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Building Permit #769 - Lot 6 Kara Lane 5/1/2018
Permit N0: --7? 6 9 Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this naize � pORTH O ttLeo ,6• ti0 0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Buildingne famil Addition Two or more family Industrial Iter No. of units: Commercial Others: Re air, replacement Assessory Bldg Demolition Other Septic 'Well, Floodplain Wetlands Watershed District_ Waterlsewer uta.,K1V i 1UN Ur WUMck TU BE PREFORMED: 11 II)SIR11 n,ecy 14dzJ-e�► kaq, app /Y c,n LA=-, , ! �: P41'Y' e4(1� Y3 l IN �- � G{ �� �1 /lL CD/� " GC G�j1�1 P� I'�,� !/►�, D� �J'/G� Identification Please Type or Print Clearly)h� OWNER: Name: C6r W Y1.yrt,1� Phone: Address: 16i n t^I-P A)o►' "l- arc-,- CONTRACTOR- rmCONTRACTOR Name: Phone: Address. Supervisor's Construction License: Exp._ Date; ' Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ X1000 FEE: $ q.3,2 Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature =� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 664 Usg000 Street FIRE "DEPARTMENT = Temp Dumpster on site yes no 'Located at 124 Main Street Fire Department.-signature/date COMMENTS Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NU I t5 ana UA I A — (I -or oegartment use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 No Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks . ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2008 Location' ��f No. Date TOWN OF NORTH ANDOVER A Certificate of Occupancy $ 4 Building/Frame Permit Fee $` ?Z Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /11 x 1 2321; / I Building Inspector %I a� W A p cau u w° ' u cin w q o z -0 w° o U r, w ►� x o w C w o w w W cn w p � ° r� cz C w" M M = m y C m O _,,, p w A w x w z w �i " rA cin Q cn CD F. U 0 CD O C• L O v Z CD O. O ca � C I ccm O C Q •VO cD E m m CD CD CL _~ CD .o � � o e_wCL cav o a C Q Cccts .C:L OCO2 z y0.. C CD CL V h O C C— � C CL H Q Y♦ ce W 19 W U) o m c o � I C h O C ' � O c vV c.c M M = m y C m O _,,, p O. Ca W CO �� m • �V!m A R �+ ' 0: i Q E c. w c V3 CD :t.2 .. c3 A� E c V ; 0 m . o 0 sc L V: C W ® m I y cm � 3 CD F. U 0 CD O C• L O v Z CD O. 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I( `go c0 oQ t1 mr �o of miQa *tom.. w Q m Ce) M co ! m!`y 10 o o c. -jj u� I� + i o •` Q co Q O F r O N N U O LL.I � N o �jETM??W�� ac LO j c CN N 0 1t` Ixo, g ,I 0 c N N 2I- mI O7 - .: I (A U Q N ' 1LO 11 111 �p U 0 O I Q +' ii D H ^7,l O V —4 \0 ✓� N N rn >~ 0 'w A I� V) O41w I~ o V) �o b a •ti cid U Cd Op V) >Z O TJ 0 b �b O Q, o 0 it 0 0 p Ob cl -0 Ncd ti Ll. � 0fig 0 O � k q l.w Q 'Z 'i t amIts ,� IIIIIiII a q. w >r oq � q o VI �4 O r. 0 .,n.- 0 O O O C N 'Z 0 U v,ww 0 O 0 y � rn>� 0 p Q N cd A i ilii iii iii iii iii U E Location No. '% % Date c,21 n z� r 6 Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ r� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� 5 6 5 J Building Insp moi TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING i a u �y, 1- 111 BUI:,DING PERMIT NUMBER: /O /� DATE ISSUED: �C SIGNATURE: Building Commissioner/Inspector of Buildings Date —/ z —C, �— SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: /%4,q �) 2 Of (4 i 1Q , A c Map Number Parcel Number 1.3 Zoning Information: �- 3 S>A/(r � 1.4 Property Dimensions: / �-g / 33 Zoning District Proposed Use Lot Areas Frontage fE° 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 30 Z -2-0 30 `4' -3o --,3(+ 1.7 Water Supply M.G.LC.40. 54) 1.5. Flood Zone Information: Public Private ❑ Zone Outside Flood Zone 1.8 S erage Disposal System: Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT 2.1 Ownerl Record �F, y S,L Vq 1-154 1.4, Name (Prin"P Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signatu,Le Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Lic;= Construction Supe sor: Not Applicable 0 �-�s Licensed Construction Supervisor: License Number /3-3 /4 ,4 //(,/ �'? ; /, /t f �i /it>lj-� y A 0 1 &—& Y �/ N� Address Expiration Date Sign Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number Address Expiration Date Signature Telephone Mg M X Z O N V SECTION 4 - WORKERS COMPENSATION (XG.L. C 152 § 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction Existing Building ❑ Repair(s) 0Alterations(s) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: k Iieoom l — I-eu e(-- 601,7-1 f CA A?