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Miscellaneous - 100 LONGWOOD AVENUE 4/30/2018
N O c 00 nc 0 0 90 i 0 n o z o m ml Z In M 'n G) Z a C Z = � a a Z r C 0 ;C : r y O o v, � n• •� O Q+ o co Z In M 'n G) Z a C Z = � a a Z r C 0 VrkD MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK gut CITY NORTH ANDOVER _ y MA DATE 06/2012012 PERMIT # JOBSITE ADDRESS100 LONGWOOD AVE OWNER'S NAME I WILLIS GOWNER ADDRESS TEL[:—: _ __ _ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW:Ej RENOVATION: El REPLACEMENT: PLANS SUBMITTED: YES NO APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER 1: --DI_-___a :... m CONVERSION BURNER �..__ �;..... y... COOK STOVE DIRECT VENT HEATER _ DRYER -. - FIREPLACE .t, FRYOLATOR.a FURNACE m..,-�... ......; " _� M. M-..ao:. ......... . .... �. -�_ GENERATOR 1 mow& GRILLE INFRARED HEATERry - LABORATORY COCKS MAKEUP AIR UNIT OVEN l.__ _ F7 E I POOL HEATER _ ROOM / SPACE HEATER =k— ROOF TOP UNIT ` ROOF TEST m. _..�� UNIT HEATER I UNVENTED ROOM HEATER WATER HEATER OTHER_ � 1 r .... ua. INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the.requirements of MGL. Ch. 142 YES + NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true a ac rat to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complia e a Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r PLUMBER-GASFITTER NAMEJEFF HUTNICK__ LICENSE # 15212 ATURE MPP MGF Ej JPEI JGF[3 LPGI CORPORATION #2840 PARTNERSHIP 0#= LLC. # COMPANY NAME:j CALLAHAN AC & HTG 1ADDRESS 91 BELMONT ST CITY NORTH ANDOVER STATEMA ZIP 01845 TEL978 689 9233 FAX CELL �u._-._REMAIL PLUMBING a(�CALLAHANAC.COM mmmm VrkD >" C ❑ a z z o d❑ � w � o ~ w o F W a W f z a w a 5 W a � W W �4 d U) o a a � �y a U J F a a Q � CO) S H w W LL H � O z z 0 F U W a z cn Q C7 d C., V :4 rlie C0,1,11rrtort'wealth of Massachusetts D(Tartment of IIIdtasiritz,Aceicients Office of bi vestigations '60# "Skington .Street Foston, MA 42-111 ia Wozl;ers'CarnpensatiOn Insurance Affidavit: Builders/Cont de s/C'on>1r�ziOrs/��e.�tzicia�as/1'�uclabers ,nlieant 1nf01'nitttloxi Naive (13usines"/Org,uli Lation/lndividual): Address Cli)`/St.a Phone #:_ Are you an enlployer? Check tLi aplsrop " 1 atn a ell'lployel with ,-,? 5- boA:6? 4. E]I am a general contractor ❑eulployees (full and/or part-time).* 1 am a sole and I have hired the sub -contractors proprietor or partner- slip and have listed on the attached sheet. no employees work-in" for zzie in any capacity, These sub -contractors have employees o workers' comp. insurance and have workers' ❑requ.0 ed.] 1 comp. insurance.t 5. [] We are a corporation its ani a homeowner doing all work and officers have exercised their myself. [No workers' comp. ilisurallce required.] t right of exemption per MGL c. 1521 ](4), (), and we have no employees. (No workers' M, C 1'riat Type oi'project (rc<luized) 6. ❑ New construction 7. ❑ kemodelinc, 5• ❑ Demolition 9. ❑ Building udditiurt 1U.❑ Electrical repairs or addiliulls 11. Plumbing repairs or additions 12.❑ Roofrepails 13.❑ Other yarn. t, comp. insurance required.] — — -- PP cyst that checks boa #1 must also Ell out tlae section below showing their workers' compensation policy inimu�atiun. T t toiueo�,ners check, submit this affidavit indicating they are doing all work and then hire outside contractors muss submit a new afli lav t ;C°traeto,s chat check. this boy must attached an additional sheet showing the tare hi the sub -contractors and state . Gej Ir the sub -contractors have employees, They must rovide their workers' com "'d'ca�ing such. P whether or thusc cutin s 6a4c P• Policy number. r•u� « «cuz zs provittirzg )PoricersP compensation insuranceforirzy errrptoyees. iieiow is illepolicy arzd job slue `rforrrzallun_ nsuranee COMPany Name: 'olicy rr, or Self -ins. Lie. #: -- a Expiration Date:__ ?b Site Address:- !— -- - eeach a co Ciiy/State/Zip:_ P)' o#'the h�orl:.ers' compensation !policy declaration ,page (showing Elie Policy ntt;'trlber and expiration date). atlttre to sectu-e coverage as required uunder Section 25A of MGL c. 152 c d/or u up to $1,500.00 y against one-year can as well as.civil penalties in the form of a STOP WORD. ORDER and a flee an lead to the imposition of crtInina.l penalties of a up to 5250.00 a day against the violator, Be advised that a co vestigations of the DIA for insurance coverage verification. Py °fthis statement may be forwarded to the Oliice of - 1-r K.f«/er me pains and penalties ofperjcrry that the information provided abo Pe is true and c•orreet. �11i�'ial use only. airy or To��•zt .Do not write in this area, to be completed by city or IOWtj official f" 2 7 r,2C'/l 'suing Authority Permit/JLa� �n . 10oard of plea (2. Bnildtug Other b Depaz'tnxenf I City/Town Clerk d. Electrical Inspector 5. I'lunlbj1l,, .1115peclor octtact person: Phone #: Aj I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK 1! - jT_ CITY _� MA DATE / PERMIT # JOBSITE ADDRESSD Gi�Y1 OWNER'S NAMETI POWNER ADDRESS k TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL © EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: El REPLACEMENT: Q PLANS SUBMITTED: YES ©I NO© FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM _Imu I DEDICATED GRAY WATER SYSTEM(DEDICATED WATER RECYCLE SYSTEM_.____._I__! DISHWASHER�IDRINKING FOUNTAIN__-.__� FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR INTERIOR € i _ ( --_-..._.r` KITCHEN SINK ___-- I _____j .._.._._._1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE /MOP SINK.__j .______I TOILET I .-._.__. _I _- -. ( � _� --.._ -._ I __._-_-J - r___-_ __._._- ( ------ j _.._._.-4 .__._.. ! URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHERc INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES .....e NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY L A OTHER TYPE OF INDEMNITY D BOND 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER —1 AGENT 1[711 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true a c rate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli e i Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 rf the General Laws. PLUMBER'S NAME - � .__.._ IY_..�Ll� ( ,LICENSE # _LS_4.r0jI SIGNATURE MPU, JP 0 CORPORATION [�# �PARTNERSHIP#LLC EA� r� COMPANY NAME �C f�GL/%/� t- T� ADDRESS -- CITY 1). 4&f/L _ _.._.._.._..-_...._. STATE_1`71-_.I ZIP TEL FAX CELL L�� EMAIL o ER El Li W U- r 4 v' appropriate .1 a1n a employer with, ,? 5- J`' box: 4. ❑ I am a general contractor T Tire Coinnnonwealttr ofliTassaclzrtsetts Dc'perrtmeniofIi'dirstrialAccidents ...'.. proprietor or partner- ship and have listed on the attached sheet. Office of Investigations These sub -contractors have 60641,aslerrirgtonStreet � 4,h )IOStorr Mi 02111 Workers'ComPensatiOn Insurance f Affidavit: ]B'uilde sont rae1:01•s/E /Ci �3licant lnfot-nl�ation i��t$tczar�,/I�Iumbcrs Md"" (13usiness/01-g,trlizatiolVlndividual): , ' r Are yqu au ent to e r? ---------- .1 -- _—_ Phone #: c: P } ' Check the -- v' appropriate .1 a1n a employer with, ,? 5- J`' box: 4. ❑ I am a general contractor T elnPloyees (full and/or part -tune).* �❑- 12111 a sole and have hired the sub -contractors proprietor or partner- ship and have listed on the attached sheet. no employees �� orkirl o for nle ill any capacity. These sub -contractors have No [ workers' comp. insurance employees and have workers' ❑requued'] 1 comp. insurance.# S• ❑ We are a corporation ant a homeowner doinb all work myself. [No workers' comp. and its officers have exercised their ulsul;u1ce required.] t right of exemption per IvfGL c. 152, §1(4), and we have no employees. [No workers' Please Pritlt I, Type of project (rcquired): d. ❑ New Cotlstru ;ti0rt 7. ❑ Re111odalulc, 5. ❑Demolition 9- ❑ Building addition 10.❑ Electrical repairs or additions 11. Plumbing repairs or addilions 12.❑ Roof repairs 13.❑ Other 'A aPPlicellt that checks box #1 must also fill out tlae section below sCoMhowing aeireworkers, c mJ ensati. Policy -- — _— i 1 l itteo Hers �vho submit this affidav t indicating they are doing all work and then hire outside contractors must sir 110°oactois dtat c}jeck this box must attached an additional sheet showing the narne of the sub -contractors and state or not those cn it'c c'';�f0�'c" lr the sub-:-ontrac[ors have employees, t'he submit a new aftidavil indicating such. Y must rovide their workers' Co-P.s Lavc p policy number. I arrt an r "f1z rs provttting workers' cofnpensation insurance for ruy employees. Below is the policy and job site _ irrj'orrrzatiorz IRSL1rallet Company Name: t, tGz.r^� Poiicy , or Self -ins. Lie. #: i Expiration Dale: Job Site Address: --�--- 4trac1l a Co City/State/Lip:_ Cop), of worl.ers' compensation policy declaration page {showing the policy number and expiration date). Failtre to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition oi'c rule UP to $1,500-00 and/or one-year in�lprisotmient, as well as civil penalties in the form of a STOP Of LIP to X250.00 a day against the violator. Be advised that a copy of this statement may be forty rmli.na.l peilaltins of a lnvcstigations Of the DIA for insurance coverage verification. WORi�, ORDER f a :fine Y forwarded to t11e Office of 11 herah„ UjjiC'iI!/ use only City 0r Town K.ruer tyre pains and penalties ofperjury that the information provided abov_—_ e is'true ant/ correct. Do nor ►rite in ,,is urea, to be completed by city or town off"rcial Issuing Authority (circle one): I. Board of Health 2. Building Departnjent b. ()tiler C orltact person, 3. City/Town Clerk 4. Electrical Inspector 5. 1~'lumbing 111spector Phone #: f C\- Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. 1 0 [ 0 c7 Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 City or Town of: NORTH ANDOVER To the Inspector Of Wires: By this application the undersigned gives notice of his or her intention to perform / the electrical work dea ow. , Location (Street & Number) /QO Zona unm/ a � e A/01/�+ A�dov e s f3 Owner or Tenant Rl f -} wl, s V Telephone No. Owner's Address 4-atne a-) to,.A;i ,n Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity No ' (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: k/1 iAq a.F nnW ka X e fl4i� do r le r Completion ofthefollowing table maybe waived by the In ector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑N-6.—off-Emergency rnd. rnd. Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. InDetection and of Initiatin Devices No. of Ranges No. of Air Cond. TotalTons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons J.KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal ❑ Other Connection No. of Dryers Dr y Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring.. No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: t 3 50 (When required by municipal policy.) Work to Start: 6 ? t o, Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C V GE: 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 cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME:. C4 //G h 4 A f LIC. NO.: 2 l 52 6 A Licensee: Ca Ah;,. 'r; d Signature LIC. NO.: (Ifapplicable, enter "exemt" in the license number line.) Bus. Tel. No.: Address: 9 / Be�,.0"4 s { /1/0 e,- Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ f . 417 SP�CUM. _ . T2�sset--� j � -- T:+'aile��I � J.3e-isls�ecitott xequzxec7($�O.QO) � ( � �izspectvxs' �cop�e�Its: - (khspectore signature ~3to :RniiiPIS) Pate :Z,NR N Cb, 3.'asseti-- �'afietT--�) � �e,31ns�ectioxt �•er�u31xeti (50.00)-• [ � . TuVectox-s' cora (ns�iet tots' atuze ~ o xnitiaTs) Slate 3, UNDERGROIM TNMCTZO.W. T.'asseci--r � S�'aiTetT--[ � ?�te�xus�ecfiouxeguiret�(�50A0)~[ � rns.pectoxs' comments: , (�nspectvxs',�ignaiuze~ao?i�iaTsj Pate '.A. I L CAIT;,�i A NAPA. ±ONAL C-9-1 I; asset--- j j Ti'a4led-- IsPectoxs' comm.eph: (�uspeetoralNignOuze- io Wiials) WAT6ot?,: . hate - pectom, co)bmmts: • S p eetoxs' Signature ~ xto initials) - date - 3Off. TAQgig APE TOES EMEED PDT AM MFT ON OUR IF TM.APXA TO DE INSREC'ED ISNOT r The Commonwealth of Massachusetts Department of IndustriqlAccidints Office of Investigations 600 Washington Street Boston, MA. 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (Business/Organization/Individual): �G /4 h a, n Address: I a ti 65T City/State/Zip: N, A 4 L� r IYA o f ffgQhone ih 979, 169q -f 233 Are you an employer? Check the appropriate box: Type of project (required): L ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. # ❑Remodeling ship and'have no employees These sub -contractors have 8. ❑ Demolition working for me in any capacity. orkers' comp. insurance. 9. Building addition [No workers' comp. insurance 5. We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.�Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. pear/ e5 s IA s l a.• 00 Policy # or Self -ins. Lic. #:_ C 6 0 1/0-1 61 -5 -el Expiration Date: 09' 1 Z2 S 20 t? Job Site Address:_ /00 ZohSwu<d Ove City/State/Zip: 4A .Otk9 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP. WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certnder the pains and�eIalties ofperjury that the information provided above is true and correct. G/2 /t2 , Phone #: / Q Y 6,l9 - g Z 2 3 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)" A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for :future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department oflndustrial .Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel, # 617-727-4900 ext 406 or 1-877�,MASSAFB Revised 5-26-05 Fax # 617-727-7749 ww�v.mass.govfdia w Y ...M...ASSACHUSET-TS:-UNIFORM.AP-?LMATION-FOR ERMIT-TO Wrint.orTipe)- DO PLUMBItG = =: Mass. P it # Building Location_ /C96 ��nti ,p ty /`T1� 'L Owner's Name 4 w� Tyrpe of Occupancy � �Aij�(� New ❑ Renovation O Replacement Plans Submitted: Yes ❑ No SUB--8SMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4THFLOOR STHFLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Address Business Telephone Name of Licensed Plumber FIXTURES I" V�W c Z N a D N F-- W n V Cr W I.- Q 3 m Y 2 N Z W T U Y N ¢ O ~ js "! N m O ~ � '" J Q H ¢ W O N cc X 94 d 3r 'r~ N O y O vn Q Q o Z= J Z o U U Y Z Q C W Q } S h W J Z y Y - H d OO y z Q O C O U. N 0- Q Q N UD N J Q t - Z O U_ (7 Z 7 I" Check one: ❑ Corporation L7Py�rfnership Firm/Co. Certificate INSURANCE C ERAGE: I have a curve liability insurance policy or its substantial a uival Yes No O q ent which meets the requirements of MGL Ch. 142. If you have checked res, pleasindicate the type coverage by checking the appropriate box. A 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 re uirement. q Signature of Owner or Check one: Owner's Agent Owner ❑ Agent ❑ I hereby certify that atf of the details and information !have submitted (or entered) in above application are true and accurate to the st of m knowledge and that all plumbing work and installations performed under the pertinent provisions of the Massachusetts State Plumbin Perm$ issued !or this bey BY 9 and Cha ter 14 0� the Genera! La wplicaGon vnll be in compliance with all Title ,9 tur o lJce sed mbe APPROVE O FILE Type of License: Master ❑ Journeyman ONLY) License Number.,-; � V�W c Z `n a D Q a Q X cc 0. '� O ti O O -' W C W S W W Y W O UX a 3 c m 0 Check one: ❑ Corporation L7Py�rfnership Firm/Co. Certificate INSURANCE C ERAGE: I have a curve liability insurance policy or its substantial a uival Yes No O q ent which meets the requirements of MGL Ch. 142. If you have checked res, pleasindicate the type coverage by checking the appropriate box. A 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 re uirement. q Signature of Owner or Check one: Owner's Agent Owner ❑ Agent ❑ I hereby certify that atf of the details and information !have submitted (or entered) in above application are true and accurate to the st of m knowledge and that all plumbing work and installations performed under the pertinent provisions of the Massachusetts State Plumbin Perm$ issued !or this bey BY 9 and Cha ter 14 0� the Genera! La wplicaGon vnll be in compliance with all Title ,9 tur o lJce sed mbe APPROVE O FILE Type of License: Master ❑ Journeyman ONLY) License Number.,-; � ro 4iI 11 0. 