lot, other diaii tacil., ofthl-, proposed lots. 4. T11c are located so as not to block the possible faiure extension of a dead end street. The creation Of this lot will not block ft future extension of a dead end street. 5- 'nlc efeaioll of thi� lots will not adversely Wect the neighborhood. Ilie development of single fan- 4 h0nlas on lots in excess of 3 acres is in keeping with the current zoning and respects 1he rural d=ctr.-r of tile exis6ng neighborhood. 6. Ille 9MLim, of tWs special permit will not be deWmental to the town as the altemativC to the creation Of 1�ds lot i's a Anulti, lot subdivision that would exceed lie number of lots generated by an approval not mquiredplan inc)uding frontage exception lots, 7. ThO PUMM Wd intent of the regulations contained in the Zoning Bylaw are met with the speew Ptreni� Appricabrpn, UPON M,-RcbJE* the 211ove findings, the Planning Board approves this Special Permit with the followling SPCOW Conditions: This de,.;i-sion must be filed with the North Essex Registry of Deeds. Included as a Part of this decision are the following plans and decisions: a) Phans tifled- Topographic Plan of Land Mary A Stella Realty Trust III '?Ycpared by: Pembroke Land Survey Company, Scale. 3 " = 40' Plan Date- 9/12/02, last revised February 5. 2003, PrW to the eAdOnOmftt of these plans by the Planning Board, the Topograpbjc Plan of Land Mary A Stella Realty Trust III, as depicted on the revised version dated February 7, 2,003, must be revised to include the dates of revisions. The Town Planner mustIpprove, anyother changes made to these plans. Any changes 1-F substantial by the Town Plarincr will require a public he' aring and a modification I 6�'ii6d .... h,Y tho, Planning Board. 530 AL .95 PLMNINr, 68g 335 20ARDar -9a41 f3V1LD1Nr-' 688-9545 CONSF-rCVATION 698.9 HE TH 688 40 -9 I A /nA InAA A Wk -1 (-41'-AUU* 1A i 14 JrM MMMAML 1. 41hLLA SR,P.C. T-390 P.303/003 F-819 Lot 3 and Lot 9 C -ray- Strefft 'Special 1'erinit Appro'ynl 'Steil. -I Realty Trust III ,Feb7 uary 2-1, Page 3 of 3 12, Prior to any site disturbance- -s"i,Q..n.,,c.Q,n..t,ro,l,,.d.ev.ic;� must be in place and reviewed by the Town Planner. b) he decision, of tile PlIuming Board must be recorded at the North Essex. Registry of Deeds and a certified copy of the recorded decision must be submitted to the Planning Office. C) Treecl.ea �i musT.�q,kpp V, area e c cared 11 x The to b I sha nDt e ceed the tree clearing area depicted on the revised plans.., 3- The conliktor sball contact Di _$.&C j:;� hq pq prior to commencing any excavation. 4, GaS, telephone, cable, Wd elc�C�c Utilities shall be installed as specified by the respeove utility cor.a.panies, 15, 'No open burning shall be done except as is permitted during the burning season under the Fire DT,artmezit repMons., 6, 1, t I'de"f9"' rb.' 1 4 1 1 d.& . e I s , tOr , age sbill' )e installed except as may be allowed by Town R S lations- 7. T h approval shall apply to and be bindiing upon the applicant� its employees and all succcssors and assigns in interest or control. 8. 'Ibis Pennit shall be deemed To have lapsed after a t'wo- Q)year. period from the date on which tbe SPecial Permit was granted unless substantial u'-s"^e or construction has commenced. 