- -f- CS &D El t S , 2 �% Q A -r11 s�-Svn 0044 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) tobe Completed bpermit applicant , fl>E �)A�,�SE'?!+%Y 1. Building (a) Building Permit Fee Multiplier 6500 t So o p 2 Electrical (b) Estimated Total Cost of Construction 0 r 3oZ a 3 Plumbing Building Permit fee (a) x (b) p? ©� 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Sigiiature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES 1+ Z SIZE 3 0 -+- 3 2 - BASEMENT OR SLAB t/-=- S'C of 3 BASEMENT SIZE OF FLOOR 'fJMBERS 2 N11 3 FD SPAN DIMENSIONS OF SILLS to L- DIMENSIONS OF POSTS "4-Z DJI�T,NSIONS OF GIRDERS "YO D�NSIONS HEIGHT OF FOUNDATION THICKNESS /0 SIZE OF FOOTING /0 X -Z' MATERIAL OF CH VINEY R t GK r-�c IS BUILDING ON SOLID OR FILLED LAND SO 1 _ IS BUILDING CONNECTED TO NATURAL GAS LINE, �' 1 0 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 Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: yj <,., t* .2-0 / //0. (Location of Facility) ignature Of Permit Applicant — — 0-7 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVER BUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. Permit Applicant Property address Map / Parcel Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 ofthe Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit. Further 1 understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for building permit for the enlargement, restoration or reconstruction of a dwelling in . existence as of the effective date of this bylaw, provided that no additional residential unit is created The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zomng Bylaw. This application is for dwelling units for low and or moderate income families or individuals, where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land. For purposes of this section "senior" shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single fancily dwelling unit on the parcel. This application represents a lot which is ready for a building permit ( all other permits from all other boatels and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, wHETIIER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. �-- AP6KKANTS S101UTORE DATE TKKFORM TO BE ATTACHED TO THE'BUILDING PERMIT APPLICATION MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 6-11-2002 COMPLIANCE: Passes Maximum UA = 617 Your Home = 350 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 2694 33.0 33.0 43 WALLS: Wood Frame, 16" O.C. 2014 13.0 13.0 97 BSMT: Conc. 8.0' ht/7.0' bg/8.0' insul 2694 19.0 19.0 65 GLAZING: Windows or Doors 384 0.330 127 DOORS 54 0.330 18 HVAC EQUIPMENT: Furnace, 87.5 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. . Z Builder/Designer Datef— c 7 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 6-11-2002 Bldg.l Dept.l Use I CEILINGS: [ ] I 1. R-33 + R-33 I Comments/Location I I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-13 + R-13 I Comments/Location I BASEMENT WALLS: [ ] I 1. Conc. 8.0' ht/7.0' bg/8.0' insul, R-19 cavity + R-0 continuous I Comments/Location I WINDOWS AND GLASS DOORS: { ] I 1. U -value: 0.33 I For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I DOORS: [ ] I 1. U -value: 0.33 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 87.5 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be I provided. Insulation R -values, glazing U -values, and heating I equipment efficiency must be clearly marked on the building plans 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 off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: 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. SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.): HEATING SYSTEMS: Low pressure/temp. Low temperature Steam condensate COOLING SYSTEMS: Chilled water or refrigerant PIPE SIZES TEMP (F) 2" RUNOUTS 0-1" 201-250 1.0 1.5 120-200 0.5 1.0 any 1.0 1.0 (in.) 1.25-2" 2.5-4" 1.5 2.0 1.0 1.5 1.5 2.0 40-55 0.5 0.5 0.75 1.0 below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): ----NOTES TO FIELD (Building Department Use Only)------------------------- PIPE SIZES (in.) NON -CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 140-160 0.5 I 0.5 1.0 1.5 100-130 0.5 1 