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HomeMy WebLinkAboutMiscellaneous - 10 GLENORE CIRCLE 4/30/20185 J I Date .. /"� �./ `....... . p`4.0 ,eye O TOWN OF NORTH ANDOVER P PERMIT FOR GAS INSTALLATION This certifies that ....� � al......? � .//..... . has permission for gas installation .. j ?��/ lit ......... in the buildings of ................. at & .... 4-;? �?. ...... . . �% . .�. �,/. � . . , North. Andover, Mass. Fe Q..... Lic. No. /l? ��U.� .. !i... �°... . GASINSPECTOR Check # /� 3 y 6039 MASSACHUSETTS UNIFORM AppucATON (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Al Owner's l New Renovation D Replacement D GAS FITTING Date (a —a1 — O 07 Permit # Amount $ Plans Submitted Name of Licensed Plumber or Gas Fitter( Jk 6 -4— 14 /11. �,_� Che k one: Certificate Installing Company Corp. Partner. Firm/Co. Lb ability insurance policy Other type of indemnity Bond 0 INSURANCE COVERAGE Check o e: I have a current liability Insurance policy or it's substantial equivalent. Yes No� If you have checked ves, please indicate the type coverage by checking the appropriate box. 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 pe . a plication waives this requirement. Signature of Owner or Owner's Agent Check one:Owner [3 A t I hereby certify that all of the details and in rmation I have sub tted (or ent d) in aboveVteneral true and accurate to the best of my knowledge and that all plumbing and installat' ns perform rider rm application will be in compliance with all pertinent provisions of the and State a an' hapter 1Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature o IM Plumber Gas Fitter IffMaster Journeyman sed Kmber Or Gas Fitter /d?d Icerrse Number w v; OU G7 W7 W ° Q o Z c z x w x z a a > a z F 7C w w w O w F Cw7 z tw- w z a �- °m z o z w o a d x o x 3 a 21° °x > SUB -BASEMENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR Name of Licensed Plumber or Gas Fitter( Jk 6 -4— 14 /11. �,_� Che k one: Certificate Installing Company Corp. Partner. Firm/Co. Lb ability insurance policy Other type of indemnity Bond 0 INSURANCE COVERAGE Check o e: I have a current liability Insurance policy or it's substantial equivalent. Yes No� If you have checked ves, please indicate the type coverage by checking the appropriate box. 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 pe . a plication waives this requirement. Signature of Owner or Owner's Agent Check one:Owner [3 A t I hereby certify that all of the details and in rmation I have sub tted (or ent d) in aboveVteneral true and accurate to the best of my knowledge and that all plumbing and installat' ns perform rider rm application will be in compliance with all pertinent provisions of the and State a an' hapter 1Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature o IM Plumber Gas Fitter IffMaster Journeyman sed Kmber Or Gas Fitter /d?d Icerrse Number Date ........ /.-�y�! ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .........!............. -��j'r-•........................................... haspermission to perform ............................................................................. wiring in the building of..�............................... at ...................................... ............................................... //' `�, �,t' ................... .North Andover, Mass. ......� ..t. Fee .. �...... Lic.No '..... a� ....-'..� .......`:'..� ��• ELECTRICAL INSPECTOR F Check # 77,5 7358 b I The Commonwealth of Massachusetts Q Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 01, Permit No. - 9V Ooeu"acy a f*r �'` 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date � ` 1 sk Co'] City or Town of n per% Rn�3oiQj , (PC To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) ,len of -(z7--, 0--ner or Tenant SQk—L t EnsLcAa Ras UCC L Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building P p O L Utility Authorization N0. Existing Service Amps / Volts Overhead [3 Undgrd ❑ No. of Meters Neer Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Tot/Al No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd, El GeneratorsKVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones TNo. