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Home My WebLink AboutMiscellaneous - 115 WEBSTER WOODS 4/30/20181.� \I PO Box 55098 Boston, MA 02205-5098 - - - - — - 617-951-0530 - - r Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: SCOTT SPECHT and REBECCA SPECHT Property Address: 115 WEBSTER WOODS LN, NORTH ANDOVER, MA Policy Number: HMA 0256502 Claim Number: BOS00059763 Date of Loss: 4/10/2015 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B 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 and claim number. Allan Leavitt Claim Examiner Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@Safetylnsurance.com 6/23/2015 PO Box 55098 Boston, MAL 022055098 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: SCOTT -SPr CHT`and REBECCA SPECHT - Property Address: 115 WEBSTER WOODS LN, NORTH ANDOVER, MA Policy Number: HMA 0256502 Claim Number: BOS00059763 Date of Loss: 4/10/2015 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B 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 and claim number. Lindsey Hodgens Claim Examiner 4/22/2015 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3418 Fax: -(617) 603-4914 Email: LindseyHodgens@Safetylnsurance.com Location No. Date <Y y TOWN OF NORTH ANDOVER Check # CR 14V< o Building Inspector Certificate of Occupancy $ ��s',•° • Eta' s�CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee� $ TOTAL $ Check # CR 14V< o Building Inspector U TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Section for Official Use Onl s -� BUILDING PERMIT NUMBER: DATE ISSUED: 194f SIGNATURE: Building Commissioner/I or of Buildings Date r WOMEN 1. l Property Address: 1.2 Assessors Map and Parcel Number. Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provi R red Provided 47 r 88f �� -' 1.7 Water SupplyM.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ 2.1 Owner of Record S C, o T'r + R E & E C -C A 1n E8S TEX 4A, -(E NameAnt) Address for Service : M-676-710 -676-71 ( #V YKA- u- � 9-7k-670-61,5-41 Signatur Telephone UV _ 2.2 Authorized Agent (S�, r, P, �..1 C 1 70 S,c> 3YaA:Q sr�j, ,c Name Pri t Address for Service: L'. 0 a,:', Signature QJJ Telephone 3.1 Licensed Construction Supervisor Not Applicable ❑ 70 S o Z -a A A t..► ..� , L. iq o t 03-3 C) Address License Number -i t -t t 0.wK is �w�c3-3 0 9^ 1 j- O j Licensed nstru tion Supervisor: Expiration Date ,� 8.�%1 ignatu Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ F f P. --j 4- � WgIzog Company Name Registration Number 3 0 A7 rz a�- lz-®➢ Ad Expiration Date rz Signature Telephone Ck ��{�I{�L_ T� 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 Print Name n Signature of Owner/Agent Date Item Estimated Cost (Dollars) to be Completed by applicant. permit 1. Building ,ter (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 3 S Check Number 7 t 1/ 1 F'Pff.,i i h.,, hi t44t L�'iUC'fv�Xy:2 sx-�F Yt�'! �Y�? I ,\:2T4 lky.�'3'; Y)1`�aC�bVUJ{Z2 i 1.F Ta. l4tV.i�+k S�IY ��.,:�..�n�r>� s:, f.q � .rn'J.z'�.5�'.:��i.'�,vT��uw'��:"9i4�`��',..,.'x kW, ., ��f �3 zi%fi��.�o. �,�jS +11Y,�,1,..}.2'tl�� ,. �� .,'`�J..q, ��.'•?,�?4\f§:�1,�3$r3 .�i�1;tF�;b.�y��`�r�J h.�'�L3Wr,.s1'�i 3, VAC �1 �w ; �r.