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- Id FORM U - LOT RELEASE FORMmvse- j� INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT_ LOCATION: Assessor's Map Number D \t4 SUBDIVISION STREET X PHONE_ PARCEL LOT (S) ST. NUMBER *****************************************OFFICIAL USE RECgPAM N TIO $" O CONS VATION AD10 INI COMMENTS COMM FOO ECTOR-HE TH SEPTIC INSPECTOR -HEALTH COMMENTS AGENTS: DATE APPROV91) DATE REJECTED DATE APPROVED DATE REJECTED !!A I E APPROVED DATE REJECTED DATE APPROVED DATE REJECTED VSC PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT rr — FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm ATE FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not reliVe the applicant and/or landowner from compliance with any applicable or requirements. --AI'IJL.ICANT FILLS OUT THIS SECTION*********************** APPLICANT !`�� LOCATION: Assessor's Map Number C F4 PHONE PARCEL SUBDIVISION LOT (S) STREET__ ��'e� �/2 ST.j� NUMBER / ***************************************** OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS 0& --� DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 im The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Afdavit Print Location: 133 CRY _ /`lp KLOA D InJ (Ti /V(A P, am a homeowner performing all work myself. Of, am a sole proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this job. ComQanv name: Address Citif: Phone #- Comtarw name: Ad -dress Gity: Phone #' s Failure to seem coverage as required under Section 25A or MOL 1522 can lead to tine irhposiion d liminal penal. d a fine up to $1.500.00 and/err one years' imprisonment as well as civil penalties in the form d a STOP WORK ORM and arm of ($100:00) a day against rne. I understand that a copy of this statement may be forwarded to the Ot%ce of ink of the DIA for coverage verification. l do herby certify ender the pains and penetles of perjury that the !**radar provided above is tare ani correct Print name U te . 4511eM ✓� Official use only do not write in this area to be completed by city or town official' pGheck if immediate response is requ i*ed Builtjing Dept Contact person: Phone RM WORKMAN'S COPPENSATIOA! Date s57t-44;ys'r9l El Budding Dept p Licensing Board p Selectman's Offlc& Q Wealth Department D Ofher ` _ .ire ��a»anronu�erst� aj, fl{ruar�u<set�s BOARD OF BUILDING REGULATIONS 4 License: CONSTRUCTION SUPERVISOR L Y' Number: CS 040870 Birthdate: 07/01/1950 Expires: 07/01/2003 Tr, no: 12282 Restricted To: 00 JOHN J HASHEM JR _ 176 KARA DR N ANDOVER, MA 01845 Administrator H g _O O ai 3 4c m c m ,.e a C D o °J `r U L �a to a CD c O a� E� a a CL ca' O 0 E Li ai "- a .c +r � O a u c L 2 t �m v 0 b A • O z Q izi1 x(a E� N rn O U a 00 v w lz O ct: ii U W a U W ° u: r� a w a cG ii E+ W 4 w' cn E cn A oo rte: p N �C v V L1•0`� o CD y: E a cC 40� m Ec�N�---� : o m m c Mo N cm . y C C o �Emr Amo % acs � m OyaC S s o cm � c N .' C = m �mo•C �CO.) y O O :o�Z «: c c CL p iV ~ y m ~ m ♦_,. c +- j_ M o.t • o c Z ui � 'r o N O U m 5CIO O H t $ a,=..m 0 Z 1@ E CD O co rr8 y 0 h c 0 O C ca is 3� �D Q Q O a' Q cma c —9.0 ev O CD Z ts CL CO) C LLI 0 U) U) crLLJW w U) X66 Date.... TOWN OF NORTH ANDOVER -00) 0 PERMIT FOR WIRING This certifies that ........ . ......... ................ S S, has permission to perform .................................................. W .................... wiring in the building of .......... S..! ... /. U - C( . ................................................. at ......... ........ r ...... F'�'t ................. ,Zortah-s- h Andover, Nfs. Fee ..... Lic. No.. '*'* .... ................. ELECTRICAL IN PECTOR Check # THEC0MM0NWF.ALM0FA14 SS4CJIUSEHSa ceUseI DEPARDRATOFPUBIICS MY Vfel BOARDOFFIREPREVENTIONRF.GUL4HONS527GtM]2.M Permit No. / Occupancy & Fees Checked APPLICA77ONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date�- Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) `d A- /a P /,q f�1z- Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No / (Check Appropriate Box) Purpose of Building /SPS / Cl�?!7 7C/ Gi Utility Authorization No. Existing Service Amp =Volts Overhead 0 Underground � No. of Meters New Service Amps / Volts Overhead [M �----- g Under found No. of Meters Number of Feeders and Ampacity and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs KW No. ;i Lighting Fixtures Swimming Pool Above No. of Receptacle Outlets No. of Oil Burners ound Tr7 No. of Switch Outlets KW No. of Gas Burners No. of Ranges No. of Air Cond. Total No. of Disposals No. of Heat Total Tons Pumps Tons No. of Dishwashers Space Area Heating No. of Dryers Heating Devices No. of Water Heaters KW No. of No. of No. hydro Massage Tubs Signs No. of Motors Bailasis Total HP DIMIR �✓i/�Gj � r I�ZA,/? 