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HomeMy WebLinkAboutBuilding Permit #665 - 210 BLUE RIDGE ROAD 5/10/2006NORTH p TOWN OF NORTH ANDOVER •� o> APPLICATION FOR PLAN EXANIINATION ,SSACNUSl� 06 • Date Received:�''�" Permit NO: Date lssued:.- - —� -- — mt'.5t complete all 'tans on this �I j LOC. TION _ _ 0 _S6_.PROPERTY O\VNER ` PARCEL: NLP NO.:____ --- ME Print ZONING DISTRICT•/ ' R-'� pip. 11067 RIC DISTRICT YES El TYPE AND USE OF BUILDING HISTO i TYPE OFINIPROVEMENPROPOSED USE Non_ Residential Resi ntial _ One family _ e\"Building Industrial Addition =Two or more family i Alteration No. of units: _ Assessu BldgCommercial _ Repair, replacement ry Demolition Others: moving (relocation) Other Foundation only _ DESCRIPTION OF WORK TO BE PREFORMED__mS ° f.+LA h C 5'04t,1 S io'v l 1�b -45 K(C CONTRACTOR Name: t pkip � '(nC)I , n 111.1 A D2Z 1 Address: �llh�L�IZt�A Supervisor"s Construction License: (���b%IG _Exp• Date: I-I(3ille It11prULLnit;nt L'eCl:Il:iL:___qp_ Exp. D ite:�— ARC'III'I-ECT:I.i`�(: I\I'I.R OW :address: �����' �-- Reg. No. FEE SCHEDULE: BC.LDING PE•1J/: Si J ER .51000.00 OF THE TOTAL ESTLIIATED COST¢%t��1 `ON SJ2i.00PER S.F. 6 `��o `Nt T Total Project Cost : x10.00 FEE:��-��� � Rcccipt Check No.:_ No.: Location a /--I:) A dS No "1p 1., 5- 61 —I,— , Date '40"T16, TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ?S3 Suilding Inspector TYPE OF SE\NARGE DISPOSAL Tannin'Alassage Body ,art � Swimming Pools Public Sewer -- Tobacco Sales Well - Food Packaging, Sales Permanent Dunlpster on Site Private (septic tank, etc. � MOTE: Pervo n.y contradt' i unregi. tete( trudory du not /rave access to the !/Ity 1111t, Signahtre of AgentrOwner Signature of Contractor Plans Submitted Plans Waived �_) Certified Plot Plan i�''!� Stamped Plans i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ S- L] Water Shed Special Permit Site Plan Special Permit �^'�- d" ����❑ CONIME� S Other 1 s- Zw DATE RM CONSERVATION ECTED �1) TE APPROVED i ) COMMENTS_lZrzu�wi Pew,,► Mme/1414ca,' S cS l6Z. "AAjej � V rias '� Gley-r'C o n ; AI( wcf•�, owV •;dL too Ix �c/te . DATE REJECTE11 DATE APPROVED HEALTH COMMENTS Zonin..t Board of Appcals: Variance. Petition No: Z_oningDecision. recciptsubmitted yes �D Planning Board Decision: _ Ccnunents 17 Conservation Decision:— Conlnicnts ��yater cf:. Sewer connection signature &date Z,,l Temp Dunlpster on site yes_—no__ Fire Department signature.'date _ ��,,,, !/ k��.. Building Permit ,approved and Issued by: Oct 20 06 03:52p J. BROWN REALTY DEV. --- �O.ea rn LARRY oGDEN tJctober 19.2006 866-9363101 p.2 976 332 2638 P.91 4tH VY%l CE It. 0GDF `I, pj. 198 FAST its MEET GEORGETOWN, MA ®1 19MS 16 fait M -362-8 oeu 9"2.Ml J. Brown Realty Development, LLC, 21 Wormwood Stftk Suite 601 Boston, MA, 02210 \� Attn: R?s. SUM.& peek* project mmmWo RE: 210 Blue Ridge Roel, Notch Andover, iia, Dear Ms. pepWagdo As you mquosted I Inspected the framing ibr the above Project 46 shoWn on VIM lagWW by Scholz Architeetunj Services, L.L.C., atlmbered 1,1A, 2, 2A.2B,2C.2D,3,3A,4,4A,4B,4C.5.5A.gg,6, and 6A, dOW 2106/06, entitled DenMdge, 843 Special. 1.Bro" Realty Day. In most resp" the �tnit complies with the drewi moble modifications. In addition ro Y� cue ewe m�ificationa wtrenp with e mirror stoat PM is the umt and the Tall Well deet as pheet SA, marred to the modifications wore trade al PeY my inatrus:tioas end m+e ale. 1mowledboo a final site inspection on 10110M and cart; fy dot to the &ening'Phos to IM dseign intent of the of my raings PmP4Md end certified by Scb9b Archiceuurat Services, l..1. C. Yours truly, Wrence N. Ogden, P.E. tAWftNCI o k to�i9/ob N NAL ENS Ub/b5/Lobb 11:11 y/a75//X15 1nl1.rPLLJrPVULNr1„ r—Hur_ uo/UO MARK B. JOHNSON (MA, Nil. OC) [)QNAI;0 F. 13ORF,N$'1-RIN (MA. ME. NH) ,101 -IN G. I,AMR (MA) KRISTINL• M. SHEEHY (MA) ANNA R. V1;I1(,Ar)0$ (MA, Nib DGNISE A. 3ROGNA (MA, CA) MARISSA A. WILKIN (MA) JOHNSON & $ORENSTEIN, LLC Attorneys at Law 12 Chestnut Street Andover, Massachusetts 0 18 10-3706 (978)475-4488 Telecopier! (978) 475-6703 May 4, 2006 Michael J, Fadden, Esquire Michael. J. Fadden, P.C. 2020 Lakeview Avenue Dracut. MA 01.826 Re: Frank Rossi Lot 127 South Bradford Street, North Andover-, MA Dear Attorney Fadden: Paralc¢ah KATHRYN M. MORIN I; IANNF. C;RISTALD1 M1('HELE C. JONII(AS KATFILL?f3N H. 4AR13T:R KAREN P. EHRAM,IIAN KAREN L. RUSSELL Enclosed please find the documents you requested, a copy of my .letter to the Town of North Andover .Assistant Building Inspector, Michael McGuire; Town of North .And.ovcr's Permit for Excavation and Four dati.on and executed l,,ot Release in connection with the above -referenced matter. If you hive any questions on the enclosed, please feel free to contact me. Very truly yours, JOT-TNSON & .BORENSTEIN, LLC 6Yka6(- r blifff Donald F. Borenste.in (dictated but not reviewed) DFB/dms Enclosures anaw-docsVosu Wa A frinkI9?00 north Indover toNng,a 71,Maddan Nr 05.044 DDC VJ/ VJ/ LVVO LL. L! 7lO7J/ /J1J I'111..1 IMLLJr MUL/CI Yf L rNVC VL/ VO MARK H. JOHNSON (AAA, NH, UC) LINDA A. O'CONNELL (MA, NH, RI) DONALD P. DORENSTEIN (ti A, ME) LAW OFFICE OF MAFX B. JOHNSON 12 Chestnut Street Andover, Masse-6usetts 01.810-3706 (978)475-4488 Tciccopier: (978) 475.6703 £o.C91.45@Is K AT iRYN M, MORIN JEAN A. SHEEHA.N UA CM7Ai r)I March 29, 2002 Michael McGuire, Asst. Building :Inspector Town of North. Andover 27 Charles Street North Andover, MA 01845 Rc: Lot 127 South Bradford