� NO. OF STORIES SIZE BASEMENT OR SLAB t e f� SIZE OF FLOOR TIMBERS 1� 2" N SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL(( GAS LINE W ",gog [ yr, _�, �.r ..t�E,^.taltt `�•s-�sbs�� 1 s ''�4...p�i`st�Y'��„h'—�Tr � -/ hzr>`: n4 �i'kt�� amu. � r', '� ` . ..:�^n�E�.g:'�� mac. , - Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea ......X No ....... ❑ 5.1 Registered Architect: Name: Address Signature Telephone S Name: Responsible in Charge of Construction Not Applicable ❑ 1 Area of Responsibility Registration Number ExpirationDate Name: i Address: •�"�'" Signature Total Not applicable ❑ Registration Number Expiration Date Name: Address Signature Telephone Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone y Area of Responsibility Registration Number Expiration Date Name Address Signature Telephone S Name: Responsible in Charge of Construction Not Applicable ❑ 1 New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ° ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: X A-2 A-5 ❑ A-3 ❑ ❑ Structural Engineering Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Owner of the subject property Hereby authorize a`"�4-✓" t I ( ) PCV t, t ` e— to act on My behalf, in all matters relative two work authorized by this building permit application Signature 6f Owner bate I USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-4 ❑ A-2 A-5 ❑ A-3 ❑ ❑ ]A 113 ❑ ❑ B Business ❑ 2A 2B 2C ❑ ❑ ❑ C Educational ❑ F Factory ❑ F-1 ❑ F-2 ❑ H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional ❑ I-1 ❑ 1-2 ❑ I-3 ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A 5B ❑ ❑ S Storage ❑ S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use ❑ ❑ ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: Structural Engineering Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Owner of the subject property Hereby authorize a`"�4-✓" t I ( ) PCV t, t ` e— to act on My behalf, in all matters relative two work authorized by this building permit application Signature 6f Owner bate I APR—:27-00 T H U 9 : 44 S . E . Cumm i n<_+ s Assoc. i aL-t es P . 01 CER rIFIE, 0 ,& or AN 5. CUM I N OS & ASSOC/A TES P,a BOX' fov PLANrow N„N. 0 885 rElleP110 IC (MV -08:4085 FAX l60M-08.2 i3OV N Of ALBERT T TRUDEL Na 366969 SCALE 1 " = 60' l HERESY CERTIFY TO TOWN OF N01?rH ANDOVER, MA BUM/NG ZPARTMENT TI iA T THE EXISTING FOUNDATION DRAWN ON THIS PLAN IS LOCATED AS SHOWN AND THAT I r DOES COMPL Y TO THE MINIMUM SUILOING SEMACKS TO PROPERTY LINES -z- 004' 004' OF FLAGGED WETLANDS NN- 1 I NN—i4 82.50' L,,53.34 S frp6't0” W R=725.0( R - 200.00' L - 14.16' WEBSTER WOODS LANE DA TE: APRIL 25, 2000 MINIMUM SETSA CKS, FRONT - 30 FEET SIDE - 30 FEET REAR 30 FEET NN -17 NN -13 NN—i4 82.50' L,,53.34 S frp6't0” W R=725.0( R - 200.00' L - 14.16' WEBSTER WOODS LANE DA TE: APRIL 25, 2000 MINIMUM SETSA CKS, FRONT - 30 FEET SIDE - 30 FEET REAR 30 FEET FORM - U -LOT RELEASE FORM p6d INSTRUCTIONS: This form is used to verify that all -necessary approval /permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ..............e.■..........■r.............■■•...................s.......... APPLICANT S'c o rT' i fZe— 1 �� Lrt' PHONE q , -67o - & / f9 7b ? << I ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREET.�5...:.'dL.........STREET�NUMBER 0f�S....0 ...6 2 OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS r OF Oman 0 *memo an a amen Box Newsom 0 ON noun a an a DATE APPROVED CONARVAnONADMINISTRATOR - DATE REJECTED (� COMnAEN'rs JS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR -HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COIvIIvIENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS RECEIVED BY BUILDING INSPECTOR _ DATE APPROVED DATE REJECTED DATE F E��omr�D APR 2 3 2001 BUILDING DEPT. ri fi 14, 7t., iA I f, Location: / / S W azSTam 6Jov qs bi City /J" kJ i9 0 ,rV,-- Phone I am a homeowner performing all work myself. .F--] I am a sole proprietor and have no one working in any capacity WON M k - 670 7(" #6VV-Q_ I am an employer providing workers' compensation for my employees working on this job. " :C', Rao 1~J ® S0 & a cj Ci w c�e-wc�e _ Phone #: Je rs6��f2�9� Insurance G. /C 1],, t �� i �� r Polic # C 01 0 6 Com an . name: E Address Cily Phone #: /I/JM/fA//W v 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 $1,500.00 and/or one years' imprisonment -as well_as_civil.,penaltiesin-theform-of-aSTOP_ WORK_ ORDER -a dayegainst.