114 �oransforrners EBelow Generators No. of Emergency Lighting Battery Units Total KVA KVA FIRE ALARMS No. of Zones TotalNo. of Detection and KW Initiating Devices • KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local� Municipal ED Connections KW imw=Coverage, PurRrantlotheMgtritaneMdW M,,h ells C n dLa, haw acimILiabl7ityh>st>t =Fbkym-kidirgCaTlceCovera�oritsst> alegtuvaler:t Y� ha�subrnatedvafidpioofofsame�theOffioe YES NO EDj L --J ff}cxthaveclladodYESpirtdtethetypeofcovwgeby VSURANC'E M-171 BOND r7 OMER 1r�earoi',Da�Reg>ested ignedunder�ie of 'RMNAME J t/ /// c/ft /i /�/V f/Gr miseeU !GP r ✓ yl �il,11-Sigtrahue ExprabmDale Fsrun*d Valueofl3xftical WRough otk $$ // OD 0 , e l/ Filtal /' LimmNo. y -� affmN, -2 Y 7 !% BusiimTel.No. 6j 7 i?- vVNE[t SIIVSURANCEW Ah Tel No AIVER,IamawarethattheLtcerrsedoesnothavethein xmmoc)mxagoeoritsatsUniialegivalartas IdiatmysignahneonthispmTr tappl> � ftr gi bYMassachuse�sGetleta um lease check one) Owner Agent M ----'Signature or Own Telephone No. PERMIT FEE er or gen R 41 Date.... . rte. Z .... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . �..........: "� . ............ has permission for gas installation . , ? ... ... . .......... . in the buildings of— at��' .. . '. ! �... 1!L`� ? :..... ,North Andover, Mass. Fee.. .... Lic. Noz�r�aj. ... .. � ...... . GAS INSPECT Check # 4137 MASSACHUSETTS UNIFORM APPLICATON FOR PERAW TO DO GAS Ff.rnNG (Type or Pmt) NORTH ANDOVER, MASSACHUSETTS Date l ^ t �) ",G �, rN Building Locations ` ]2P ► .9 Permit # 7 downer'ow- s Name amount $ d New Renovation Replacement Plans Submitted (Print or type) QMk one., Certifi Nanie- - `` Address ` � M'� t /V C��' !�1 n Partner. Business 'Telephone r., 01 Firm/Co. . Nwrie of Licensed Plumber or Gas Fitter -INSUKANUE GUVEKAUE Cheek one: I h?. e a current liability Insurance, policy cr it's substantial equivalent. Yes 0" Noo Ifycrj have checked y please indicate the type eovesage.by checking the appropriate box LhCbility insurance policy Q Other type of indemnity 0 Bond Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the AdLass. General Laws, and#hat my signature on this.permit application waives this requiremeaL ofowpa Check one: Owner I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe Massachusetts to✓� and Chapter 4�vftlte ®n Laws. OVER (OFFICE USE ONLY) Signature ofLicensed Plumber Or Gas Fitter Plumber I i ©O q,!5 — 0 Gas Fitter License um r Master Journeyman n Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that -y. . . ....................... has permission to perform... ... �.� .-.... ........... . plumbing in the buildings of ../._.-.-�!'%! .. . .�.-. y . ,North Andover, Mass. Fee.-// �� .... Lic. No% .,. %�. . PLUMBINGINSPECTOR Check # 5377 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING . � (Prim a Type) . I Aty, Town BuNN AT: Locadon�C� III�C,�%Z1t Date '!-19- Owneeme s NaI �"1 'GC>.USi�tCc1� Type of New Renovation ❑ Repi mnent ❑ FIXTURES Pauls Submitted Yes No (Print or Type) Check One: Caffmte Installing Company Name% �g `"� I ��) Corp. /3 X3 Add. 9 q� 5 �` ❑ partnersbip . Q �iy, r ti �M T CS t��/' ❑ Firm/Company Business Telephone %� `�� y' ^�_ Name of Licensed Plumber or GGasfitter A.�Z> 7 I bereby certify that all of the details mW information I have mbmkW (or eatacQ in above application are true and &=mte to the bat of my knowle* and that all phsmbiag work and installations paformed wider Permit issued for this application will be in compliance with all pauamt prwiaions of the Masaachusetta State Cm Code and C Mpta 142 of the C c=W Laws. I bare informed the owner or his agent that I do not have liabWty inson= induding completed opaatiow coverage, 5P— a(t)*va/A1ene � P I bare a mica l;ab0ity ins== policy to indude completed operations coverage. BY Title City/Town APPROVED (OFFICE usE oNLif) Signature of Licensed Plumber (Type of Plumbing License W5 ton 5 t—1 iaster ❑ Journeyman License Number l z z ZY a .A a W W a 59 z_ a J s.z a x p O d °`114 i 0: c a r°, z=1 6. z 0 19 q O 1n O• a < }< me h < a W z q p < q q J z .. C a d W a O .