Street, North Andover,_M�1 Dew- Mr. MCGttare: I represent Lunda Rossi, Tn►stee. of The South Bradford, Realty Trust. Ms. Rossi is the owner of a lot of Land located on. South Bradford Road. in North Andover, being sliowti as Lot 127 on. a Plan of Land entitled "Subdivision Plan of Land in North nyidover., :Donol roe & ParIchurst, Inc., Surveyors' dated September 25, 1.989, approved by the Land Court Recorder ora..M.,ay 17, 1990, and being Land Court Pl.an No. 36903L1. Accordingly, Lander the.Massachusetis Zoning Act, G.L. c, 40A, §6, para. 5, the lard shown on that Plan wa.s governed by the zoning provisions in effect at the tirn.e of the original submission of the Plan, for, a period of 8 years from the date of approval. Thus, Lot 127 was protected and exempt G-orn changes in the Town's Zoning Bylaw whenmy client purchasedtLot 127 by Deed dated and registered on July 2, 1992. Since that tirr►e, Lot 127 has not been held in common with any adjoiniti.g land. See letter of Ms. Ross.i's cotaveyanchig attomey, :Russell. Bodnar, Esquire, dated March 28, 2002, enclosed herewith. Accordingly, Lot 127 continues to enjoy "grandfathering" protecdon, as on isolated residential, lot, under. Paragraph 4 of §6 of G.L. c.40A. That Paragraph provides a perpetual exen-iption fi-om. increases in area., frontage, width, yard. or depth requirements for lots :for single and two-family res.identia7. use, thatt have been held in ownership separate from adjoining laand. .Accordingly, where Lot 1.27 complied. witli. the zoning di.mensio,nal requirements in place at the time o:l'the submission of the Subdivision Plan crea.tang it, Where Lot: 1.'27 was conveyed to my client within 8 years of the approval of the Subdivision Plan,, and where Lot 127 lams bCeD. held in separate record ownership ftonr. adjoining land. since that time, the zoning reguirement9 in effect at the time of the submission of the original F:INaw-Docsftsal, Frar, 02-086 NMth Andover ZoningWrGuira-Ur 3.25-02.doc cUuw L L. L ( i f o JJ r I Jl J I•Ill.flHCl..J 1' HllLtIVt'l, h'Alat ♦+��� btj _ Michael .McGuire, ,asst. Building hispector March 29, 2002 ?age 2 Subdivision Plan apply and, a Building Permit for the .lot should be issued, accoydii,gly. (.it-i.s nay understanding that a Building Permit Application has been. 6.led by.my client and, that actioti. on the A.pplicati.on has been reserved pending the submission of this material, concerning the "grandfathered" status of the lot.) For yow reference, I enclose a copy or my client's Deed. and Certificate of Tille, and Sheets 1 and 5 of Land Court Plan No. 36903U. if you (o): Town Counsel) should require any additional inforrafltion or docLunentati.on or, should wish to discuss this matter further, please do not hesitate to contact use. Very truly yours, 'LAW OFFICE OF MARK B. JOHNSON Donald, F, Bomnstein DZ'B—klb PC: Linda Rossi R:%Ncw-0nca\Rosai. T°mW02-066 Non.li AiOnva Zoning?.Mc0jh-u-Lu• 3-25-02,doc UV/ UJ/ LUUS? 11. 1 I I ']Itl77/1717 Mitt - 1HtL•Jr PVVtNr't, Qj Nk 0 0 04 QJ/ VJI ZUE)o 11 . 1 ! 7l77J I I J1 J I'll V("1HCLJf HLLCIVr t. i'HkaC J4/ YJI_1 RUSSELL A. HODNAR ATTORNEY AT LAW CHM NUT GREBM SUITE 65 %5 Tt rRNPISCL STREET NORTH ANDOVER, MA 01R45 Match. 28, 2002 TO WHOM IT MAY CONCERN: 'rELEPIIONE (978) 688-1500 fAX (978) 688-1582 Please be advised that I have represented Linda Rossi in the past with .regard to various real estate parcels purchasedby her. As a result, I have done the title examination For Lot 1.27 South :Bradford Street, North Andover, Massachusetts. I Please be advised that Lot 1.27 has never been owned in common ownership with any other abutting parcels. Title thereto has always been independent and separate from any of the other surrounding lots. I trust this letter will serve as a certification of ownership, and I invite t}ie reader to contact Ine should any ft,rther qu.estwi ps arise, n �ery truly yo s, Russell. A. B dnar RAB/tf cc: Linda .Rossi Flue 11 d5 OO:�Ip J 1 V 1111 J1 NORill HNOOVER MtUrIHttJrHulitNt tU LOT RF -LEASE 070688954E The undersigned, being a majority of the Planning Boaxd of the Town of North Andover, Massachusetts, hereby certify that: PAGE 06/08 P-4 The Town o:fNorth Andover, a municipal corporation situated in the County of Essex, Commonwealth of Massachusetts, acting by its duly organized Planning Board, holder of a Covenant regarding the Coventry Estates Subdivision, dated .August 2, 1988 from Coventry Development Corporation, registered in the Essex North Land Registry District as Instrument No. 45659 and noted on Certificate of Title No. 11367, in Registration Book 84, Page 273, as amended by an ,Amendment To Covenant dated October 24, 1991, registered in Essex Norah Land Registry District as Instrument No. 51356 in Registration Book 3339, Page 150 acknowledges satisfaction of the terms thereof and hereby releases its right, title and interest in the lot designated on said plan as follows: Lot Released. -- Lot 18 (a/k/a Lot 127, 11 Lancaster Road) Coventry Estates Subdivision, as described in Certificate of Title Number 1141.0. EXECUTED as a sealed instrument this ��day of August, 2005 � Majority of Planning Bc Of the Towr North Andover A ,/ Ub/ U5/ LUUb 11: 1 ( M Ik r1HGL.JI" HI)UCIVr'l, r-HQr- U I I U0 COMMONWEALTH OF MASSACHUSETTS, ESSEX, ss. On this Id day of August, 2005 before me, the undersigned notary public, personally appeared J161 -P- b VAeal-A , one of the members of the Manning Board of