0 -u * M Z ;u 0 OQ Z 0 0 X > Z 0 < m ro 4iI 11 0. 0 -u * M Z -i 0 -u * M Z ;u 0 Z 0 0 X > Z 0 < m Clmmenw.at'th I/ Ma,aac4asa(j �Ipal�n4rlll��If �f/YtQfa . BOARD OF FIRE PREVENTION REGULATIONS Permit No. Occu ancy and Fee Checked to r!'l l/99J kavcbbiik) APPLICATION FOR PERMIT TO PERFO,R"AM_ELECTRICAL WORK All work to be perrornicll in accotdancc with the Massachusetts CI Ctncal (,ode (,%.1CC), S 7 CAIR 13.00 (PLC.ISC PRbVT 1rV INK ORTYI'L:.4LL INf ORr1•t: TfOiV) Dite: City or Town or: /r%/di'%'t% / deeltay- To the litshector of Frit -es: By this application the undersigned gives notice of itis or hcr.intentiott to perform the elccrrical work described below. Location (Street & Nwnber) �� 0 h e3 ('a0 a C/ Owner or Tenant f `! le ton /Vi /Vs, Telephone No. 7 (,���j Owner's Address Is this permit lit conjunction :Pith n building Yes El No ® (Cltcct: Appropriate Box) 1'urliose of Building Utility Authurizntiun No. Existing Service Aitips / Volts Overhead ❑ Uudvrd ❑ No. of deters New Service Amps / Vults Ovcrl►c:td ❑ Undord ❑ No. of �Ietcrs Number of Feeders acid Ampacity Location and Nature of Proposed Electrical Work: Completion of the (ollvviii q table may be waNed by the htsoeetor of IVire r No. of Recessed Fixtures No. of Ccil.-Susp. (Paddle) Facts !10. of 11 otal Cransfortncrs KVA No. of Lighting Otitlel,No. or Hut 'Tubs Gcticrators KVA No. of Liahtina Fixtures e e Swinimina Poul Above ❑ 1n- ❑ o prod. rnd. t o. o mergence Lighting Battery Units No: -of Receptacle Outlets No. of Oil urners FIRE ALARIMS INo. of Zoties No. of S!vitches No. of Gas urners No. 0 Detectiott and Initiating Dcvices N' U. of Ranges No. of Air Cot d. Total rdor Alerting Devices No. of Waste llis posers P Rcat Yutttp Totals: LNu ►ber 'Pons__ K\V__ No.f clf- ontaincd Detec ion/Alertinp Devices \o. of Disltu ashers Space/ Heatitt KAY Muutcipal Local Connection Other No. of Driers Heatin- Appliances Key Security S tents: No. of D vices or Equivalent Nu. of Water I1catcc's K\I No. of 110. ol• Si�rts Ballasts l;ata ♦Miring: NI O. of Device or E uivalent No.Hidromassagehatt►tubs o tNo.or�lotors TotalIIP Telecommunication Wiring: lo. of Devices or uivatettt OTHER: Attach additional detail if desired. or as required bt• rhe tasp•.cror o/ ,,,SCA. 1NSUR.A"NCE COVE1LNG E: Unless waived by the o�� mer, 110rmm o permit for the performance of electrical work; may issue unl=ss the licensee provides proof of liability insurance includittg "completed operatioii' coverage or its substantial equivalctit. llie undersigned certifies that sttcli coverage is in force, and has exhibited proof of sante to the permit issuing office. CRECK ONE: li`SUR-,\NCE ® BOND ❑ OTI i ER ❑ (Srccify:) (Expiration Date) Estimated Value of Elcetricat Work:* 6 6. 13-0(When required by municipal polic)'.) Wort: to Start: ��01-� G 1 hupcctiuns to be requested in accord cc ��i t �1 ulc 10, a o (completion. certify. under rite Irahis null Penalties of perjuq•, than the infornra o on ti a Pl' ativu is t e nrp ete. 11101, NAME: Castle E e L1C.N0.: A16191 Licensee: James R Present'-- Signator LiCANO.:26186E (Tapptieoble. enter—evempt -hi the license nuoiber tine.) 11 us. Tel.',No.- Address: 21 E rWood MA 02062 Al t. Tel. Ni OWNER'S INSURANCE NVAIVER: I alit aware tha th icetuce does not have the liability ituurance coverage norniAly required by law. 13y Illy siytwture below. I hereby w 1 • his requirert►cut. I ant the (check. Otte) ❑ owner ❑ owllcr's a_emt. a:vuertAgcnt Rr)ltT FEE• S ��• Sieuaturc __ 'l'c1c11huttc\u. coo Z CD OW 0 0 Cl) m 0:( 4• 1 Z 0 OM co E x cc Z )o NJ : o < fD rIA m 0 0 rlQ 0Vl W O QQ • CO2 0 Z 0 0 Cl) m 0:( 4• 1 Z 0 OM co E x cc Z )o NJ : o < :\J*,) . rIA m 0 Z 0 0 Z 0 co E x cc Z )o NJ : o < :\J*,) . m 0 MASSACHUSETTS UNIFORM APPLICATON FOR PEW TT TO DO GAS M-6NG (Type or print) Date l j _ j �j - v NORTH ANDOVER, MASSACHUSETTS Building Locations /0 O OLO 0 9 U)Iro /' ZI-1 (ff- I Permit #-3 F J U IV, '4ow") 4/t7-fi Owner's Name New 1:1 Renovation 0-- Replacement Amount $ M,4 T7 Plans Submitted (Print or type) Name G S AA,,-- T7. 7 a6u 4d&) , 4 v Name of Licensed Plumber or Gas Fitter )o Check one: Certificate Installing Company 11 Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0---- No 0 If you have checked Vis, please indicate the type coverage by checking the appropriate box. Liability insurance policy [z]/ Other type of indemnity 13 Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent 13 1 „cicuy w1u'y u1dL all u1 LIM uclans auu ulrorinaumi on i nave sunuea dor enterea) 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 Massachyletts State Gzt� Cod Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 1"5— 7 C f - Gas Fitter License Numoer Master Journeyman rA F � z w � x a U H a z -It o A w a 3 a a ° a > H o t7 aO. SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) Name G S AA,,-- T7. 7 a6u 4d&) , 4 v Name of Licensed Plumber or Gas Fitter )o Check one: Certificate Installing Company 11 Corp. Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0---- No 0 If you have checked Vis, please indicate the type coverage by checking the appropriate box. Liability insurance policy [z]/ Other type of indemnity 13 Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent 13 1 „cicuy w1u'y u1dL all u1 LIM uclans auu ulrorinaumi on i nave sunuea dor enterea) 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 Massachyletts State Gzt� Cod Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 1"5— 7 C f - Gas Fitter License Numoer Master Journeyman ro kti Z-1 CD fD tii 10 o S a. O r. l Aty OQ ti Owe > CD :a CD m Z 0 CD yl' Official Use Only v Permit No. �� a VIE CO,c"O.V E,4L'DfOTW,9SS 4CWVSE7TS 17 cr- Department of ft6& Safety Occupancy & Fee Checked /b 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 FMR 12:00 (Please Print in ink or type all information) Date w To the Ins or of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number L 0 0 L-0 AJ Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes No p (Check Appropriate Box) Purpose of Building 2� S L �' Utility Authorization No. Existing Service Amps Volts Overhead p Undgmd p No. of Meters New Service Amps Vofts Overhead p Undgmd p No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work (A-) /t i r OTHER: too A IN>URANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I hsive a current Liability Insurance Policy including-ggmpleted Operations Coverage or its substantial equivalent 0& NO = ve sII — valid proof of same to the Office OCE NO - If you have checked YES please indicate the type of coverage by checking the appropriate box. INSrURANCE BOND - OTHER = (Please Specify) a (Expiration Date) Estimated Value of Electrical Works y O r) © - Work to Start Inspection Date Resquested Rough Final Signed under a Penalties of penury: vl FIRM NAME; /`�A-/_ 1'�^fL: S CAP-> � , A LIC. NO. NO. BUj Address �� ^� O O� 5 f _ P SiU w. ^ �( AIt Tel. No. OWNER'S INSURANICE 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. PERMIT F - (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above p In p No. of Lighting Fixtures Swimming Pool grnd p rnd p Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets I -b No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. at Ranges No of Air Cord Tons Initiating Devices Heat Total Total No. Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers SDaceJArea Heating kW Detection/Sounding Devices p Municipal p Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters XW Signs Bailases Wiring No.Hydro Massage Tuds No. of Motors Total HP OTHER: too A IN>URANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I hsive a current Liability Insurance Policy including-ggmpleted Operations Coverage or its substantial equivalent 0& NO = ve sII — valid proof of same to the Office OCE NO - If you have checked YES please indicate the type of coverage by checking the appropriate box. INSrURANCE BOND - OTHER = (Please Specify) a (Expiration Date) Estimated Value of Electrical Works y O r) © - Work to Start Inspection Date Resquested Rough Final Signed under a Penalties of penury: vl FIRM NAME; /`�A-/_ 1'�^fL: S CAP-> � , A LIC. NO. NO. BUj Address �� ^� O O� 5 f _ P SiU w. ^ �( AIt Tel. No. OWNER'S INSURANICE 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. PERMIT F - (Signature of Owner or Agent) O o c� m y D aOL -„ F- CL CD Cc jw 3 7 n (D r; o 0 CD m O CD 3 -o m n 3 CD :3 -n0 CD CD 4A fA (A fA (A 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER:Q �& DATE ISSUED: SIGNATURE: Building Commissioner/I for of Buildings Date ar,%- i 1vl4 1- JX 1 r, uv r f1KMA 11UN 1 1.1 Property Address: L64s=woo4 AVe 1.2 Assessors Map Number Map and Parcel Number: Parcel Number x/66 1.3 Zoning Information: R-3 5iw-Le- i -wa,/ flies. coningI)is1rict Pr se 1.4 Property Dimensions: `1x35 s.r /l3.63'Fr- =3'.cortin Lot Areas Frontage ft :.6 BUILDING SETBACKS 00 Front Yard . Side Yard Rear Yard Required Provide ReqWred Provided R red Provided _ o 010 ` 40 #91+ IY/ 36 1 31 If .7 Water Snpply M.G.L.C.40. 54)• S. ublic 1► private 0 " Zone'_7 Flood Zone Information: ' Outside Flood Zone K 1.8 Sewerage Disposal System: Municipal On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT . r owner of Record r --- hit z't'TF{•ew �-- �<'� "fi(\ (eek �� ��� S 'ame (Print) 7fr, tgnature ' 2 Owner of Record: !dame Print j WTION 3 - CONSTRUCTION SERVICES t Licensed Construction Supervisor: tensed Construction Supervisor: dress nature ` Telephone Registered Home Improvement Contractor npany Name /60 &Caj Address for Service q6 o - Address for Service: Not Applicable 0 License Number c5 6`/( 6'7'1 Expiration Date /0//(, bl'0f Not Applicable 2 Registration Number 1 Expiration Date .ature Telephone SECTION 4 - WOREERS COMPRNRATTON (M C t r 14-1 r 1e,.�c� 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 Su b - C- G ?-(i Lc -toe S s - tvc, 7-1<e v s CiC Signed affidavit Attached Yes .......❑ No ....... 