� Ii. Z q W IL W. W h t7 y it O Z 3 q! Z O p mss. g Z tl F" O V Y 3 I.Y J N p 0 0 J 3 s h la p O SUB"BSMT. BASEMENT 1ST FLOOR ( I 2ND FLOOR I 3RD FLOOR 4TH FLOOR STH FLOOR STH FLOOR 7TH FLOOR STH FLOOR (Print or Type) Check One: Caffmte Installing Company Name% �g `"� I ��) Corp. /3 X3 Add. 9 q� 5 �` ❑ partnersbip . Q �iy, r ti �M T CS t��/' ❑ Firm/Company Business Telephone %� `�� y' ^�_ Name of Licensed Plumber or GGasfitter A.�Z> 7 I bereby certify that all of the details mW information I have mbmkW (or eatacQ in above application are true and &=mte to the bat of my knowle* and that all phsmbiag work and installations paformed wider Permit issued for this application will be in compliance with all pauamt prwiaions of the Masaachusetta State Cm Code and C Mpta 142 of the C c=W Laws. I bare informed the owner or his agent that I do not have liabWty inson= induding completed opaatiow coverage, 5P— a(t)*va/A1ene � P I bare a mica l;ab0ity ins== policy to indude completed operations coverage. BY Title City/Town APPROVED (OFFICE usE oNLif) Signature of Licensed Plumber (Type of Plumbing License W5 ton 5 t—1 iaster ❑ Journeyman License Number l Location 10 ISA R A, J (2 tU �- No. & 3 Date d a TOWN OF NORTH ANDOVER O A +r Certificate of Occupancy $ E<� Building/Frame Permit Fee $ s�cNus Foundation Permit Fee $ Other Permit Fee CF A Z C $ 50 TOTAL $ `SD Check # - p010 155U� T Building Inspector Ci rte., TOWN OF NORTH ANDOVER BUILDING DEPARTMENT � A Z E APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING rr ar zsr , m BUILDING PERMIT NUMBER: / DATE ISSUED: SIGNATURE: Building Commissionerfi for of Buildings Date SECTION 1- SITE INFORMATION I 1.1 Property Address: 1.2 Assessors Map and Parcel Map Number Number: Parcel Number 10 I� (� n io� � J 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required Provided Reqwred Provided 1.7 Water Supply M.G.LC.40. 54) Public ❑ Private p Zone 1.5. Flood Zone Information: Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: J `t 13-3# 10 A UV 6 f kD �IP MI Vu 60 t (Y [7 Y License Number Address 1 —03 Expiration Date Signature Telephone X.2 Registered Home Improvement Contractor Not Applicable - Company Name Registration Number Address Expiration Date Si nature Telephone 0 SECTION 4 - WORKERS COMPENSATION (MG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check altapplicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A z E D use c) �o r ti ,e w 1-4--c I SF,CTTON 6 - FSTIMATF.D CONSTRUCTION COSTS I t " t' `f P T, - " Item Estimated Cost (Dollar) to be Completed by permit applicant ,gghFI�1E -� Ox 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC)�- 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of (honer Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION T4 9�&,as Owne �subject propert Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Sip -nature of Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TFVMERS IS12 ND 3kD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978)688-9545 Fax(978)688-9542 Building Demolition Affidavit ORT 1CN O0 s4�o q O ��SSArIED pcHus���y DATE .S - 2- Z -Q -�— OWNERS NAME & ADDRESS Cyep'r, 30 L i N e✓ S~ 1 �— V A PROPERTY LOCATION % a /<A CS A, b P\ DESCRIPTION S� N (rL(-S ��¢•✓1 ��E , /i�ervtOU�' �t �ovot/1�7Q-Ti��,% CONTRACTORS NAME & ADDRESS 61V,57'- Ale-. ,g -O? Fotl) X -71D l-�-- DEPARTMENT SIGN -OFFS 5-z! -oz. , 5) 4, Fe e) EXTERMINATOR DIG SAFE NUMBER* o�-O 0 0-46? 0 �-O L/ 7 BLDG. INSPECTOR DATE RECD Town of North Andover o'�;.•�d ;"� Fiuiiti►ng Department , l Charles Str9m k,(.,V. er, .Massachusetts o18a5 Fax (978) fi88-9542�«,�:�� Bcr ldin� Demon, idol. Affidi vit PRC�P�R� AJ _�r C /N�, . -_ N rr �. 5..�r _ ��.. - � F�_�� '' s� � �• _ �i d r �Ej�!/F.Ei . � ` r c ,;C,' , � ... - zi - ��Z. � i � . , 'gyp J �.. •� Re 27 r_a \T_S , 1- _ - - - ----- Ilkp. Y[TfR COCK _... ._._ 7aVALVS $"L _.- - ' Irr.UL N J01. Iwtl �otl• I.«. -A, v1 AND Y11"11K Cl *long*. nAnttl —_ --- row� 1 J r M A ± rT�st► • u c o„ rZLiiY ' OAT W.O. owN[w I jt ulv •_ 4�" ��p N 10 --�+- KLM JE- R LINL 4[MKNT MAIN TO LIMMIKING CURS U [P[CIAL I OR 1NflOr KIND OK MO.