the Town. of Andover, Massachusetts, proved to me through satisfactory evidence of identi.Fcatien, which was ❑ photographic identification with signature issued by a federal or a.te governmental agency, LI oath or affirmation of a credible witness, [personal knowledge of the undersigned, tb be P the person whose name is signed on the preceding or attached document, and acknowledged. to rrie that he signed i.t voluntarily for its stated purpose and that as one of the members of the Planning Board of the Town of North Andover, Massachusetts, he had the authority to act in that capacity. Notary Public s9, KATHLEEN H. I•IAABEFi My Commission Expires Not°n y Pubilc commonwealth of Massschusers My commission Expires October 28, 2006 4 This certifies that 14 T 'I-) .......... has permission for gas installation. . ................. in the buildings of ... t ......................... at ..... 2 1 North Andover, Mass. Fee Lic. MA .... GAS INSPECTOR"-` Check # 2 2 ` •`L\ MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITYD-- y MA DATE i 1,' PERMIT # JOBSITEADDRESS �IO.__. ,Q _� �z . OWNER'S NAME GOWNERADDRESS TEL�q¢ (,'J_iCS2 �FAX�-j TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL( EDUCATIONAL ❑j RESIDENTIAL CLEARLY NEWU RENOVATION: fA REPLACEMENT: PLANS SUBMITTED: YES F-11 NOO APPLIANCES 1 FLOORS— BSM 1 2 3 1 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE = I _ ! ❑ . _ 1 ��� . ' _ .� DIRECT VENT HEATER Y I ❑❑ .. m. J1-11-31-11-_ - F-4177-311-7-11=7 _.J _= J =- F9==- 1 FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER LROOM / SPACE HEATER kOOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES &0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Z OTHER TYPE INDEMNITY © BOND [.] OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT 0 SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and and that all plumbing work and installations performed under the permit issued for this application will be in Com Massachusetts State Plumbing Code and Chapter 142 of the General Laws. to the best of my knowl ertinent provision of the PLUMBER-GASFITTER NAME �Q �. _ y.� �,.., Cn LICENSE # Z2si'�. SI URE MPI MGF JP JGF { LPGI I CORPORATION PARTNERSHIP ❑# i LLC [2# COMPANY NAME: CITYPT 11 STATE ZIP atC65 TEL FAX � y4 CELL /f EMAIL H °z 0 H U W P� W 1 til I o El a z W r � W w W � � ~ W co a 5 Qco a O � w w c a 0 A, a a � U J H a a � a � w x w I --w W H O z z 0 H U W a C�7 Cx7 I 4' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 3www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):_s- - Address: 1'1 -7� n,bls-�.g,�c1_K City/State/Zip: ��,, ., fi �3 �A 6`ffbS Phone #: bb3 .3'7-x'7,3 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Job Site Address: Expiration 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. 1 do Iterebrtify ulldelte pains—a9ld penalties of perjury that the information provided above is trite and correct. •44— V_` Date: l' f - 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 #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia it — {,�� -- - ---- � \� of ./:�cnz�.-c\2Zr2 ,m. ©mom | '7 \ % \� /\ \ \M E z| . U) $! f / $»� .�. -x m m /L ..I > 00z 2 3 J • k 2 2 .� _o M kik n \��" $ . . _CN ',./f� <Ul : z ® �. Z | \� 7\\r1i \7 f»®�©«�«»2�c�<-�7` »©m«\ ol / / / � =o0Glo® E9Zoe - 0U, D0 @ §;- S g£/ n- ; e§§, 0 ,/ °q o m =R8 I wo .S/\\fm� j\.CL0 C R } 0 ® .:77o'cr �a2§g\a 2§0 ■E/ Z ; 2E%g0 EEe »� 2 � a=;ami`= �«->o ID D §E/ E � �gJom ' 7§ 772/ vi. ' gym® « )UL § P\ co �`} • ID :3 2CD ao0 a \7 \x yam CD3 �o ~` V\E¥\® ® k\ .G CD (a c © E 0 CD :o c\ a . 3 �,ra= _ (k\\k\ /\ ) N 7 0 4L Date .... y ....... ) ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................................. . ........... ............................. has permission to perform ............................................................................... wiring in the building of ................................ .... V� ...... �—North Andover, Mass. at .................. k ................. . ...... Fee ........ Lic. N6;;---7.- ................ ...... .... EL CI;Wlc IN�e Check # S—/ 8264 I •a N . Commonwealth of Massachusetts 0 Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Y ' - Occupancy and Fee CheckedS [Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) D ate: r -&Z4 7 t 2,er-2 8 City or Town of. NORTH ANDOVER To the Inspect of Wires: By this application the undersigned gives notice off his or her p'alention to perform the electrical work described below. Location (Street & Number) Z iC.� LJ 1cceI caLc %2d , Owner or Tenant V/(�c�01Z, - �/ ay�jgy� ��D Telephone No. 3i'7 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /� / PA� %, fY�. �.• 271. _1 Com letion of the followinp, table may be waived by the InsP ector of Wires No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- El rnd. rod. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number """"""'.... Tons KW " """"" No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: , _4az (When required by municipal policy.) Work to Start: X SOB Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance.of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perju , that the information on this application is true and complete. FIRM NAME: �ja�liToceLIC. NO.: e_2-5-15- Licensee: 6b ET Bkadlnl Signature LIC. NO.: (If applicable, enter "exempt" in thy license um li e.) us. Tel. No.•_ ^3�cL'8 Address: , l I� 3 � Alt. Tel. No.:l6 *Per M.G.L c. 147, s. 5711, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ W�°% 4� �, �?