9, The -ninoff, for the rooftops of all Tiew building shall be completely infiltmted. cc. COVServafion AdminiStTatior Dir( --tor of Public Works T:iWtb Administrator nnildlfilg lnsp=tor Police ar�r�,f Firo: CWef Applk.aw Engpnecr Abutters Asstzsor DPW File 7Z: aw �a n i-�M A 8 4 WARD OF APPI CONSFRVATION6U-9510 IMUTTMRS-95-40 PL-INNNG681,34533 10/29/2004 FRT 1AaAA r TnD TTn --.1 M North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM in accordance with the provision of IVIGL c 40 S 54, a condition of Building Permit Numbe is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal faci . lity as defined by IVIGL c 11, S 150 A. The debris will be disposed of in: 47-t (Location of Facility) Signature of Permit Applicant NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The COmmonweafth of Massachusetts Depaftent of Indusbial Accidents Ofte of tnv*Wgoftns Boston, Mass. 02111 - Wbrkm'C*7wmtlon Inswwne Affldavt Flow Pdrt Nam tQCadm C& 1:3 1 am a hwwmw porkffdng A vm* myW. F-1 I an a We proprIeW a -d have no one woMng In any cape* F-1 I am an empkW pvAdIng workeW corn- fbr nly employees worNng on he job. C�Wg= rW= Litchfi.eld Company, Inc Addmw 26 Ray Ave Cft �urlington. MA Oisol PhaMt (781) 270-6859 Savers Property Insurance/Renaissancepdk,# Co. Cmp= ram. Aftm CUE Phonet nKnum Co. Pdkv# M FdkNe to somm no- a ep m mqL*od tudw Sedlan 25A or MOL 152 cw kWtOffwbmpwNmd.lnh pw&jmCf,afimUPlO$l,5W.W muft vemkkwba.. jm.wdAsAhd4mddm Jobs Am dA BTIV YAMORDERmdA ft d-MMAMA d* Mq@lMlt MIL I =t"imi*d Md a copy of t iffwbefawm to the Ofte of lmmdgsftn of Im Mk JW COWMW VWftdlWL I do hw*# cw* wxfw ft Pw PWIWF ft k*Mmft prov*W ebm Is &w aW swadu 5/6/05 (781)270-6859 Print nerne Kristi4 R4zR!y_ MOM# OfficW as only do not wrb In this mr�lo be cwMWed by dty or town my or 13 Bu#ft 09# 13Chock f knmedeft mp=f k mqukvd (3 Ubsoft Board 13 Sskcftm's 0*0 Conted Ph" P [3 h*&" DeWftlent 0 OUW Professional Land Surveyors Civil Engineers ESSEX SURVEY SERVICE 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND MCATED IN 4koUVL (2 MASS. A 6 AL 43 4 I? 32' &,67 N I hereby certify to the ding Inspector that the pro - LOT AREA: LOT. FRONTAGE: 1.�Of posed construction'shown conforms to the dimensionalzo IDE YARD S :"3d1T REAR YARD:�� HRISTOPHER MUL0 111b, 31317. C Ji 'PEADOL ago E., �FAX 7 RES�heck Compliance Certificate Massachusetts Energy Code RES checkSoftware Version 3.6 Release I Data filename: CAProgram Files\Check\REScheck\Litchfield Companies.rck PROJECT TITLE: The Rosewood CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: I or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) WINDOW / WALL RATIO: 0.20 DATE: 10/26/04 DATE OF PLANS: October 26, 2004 1 PROJECT DESCRIPTION: Litchfield Companies I COMPLIANCE: Passes Maximum UA = 562 Your Home UA = 545 3.0%better Than Code (UA) I /p Permit Number ,M%/ syojtlo�-- Checked By/Date 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 Massachusetts Energy Code requirements in RES checkVersion 3.6 Release I (formerly MECchec� and to comply with the mandatory requirements listed in the RES checkInspection Checklist. 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 RVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 13 10 and J4.4. Gross Glazing Am or Cavity Cont. m Door Re-jr—imet R -Value R -Value U -Facto UA Ceilm"g 1: Flat Ceiling or Scissor Truss 1169 30.0 0.0 41 Ceiling 2: Cathedral Ceiling (no attic) 748 30.0 0.0 25 Wall 1: Wood Frame, 16" o.c. 2848 13.0 0.0 184 Window 1: Wood Frame:Double Pane with Low -E 565 0.350 198 Doorl 1: Solid 38 0.370 14 Floor 1: All -Wood Joist/Truss:Over Unconditioned Space 1764 19.0 0.0 83 Furnace 1: Forced Hot Air, 90 AFUE I 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 Massachusetts Energy Code requirements in RES checkVersion 3.6 Release I (formerly MECchec� and to comply with the mandatory requirements listed in the RES checkInspection Checklist. 