^iIZL LRNOTN Oul<rID[ NO. -715[ KING OR LINOTN O[VIGrK NO.iI=[ it RKD FIfTINO[ r I n INnf � I wtsKR ._..�.� Cuwf SOX fi D TAP -_ n Rlfu COCK .uwf COCK fADDL[ w1011, 1114170 _ i[ R[Ol'R f i- 1149111) - 11.1111I Sell Y[TfR COCK _... ._._ 7aVALVS $"L _.- - ' Irr.UL N J01. Iwtl �otl• I.«. -A, v1 AND Y11"11K Cl *long*. nAnttl —_ --- row� ,.._ 1. ± • ' f I jt tkltti 10 ' 1 I 1- 6 -' � I FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. "AP'P'LICANT FILLS OUT THIS SECTION*********************** APPLICANT Zjks HSM L "sT. /QC - LOCATION: Assessor's Map Number C 1_4 SUBDIVISION STREET PHONE PARCEL LOT (S) ST. NUMBER / *****************************************OFFICIAL USE ONLY*********************************** RECO'N TIO O NA CONS TION AD INI COMMENTS COMMENTS 7 TH SEPTIC INSPECTOR -HEALTH COMMENTS AGENTS: TOR DATE APPROV9D DATE REJECTED use PUBLIC WORKS - SEWER/WATER CONNECTI DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 jm DATE APPROVED DATE REJECTED UA It APPROVED DATE REJECTED DATE APPROVED DATE REJECTED SNS bL� __DATE GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVER BUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. �SyEih I��Iisr��� Permit Applicant Property address Map / Parcel �7,'- -0 6 y= /l9 / �/ Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit. Further I understand that my interpretation of the exemption status is subject to review by the Budding Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for building permit for the enlargement, restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw, provided that no additional residential unit is created. The lot(s) was / were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals, where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents, where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land. For purposes of this section "senior" shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40 % permanent reduction in density (buildable lots) below the density permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the planning board that will ensure its protection This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit ( all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that year. One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits. Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERM NATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A ABOVE EXEMPTION WHICH DOES NOT COMPLY, WIEIIIER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS FOR REFUSAL BY THE BUILDING DEPARTMENT TO ISSUE A BUILDING PERMIT. 2??W-0 - ,� Ax-- 1- 5--- / 5-- C) —e-- AP ANTS S NATURE DATE S FORM TO BE ATTACHED TO TBE -BUILDING PERMIT APPLICATION North Andover Building Department Tel: 978-688_954 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall b disposed of in a properly licensed solid. waste disposal facility as defined b e c11,S150A. yMGL The debris will be disposed of in: Co - o / (Location of Facility) F ignature of ermit Applicant Date NOTE: Demolition permit from tt a Town of North Andover must be obtained for this project through the Office of the Building Inspector Cl) m m U) C6 0 CO) CDZ CD o CZ �. n� .o 0 o v a� c � d CCD O .. .. a: t= to CD k 0 CD 0 CD C C ?10 O d m O -•y O Q N CO) Fat m n C y u a n m Z •m H --I 0 „_,= �m y T ,. =rd"'d 0 m O? CD O m y O y S' Vim® C a ..i O_ co ,y,O CA r rn a% m i 3 um ^^ V''/ !^^ 1 C')= U2 o 0.110 Oy 3 l•, d y z C¢a° _ o -, � r- �1 CA J CD CO, -�' CA Q �O� F CO r. c 0 d d� C n c=,, b � G Crl o o" til -,1x w rA Crl a a btz m w n � oda 0 r rD CL O O x Gl O Q� 0 c -f 3aim os 917911&; 3AI,YCJ VcVV IL ovocn:n Date ..! . �Z... r . TOWN OF NORTH ANDOVER a PERMIT FOR GAS INSTALLATION ' This certifies that ........................ ..... `!-......... . s has permission for gas installation ;-r..: ... ..: -:.' .(..... ' .. . in the buildings of ..:......... ............ ..................... at .................................... North Andover, Mass. ol Fee......... Lic. N0.:..1..:.... ....