— �g✓m� of c HORT1{ ° n TOWN OF NORTH ANDOVER `•, oAPPLICATION FOR PLAN EX., MINATION ,SgACMUSt� Permit NO: Date Received:�� Date Issued:_ _-,-- - - - IMPORTANT: Ap`hlicant 1110st cotllplcte all items on this ILOCATlONT I- PROPNTY O'WFNER tiq- _PARCEL: Print _ ZONING DISTRICT: f�- '� pie, ) 5067 �rre'r"nv.- "m rDI!'T vFC (-I S''al �/t'/ S /0V I YJM A1rU u»✓ yr auiuuuw -- - -- -- - TYPE OF INIPROVENIEN PROPOSED USE Resi ential Non- Residential _ ew Building X -- One family Addition - Two or more family Industrial _ Alteration No. of units: _ _ —� _Repair, replacement - Assessory Bldg C Commercial Demolition Moving (relocation) _Other =, Others: Foundation only DESCRIPTION OP WOKK 10 til✓, YKrrILIKIVILL) I O �TIU1-- &-A 0. 1 "- 9-b CONTRACTOR Name:�l� l tr�� 12 Phonc(Dli'2(Z'g5 kfo- Address2t �NLuwtxA S --66ol O22 1 Q 256 � Supervisor's Construction License: ccylo(oy _Exp. Date: 91 ► HUtnc lnlprUvcnlcnt LiccnSe: Exp. Date: ARC'I11TECT. FMI-INE R ( €' �'� .�� Nc-u)1c: Phone: —6-1�U�-- Address: TO i ecto� _ Reg. No. 1 ► l35 -I _ FEE SCHEDULE: BLLDLVG PEI4,L1 T: S I�iER $10#0.00 OF THE TOTAL ESTIMATED COST, :t�SF��U�N._,� S 125.00 PER S.F. �. i / T Total Proicct C'ust :� o r (� x10.00 FEE:$--'�- Check No.: Receipt No.: X2-5-2 41 /1/�� I TYPE OF SEW ARGE �— E DISPOSAL�— iPublic Sewer ✓ —�= TTTajj,,;-,', i Well __�1 ��— JtTartment Private (se th forms to be filled out for the appropriate permit to be obtained. __.....g, interior Rehabilitation Permits Building Permit Application Debris Removal Form Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract o Floor Plan Or Proposed Interior Work Addition Or Decks Building Permit Application o Form U N 0-T N e2q)e41 o Surveyed Plot Plan o Debris Removal Form o Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses D Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrauii Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) u Building Permit Application J o Certified Proposed Plot Plan j Photo of H.I.C. And C.S.L. Licenses j Workers Comp Affidavit o Two Sets of Building Plans One To Be Returned) to Include Sprinkler Plan And Hydrauli Calculations (If Applicable) j Copy of Contract u \,Iass check Enemy Compliance Report lu all cases if a � ariance or special permit was required the Toil it Clerks office must .>tamp 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' Bi of recording must be submitted with the building application Doc: I\SPU TION %L SER% K ES UEPAR'r%1E1'r:BPF0Ri105 TYPE OF SE\NARGE DISPOSAL Public Sewer V Well I Private (septic tank, etc. i Tail ningAtassa�ge Body An Tobacco Sales Permanent Dunlpster on Site Swimming Pools - Food Packaging, Sales NOTE: Persons contrwft 1 unregisterel 1rudory (Io not have lwee,sw to the I/ny �lIII/I Signature of Agent/Ownne'r Signature of Contractor Plans Submitted Plans Waived U Certified Plot Plan I_` -I Stamped Plans i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM PLANNING & DEVELOPMENT DATE REJECTED x DATE APPROVED ELS/ to A i( L] Water Shed Special Permit /� ,// ❑ Site Plan Special Permit r �" l�w��❑ Other CONJME� S CONSERVATION r - 3(ATE RB�IECTED ' 'D TE APPROVED COMMENTSi�2u� P c4e,4 19/-19/dt . 'VA W- A ' J �. 006 I��e� n'I/✓ e 1 ` 44 r 5 U ��1I� VKd /� �� ��� 2 t�' V �I � `` �� 11__2 f r -I All wcr 'owk�;dL 1Pt3���_ DATE REJECTE DATE — 10 APPROVED HEALTH COMMENTS Lonin�.t Board of Appcals: Variance. Petition No: Zoning Decision, receipt submitted yes !�l Planning Board Decision: _ Conllllents Conservation Dccisio 1: _ (onlincllls Nater Se"er connection signature & date07 Temp Dunlpster on site yes_—no__ Fire Department signature.'date Building Permit ,approved and Issued by: '1 BUilding Setback (ft.) Front Yard Side Yard Rear Yard cd ProN DIMENSION N-umbcrofSxorico: — Total square feet ofUnorouu.based on Fxterinr dimensions Total land area, sq. ft.:_ NOTES and DATA -(|ivdepxnmcu use ^ `- -------�-----'----- i ' | � I CT":J�/,�7����.�������--'----------'----------------'--_� �-__--_----_'] Building Setback (ft.) I, Front Yard Side Yard Rear Yard i Required Provided Rcc uircd Provides Required Provided 301 DIMENSION Number of Stories D Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.:__ NOTES and HATA —I l nr donf,rfm •nf ..—% / aev— oQA/ '��^t�'.�,, Loa,';_' a/o�os�.�o� 7i �2 S' S LrA0 1V- j R TYPE OF SEVbARGE DISPOSAL Tanning /Massage Body Art Swimming Pools Public Sewer Tobacco Sales Well I Food Packaging. Sales Permanent Dempster on Site I Private (septic tank, etc. � I NOTE: Persons contradl unre;;icleret lrt/ChMJ' (it) not htwe uccess to the ln/I' iwd Signature of Agent/Owner Signature of Contractor _ Plans Submitted `'r Plans Waived U Certified Plot Plan^` Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT DATE REJECTED C, DATE APPROVED 't SlUnk E Water Shed Special Permit O �J Site Plan Special Permit -r- �w�❑ Other COMMEIm S ,� Zf 6-4,, DATE RPYIECTED 'DTE APPROVED CONSERVATION F —T b COMMENTS_�i i u 1 v-- MME4 6 IjL✓je-s5, 4Nue.nc,64 6,elf 4&<CLj6t,,, " L 4sivvl)AAJej rilDD Wei -IC 6,1 }4t All luc4- owV "dL (00" 7-oAe.DATE REJECTS DATE APPROVED HEALTH COMMENTS Zonin.