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 RVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 13 10 and J4.4. Builder/Desi er—O Date —44 REScheck Inspection Checklist Massachusetts Energy Code RES che4Software Version 3.6 Release I DATE: 10/26/04 i PROJECT TITLE: The Rosewood I Bldg. Dept. Use Ceilings: 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: 2. Ceiling 2: Cathedral Ceiling (no attic), R-30.0 cavity insulation Comments: Above -Grade Walls: 1. Wall 1: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: Windows: 1. Window 1: Wood Frame:Double Pane with Low -E, U -factor: 0.350 For windows without labeled U -factors, describe features: # Panes Frame Type_ Thermal Break? Yes No Comments: Doors: 1. Door 1: Solid, U -factor: 0.370 Comments: Floors: 1. Floor 1: All -Wood Joist/Truss:Over Unconditioned Space, R-19.0 cavity insulation Comments: Heating and Cooling Equipment: 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number Air Leakage: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfin (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. Materials Identification: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -factors, and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: Ducts shall be insulated per Table J4.4.7. 1. Duct Construction: All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to traxisport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. Temperature Controls: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: Rated output capacity of the heating1cooling system is not greater than 125% of the design load as specified in Sections 780CMR 13 10 and J4.4. Circulating Hot Water Systems: Insulate circulating hot water pipes to the levels in Table 1. Swinnuing 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 non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: ffVAC piping conveying fluids above 120 OF or chilled fluids below 55 T must be insulated to the levels in Table 2. Table 11: Minknum Insulation Thicknessfor Circulating Hot Water Pipes. Fluid Temp. Insulation Thickness in Inches h Insulation Thickness in Inches by Pipe Sizes Heated Water htm-Circulating Runouts Circulating Mains and Runouts Te=erature ( Ej lip to I ff Y -V to 1,25fl 1.5" to 2.011 Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table2: Minintum Insulation Thicknessfor HVAC Pipes. I Fluid Temp. Insulation Thickness in Inches h Pipe Sizes Piping SysLem lypes Range ( F) 2"Runouts l"andLess 1,25" to 2" 2,511 to 411 Heating Systems W Lo I Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FLELD (Building Department Use Only) I co CD a Z ca CD CL cn n 0 z cn to CD cn cr CD E; CD 0 CD 0 mm P. 8 c CD ca CD CL co) CD C4 Z oq CD CD CD 0 =r 0 —.ca 0 cr Go 1= 0 oc 0 CA CL 10 M_4 = S .00 a co 0 m C2 CO) 0 CML cl) CP �* = z =r.0 C41 -4 go C4) S =r CD D) C*O2 CD w CD 0 =r CD CD ca CD B4 0 z cw) 0 LA. 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C. CD CD CD CD 0 cn cn n 0 cn V-. cn cn cn op 71 �� 0 0 I 0 I= C —.Go CL ce Qkllll�, U2 3:. KID CL 0 CO) CD co) .0. am a 0 -1 C7 PC 0 to) C2 CL C-) cp -0 c 9 M =.= fA a) 0 C4 = NO 0 CD =r: 0 ia. N, C"Do CL -P CL =r M CD Fn' C042 C, Co CD 0-0 CD ;;;%.b-cM) 0: 44% 32,4 CL'%. =- wo. co 0 C) z S. lcw) 0 c') CD kl�-- C40 Er 7% to 0 - CL=t*s R Er CD CO) M co CD CI, 0 coo CL" 0 W W CL cr 71 �� 0 0 I 0 C/) z CL ce Qkllll�, U2 CD CA S a CD co) .0. OQ PC 0 =r CD CD =r: 0 ia. N, C"Do CD -1 C, CD 20 CD 0-0 CL'%. t.0 wo. kl�-- C40 71 �� 0 0 I 0 C/) z OQ PC 0 C/) 0 ia. N, 0 441� CD 117 /0 Professional Lan d. Surveyors. & Civil Engineers I I I MORTGAGE INSPECTION ESSEX SURVEY SERV . ICE 1958 - 1986 PLOT PLAN OF LAND OSBO ; R . N PALMER .. 1911 -, 1970 A, o, .,,, L�C ! ATE I D IN BRADFORD &'WEED 1885 - 1972 L L N 0 V - ; - 1S 'USEV, FOR A if T Hdl 0 THU THP�N G F I, � 41 1 '. F 10 N�J E 03 V 0 U NO', A R i E S. 