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and co►rect. Signature � o Date,-11— Print ate/7Print name CAIi^ e ' ^ Phone Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing 0 Building Dept []Check if immediate response is required [] Licensing Board p Selectman's Office Contact person: Phone #: Health Department Other • �` H4lIE I14pRO�JEMENI C�i�AC'i0R Apt OK lips f A14IlY FOOLS i DAi 105 ING ; GLENN WIGGIN BROADWAY 54 'W &41 IARRENCE. MR 01843 ppplWlB'if�ATbR �i�e G�rx�r+�srw+eiiiO� y(. '�iiba+rt�%lo/� �y �st,l�lU/�l�� yo�F��B��tll��Ay�my IAIJ AMW i Licomm lA1Ai'� MMU MVEMMW fjm~ r E�irl�: 0M111Wi�f�f� 7r. ems' 440 IKON I1 N Ya 00 wrtYW C Poutas '8Z S sis01DMV `e t/IMIFamm k" also AditAiel Mw ACo�D,� RTtt= Ai 61 95000 746. (6 �11;iot, °Whittier, Hardy IIl RoY Insuranee Agency, Inc. S7 Put"M Strast Wiu%hrop, IMI 02152 y Poo At Patio d. , Inc., 91 South Broadway LaAwr6ftt MA 01643 ANY REQUIREMINT. TERM OR C0140iT POLICIES AGGREGATE LIMITS SKOV* ANY ! THI Ai le ALTER THE KRIS NO ltif�HTS UPON THE CBRTII MRTIFICATE RAGE AFFORDED BTT 14EEI'.1C111 INSURERS AFFORDING COVERAGE WSUREF A, -i ranSCOnt nanta Ins. Go. INSURER t INSURER C' INsupEa D' �.-.--.- IN$W� E: p N ABOVE FOR Tree i OF OTHER D0CUNIENT �MTH "SPECT TO WHiC 168CAMEO 4gEIN IS SUBJECT TO ALL THE TER ci+o 2Y PAID CLAIMS. ISATE (VioWOCmr 03/09/zo01 OF SUCH A TYPEO}'iklURANGR POLICY NUMBER GlNERAL LIAlILRY 164095968 SIAL QONCRAI LIAMILITY CLIJMB MAW OCCUR PCR: pENi-4f7LCT LOC DATE MNIAOr I -12/3112000 S 12/31/2401 NMR$ vOlM O00%;(0 5V 05 i 50000 FAEDAWGE (A nY sm Nn) b 90000 MEb EXP (Anyoft psrnan) b 5 aw peK$0NAL&ADWNAURY i Sao 0@NF.rZAL AG 0R WATE 0 PRODUCTS • COMPIOP AGOY AX AUToao6aE X tu►slLm bag 07 ANN, AUTO j ALL OWN$p AVOS SCHEDULEO AUTOS NyRp AUT06 wOk•OwNd4 AUTO$ i 12/31./2400 12 31 2001SING" LIMIT I : 1 000001 BODILY ODILY ftuAY BODILY INJURY (PsI eeaden0 PROPERTY DAMAGE $ (Par accant) 9lWAiliLfTY NY AUTO j AUTO ONLY.EAACCIDONT b OTHER THAN EA AGC Ste_ AUTO ONLY. AGO b LiAEILITYCACN OCCU✓K F7CLAIMS MADEALiGRGGATERtAfENTgN S i OCCURRENC! E A WORK&KICOMPINEATIONANO EMPLOYEa6' UAB16ITY 164095968 12/3112000 12/31/2001 E.L. EACH NOOMNT b `iL.DISEASE, GAEMPLOYE E S.L. DISEASE - POLICY LWIT d -7-If 1 ... NVORM-1 IQrcLI;1WMrT1WffNs ADDED BY ENucar-minTmanw=05 ADDITIONAL p.Lg00', IN19URAN LITTER SHOULD ANY Of THEASOVSC1680FONDPOLICIESMCANCSL=6W LITHE EXPIRATION DATE THEREOF, TME ISS MO COW WY WILLENOFAVORTO MAIL DAYY WRITTEN NOTICE TO THE CIRTIrIOATC HOLM NAMED 10%4 LEFT, BUT PAILUAETO MAIL SUCH NOTICE��``SHALL pglO" NO QyU6APON ORIOASIL1TY OFiANTKIRD UPON TI1C5QMPANY Ar AGENTS OR RErHEE6T4YAvmw For Information Purposes Only a� NVw1N�� te- r �Q � Xr I PA Z v N a� NVw1N�� te- r �Q � Xr I PA Z Cl) m m Cl) 0 m _ CO) .O az COCL O d CL _. >to O CD o p d Q � o CD o CO) .p CD O O 'O. C CA d cl) CD O _ rh CD CD a CO)CD O CD O CCD 0 A OF 0 0 I V J 2 0 Cn c e?�O m = r'j o 0 ca m 0 m C7 0 O yon Z =ry co) _•1 Oft „O,r .O► O y 17 m a�W m m ..�ooH CO) W _ o ` m � > CD CAco m �. c o o 0 C2 O N CD .m x o� Z CL cc 0 ??: CD N . � Co O cis C a m h 97 Ca VO d H T v, CL :0 c :� 7d b z n : co � H a ..IE CD `yQ � N .� CD O . H O 7%. (n .a, o� goo. :Y CD o H ♦ -� oca .moi Vf m .. CD Ara: *4 o 'o n o 0 _ Qo I c o L -7-1111-1-- (n 9 917d cn - w -P 97 til T F �r r -7 7d b z n : 7z o a G1 r � b.. rte. xro96 �.