( Board of,lppcals: Variance. Petition No: Zoning Dccision. receipt submitted yes Plannin( Board Decision: n Continents 7 Conservation Decision: Comments 'Nater & Se%A er connection siunature & date Temp Dumpstcr on site yes__no__ Fire Department signature'date Building Permit ,approved and Issued by: 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 * Debris Removal Form Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract u Floor Plan Or Proposed Interior Work Addition Or Decks j Building Permit Application u Form U 0CrT N e26e4 u Surveyed Plot Plan u Debris Removal Form u Workers Comp Affidavit u Photo Copy of H.I.C. And C.S.L. Licenses j Copy Of Contract u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) Li Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses :j Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydrauli Calculations (If Applicable) j Copy of Contract u XIass check Energ-, Compliance Report In :III cases if a Variance or special permit was required the Town Clerks office must stamp the decision fro in (he 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 Dor. I%SPEC 101, %L SERV K ES DEPARTNIE\T:131"FOR H15 T-- - - - - - — - --- i NORTH Of ,..o •'1ry0 p TOWN OF NORTH ANDOVER '» �..="•' APPLICATION FOR PLAN EXAMINATION �SSCMUSt Permit NO:Date Received:__ Date Issued: IMPORTANT: ;applicant in LUC.TION _ PROPERTY OWNER MAP NO.: /04_a _ PARCEL:_& TVPF. AND tTSF. OF RIifTIDING complete all items on this nate Print ZONING DISTRICT:]R-5jd^! Aa ?` a PIP— 15007 HISTORIC DISTRICT VFS CI 55'aiW/ 6'l S %0'v TYPE OF INIPROV EMEN PROPOSED USE Resigrential Non- Residential vl�ew Building Addition Alteration _ one fain ily Two or more family No. of units: _ Industrial _ Repair, replacement Demolition - Assessory Bldg ;__ Commercial Moving (relocation) _ Other = Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED (-hw S+tu ,�6 t a- 1�(o CONTRACTOR Name: t O roS j 2 Phone(Dli-Z (Z' q k(c Address:21U�Wbc�A gl CSI Supervisor's Construction License: Csoe-lo(Ou _Exp. Date:91 �t Hon)c Improvement Liccnse: Exp. Date: f' �RC'I IITECT I,.Nt (INFER (�P. S''} ,.��C1►� �:]nll :Phone: �I Address:— -r6 LCA0 y 0 Ret;. No. L)5 -I ---- FEE _FEE SCHEDULE: BC LDLNG PER,11/ �T.SIO. :OO OVER 8100!1.00 OF THE TOT4L EST1;11ATED COSTU' I ' O CV S1 2.5. 00 PER S. F. fo `ri 't S� �', 3—~ Total Projcct Cost :S 4 f P F)ey t x 10.00 FEE:. Check No.: -T— I Receipt NO.: Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only yy- Permit No. 6� X) Occupancy and Fee Checked [Rev. 9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR11ATION) Date: City or Town of: L .� - , —Z To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the elec ical work described below. Location (Street & Number) 7 /C? Owner or Tenant Owner's Address a� S .� .-� i ���`.� � c ., %•� �- Telephone No.J'(-T s' Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service v Amps /2- lxy c-- Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity S/ i5— 9 Location and Nature of Proposed Electrical Work: ,� , , Ae, v /,/, Cmmnlntinn nftho fnllnwino rnhla , i,. , a t„, it. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans o. o ft Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and InitiatingDevices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Num erons K No. oSelf-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ unicipal ❑ Other Connection No. of Dryers No. of Water KW Heaters Heating Appliances KW No. o o. o Signs Ballasts Security Systems: No. of Devices or Equivalent Data Wiring: : No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER. . I ttach additional detail it'desired, or cis required by the Inspector of 11"ires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: j- /y -o S Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage orce, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: %%. r S,-. �,� / /�— �- LIC. NO.: Licensee: Signature f� LIC. NO.: (/%ul?plieable, ea ter "exeni; - in the license aanber line.) Address �� >- _s /�/ Bus. "Tel. No.: i'r�c=.7 Alt. Tel. No.: *Security System Contractor License required for this work; if apppl�able, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $7 l )t -d & IIF -67 llq-ll� Date .... X(15e X ..... �0\ TOWN OF NORTH ANDOVE PERMIT FOR GAS INST 14 This certifies that has permission for gas installation Are 5 in the buildings of ... 7iw. ................ at .. . . 1112,,. /-. . . . 3 ............... North Andover, Mass. FeZ'. Lic. No.. . �11. :� 7 x . . ""/ ��. ........... GAS INSPECTOR Check# 5 7 L�G NIASSACHUSET IN UNIFORM APPUCATON FOR PERNllT TO DO GAS FrrDNG (Type or print) Date ! c� NORTH ANDOVER, MASSACHUSETTS Building Locations oZ 10 1 f t) PCD t I9 Q Permit # Owner's Name New Renovation ❑ Replacement Amount $ J3 20 (_tj,j P e Pa1j V Plans Submitted ❑ Name of Licensed Plumber or Gas Fitter e C k one: Certificate Installing Company Corp. ElPartner. 0-FirrrdCo. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ®� No 0 If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy --- Other type of indemnity ID 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: Signature of Owner or Owner's Agent Owner Agent ___.J best of my knowledge and that all plumbing work and ins. compliance 4vith all pertinent provisions of the Mass;chu By: 'Title. City/Town \PPROVED (OFFICE USE ONLY) ueu kur emereu) in aDove appiwation are true and accurate to the �performeedeermit Issued � d fort ' ppIication will be in Gas Co C apter of th G oral Laws. Signature of .[--L er Gas Fitter Nfaster Journeyman Plumber Or Gas Fitter :2 9' pg::� License INUMmir -A, :,J 0 Date. 7 01 �,/?,- e . 1?e, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . T)/Y.,� .". j .... F'.,.