'i A L 'ES. P E R Nit 1 0 R V f, R 1 A IN X. - 1, Christopher R, Mello A Registered Land Surveyor, Do �6by Cd�. ijfy That Mortgage Inspection Plot Plan Was PreDared For on With A New or. "ft. Y W, Mortgage And:Is Not Intended'Or Represente&ZO—Be A Land , lr,,.�', 't, Ai e, Y, op6r 7V ::,-Corpers Werer Set Jt Cannot Be' Used For Establishing Fence " Hedge Ok,, Ba-ij, bil, ty espons Is'Extended HJ—ei n To ihe Land Mer or occupant. T'his P I an' or.-Reaording, e kF 0 tjo i' vwm -441.gm-'j- t4r 11r �A Hereon ff;1 (i DENEMfiff0FROWSMAZY PmWtNo. Ba4id)OFFBEPREVffMMRBGEL4VMM7a&nlg OWUPMCY & F tm:., M Clecked A [CAIIUN FUR Pkj<Wf I U AMURM EUCMCAL WORK j PI PAULWORK TO BE PERFORMED IN ACCORDANawnmTHE MASSACHUSSTS E12CMICAL CODE, 527 am 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) D Town of North Amlover To the Inspector of Wires: The undersiped applies for a permit to perform, the electrical work described below. Location (Stred & Number) U Owner or Tenant )rA t -k-) V`Y*1 eA owner's Address Is ims permit in conjunction with a Purpose of Building yesu (C!heck Appropriate Box) ;z -3 1 qq 01 Utility Authorization No. VEHOMMMOMM Existing Service Amps ...L.Volts Overhead R Un&Wound No. of Meters New Arnp@LW /CLiC*olft Ovedoul Un&%round No. of Meters Number of Feeders uW Ampacity Location mW Nature of Proposed Electrical Work Na of Uoft Oodso �G ft of Hot Wn No. offroAnwn TOW — KVA Na WU—gbdnS R=U: Swbnwlq Pool- Abon Bebw .1 1. (I KVA ?4& it —Rwepu* Ov" No. a(011 Bwom W OfBmqmq UsMins Bam units NO. of.Swiftb Oudes 56 No.o(GmBr M U FMEALARM Nm of Zmw No. of.Rmwo M. Of Mr Coo& ft of DauWw wd W of Dispoull W of, Had Told Toid Panyp Tom KW kideft Devi= Na ofSouaft D@W= No. of Dishwuhm Spwo Am Hubs KW ?k of SW ContWned DaiectimGmAq Dnim Lwd munjeW Othff Camecd= ft of Drym Hoeft Devim KW No. ()f Wow Hamm F KW I Na Na of SAILU - I No.*" MWW Tdo I ?k of )WH Toud HP to 61 e - YES NO 1hneaftrftdmNpWCfs=1xDAV01ftka rYWlR*&dWYM0=hkft0etfflCfwmvby WO&IDSM kwaimlOw MMNAME Rck.-.kil rSh rg we t 7C-0 il= 11 PZ* j::,4r%-c — U=Nm V) .v Na e-ywe,44-CC-V'Cj4e 713 ([1 e -r cr q 04A 0 L&Z(AkTd% Aft. (I t3 addianylsipsamecrillb afts (Plamcbeckone) Owner Agent aignawre 01 Uwner of Agm Tilephane No. ...?BRW FEE I � civ o�c l _ _ �w��29� Id 4 Date .... .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING As This certifies that ....... /3� ........................ �4ias permission to perform ........ ............ i ................................ . . . . . . . . . . . . . . . . . . . wiring in the building of .... t. —11 .. ....... A/ . .... at .... ...... .......... ......... . North Andover, Mass. .............. .. ..n ....... .. ..... EECTRICAL INSPECTOR Check # �D\ LPenwt NO. 0 ccupmy & Fees Checked ."'Pt.No. ; wmmml� I APP)ICA71ONFORPERMIT70PERFORMELEcnz[CAL WORK ALL WORK TO BE FERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMFt 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) D I Town of North Andova ne undersigned applies for a pennit to perform the electrical work described below. Location (Street & Number) owner or Tenant ��T T owner's Address &L Is this pennit in conjunction with a purpose of Building Yes L--j- 1W To the Inspector of Wires: r. DUJL) 2. � I qq 01 Utility Authorization No. . Existing Service Amps I ...L.Volts Overhead Underground No. of Meters New Savice AmpsLW /6Li<Afolts Overhead Underground Ea No. of Meters rN J Number of Feede 1 13 and Ampecity Location and Nature of Proposed Electrical Work No. of Ughting Outlets �-G No. of Hot Tube No. offransfimners Totfil — KVA Now of [Aghtinj Ritores Swbming Pool Above Below G�tm KVA No. of ReceptICIS Outlets ? 