0 SECTION 5 Description of Proposed Work (check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑Addition D Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Construction A-d� (awt,'f.r Rv(, 2nd Cf r (d(Na- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cosi (Dollar) to be Completed b permit applicant ��I�, $� ' Y �£ ` r. �¢� (a) Building Permit Fee SE�Y� n k I. Building Cra�t) • Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee (a) x (b) 4 Mechanical HVAC 5. Fire Protection 6 p 6 Total 1+2+3+4+5 tJ Check Number SECTION 7a OWNER AUTHORIZATION TO COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I'--� a Owne /Authorized Agent of subject property Hereby authorize Q e- leg � 3 to act on IV bel It m all ratters rel rve to war authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/ �zedAgentf 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 Cl1av/es - fir, —i';/ 1V A otd c4'" N" -'� ec if FORM U - LOT RELEASE FORM 6- a B-o / 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 /,(,at. T? a. Tk (ee LOCATION: Assessor's Map Number 0 G SUBDIVISION N O STREET L. oK 3,w<!.G c� l61%0e, PHONE 79 S- 6 F6 - 9(- rA� PARCEL AM f 6-'t / 6 LOT (S) ST. NUMBER 6 U * **********************OFFICIAL USE ONLY****** RE06MMEiNDATXONS OF TOWN AGENTS: ATION ADMINISTRATOR DATE APPROVED DATE REJECTED �— COMMENTS P-0 1– 041 ') 10o" TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWERIWATER CONNECTIONS :'J zr–�/�'� 6"-9/Ls / FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM & NdRTh o ~ M 9 ACMIlS���� In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit. # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGI: cl 1, sl 56a. The debris will be disposed of in /at: A 0 ---C A P,- Nowrthsr�e Ga",Ta�� Facility location Signature of Applicant JA D e NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 0 RECEIVED Town of North Andover JOYCE BRAD ice of the. Zoning Board of Appeals TOVJ} CLERK ty PJO R T -•� Development and Services Division William J. Scott, Division Director 2001 FEB 28 A. 1.1: 25 1 27 Charles Street North Andover, Massachusetts 01845 D. Robert. Nicetta This is to cerfify that twenty 1201 days Building Commissioner have elapsed from date of decision, filed Athout filing of ark eal. Joyce A. Bradahaus c00/ T Ct Telephone (978) 688-9541 Fax (978) 688-9542 ATTEST: Tru own �e � Any appeal shall be filed alit Notice Copy Notice of Decision within (20) days after the Year 2001 date of filing of this notice Town Clerk in the office of:the Town Clerk Property at: 100 Longwood Avenue NAME: Matthew & Kathleen Willis EDATE. 2/14/2001 ADDRESS: 100 Yvon rood Avenue ION: 001-2001 North Andover, MA 01845 ING: 2/33/2001 ' The North Andover Board of Appeals held a public hearingits at regular meeting on Tuesday, February 13, 2001 at 7:30 PM upon the application of Matthew & Kathleen Willis, 100 Longwood Avenue, North 4 Andover MA requesting a variance from Section 7, Paragraph 7.3 for relief of front, left and right side /! setbacks in order to: add a: family room with an attached deck And for a Special Permit from Section 9, Paragraph. 9.2 in order to alter or extend an addition on a pre-existing,. non -conforming lot within the R-3 zoning district. j j € 64 4 - --," -1 PM The following members were present: Waiter F. Soule, Raymond Vivenzio, John Pallone, Scott Karpinski Ellen McIntyre. Upon a motion made by Scott Karpinski and 2 by Walter F. Soule, the Board voted to GRANT a dimensional Variance for relief of a right side setback of 6' and left side setback of 8' and front setback of I0' in order to add a family room with an attached deck And to GRANT a Special. Permit to.allow for the addition on a non -conforming lot on the following conditions: That the existing home owner does not change the grading in any way that could create, or effect, a run off of water onto the neighbor's property and that the foundation grading and drain is sufficient in order to avoid a runoff of water in the driveway. On the condition that the proposed structure does not exceed 16' in height and that the proposed deck remain as an open deck without any enclosure surround the deck In accordance with the Plan of Land by , Scott L: Giles,. RPLS, #13972, 50 Deermeadow Road, North Andover MA dated: 12/28/2000.. Voting in favor: WFS/RV/JP/SK/EAR. The Board finds that the applicant has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of this variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Town of North Andover 1` Board of Appeals, Raymond Vivenzio, acting Chairman M. on V1//- BOARD 1/2BOARD OF APPEALS 688-9541 BUILDING 6889545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 �SSfZX NORTH RtGIS My OF DFEDS - �41 LAWRENCE, MASS. A TRUE COPY:.,AT Rr or DF -F m ^ - Registry of Deeds .7 - ` Lawrence, nH 01840 Registry of Deeds Northern District of Essex Couoty 03/26/01 Lawrence, MA O184O WILLIS JC O4/O2/O1 # 137 Rec: Type PLAN 30.00 1nst 8474 Couies 1,00 # 138 Rec: u�� JO^OO Type '~ ' Ir�t 8475 ''- ;3 7 3 /utal Total ' 61.00 ' # 139 Payment Check 61,00 T`�8K 70/� 7h�mes l Durkc THANK YOU' Thomas I Burke Register of Deeds MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 TITLE: PLAN NO. 1148 CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 6-24-2001 DATE OF PLANS: 2-7-01 PROJECT INFORMATION: FAMILY ROOM ADDITION or 2 Family, Detached Other (Non -Electric Resistance) COMPANY INFORMATION: BRUNO ASSOC. 