(J ...... has permission to perform ... IV. r, plumbing in the buildings of . . r� ........ at. . �. � �� . :-� . 13 � . 6 ................. North Andover. Mass. Fee"—'-7.� Lic. No..F7.'�' PLUMBING IrrSPECTOR Check # C-,(, /J, ,, 702-1 ■ t MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location C2/Q `/`�j/ye e�g2 Owners Name S eveDate o e4po eO tj-s Permit # —777 Amount 5 2,- Type of Occupancy New ©renovation Replacement 13 Plans Submitted Yes ❑ No F1YTi TD L'c (Print or type) Installing Company Name ( ,c}y, ,>��— �' (� Check one: Certificate ❑ Corp. Address ❑ Partner. u4i ess a ep h one y= S—�•_ S yy 9 Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type 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 ❑ I hereby certify that all of the details and infonk e submitted (or entered) i best of my knowledge and that all plumbing wMationspe,4rmed un compliance with rill pertinent provisions of thtts SY�tCe I�lvimhin P . By: Title City/Town APPROVED (OFFICE USE ONLY Agent ❑ n abo e application are true and accurate to the Pe t Is ed for this application will be in 1 h, ter 142 of the General Laws. Type of P.16dbing License L ICCIISC INUMDFFMaster Journeyman ❑ October 26, 2006 Town of North Andover 1600 Osgood Street North Andover, MA 01845 ATTN: Brian Leathe RE: 210 Blue Ridge Road, North Andover, MA Dear Brian: Please find enclosed the original letter from the Engineer regarding the above captioned property. Thanks and have a great day! Susan /Enclosures 21 Wormwood Street, Suite 601, Boston, MA 02210 Phone: (866) 936-3100 Fax: (866) 936-3101 www.jbrownrealtydevelopment.com LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 —352-2858 cell 978-502-5921 October 19, 2006 J. Brown Realty Development, LLC. 21 Wormwood Street, Suite 601 Boston, MA. 02210 Attn: Ms. Susan A. Pappalardo, Project Manager RE: 210 Blue Ridge Road, North Andover, Ma. Dear Ms. Pappalardo As you requested I Inspected the framing for the above project as shown on plans prepared by Scholz Architectural Services, L.L.C., numbered 1,1A, 2, 2A,2B,2C,2D,3,3A,4,4A,4B,4C,5,5A,5B,6, and 6A, dated 2/06/06, entitled Denbridge, B43 Special, J.Brown Realty Dev. In most respects the framing complies with the drawings with some minor acceptable modifications. In addition as you are aware modifications were required to the steel post in the basement and the Tall Wall design as shown on sheet 5A, these modifications were made per my instructions and are acceptable. I performed a final site inspection on 10/18/06 and certify that to the best of my knowledge the framing complies to the design intent of the construction drawings as prepared and certified by Scholz Architectural Services, L.L.C. Yours truly, � �`awrenc1eH. Ogden, P.E. ,Vjti OF bjRs�C' 9 LAWRENCE G Q' LD g 0b D i y .o p 765 p FSS NAL BOARD OF BUILDI G REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 090619 Birthdate: 08/06/1958 J / Expires: 08/06/2008 Tr. no: 90619 Restricted: 00 STEVE KIPUROS 21 WORMWOOD ST # 601 �— BOSTON, MA 02210 Commissioner NO TE. - 1) THIS PLAN IS NOT TO BE CONSIDERED AN ALTA/ACSM LAND TITLE SURVEY, NOR IS IT TO BE USED FOR RETRACEMENT OF PROPERTY LINES. 2) WETLANDS SHOWN HEREON WERE DIGITIZED FROM PLAN ENTITLED "SITE PLAN LOCATED IN NORTH ANDOVER, MASS." DATED 7/23/2002 & 9/22/02 PREPARED BY SCOTT R. GILES, RPLS. z a 0 w r LOT 85 L.C.C. 36903 S LOT 128 L.C.C. 36903 U spUry � o R249 l �s 02 WNDOW 4ST g O, OVERHANG 2 ST WOOD FRAME D WELLING LOT 127 (50' WIDE) ROAD ro M to ASSESSORS.• MAP 104.D, BLOCK 180 ZONING: RESIDENTIAL DISTRICT 1 REFERENCES - PLAN: LCC 36903U CERT. NO.: 11410 STEPS o y N uj J CA:a J 43.7' y LOT 20 DECD PLAN #10883 47,225 S.F. ,. 1.08 ACRES 70 SRP\SER eUo FRFT4�X910 �R zoNe IJ 0) OO Q DO O #3-A #4-A #5-A EpSEMEN� 1 AL AL #6-A #2-A AL 2p3.32� AL AL AL J. #7-A AL A LOT 126 LOT 86 AL L.C.C. 36903 U L.C.C. 36903 S I CERTIFY TO THE NORTH ANDOVER BUILDING INSPECTOR THAT THE DWELLING SHOWN HEREON IS LOCATED ON THE GROUND AS SHOWN AND THAT IT CONFORMS TO THE DIMENSIONAL REQUIREMENTS OF THE ZONING BYLAW OF THE TOWN OF NORTH ANDOVER WITH REGARD TO SETBACKS AT THE TIME OF CONSTRUCTION. nOF AT 210 BLL PREPARED FOR.•ALSM T T A A T t-1 f- N PROFESSIONI&ILAND SURVEYOR LOT 19 PLAN #10883 April 24, 2006 Town of North Andover Gerald A. Brown, Building Inspector 400 Osgood Street North Andover, MA 01845 RE: 210 Blue Ridge Road, f/k/a 11 Lancaster Rd., North Andover Dear Mr. Brown: Please find enclosed the following: 1. Building Permit Application; 2. Certified Proposed Plot Plan; 3. Workers Comp Affidavit; 4. Two Sets of Building Plans; 5. Two Original REScheck Compliance Certificates Massachusetts Energy Code; 6. Site Plan; 7. Revised Site Plan; 8. Photo of CSL License; 9. Debris Disposal Form; 10. Homeowners License Exemption Form. Kindly review and contact me @ 617-212-4986 or 866-936-3100 with any questions or comments you may have. Very truly yours,, Susan A. Pappalardo /Enclosures 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///-20� r 12d.. AlAndawIs 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: 1,4SZvi `,7 C'1e�� < (Location of Facility) t; Signa of Pe pplicant Fire Department Sign off�.