`...................... GAS INSPECTOR Check # MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 'moo - "cam e-- , Mass. City, Town Building 10�zP'A AT: Location New Renovation ❑ Plans Submitted Yes ❑ No ❑ Date 1 ✓ �4- 19_©Z - Permit # -AF�3 Owner's-, Name Jd4tnaL �� V Type of Oaxlpancy Replacement ❑ , (Print or Type) Check One: Certificate Installing Com any Name �utnhl [� Corp. /9� Address r m4) ► , ❑ Partnership i r Y►'�-4� C1Firm/ Company Business Telephone — Name of Licensed Plumber or Gasfitter to, I k , .,or ry, �1 i20� 1° 2— I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Isws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Sip -am of 0—/ Agent I have a current liability insurance policy to include completed operations coverage. ❑ I By •'�•le ;vin ROVED (OFFICE use c -,,ME LICENSE: Plumber ❑ Gasfitter aster 0 Journeyman -�7 Signatuik of Licensed Plumber or Gasfitter License Number i �nn�nn�uu�n�nnn�n� �n�nnn�n�u�nnnn� n �n�nn�nnn�n�nuu�iu �umm�m���nnnm� n MAIN"nn�nnnn��nmm��in (Print or Type) Check One: Certificate Installing Com any Name �utnhl [� Corp. /9� Address r m4) ► , ❑ Partnership i r Y►'�-4� C1Firm/ Company Business Telephone — Name of Licensed Plumber or Gasfitter to, I k , .,or ry, �1 i20� 1° 2— I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Isws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Sip -am of 0—/ Agent I have a current liability insurance policy to include completed operations coverage. ❑ I By •'�•le ;vin ROVED (OFFICE use c -,,ME LICENSE: Plumber ❑ Gasfitter aster 0 Journeyman -�7 Signatuik of Licensed Plumber or Gasfitter License Number 3;3; Date ......... ..S ..C�' TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... ........................... �as permission to perform ........... r /.... wiring in the building of C r ''' ,� /Vi .� North Andover Mass Fee . 5 ..:. J. Lic. No - :. (7) ...... .... ,,1........................ . ` ELECTR[CAL I SPECMR Check # // Official Use Only Permit No. Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ail work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Dateral y J S 0Z To the Inspector of Wires: Location (Street & Number k Q Owner or Tenant P1111 y S/ L U A Owner's Address —40 /I �/�- a�i Is this permit in conjunction with a building permit Yes LU' No ❑ (Check Appropriate Box) Purpose of Building (Rehy1 L it RWIV `r S'V k o'y/ f Utility Authorization No. O D 7 S � M P 4iWsting Service �Q p Amps 2Z 0/.? ro Voits Overhead ❑ Undgmd No. of Wers N(.y Service Amps Voits n rt Overhead ❑ Undgmd ❑ No. of Meters Number c#'I Feeders and Ampacity r°�! ��7� V 'rM/l CP Location and Nature of Proposed Electrical Work i OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy inGudin n feted Operations Coverage or its substantial equivalent ES NO = have submitted valid proof of same to the Office EE NO - u h ve checked YES please indicate the � o rage by checking the appropriate box INSURANCE = BOND = OTHER = . (Please Specify) �� AIV72 /�� X// Y/ (Expiration Date) Estimated Value of �� Elect 'ca Work$ Work to Start ��/ [� Inspection Date Resquested % r/ b Rough Final Signed under P alties oferyu t / p FIRM NAME / �� 4e C'f'(2/ � LIC. NO.��b I'O)/ Lensee Signature AIL Tel. No. �� I T� vl k 1* . �1�1A� �� V(0 ' � Buis. �% ;7nAddress "e OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my .signature on this permit application waives this requirement Owner Agent (Please Check one) Telephone No. PERMITI`EE $ -4� ' )6 (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool gmd ❑ grnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone _ No. of Detection and Initiating Devices No. of Ran; es Total No of Air Cond Tons Heat Total Total No. of Dip�sal No. Pumps Tons KW No. of Sounding Devices _ No./ of Self Contained 'i Noof Dishwashers Space/Area Heating KW Detection/Sounding Devices _ ❑ Municipal ❑ Other No. f Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy inGudin n feted Operations Coverage or its substantial equivalent ES NO = have submitted valid proof of same to the Office EE NO - u h ve checked YES please indicate the � o rage by checking the appropriate box INSURANCE = BOND = OTHER = . (Please Specify) �� AIV72 /�� X// Y/ (Expiration Date) Estimated Value of �� Elect 'ca Work$ Work to Start ��/ [� Inspection Date Resquested % r/ b Rough Final Signed under P alties oferyu t / p FIRM NAME / �� 4e C'f'(2/ � LIC. NO.