28 BERKELEY ROAN. ANDOVER, MA 01845 COMPLIANCE: Passes Maximum UA = 104 Your Home = 92 Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 288 30.0 0.0 10 WALLS: Wood Frame, 16" O.C. 442 13.0 0.0 36 BSMT: Conc. 8.0' ht/7.0' bg/8.0' insul 288 19.0 0.0 13 GLAZING: Windows or Doors 45 0.330 15 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 1250 of the design load as specified in Sections 780CMR 1310,'Nnd J4.4. Builder/Designer Date TITLE: PLAN NO. 1148 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 6-24-2001 Bldg. Dept. Use [ l [ l L ] L ] CEILINGS: 1. R-30 Comments/Location WALLS: 1. Wood Frame, 16" O.C., R-13 Comments/Location BASEMENT WALLS: 1. Conc. 8.0' ht/7.0' bg/8.0' insul, R-19 interior cavity Comments/Location WINDOWS AND GLASS DOORS: 1. U -value: 0.33 For windows without labeled U -values, describe features: * Panes Frame Type Thermal Break? [ ] Yes Comments/Location DOORS: 1. U -value: 0.33 Comments/Location HVAC EQUIPMENT: 1. Furnace, 87.5 AFUE or higher Make and Model Number [ ] No 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 CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-1" 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- Cl) m m U) 0 m _m .p C � d y Cl) CD Z CO) al o CZ �' CO) O d 0 CD CD O CLQ d CD CD o CD ww . C CD y CD d O y �CDCD I O CACD O O CD 0 C CD W 91 13 CD O f � Q/ m go a O cm C H C ei I 1 2 V! H 0 0 c (�� Q H d_ O O MH S d O m m C") H CD dc R. O pfd-► d G � a T O m N CA O CD CA CDx CA G -r. 0 d O y A ` o :• x O =r?: m m H d �+ CD d N d d Q _ C � CD m`N �1� �• H QCD : O ~'O � '+A -coJS ��m 4 CD H it �� �1 Zt -OW d* L ':' �CM)da C, H 0 0 c (�� .'7 0 y z rA b � 7 . GOD Ll x H 0 0 c J RECEIVED Town of North Andover JOYCE BRADice of the Zoning Board of Appeals T0V1CLERK Development and Services Division RIORT W „ �t3' P William J. Scott, Division Director 2001 FEB 28 A.1.1 : 25 27 Charles street North Andover, Massachusetts 01845 D. Robert. Nicetta this is to ced y that twenty (2o) days have elapsed from date of decision, filed 2 Building Commissioner Jithout tiling of anDab Joyce A. Brddahaus Q r� �►► Telephone (978) 688-9541 Fax (978) 688-9542 ATTEST: A True Copy Any appeal shall be filed own Notice of Decision,y a within (20)1 days after the Year 2001 date of filing of this notice Town Clerk an the office of the. Town Clerk Property at: 100 Longwood Avenue *n2WEEEEFhew& itATE: 2/14/20010 Iron ETITION: 001-2001ndover, MA01845 n A n.Tr • The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, February 13, 2001 at 7:30 PM anon the application of Matthew & Kathleen Willis, 100 Longwood Avenue,. North Andover- MA. requesting a variance from. Section 7, Paragraph 7.3 for relief of front, left and right side setbacks Err order to: add a. family room with an attached deck And for a Special Permit from Section 9, Paragraph.9.2 in order to alter or extend an addition on a pre-existing,_ non -conforming lot within the R-3 zoning district. The following members were present: Walter F. Soule, Raymond Vivenzio, John Pallone, Scott Karpinski, Ellen .Mclntyre. Upon a motion made by Scott Karpinski and 2°d by Walter F. Soule, the Board voted to GRANT a dimensional Variance for relief of a right side setback of 6' and left side setback of 8' and front setback of 10' in order to add a family room with an attached deck And to GRANT a Special. Permit to.allow for the addition on a non -conforming lot on the following conditions: That the existing home owner does not change the grading in any way that could create, or effect, a run off of water onto the neighbor's property and that the foundation grading and drain is sufficient in order to avoid a runoff of water in the driveway. On the condition that the proposed structure does not exceed 16' in height and that the proposed deck remain as an open deck without any enclosure surround the deck In accordance with the Plan of Land by Scott L: Giles,. RPLS, #13972, 50 Deermeadow Road, North Andover MA dated: 12/28/2000. Voting in favor: WFS/RV/JP/SK/EM. The Board finds that the applicant has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of this variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall Iapse and may be re-established only after notice, and a new hearing. Town of North Andover Board of Appeals, Ml/Decisions2001/2 Raymond Vivenzio, acting Chairman BOARD OF APPEALS 688-9541 BUILDING 68&9545 CONSERVATION 688-9530 HEALTH 683-9540 PLANNING 688-9535 ESSEX NORTH REGISTRY OF DEEDS LAWRENCE, MASS. A TRUE COPY: ATTEST: JAM" RECIStER OF DEED Registry of Deeds, Northern District of Essex County Lawrence, MA 01840 03/26/01 WILLIS Jc # 137 Rec: Type PLAN 30.00 Inst 80, 4 Copies 1.00 # 138 Rec: Type CERT 30.00 Inst 8.75 Total 61.00 # 139 Payment Check 61.00 THANK YOU! Thomas J. Burke Register of Deeds tl06tT1 Zoning Bylaw Review Form .tl Town Of North Andover Building Department * ° 27 Charles St. North Andover, MA. 01845 Phone 978-688-9545 Fax 978-688-9542 Street: ZbO © G W oo z) AOL Map/Lot: Irz, p C 5 - A licant: Applicant: A -N e w I , w I Lt- i. Request: I IK I €IAci A eoa x.014L' o xa�' S�xda'f 6>(8 . ©Pe'v br-c K Date: j 1 - 3 - o O riCaaC Lou auvweu LIML aver review Or your Application ana i-ians your Application is APPROVED / DENIED for the following Zoning Bylaw reasons: Zonina ---T� - - Zemedy for the above is checked below. Item # Special Permits Plannina Board Site Plan Review ; Access other than Lot Special Permit Special Permit ng Care Retirement Estate Condo Special Permit Permit R-6 Density Special Permi Watershed Special Permit Permit Permit d Permit Item # IVariance Setback Variance