- Dumpster Permit Date a REScheck Compliance Certificate Massachusetts Energy Code REScheck Software Version 3.6 Release 2 Data filename: Y:\Energy Calc Files\06-015.rck CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) WINDOW / WALL RATIO: 0.13 DATE: 03/21/06 COMPLIANCE: Passes Maximum UA = 1176 Your Home UA = 1120 4.8% Better Than Code (UA) Flat Ceilings: Flat Ceiling or Scissor Truss Sloped Ceilings: Cathedral Ceiling (no attic) FF Walls: Wood Frame, 16" o.c. FF Windows: Vinyl Frame:Double Pane FF Doors - French: Glass FF Doors - Solid: Solid SF Walls - Full Ht.: Wood Frame, 16" o.c. SF Windows: Wood Frame:Double Pane SF Walls - Knee Walls: Wood Frame, 16" o.c. Lower Level Stud Wall: Wood Frame, 16" o.c. LL Windows: Vinyl Frame:Double Pane LL Doors - French: Glass Fdn. Wall: Solid Concrete or Masonry: Exterior Insulation Floor Above Garage: All -Wood Joist/Truss:Over Unconditioned Space Insulation at L.L. Slab: Slab-On-Grade:Unheated Insulation depth: 4.0' Furnace 1: Forced Hot Air, 90 AFUE Air Conditioner 1: Electric Central Air, 10 SEER Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value U -Factor UA 2493 38.0 0.0 75 960 22.0 0.0 44 2280 13.0 0.0 145 351 0.550 193 144 0.500 72 20 0.400 8 1365 13.0 0.0 93 230 0.550 127 563 13.0 0.0 46 877 19.0 10.0 31 100 0.550 55 41 0.500 21 1338 0.0 10.0 103 834 19.0 0.0 39 99 10.0 68 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 REScheck Version 3.6 Release 2 (formerly MECcheck) and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Condition found in the Code. Th HVAC equipment selected to heat or cool the building shall be no greater than 125% of the sign load WA4W_Qified . Sections 780CMR 1310 and AA Builder/Designer nNoll 1057 ?1 0 TOLEDO U9. OHI% 8 0 i.N Date RES check Inspection Checklist Massachusetts Energy Code REScheck Software Version 3.6 Release 2 DATE: 03/21/06 Bldg. Dept. Use Ceilings: [ ] 1. Flat Ceilings: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation Comments: [ ] 2. Sloped Ceilings: Cathedral Ceiling (no attic), R-22.0 cavity insulation Comments: Above -Grade Walls: [ ] 1. FF Walls: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: [ ] 2. SF Walls - Full Ht.: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: [ ] 3. SF Walls - Knee Walls: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: [ ] 4. Lower Level Stud Wall: Wood Frame, 16" o.c., R-19.0 cavity + R-10.0 continuous insulation Comments: [ ] 5. Fdn. Wall: Solid Concrete or Masonry: Exterior Insulation, R-10.0 continuous insulation Comments: Windows: [ ] 1. FF Windows: Vinyl Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: [ ] 2. SF Windows: Wood Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: [ ] 3. LL Windows: Vinyl Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: [ ] 1. FF Doors - French: Glass, U -factor: 0.500 Comments: [ ] 2. FF Doors - Solid: Solid, U -factor: 0.400 Comments: [ ] 3. LL Doors - French: Glass, U -factor: 0.500 Comments: Floors: 1. Floor Above Garage: All -Wood Joist/Truss:Over Unconditioned Space, R-19.0 cavity insulation Comments: 2. Insulation at L.L. Slab: Slab-On-Grade:Unheated, 4.0' insulation depth, R-10.0 continuous insulation Comments: Slab insulation to extend down from the top of the slab to at least 4.0 fl. OR down to at least the bottom of the slab then horizontally for a total distance of4.0 fl. Heating and Cooling Equipment: 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number 2. Air Conditioner 1: Electric Central Air, 10 SEER 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 cfm (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/$2 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 transport 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 of the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Siang: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: All heated swimming pools must have an on/offheater 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: HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts I" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 Insulation Thickness in Inches by Pipe Sizes Heated Water Non -Circulating Runouts Circulating Mains and Runouts Temperature ( F) Up to 1„ Up to 1.25" 1.5" to 2.0" 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 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts I" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 1.5 1.5 2.0 120-200 0.5 1.0 1.0 1.5 Any 1.0 1.0 1.5 2.0 40-55 0.5 0.5 0.75 1.0 Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) A REScheck Compliance Certificate Massachusetts Energy Code REScheck Soffware Version 3.6 Release 2 Data filename: Y:\Energy Calc Files\06-015.rck CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) WINDOW / WALL RATIO: 0.13 DATE: 03/21/06 COMPLIANCE: Passes Maximum UA = 1176 Your Home UA = 1120 4.8% Better Than Code (UA) Flat Ceilings: Flat Ceiling or Scissor Truss Sloped Ceilings: Cathedral Ceiling (no attic) FF Walls: Wood Frame, 16" o.c. FF Windows: Vinyl Frame:Double Pane FF Doors - French: Glass FF Doors - Solid: Solid SF Walls - Full Ht.: Wood Frame, 16" o.c. SF Windows: Wood Frame:Double Pane SF Walls - Knee Walls: Wood Frame, 16" o.c. Lower Level Stud Wall: Wood Frame, 16" o.c. LL Windows: Vinyl Frame:Double Pane LL Doors - French: Glass Fdn. Wall: Solid Concrete or Masonry:Exterior Insulation Floor Above Garage: All -Wood Joist/T russ: Over Unconditioned Space Insulation at L.L. Slab: Slab -On -Grade: Unheated Insulation depth: 4.0' Furnace 1: Forced Hot Air, 90 AFUE Air Conditioner 1: Electric Central Air, 10 SEER Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R -Value -Factor UA 2493 38.0 0.0 75 960 22.0 0.0 44 2280 13.0 0.0 145 351 0.550 193 144 0.500 72 20 0.400 8 1365 13.0 0.0 