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal ❑Other Connection Low Voltage No. of Ranges No. of Air Cond, Total tons No. of DisposalsNo. of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers No. of Water Heaters �► Heating Devices KW Sir sf Ballasts No. Hydro Massage Tubs No. of Motors Total HP vaxt:x: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current LiabilityInsurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO [ I have submitted valid proof'of same to this office. YES ❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box INSURANCE N BOND ❑ OTHER ❑ (Please Spec . Z z5 0 Estimated Value of Electrical Work S tExpiration DateT Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME Address OWNER'S INSURANCE WAIVER: I am aware that the Licensee stantial equivalent as required by Massachusetts General application Waives this requirement. Owner Agent LIC. HA. LIC. NO.� Z� Z6 g/� Alt. Tel. No.J--O-ZL-0 % ave the insurance coverage or its that my signature on this permit check one) Telephone No. PERMIT FEE $—X/ Signature of Owner or Agent p+: 5- z � 7��f �� 6'�L �-a� o�� LaMarche Associates 233 West Central Street Natick, MA 01760 508-650-9777 Fax: 508-650-9870 November 13, 2006 Building Commissioner/Inspector of Buildings N. ANDOVER, MA 01845 Board of Health/Board of Selectmen N. ANDOVER, MA 01845 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 313 Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 t be applicable. If any notice underMassachusetts General Laws, Chapter 139, Section 36 is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss, cause of loss and LA file number. Insured: RONALD & KRISTEN PASCUCCI Loss Location: 10 GLENORE CIR N. ANDOVER, MA 01845 Policy Number: HP546784 Date of Loss: 11/12/2006 Cause of Loss: Water LA File Number: MA -2-12247 RECEIVE[ NOV 17 2006 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. E46 Jorgensen Adjuster LaMarche Associates, Inc. - 800-349-1525 Page 1 of 1 3v3 �1 Date . .. ..... ,ORT" °t'"'°,�._ .:� e 60 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............... . , ...... / I..d ................................ . .... has permission to perform ........IV .e. w ........ ........................ mrirj;-ig in the building of ........... ...... v— - v ....................... at .. ....... ()../. ......... r ........ /0 ....... orth;Ando ej,,_M Feeg..'J Lic. Nol.-*J..M-� ................ .. . .. .... ................. LYTR 1, 1 1 CAL INSPECTOR Check # /("� a. Official Use Only � L� Permit No. L /. !sr•�i (iE���viG�i/�iT�.�%� t�%i�.�$1�i�.$�i!%%� vow --r Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date, --44 D (� 2 To the lnsp--Ekr of wir s: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number 4k cJe,. C, Owner's Address S"AIL-- Is this permit in conjunction with a building permit Yes P'-' No ❑ (Check Appropriate Box) Purposeof Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgmd ❑ No. New $ervice Amps Voits Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work � 97K-, ER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested ough Final_ Signed under the Pen (tiesof r)ury:. Q FIRM NAME �.Z/ / ///,G / LIC. NO. a2 & F / Z Lkensee �/ �!// G/ d Signature r� LIC. NO. N-90 �9'2 !�O . t/�K/i9CA� w, ,� /LZ,✓e t f us Tel No - T, Address l. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not hay 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. PERMITTEE $ /� U (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA c� Above ❑ In ❑ No. of Lighting Fixtures �+� Swimming Pool grnd ❑ grnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets b�U No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and I Total No. of Ranges No of Air Cond Tons Initiating Devices f Heat Total Total No. of 6i sal No. Pumps Tons KW No. of Sounding Devices No.! of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Sign Bailases Wiring No.. Hydro Massage Tuds No. of Motors Total HP ER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested ough Final_ Signed under the Pen (tiesof r)ury:. Q FIRM NAME �.Z/ / ///,G / LIC. NO. a2 & F / Z Lkensee �/ �!// G/ d Signature r� LIC. NO. N-90 �9'2 !�O . t/�K/i9CA� w, ,� /LZ,✓e t f us Tel No - T, Address l. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not hay 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. PERMITTEE $ /� U (Signature of Owner or Agent) P L: Date.7- (0� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION sob This certifies that ........................................... has permission for gas installation ............. ....... in the buildings of . . .. . -. /"' ��- � I '.I, ..................................... at . . ' " / I - / / , I - — ............................ North Andover, Mass. Fee ... ? .... Lic. No.. I .. ......... ...... GAS INSPECTOR Check# J"L( r L 4 , 7 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date D.:)— NORTH ,,}NORTH ANDOVER, MASSACHUSETTS V0 Building Locations �Permit # Amount $ Owner's Name �?11 New © Renovation ❑ Replacement ❑ Plans Submitted ❑ CAC one: Certificate Installing Company Name �tYPe)N� jM3k �C. ❑ Corp. Address Lf6 c VCl-�y�'-' Name of Licensed Plumber or Gas Fitter�-- ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes [3 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: ❑ Owner ❑ Agent 1 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 Chapt r 142 of the General Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber i 355 Gas Fitter License Number Master ❑ Journeyman wwwwwwwwwwwwwwwwwwwww �wwwwwwwwwwwwwwwwwwwww , , • owwwwowwwwwwwwww�wwwww�� FWEI , , , wwwwwwww�wwwwwwwwwwwww • • wwwwwwwwwwwwwwwwwwwww � , • wwwwwwwwwwwwwwwwww�wwww • • wwwwwwwwwwwwwwwwwwwwww , , • wwwwwww■wwwwwwwwwwwwww , • wwwwwwwwwwwwwwwwwwwww , • wwwwwwwwwwwwwwwwwwwww CAC one: Certificate Installing Company Name �tYPe)N� jM3k �C. ❑ Corp. Address Lf6 c VCl-�y�'-' Name of Licensed Plumber or Gas Fitter�-- ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes [3 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: ❑ Owner ❑ Agent 1 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 Chapt r 142 of the General Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber i 355 Gas Fitter License Number Master ❑ Journeyman <���. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,/" This certifies that .1`.1?:�e::0!' : ! �'.�....... ................ . has permission to perform ...�-. ...� `..`.`...`........... . plumbing in the buildings of .. `.'.`.................... . at ....I L .. �.4 r7 �. �-r, t �,. �. _............. North Andover, Mass. Fee.)..! �':... Lic. No..//.I) J. Check # y ( /)t 520,8 PLUMBING INSPECTOR I/ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location )or Q UI Q - e, <' J �C? Date r) -1 ��• Permit # Amount, - Owner I CJQK� . New ED Renovation ❑ Replacement Plans Submitted Yes No ❑ FIXTURES (Print or type) � Check one: Certificate Installing Company Name k-�y�C ��� �c� rs ❑ Corp. ❑ Partner. ❑ Finn/Co. Name of Licensed Plumber: M/- 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® Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Co e and Chapter 142 of the General Laws. . lBy: OVED (OFFICE USE ONLY N.'-. LA--, %- \,--- Signature OT LiCemennm er Type of Plumbing License i��� ❑ icense TNumDer Master ❑ Journeyman 4111 Date.....79 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... WT'..�o .d a/t ... ........... . ............................................. has permission to perform ............ 5. 5( . ............................. wiring in the building of ....... ..................................... at .......... ��O ..... 