4�- No. ofoilBurners No. of Emergency Ughting Ba" Units No. of Switch Outlets No. of Gas Bumem FIRE ALAMS No. of Zones No. of Ranges No. of Air Cond. -Totd TOM No. of Detection &W No. of Dis No. of Had Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Ann Heating KW No. of Self Contained DetectiorMunding Devim Lmd mwdcipd Odw No. of Dryers Heaft Devices Kw Connections -t No. of WsW Heaters I KW No. of No. of slow sil"is 10-tmmc)ILC-�s to - T - No. Hydm Manage Tube No. of Motols Total HIP hU=COVWF 1hmeacu=t1i&*JwwzeFcLyirkdv Yo E3 M 0 1hww9ftriWdvddpwdcf==lDfrOflkr- Ir)uuhm d- 11 . . — B= 0 aum [I WalklDSM DaRcom0d Pz* Vab cfEbmWWc& $ FkW FIRMNANE C- 62' 2,,� 5 03 &W=TdNb, Adi=(c) I(- e -Y? 4 e44 C% -v, cl -e T3 "e-r"rq P4AC)t&Z(AkTeLNd, OW?�WSMWANCEWAM3klamamiudLaLiowdpmmt bimnnwm*orilsabmdquAgnapwbymmdnmcmmdLm (Please check one) Owner 1:3 Agent Tilephone No. ....pMtWr FEE126200 Signature of Ow or Agent Date -/ V -x- 4, L_J�WN OF NORTH ANDOVER PERMIT FOR PLUMBING A, - This certifies that . .14--,. ......................... has permission to perform ... Y .............. plumbing in the buildings of . � '.,j .............. at ......... North Andover, Mass. Fee.6 ....... Lic. No.. .(� . ...... ...... LUMBING INSPECTOR Check # y 2 (; (- 6639 -W MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS I /�X/ /1--, Date Building Location My Owners Name CJ Permit # Amount Type of Occupancy Zze - 5 Renovation Replacement Plans Submitted Yes No Nev 0--- 1:1 11 1:1 I FIEKTURES I (Print or type) heck one: Certificate Installing Company Name e�74CXD-� Q\ WOQ," M -Corp. -.2 C/o -7 t Partner. Address J )AXI kc - 1 BusinessTelephone Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type o insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond 11 El Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance tignature Owner 0 Agent 0 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the Obest of my knowledge and that all plumbing work and installations performed under Perr"ued for this application will be in compliance with all pertinent provisions of the Ma t, State PluWg ,Code ,_y_OF 142 of the General Laws. VED (OFFICE USE ONLY Type of Plumbingj�Ufense /3006 License Numoer ' Master 11", Joumeyman Date. 40RTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .......................... has permission for gas installation .................. in the buildings of ....................... at .............. North Andover, Mass, Fee. 7� ..... Lic. No ........... ........ .GASINSPECTI' Check# qt9e' 5 r /-65 S mAssAmusEyrs uN[FoRm APPUCATON FOR PERM TO DO GAS FrITNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Locations Permit # 5 2 4 f Owner's Name Amount $ 1;4e -t, P,�.,ta 00. New Renovation Replacement Plans Submitted 1:1 (Print or t k I XT- QK . 1� S 0\ t -y Address Name of Licensed Plumber or Gas Fitter :5� � L L, ecpilrne: Certifiate Installing Company Corp. 7 -- ElPartner. [3 Firm/Co. INSURANCE COVERAGE Check one: Noo I have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 I . A t ---v-- -b checkinotheann priatebox. 11 you nave checked Yes, p ease n !!;�� .7F el j Bond Liability insurance policy Er Other type of indemnity El 1:1 owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 13 1 hereby certify that all of tne aetans ana iniormaLion 1 Havo bubn LLCU kk)i 111—y—FFIX-1— -- -..- best of my knowledge and that all plumbing work and installations performed under Permit ls��for this application will be in compliance with ail pertinent provisions of the Massachus s '�tate Gas Co,* a Chap the General Laws. (OFFICE USE ONLY) _Sipature of t4feefised Plumber Or Gas Fitter r'�--rPlumber / G Fi ter License Number aster Joumeyman mul 1EXT3 270 ft-wj AM a 32�� IF2�-Ml I 12ND. FLO 5TH.FLOOR '7�—TH. LOOR (Print or t k I XT- QK . 