��b I'O)/ Lensee Signature AIL Tel. No. �� I T� vl k 1* . �1�1A� �� V(0 ' � Buis. �% ;7nAddress "e OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my .signature on this permit application waives this requirement Owner Agent (Please Check one) Telephone No. PERMITI`EE $ -4� ' )6 (Signature of Owner or Agent) 4 Location / 0 YA PA -�/ P , U No. 62 /) Cl Date „oRTM TOWN OF NORTH ANDOVER Oit�c �1ti0 F Certificate of Occupancy $ tBuilding/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check # (-�) O v '15 7 X14, i AiI A (& J Building Inspector Uniformly Loaded Floor Beam[ AISC 9th Ed ASD 1 Ver. V5010215 By: JERRY BRUNO , BRUNO ASSOC. on: 07-07-2002: 6:54:45 PM Proiect: SILVA - Location: KARA DRIVE N.ANDOVER ala Summary: A36 W 12x40 x 24.0 FT Section Adequate By: 3.6% Controlling Factor: Moment of Inertia Deflections: Dead Load: DLD= 0.30 IN Live Load: LLD= 0.77 IN = U373 Total Load: TLD= 1.07 IN = U269 Reactions (Each End): Live Load: LL-Rxn= 11160 LB Dead Load: DL-Rxn= 4320 LB Total Load: TL-Rxn= 15480 LB Bearing Length Required (Beam only, Support capacity not checked): BL= 1.25 IN Beam Data: Span: L= 24.0 FT Unbraced Lenqth-Top of Beam: Lu= 0.0 FT Live Load Deflect. Criteria: U 360 Total Load Deflect. Criteria: U 240 Floor Loading: Floor Live Load -Side One: LL1= 60 PSF Floor Dead Load -Side One: DL1= 20 PSF Tributary Width -Side One: TW1= 9.0 FT Floor Live Load -Side Two: LL2= 60 PSF Floor Dead Load -Side Two: DL2= 20 PSF Tributary Width -Side Two: TW2= 6.5 FT Wall Load: WALL= 10 PLF Beam Loading: Beam Total Live Load: wL= 930 PLF Beam Self Weight: BSW= 40 PLF Beam Total Dead Load: wD= 360 PLF Total Maximum Load: wT= 1290 PLF Properties for: W12x40/A36 Yield Stress: Fv= 36 KSI Modulus of Elasticity: E= 29000 KSI Depth: d= 11.94 IN Web Thickness: tw= 0.29 IN Flange Width: bf= 8.01 IN Flange Thickness: tf= 0.51 IN Distance to Web Toe of Fillet: k= 1.25 IN Moment of Inertia About X -X Axis: lx= 310.0 IN4 Section Modulus About X -X Axis: Sx= 51.9 IN3 Radius of Gyration of Compression Flange + 1/3 of Web: rt= 2.17 IN Design Properties per AISC Steel Construction Manual: Flange Buckling Ratio: FBR= 7.77 Allowable Flange Buckling Ratio: AFBR= 10.83 Web Buckling Ratio: WBR= 40.47 Allowable Web Buckling Ratio: AWBR= 106.67 Controlling Unbraced Length: Lb= 0.0 FT Limiting Unbraced Length for Fb=.66*Fy: Lc= 8.45 FT Allowable Bending Stress: Fb= 23.76 KSI Web Height to Thickness Ratio: h/tw= 37.0 Limiting Web Height to Thickness Ratio for Fv=.4*Fy: h/tw-Limit= 63.3 Allowable Shear Stress: Fv= 14.4 KSI Design Requirements Comparison: Nominal Moment Strength: Mr= 102762 FT -LB Controlling Moment: M= 92880 FT -LB Nominal Shear Strength: Vr= 50721 LB Maximum Shear: V= 15480 LB Moment of Inertia: Ireq= 299 IN4 1= 310 IN4 Uniformly Loaded Floor Beam[ AISC 9th Ed ASD ]Ver. V5010215 By: JERRY BRUNO , BRUNO ASSOC. on: 07-07-2002 Project: SILVA - Location: KARA DRIVE N.ANDOVER Summary: A36 W 12x40 x 24.0 FT Section Adequate By: 3.6% Controlling Factor: Moment of Inertia SHEAR, MOMENT, AND DEFLECTION DIAGRAMS 20000 10000 Shear (Ibs) 0 -10000 -20000 100000 50000 Moment (ft -Ib) 0 -50000 -100000 -.9 -.45 Deflection (in) 0 .45 .9 Controllinq Load Cases: Shear: Critical shear created by combining all dead and live loads. Moment: Critical moment created by combining all dead and live loads. Deflection: Critical deflection created by live loads only. LOADING DIAGRAM Span = 24 ft Reactions Live Load Dead Load Total Load Uplift Load A 11160 Lb 4320 Lb 15480 Lb 0 Lb B 11160 Lb 4320 Lb 15480 Lb 0 Lb Span Uniform Loading Live Load Dead Load Self Weight Total Load W 930 Plf 320 Plf 40 Plf 1290 Plf . 4 1 S 04 "OR7y t y 'SSACtiUS�S CERTIFICATE OF USE & OCCUPANCY Building Permit Number 6 !7 i Date 3 —13 3 THIS CERTIFIES THAT THE BUILDING LOCATED THE BUILDING LOCATED ON /0 1<,AP � _2) R / (J E - MAY BE OCCUPIED AS 3S I logt-AVVI IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO G r o D -v Li A� r- Si L V A 10 I r A R ,4 l71z e- S. Al. cr Cc, C) CD =921CL 0 R C2 CL r7l CD email z V) ca—. CL CL 0, m =rm M CD -40 0 0 .4m : 0 Vmmw-.CD 0CA CD cl) zoom ZS C.), rw: C3 C4 cl . CD, COD ci CD r CI) CD / Cc C ) 0 CD: 06 J c.D Mv S 60) Ak.cr CO 4c CL C/) co) cc c, AD C7 r* S"CD um iO �_ w Vie' i � � � :� � ®�k� .9 CD C* cn ;w ca cry w. Im CD CD c .=,CD N(W O v 0O J) 00 5 L 07 0 EIL C) 0 VO 2 QA W 0410 C.1%. to