67� ....... orth Andover, Lic. No. C/(`/-/* ................. LE RICAL INS Check # '7 5;z P . RW Commonwealth of Massa$-.h.usetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS v3 Official Use 0nl-1 Permit No. Occupancy and Fee Checked ©lo vo [Rev. 11/99] 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) Date: Sqj4mLfr 11-14.W.1 City or Town of: i 4-lt Any/over' To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) /Q (�lG ntJl'� (moi reLt Owner or Tenant .5-4eveo'1- %nr lir✓l. Tg 1pn tAn,, Wn 09f'--) CC-. /,at Owner's Address Is this permit in conjunction with a building Purpose of Bui (Check Appropriate Box) Utility Authorization No. Existing Service Amps 1 Volts Overhead ❑ New Service Amps / Volts Overhead ❑ -Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Undgrd ❑ No. of Meters Undgrd.❑ No. of Meters rmmnlvBnn Aftho fnitnwino tnhlo mmv h" wnivod hu tha Tncnnntnr nr[,Vi. M No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool bove ❑ - E]o. rnd. rnd. o mergency ig ing Batte Units No. of Receptacle Outlets No. of Oil Burners _ FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Num er Tons No. of Self -Contained Detection/AlertingDevices - No. of Dishwashers Space/Area Heating KW Local ❑ Mun'cne tion © Othe r , No. of Dryers Heating Appliances KW Security ystems: No. of Devices or E uivalent No. of Water I� Heaters o. o o. o 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. 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 U BOND ❑ OTHER ❑ (Specify:) Scottda le Inc. Co. 5/1/03 Estimated Value of lectrical Work: ggfOU (When required by municipal policy.) (Expiration Date) Work to Start: glZI -' Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: Wayne Alarm Systems, Inc. LIC. 1111 1 1 1 Licensee: Ralph W. Sevinor Signature P.S.LIC.NO.:000160 (If applicable, enter "exempt" in the license number line..)7 — 5 — 0 0 0 0 Address: 424 Essex St nn MA Lynn 01 902 Bus. Tel. No.* , Alt. Tcl. No.:7_$1- 5 _96 —OIL 0 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: $,3J'� Location J 4 " 10 OVetior - CIrcIv- No. q S y Date L' _cf - D ',;� Check # 154/ � TOWN OF NORTH ANDOVER sv- Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ % D Other Permit Fee $ TOTAL $ —T Building Inspector • The Commonwealth of Massachusetts 1.2 Assessors Map and Parcel Number. Q ' D State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards BUILDING DEPARTMENT Massachusetts State Building code Lot Area sq) 69 C) Frontage(g) 780 CMR Address APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OF OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING nurrumg remit iNumner: Lf / J r' ( Vate Issued: 4-8 _8 Signature: klr/`-� A l -1 _ 6 _ Building Commissioner/Inspector of Buildings Date CF.(TInN 1_CITW rNFnDM A'1'InN 1.1 Prrly A . (--yientore C13 1.2 Assessors Map and Parcel Number. Q ' D Nam (Print) eg CA(- Map Numb Parcel Number 1.3 Zoning Information: 1.4 Property( Dimensions: Zonin District ' osed Use Lot Area sq) 69 C) Frontage(g) 1.6 Building Setback R Front Yard Side Yard Rear yard Required Provided Required Provides Required Provided 107 Waif Supply 9M.G.L.C.40.4 § 546 1.5. FloodZone Information: 1.8 Sewerage posal System: Public Private Zone Q Outside Flood Zone O Municipal On Site Disposal System 2.1 Owner of Record 1`o( -A A✓►Aatee- r Nam (Print) eg CA(- Address: too ©� i1t/� w Signa Telephone cJ 7 2.2 Authorized Agent: Name (Print Address Signature Telephone C1WVT1n1%T4 VnNCTD7irTInV CCDVr QW -7- 3.1 W DDA7- 3.1 Licensed Constructi`o�n Supervisor. YY V jAMes 6AIZCOC. vL Not Applicable Q Licensed Construction Supervisor: 4, License Number C5 , C.3 so3 Addressa �1 11iS ! , n J Qp�wx ,, (AA - �i�,�(� 4-! Q ExpirationDate -7 _ oM3 t Signature �' �..e'/'""'`''- - Tel one �3-33 Fib ho 3.2 Regired Home Improvement Contractor. Not Applicable p Company Name Registration Number Address Expiration Date Signature Telephone NaR7ry Cf t�• 4 s i �,s$ACHU+E� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number _vp' Date 9 —6 aOD� THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS C51' J� c2 m i� L r��enuC 'E, IN ACCORDANCE WITH THE PROVISIONS OP THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. //%coo /",s - a �/.j 8 Aih S J t3 -,n iv // u -P CERTIFICATE ISSUED TO 1�� vUC/Jb vClz --.) /4-7,—e GAS /DD ,7-o /)A),) V CA 4e- 6-/— ?,11 Za cZ Building y SR -L* O F=4 • z z 0 W a cv A �! L 0 A z as a A to o � I C� o•— c/� IM:2 y A .o •E m m CD o co 0 d CJ tai o d H C O G cv C° .m o CR c z CD V y � C ev CO2 D 0 U) U) W W CCW LLI CO ,r Town of North Andover pORTH O ,Leo Building Department 3? yt •, 0 27 Charles Street ti North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 4 COC FI[w1 wKM 1' ��SSA C NUs���� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS t LOT NUMBER ` DATE REQUEST FILED _ G(QY.ore- Circle SUBDIVISION .mss' f 1 e1 - ©A �(P C q_ V{ I b Ioa DATE READY FOR INSPECTION 'I y0'2 FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE ROUTING CONSERVATI D.P.W. — WATER METER DATE DATE DATEZ D Z D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO T11E INSPECTION REQUEST DATE. SIG ATURE / D AUTHORIZATION Location lam/ fp U O t p- el r " No. 44 g (?-- Date 6` 4— O z— NORTH �TOWN OF NORTH ANDOVER f ,r .1 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit F�e,e,1 $ Other Permit Fee �'i)�S $ TOTAL $ Check # 15 6 � z 1 Building Inspector Town of North Andover Office of the Building Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 D. Robert Nicetta Building Commissioner CHIMNEY APPLICATION AND PERMIT DATE LOCATION OWNER' S NAME_ , /, L_ / a BUILDER'S NAME 1 MASON'S NAME MASON'S ADDR MASON'S TELE: MATERIAL OF I Telephone (978) 688-9545 Fax (978)688-9542 /)0k,PERMIT # llc INTERIOR CHIMNEY EXTERIOR CHIMNEY NUMBER AND SIZE OF FLUES �cO THICKNESS OF HEARTH Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE SIGNATURE OF MASO CONTR. LIC. # r EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED FEE ( S ROBERT NICETTA, BUILDING INSPECTOR 7&_�'—� INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-95415 CONSERVATION 68 8-95 30 HFALTH 688-9540 PLANNING 688-9535 Location i d G1,U ar'- No. Date z73- 0 NORTH TOWN OF NORTH ANDOVER OfY`° ,�,h•0 ' Certificate of Occupancy $ Building/Frame Permit Fee $ 62110 tss�►cHuse Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a� S� Check # �?D �, 5469 `� Building Inspector tftrttW"�c-euuc rluti u: � 11 �'fl Uh'i ISYIANSEN 8 SERGI 1 8 ? 8 3( 2, Q96j P. Ol Lor s 11 . IssuED 7-),,4k s Gi Ec� Lol (30C110*- f OUNDA WN LOCATION _PLAN CLt�., AR.A ....0 WC CMMTAW /s MADE AMP UWrI'o t'G INC Aid W CU fNr. LOCATION: LOT 4 BEERRIWYON PLACE NORTH ANOWR, IIA. j6f�OSMAN ar%afxr� r =newro xf. V171 l 7 �N� AWOM w 0010, ,E'XlSfMtG F"DAWM A NW xatlWrAt�lllaNeo�'� �IIMINor areero ri 1� peeM/ AAq NSP .y c WALD I" = 80' wf*102 CHRIS77ANSEN &SERGI sumrfm W xwm St. rWwNA ul" soon rL SN offwua NOW" SECTION 6 - DES TION OF PROPOSED WORK check all applicable) New Construction M Existing Building Q 1 Repairs Q Alterations Q Addition Q Accessory Bld . Q Demolition Other Q Specify Brief Description of Proposed : CoAqc Oct -t' f c,� Oa�v sQ , ^� 3 C (KV a c� S-1 S-2 U Utility Q Specify: M Mixed Use Q Specify: S Special Q SECTION 7 - USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) A Assembly A-1 A-2 A-3 A-4 A-5 B Business Q E Educational Q F Factory Q F-1 F-2 H High Hazard Q 113 I Institutional (3 I-1 I-2 I-3 M Mercantile Q R Residential V R-1) R-2 R-3 S Storage Q S-1 S-2 U Utility Q Specify: M Mixed Use Q Specify: S Special Q Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index (780 CMR 34) SECTION 8 - Building Height and Area BUILDING AREA Number of Floors or stories include basement levels Floor Area per Floor (sf) Total Area (sf) Total Height (ft) CONSTRUCTION TYPE IA Q 113 Q 2A Q 2B Q 2C Q 3A Q 3B Q 4 Q 5A Q 5B ❑ Proposed Hazard Index (780 CMR 34) Existing (if applicable) Proposed SECTION 9 -STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes Q No Q SECTION 10a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, , As Owner of subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. G Signature of Owner " Date revised bldg form/state JMC SECTION 10b - OWNER/AUTHORIM AGENT DECLARATION I Ct `k r t P- 3 C, n P D 'as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. lPS C42Q6 ze2 Print Name of SECTION 11 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to Official Use Only be completed b permit applicant 1. Building a �� •i7 00 (a) Building Permit Fee ( 00 2. Electrical 1 0 Multiplier(b) Estimated Total Cost of Construction from (6) 3. Plumbing I � � � � � Building Permit Fee (a)x(b) 4. Mechanical (HVAC) i --)/ 0 00 5. Fire Protection 4040 6. Total = (1+2+3+4+5) 3 YD' 000 Check Number FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT— -KLAti&a_( A I —___PHONE_ `�8 i - -"'71'� LOCATION: Assessor's Map NumberPARCEL,PARCEL— _— SUBDIVISIONt�Eqf t �� -T0fV ( LOT (S) STREET�6�-Leno(,If C1CAQST. NUMBER_ I D OFFICIAL USE ONLY*********************************** RECOMMPWATIONS OFT AGENTS: CONS VA ON DMINIS R DATE APPROVED DATE REJECTED �- COMMENTS TO PL NNER DATE APPROVED TO� DATE REJECTED' COMMENTS FOO R -HEALTH ? / ��TE AP ED _ — � Y ) ! 4 --DATE RE ED EALTH DATE APPROVED DATE REJECTED - COMMENTS----- ----------------------- -- PUBLIC WORKS - SEWERMIATER CONNECTIONS 3 - •Z'? - o2 - DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING Revised 9197 jm 3/Z -716 z TE MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 TITLE: PLAN NO 743 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 3-7-2002 DATE OF PLANS: 6-13-94 PROJECT INFORMATION: COLONIAL HOUSE COMPANY INFORMATION: BRUNO ASSOC. 28 BERKELEY ROAD N.ANDOVER, MA 01845 COMPLIANCE: Passes Maximum UA = 963 Your Home = 802 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 2486 30.0 0.0 87 WALLS: Wood Frame, 16" O.C. 3876 15.0 0.0 298 BSMT; Conc. 8.0' ht/7.0' bg/8.0' insul 1560 0.0 11.0 89 GLAZING: Windows or Doors 832 0.350 291 DOORS 105 0.350 37 HVAC EQUIPMENT: Furnace, 98.0 AFUE -------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. /) Builder/Designers ����,-d7 Date_���— TITLE: PLAN NO 743 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 3-7-2002 CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-15 Comments/Location BASEMENT WALLS: 1. Conc. 8.0' ht/7.0' bg/8.0' insul, R-11 continuous Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.35 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: 1. U -value: 0.35 Comments/Location HVAC EQUIPMENT: 1. Furnace, 98.0 AFUE or higher Make and Model Number AIR LEAKAGE: Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 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/ft2 pressure difference and shall be labeled. VAPOR RETARDER: Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values, glazing U -values, 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 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 CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.): PIPE SIZES (in.) TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 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 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 1 1.0 1.5 2.0 140-160 0.5 1 0.5 1.0 1.5 100-130 0.5 1 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: �1 Location: ar ` j ® G teen O ('P C k iz de - City Phone am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity EYI am an employer providing workers' compensation for my employees working on this job. Address i d© — OL nAvCA 1<0 RoAA � /� p\tef QjW: I io I-trlrl►® �SASS . MASS, Phone#: 579) (o96" -T -1a Insurance Co. l39 & F COf AK C& COOP Policy # NOW C I) ©3 i G Comoanv name: Address City: Phone #' Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. R1 2 7 /c Q Print name C��r les Q Carr0 ( I Phone # y? , GNo 17a4 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept E] Check if immediate response is required Building Dept p Licensing Board F] Selectman's Office Contact person: Phone #. F, Health Department 13 Other FORM WORKMAN'S COMPENSATION 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: 96a (Location of Facility) Signat re of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Building Value Calculation -for Property at..... LOT # �� 5,7��k�ki �:!