1� S 0\ t -y Address Name of Licensed Plumber or Gas Fitter :5� � L L, ecpilrne: Certifiate Installing Company Corp. 7 -- ElPartner. [3 Firm/Co. INSURANCE COVERAGE Check one: Noo I have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 I . A t ---v-- -b checkinotheann priatebox. 11 you nave checked Yes, p ease n !!;�� .7F el j Bond Liability insurance policy Er Other type of indemnity El 1:1 owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 13 1 hereby certify that all of tne aetans ana iniormaLion 1 Havo bubn LLCU kk)i 111—y—FFIX-1— -- -..- best of my knowledge and that all plumbing work and installations performed under Permit ls��for this application will be in compliance with ail pertinent provisions of the Massachus s '�tate Gas Co,* a Chap the General Laws. (OFFICE USE ONLY) _Sipature of t4feefised Plumber Or Gas Fitter r'�--rPlumber / G Fi ter License Number aster Joumeyman —dite. �.. A ? ....... 40RTH ov TOWN OF NORTH ANDOVER z PERMIT FOR GAS INSTALLATION This certifies that .... .'0'. .'. .- . 5. >� . . :'� . � . � .................... has permission for gas installation C1, r 1,1 '— . ...................... in the buildings of .... ...................... at ............... North Andover, Mass. Fee..'.�.�.. Lic. No..�. ?�.? .... .. ....... GAS INSPECTO R Check # 0 )c 53010 It MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 2 (Print or Type) A16M /1-�160i/Cee , Mass. Date C)A2;E;-,2 7 20 OS' Permit# S'11-6 Building Location .1941( Q�4X- 4 Owner's Name Telephone (1117-,W Type of Occupancy 4g New Renovation Lj" Replacement Plans Submitted: Yes NoEl Installing Company Name EnergyUSA Propane, Inc. Check one: Address 500 Myles Standish Blvd. Corporation Tauton, MA 02780 Partnership Firm/Co. Business Telephone (800) 822-1300 X8061 Name of Licensed Plumber or Gasfitter William Kent Corson Certificate 132 C INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes ID No If you have chocked Xqs ., please indicate the type of coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement Check one: Owner F-1 Agent ri Isignature of Owner or Ownees Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By [DPIumber Title mXGasfifter City/Town MXMaster' ,APPROVED (OFFICE USE ONLY) [::]Journeyman Signature of Licensed Plumber or Gasfifter License Number 3707 0 =0Z M-30=967 Installing Company Name EnergyUSA Propane, Inc. Check one: Address 500 Myles Standish Blvd. Corporation Tauton, MA 02780 Partnership Firm/Co. Business Telephone (800) 822-1300 X8061 Name of Licensed Plumber or Gasfitter William Kent Corson Certificate 132 C INSURANCE COVERAGE: EnergyUSA Propane, Inc. has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes ID No If you have chocked Xqs ., please indicate the type of coverage by checking the appropriate box. A liability insurance policy El Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement Check one: Owner F-1 Agent ri Isignature of Owner or Ownees Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By [DPIumber Title mXGasfifter City/Town MXMaster' ,APPROVED (OFFICE USE ONLY) [::]Journeyman Signature of Licensed Plumber or Gasfifter License Number 3707 SEP -09-05 FRI 11:10 AM FAX NO. P. 01 -f nc %,ommonweaffn Of MassuhusdiS Department of1hdustridA"ider& Offxt of Invesfigafim 600 Washington Street Boston WWW. '7 rs' Compensation Insurance Affiftvit: Builders/CO)3trgct0m)EIeetTidansMIumbers Applicant -Information rjease Print LA--�Objv Name (Bv*wss0pnizafion4ndMdaaQ: EnerjULUSA PropAne, Inc. LF -USA Reating & Air Conditioning Services.*'in 4 Address: 100 Myles Standish Blvd. Cjty/,3tatejZ,'jp. Taunton, MA 02780 Monet (800) $22-1300 Are you an employer? Check the7appropriate box- TYpe of project (requirc4); 1.