93 230 0.550 127 563 13.0 0.0 46 877 19.0 10.0 31 100 0.550 55 41 0.500 21 1338 0.0 10.0 103 834 19.0 0.0 39 99 10.0 68 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 REScheck Version 3.6 Release 2 (formerly MECcheck) and to comply with the mandatory requirements listed in the REScheck Inspection 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 HVAC equipment selected to heat or cool the building shall be no greater than 125% of the (ksign load„7� in Sections 780CMR 1310 and J4.4. Builder/Designer 0 Wo. 1 1 0 7 m TOLEF3Q, .?,. OHIO Date 4U Q REScheck Inspection Checklist Massachusetts Energy Code REScheck So$ware Version 3.6 Release 2 DATE: 03/21/06 Bldg. Dept. Use Ceilings: 1. Flat Ceilings: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation Comments: 2. Sloped Ceilings: Cathedral Ceiling (no attic), R-22.0 cavity insulation Comments: Above -Grade Walls: 1. FF Walls: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: 2. SF Walls - Full Ht.: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: 3. SF Walls - Knee Walls: Wood Frame, 16" o.c., R-13.0 cavity insulation Comments: 4. Lower Level Stud Wall: Wood Frame, 16" o. c., R-19.0 cavity + R-10.0 continuous insulation Comments: 5. Fdn. Wall: Solid Concrete or Masonry: Exterior Insulation, R-10.0 continuous insulation Comments: Windows: 1. FF Windows: Vinyl Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: 2. SF Windows: Wood Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: 3. LL Windows: Vinyl Frame:Double Pane, U -factor: 0.550 For windows without labeled U -factors, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments: Doors: 1. FF Doors - French: Glass, U -factor: 0.500 Comments: 2. FF Doors - Solid: Solid, U -factor: 0.400 Comments: 3. LL Doors - French: Glass, U -factor: 0.500 Comments: Floors: [ ] 1. Floor Above Garage: All -Wood Joist/Truss:Over Unconditioned Space, R-19.0 cavity insulation Comments: [ ] 2. Insulation at L.L. Slab: Slab-On-Grade:Unheated, 4.0' insulation depth, R-10.0 continuous insulation Comments: Slab insulation to extend down from the top of the slab to at least 4.0 $. OR down to at least the bottom of the slab then horizontally for a total distance of 4.0 $. Heating and Cooling Equipment: [ ] 1. Furnace 1: Forced Hot Air, 90 AFUE or higher Make and Model Number [ ] 2. Air Conditioner 1: Electric Central Air, 10 SEER 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/fit 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 transport 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 of the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Siang: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/offheater 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: [ ] HVAC piping conveying fluids above 120 T or chilled fluids below 55 °F must be insulated to the levels in Table 2. 1 Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts l" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 Insulation Thickness in Inches by Pipe Sizes Heated Water Non -Circulating Runouts Circulating Mains and Runouts Temperature ( F) Up to 1„ Up to 1.25" 1.5" to 2.0" 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 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range F 2" Runouts l" and Less 1.25" to 2" 2.5" to 4" Heating Systems Low Pressure/Temperature Low Temperature Steam Condensate (for feed water) Cooling Systems Chilled Water, Refrigerant, and Brine 201-250 1.0 1.5 1.5 2.0 120-200 0.5 1.0 1.0 1.5 Any 1.0 1.0 1.5 2.0 40-55 0.5 0.5 0.75 1.0 Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) .�� The Commonwealth of Massachusetts I A Department of Industrial: accidents Office of Investigations . :;•Iii ;.i. 600 Washington Street Boston, M4 02111 wwminass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly_ Name tains -3-c. Address: 71 LJ6g.Hk)AAJ City/State/Zip: _&s4uyl , 6AA 6 Zz i 0 Phone #: le l -7 -zrz- s 5-zec, Are you an employer? Check the appropriate box: 1. ❑ 1 ata a employer with 4. ❑ 1 am a general contractor and 1 inployees (full and/or part-time).* 2. 1 am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, 31(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. Vew construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box M I must also till out the section below showing their workers' compensation policy information. 1 lomcusvners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit it new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the mune of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is lite policy and job site information. Insurance Company Name: Policy's or Self -ins. Lic. #:__ Expiration Date: Job Site Address: 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 i dGL c. 152 can lead to the imposition of criminal penalties of a tine 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 tine 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 cla here6V that the information provided above is true and correct. (/ficial use only. Do not write in this area, to be completer) by cilp or town q cial. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. BkflWhg Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone M U) m m m X m m CO) az CD O d .o o p CL Q CD o C CD Q O to CD O H 0 y CD 0 r� CD CD P. CA CD CA 0 CD O CCD I O m � r� 0 c a c J n� O� y m o c CA v J N o� cn O a +� .w NCD CD . i rtf 0 rA CL t� n� iroTl n Cy� �o �, Ml o o ~" rtf 0 rA t� iroTl n Cy� �, Ml o �r G M