•*,S �.�t�tittv�ag��i+,. .k :'�, .�. �` u�,�"� yRoom fn�' xi��q k�,. .',t4 pyS ��lr�-�x.;i�a�'tt Length Width Sq.Ft. Cost per Sq.Ft. Total Cost Kitchen 27.5 15 412.50 65 $ 26,812.50 Brkfstnook - 65 $ - Dining Room 15 14.5 217.50 65 $ 14,137.50 Family Room 17.5 15 262.50 65 $ 17,062.50 study/office 15 14 210.00 65 $ 13,650.00 Living room 14.5 22 319.00 65 $ 20,735.00 Garage 24 36 864.00 65 $ 56,160.00 Entry 15 15 225.00 65 $ 14,625.00 2nd floor foyer/sitting 45.5 3.5 159.25 65 $ 10,351.25 Great room 36 24 864.00 65 $ 56,160.00 mudroom 12 8 96.00 65 $ 6,240.00 Walkin closet 5.5 11 60.50 65 $ 3,932.50 Basement Finished - 65 $ - Balcony - 65 $ - Screened Porch - 35 $ - laundry 7 3 21.00 65 $ 1,365.00 Bedroom 1 14.5 19.5 282.75 65 $ 18,378.75 Bedroom 2 14 11.5 161.00 65 $ 10,465.00 Bedroom 3 14.5 15 217.50 65 $ 14,137.50 Bedroom 4 16 12 192.00 65 $ 12,480.00 Bedroom 5 11.5 15 172.50 65 $ 11,212.50 Bathroom 15 11 165.00 65 $ 10,725.00 1/2 Bath 12 8 96.00 65 $ 6,240.00 Bathroom 2 8 11.5 92.00 65 $ 5,980.00 Bathroom 9 8 72.00 65 $ 4,680.00 Deck - 10 $ - Balcony 65 $ ix� ...iamn �kti� � J, .:r(eYx7�. .iel. ha. x,.i.t % � 3.,...Fi.xfisrl.'•.a+4»��i`u Y��>,Ao. :.s E�.a2,.aSre2* .�ttntlt .,.nuav�,1 ,Ise. ConLn cG V o Z -� o z ifra qi, a z -a Cl) J p �v ♦ W Z o� _ W D !� L IE �S Ucu �►IhO� a o O 47 um LnLLJ c 3 A 71 N O ` w CL cr- �~ c `� Q 0 E � (U �.. c�i rn O Q•0.� o c C:)C.D w c"v 0• vs n� m >qq� `o c > u�c rn v E Q iZ- O "' 0. o m ai ai a c O o ot .. c a H C o U L. O cC O W O r N o- c " c 'o W E ay c c U a= a 3 N �° a ui °'tn t �°�o c �c Z o� vai U. g t� o a, in z> m . N G w wz A O w u u w° u C/)w° o w � z Q � 7 C2 T � x O t w � a C4 w Cd O v, ,,...�� U U w a°' u chi w p U ow• z m 7 a°' ro w w A w c w� z V)V) ° ui am CIO 2 O LO w a p Z O U m 0 co crO O G ti CD .y E GD i CD L C O GD V tC CL CO2 O 2 .y C O V O .0 _O CO) L O V CD N c CO Q, c O .0 c:2 m m W 0 LLI w W ClW Cl)Lli o V� is C.) V t-) R O Q: ►: m C M.0 O 4 I J 2 y4D � Ea 4 .. m co) u C Em c 1'Vol m C�' H y y a11E._ 446 o CCA yC13 O � m A Ev o �av� m m m CD M CD e c.0 QZ • � c .:C Ha COL. o m C.)Z o coa�c c CD o m(D:5CL o = F" w fV m y021- z ... c O C U) d t Z C.3 m o m� c g d coo _ A m� O .0 o e O C =team CIO 2 O LO w a p Z O U m 0 co crO O G ti CD .y E GD i CD L C O GD V tC CL CO2 O 2 .y C O V O .0 _O CO) L O V CD N c CO Q, c O .0 c:2 m m W 0 LLI w W ClW Cl)Lli ZONING DISTRICT: R 1 MIN. LOT AREA = 87,120 S.F. MIN. LOT FRONTAGE = 175 FT. MIN. FRONT SETBACK = 30 FT. MIN. SIDE SETBACK = 30 FT. MIN. REAR SETBACK = 30 FT. 305.960 E (TYpj .dL �_ L!N I �llt.ED ZpN�G�T6`.K--o = Q= �o I / oO D�Z37 o / u 3& X116 f EDGE OF / WETLANDS D-47 D-45 I D-44 D-43- \ D-46'�2� / - f -17 -1.7?- -_D _ 4f- -176- � — D-#1 -176 / LOT e� \ AREA = 100, 690 SF i i LIMIT OF 100' . • % • / j BUFFER ZONE -182-- I / \ \ 180 ...... .... ��SEDIMENTAT/ON CONTROL 150' OFFSET �_ ... • �.j / ` . / / J FROM WETLANDS 18 LEACHING / A/ CHAMBER L0�5 H 0q 77ANSEN R, CIVIL 192.0 / No. 28895 y T6P FND. = 191.0 ki 31.5' GAR. ass/ONAL ySCREE� 1PORT 43' V $EWER SERICE ! INV - 182.00 14.84' 3.02 PROPOSED SITE PLAN `•" `SEWER SERVICE STUB FOR 1fV , W � IN 179.8' / ,� RE CIRCLE LOT 4 BERRINGTON PLACE IN NORTH ANDOVER, MASS. �- •t = X32• ,�..., , l 86 PREPARED FOR. JAMES CARROLL SCALE: 1 " = 40' DATE: MARCH 26, 2002 X PROFESSIONAL ENGINEERS jO CHRISTIANSEN ; SERGI LAND SURVEYORS 160 SUMMER ST. HAVERHILL, MA 01830 TEL. 978-373-0310 © 2002 BY CHRISTIANSEN & SERGI, INC. DWG. NO. 01.039004