Lot Area Variance for Si n Special Permits Zoning Board Special Permit )nforming Use Earth Removai Special Permit ZBA Special Permit Use not Listed but Sir Special Permit for Si n A 1+0-0 Other �S P_ecfdi -pej M t ilar The above review and attached explanation of such is based on the plans, request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by rete ce. he building department will retain all plans and documentation for the above file. j C wilding Department Officiai Signature Application Received Application Denied Denial Sent: if Faxed Phone Number/Date: U Cc; -0 %' Item Notes Item Notes A Lot Area F Frontage 1 Lot area. Insufficient e 5 1 Frontage Insufficient 2 Lot Area Preexisting e 5 2 Frontage Complies 3 1 Lot Area Complies 3 1 Preexisting frontage Li e S 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed e 5 G Contiguous Building Area V 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient .e S 2 Complies 3 Left Side Insufficient Ll e- 5 3 Preexisting Height 4 Right Side Insufficient E a, 4 Insufficient Information e, S 5 6 Rear Insufficient Preexisting setback(s) — 4 ke l 1 Building Coverage Coverage exceeds maximum Nr'� 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed 4 s 4 Insufficient Information 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 2 In District review required Not in district S 1 2 More Parking Required Parking Complies 3 Insufficient Information Zemedy for the above is checked below. Item # Special Permits Plannina Board Site Plan Review ; Access other than Lot Special Permit Special Permit ng Care Retirement Estate Condo Special Permit Permit R-6 Density Special Permi Watershed Special Permit Permit Permit d Permit Item # IVariance Setback Variance Lot Area Variance for Si n Special Permits Zoning Board Special Permit )nforming Use Earth Removai Special Permit ZBA Special Permit Use not Listed but Sir Special Permit for Si n A 1+0-0 Other �S P_ecfdi -pej M t ilar The above review and attached explanation of such is based on the plans, request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein by rete ce. he building department will retain all plans and documentation for the above file. j C wilding Department Officiai Signature Application Received Application Denied Denial Sent: if Faxed Phone Number/Date: U Cc; -0 %' Plan Review Narrative The following narrative is provided to further explain them asons"for the action on the property indicated on the reverse side: /Z? e27-��in S "i's f !'L S"ROC-J- �JF"- <9 3, Referred To: Fire Health Conservation Department of Public Planning Historical Commission Other BUILDING DEPT Zoni ngBylawDenia12000 C i I . . 3nd q-j,vagso�:1 rn I, a rn �CnG�Op "'nnn,� bw -n �Zv2 2�co nm�o oCil �tio � sir rTl ad=o D co n Z � m � � Z �o?.Z- n y, OL � (7)o m OZO o Q 0 r7rTj r co m o �, � z OL o co 1 r r co CERT/F/ED FOUNDATION PLAN LOCATED IN DATE i L- 13 O& S. L.G/LES R.L.S. L AWRENCE a NOR TH ANDOVER olv5 w / � r��a l -I nZn�Z� �I�o(Rq ro �o4 CERTIFY THAT THE OFFSETS SHOWN ARE FOR THE USE OF ��`" °f OFFSETS SHOWN THE BU/L D/NG INSPECTOR ONL Y, S SUCH CONFORM TO THECES USE IS FOR DETERMINATION OFZONING U 13M ZONING BY L AW OF CONFORMITY OR NON CONFORMITY 1 �= WHEN CONS TRUC TED o � l 1 sol CERTIFIED FOUNDATIONFLAN LOCATED /N 4 �p SCALE. / "- DATE.' lc' t3 S.L.G/LES R.L.S. 30 8`1 L AWRENCE a NORTH ANDOVER w / � CERT/FY THAT THE OFFSETS SHOWN ARE FOR THE USE OF ��`" of M� OFFSETS SHOWN THE SU/LD/NG INSPECTOR ONL Y, & SUCH CONFORM TO THE USE IS FOR DETERMINATION OFZONING v 3M ZON/NG B Y L A W OF CONFORMITY OR .NON` CONFORM/T Y WHEN CONS TRUC TED 0 30� f�Afl h.-Lj -DI . wt 100 L o 0,1 w o o c-. -� liI T7pl'm NO , z E� A- Z�J � � (\,i -,C s aoU L�� N. L og taUHry 4 A°quo ,6 k 9SSacwuS£i Zoning Bylaw Review Form Town Of North Andover Building Department 27 Charles St. North Andover, MA. 01845 Phone 978-688-9545 Fax 978-688-9542 Street: / o O '.6.4v a 4,'0 / U L� Map/Lot: 0719-&_ 6n -r-„ Applicant: Request: Date: plaaca ha �•• v. ,.,�-.,MN11%-auVn ana,rians your,Apprcation is APPROVED'/ DENIED for the..fnllowih-g Zoning "Bylaw reasons: ,temedy for the above is checked below. Item # Special Permits Planning Board Site Plan Review Special Permit Access other than Frontage Special Per Frontage Exception Lot Special Permit Common Driveway Special Permit Continuing Care Retirement Special Permit Independent Elderly Housing Special Permit Large Estate Condo Special Permit Planned Development District Special Permit Planned Residential Special Permit R-6 Density Special Permit Watershed Special Permit Item # Variance 62.3.4 Setback V Lot Area Variance for Sign S ectal Permits Zoning Board S Special Permit Non -Conforming Use vermit Use not Listed but Similar —I Permit for Information The above review and attached explanation of such is based on the plans, request for or Information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Reyiew;Narrative" shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file. Building Department Official Signature 9 Application Received Application Denied Denial Sent: If Faxed Phone Number/Date: ►, - Plan Review Narrative The following narrative is provided to further explain the reasons for the action on the property indicated on the reverse side: ZoningBylawDeniaU000 Of