[Zlamaewployetv�ffi 48 4. 1 am a gmeral contractDr and 1 6. [IN= cmployces (fall aiWor parwhw).* 2. D I am a soleproprietor or panncr- have hired ft sub-ontractors listed ou ffic attachod sheet 1 7. 0 Remodelial ship and have no enyployces Uese sub-contracM have 8. Dmwlition WoTkinp � for mc in any capacity. (No voykeW emap. insurance workm' comp. imurance, 5 We are a corporation and Mi 9. Building aftion required-] O(r=3 have exercisca %cir 10-11 EltChical repairs Or addidow 3. [:11 am a lx�mcowncr doing all woA- ri0t of excavOm Per MOL 11 .0 Plembing rq*irs or additiow mysclE [No worken ' conv. c� 152, § 1(4), and we have no 12-C] RoofrTafis insmuaccTcquired.] t I employm. [No wmkcis' requbed.] 11g) 01ba Gas Fitting 2=1k:1fiMdw*sbox#1 nwa PW idlouthe =ct=1xjow&ow=gfiwwwMjwWoMp,=Mn PoSq, C lzmliow *&a subn* Wa affidavit ind�wiq favy an doing *U wwkmd fitenhim GoWde mnUr,4ofzznWzdbmA a Dew dridevit =d=15ng mck -Convoclors %bat cbc�k lik lox vv= onadwd an od&60ud sheid Amvft Ibc nam ofte v&oontacm and 6eir v#mmkcm, cMjjj% pWity ie6Mvkti0zL ION anCftq*jvr11WfTpr0tidin.- workers" COMPM4don insunmefor myemploym DaimVisthepouq0adjobske *Ormation. I iu=;moeCowf=yNamc. HUB International New England I Policy #oT SelMiks, Jjr- W-. 2314174 ExPirationDate: 3/16/06 Job SiW Address:, "All locations in cl%,v 19 atY1staw&ip--AL&.—bov-4&, /W At"keh A copy Of the vOrkm3 compensation policy dechwation pap (shov4ug the poricy number -and exp'"'Ation "e). Failum to secare coverage as TcquiTcd under Section 25Aof MGL e. 152 can ]cad to *c, kWosition of oiminal al of a I pen ties; rme up to $1,500.00 an&" ouc-y= iinprkoUMM14 as well as " Peuldes in ft form Of 3 STOP WORK ORDER and a Imc 3fopto$250.00c',*apiustthcviohvor. Be advised 1hat a copy ofthis statane'at maybe fbrwaded to the Offim of tuvccdga&ns of the DIA for fimumee coycrage, verif'Icatim f do JlarO ce;Wfj�, under the pains andpenaNes ofpedu'Y MW the infonnadon provided iffbm is hwe and correct - Kent Corson 1300 X8051 (Ww-W use only- 1)v 1W wyke in thisd` rca, 16,k cmphUd by c&y or Mrn officiat City or Town: Inning Aulhority (circle one): I- )Mzrd Of 11n. ltb 2- Building J)cpahmeut 3. C-ItyrrovM Ctprk 4. 161ectriew 3n3pedor S. Plumbing Inspector 6. Other Contact 1person:-- Phone I MORTGAGE INSPECTION PLOT PLAN OF LAND LOCATED IN kOr// MASS. L7 /0 4v��4 fl 0�v Professional Land�Surveyors. Civil E.ngineers ESSEX SURVEY �S.ERVICE 1958 - 1986. OSBORWPALMER 1911- 1970 BRADFORD & WEED .1885 - 1972 "'vd,,0 7?iLIL NOT PE IS 'JSEC FOR S. SPE 0!,iL jy " 121, 1 . I, Christopher R. Mello, A Registered Land Surveyor, Do ereby Certify That The Above Mortgage Inspection Plot Plan Was Prepared ForA.&-//82/;W, W'/' - In Connection With A New Mortgage And Is Not,Intended Or Represented To —Be A Land Or Property Line Survey. No Corners Were Set. It Cannot Be Used For Establishing Fence, Hedge Or Building Lines. NO Responsibility is Extended Herein To Th . e Land.Owner Or Occupant. This . Plan Shall Not. Be Accepted For Recording. The Location Of The Structures As Shown Hereon Is In Compliance With The Local Applicable ,Zoning By -Laws In Effect When Constructed, With Respect To Horizontal Dimensional ,ts Or Chapter 481 Of 1987. —Requir-emen V �x �z SCALE: DATE: Ao6b �f k 2c&�- I REFERENCE: BK 1 PG PZ /-��/z This Plan Has Been Prepared For Conveyancing Purposes Only For The Above Party And Is Not To Be Used For Boundary measurements. '�Subject Property Is Located In Zone On A Federal Insurance 3131.7 o nistration Designated Flood PE -2; c /ST Hazard Area �r map 2 sill Dated 6 104 LOWELL STREET PEABODY, MASS. 01960