�n/�• oni 0 9 0 c �oRr o Town of C.UsNORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: J PROJECT: I`T & DATE: 7 UNIT NO.: FLOOR: REMARKS: WING: BUILDING NO.: //S-- 40 7c -- Excavation - depth and soil conditions Framing - Other: Date: 'I- / i -&49 Date: Date: Inspector A A4 'C' Inspector Inspector Footings and foundations and drains - Insulation - Other: Date: '/' ,7- 3 - 0 0 Date: % " % ` oE) Date: t Inspector Inspector ,��'��--- Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: ""2-46 Date: 6 � Date: Inspector Az Inspector Inspector Electrical - final Plumbing and/or gas - final Other: Date: Date: ` Date: Inspector Inspector Inspector Fire Dept - oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: C(" T` 00 Date: C/— ca- p �� Dat • C of 0 #� '`� Inspector Inspector �� Inspect Form #995 Action Press, 685-7000 U N2 2736 Date ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... ........ ............................... tt has permission to perform ...... ( ..... o. I ......... .............. wiring in the building of .... h ....... '. ................................ // / -,(,; buc)6r/ L P? North Andover /Mass. at............ .................... e�. .............. Fee �W(JU ... Lic. No. :/; .'auj ....... ELi&RIC;�*i*N'S*?P*E'*CTOR"***""*"***** Check # 4 - WHITE: Applicant CANARY: Building Dept. PINK: Treasurer The Commonwealth of Massachusetts Office Use Only Department of Public Safety Permit # J Board of Fire Prevention Regulations 527 CMR 12:00 Occupancy & Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date November 28, 2000 City or Town of No. Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (street & Number) 115 Webster Wood Lane Owner or Tenant Scott Spechte Owner's Address Same Is this permit in conjunction with a building permit: Yes FX_1 No = (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Undgrd =No. of Meters New Service Amps Volts Overhead Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Finish Basement No. of Lighting Outlets No. of Hot Tubs No. of Transformers No. of Lighting Fixtures 22 Swimming Pool Generators No. of Receptacle Outlets 17 No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switches 10 No. of Gas Burners FIRE ALARMS No. of Ranges No. of Air Cond. Tons No. of Detection No. of Disposals No. of Heat Pumps kw No. of Sounding No. of Dishwashers Space / Area Heating kw No. of Self Contained (1) smoke detector i No. of Dryers Heating Devices kw Local No. of Water Heaters No. of Signs Municipal No. of Hydro Massage Tubs No. of Motors Low Voltage Wiring Other: (1) 100 amp 240 volt 1/0 load center (1) Micro /Hood INSURANCE COVERAGE: Pursuant to requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES ' NO 1 have submitted valid proof of the same to this office YES x NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE J BOND OTHER (please specify) 2/2/01 Estimated Value of Electrical Work (Expiration Date) Work to Start Inspection Date Requested: Rough 11/28/00 Signed under penalties of perjury: Final Upon Request FIRM NAME Dumais Electric LIC. NO. 12170A Licensee Mark A. Dumais Signature LIC. NO. 26665E Address 8 Newport Street Bus. Tel. No. 978-683-9438 Methuen, MA 01844 Alt. Tel No. 978-685-4553 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or it's 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 Fee �\ (Signature of Owner or Agent) Location /�/�5�-c r , —*– _ �tJ No. �� Date ' NaRTM TOWN OF NORTH ANDOVER Ce 41 i Certificate of Occupancy $ Building/Frame Permit Fee $ s�CMus Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # /fir 1434.5 Building Inst c✓ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING iYY BUILDING PERMIT NUMBER:�� DATE ISSUED: `Q SIGNATURE: Building Commissioner/IREREtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Propetty Address: 1.2 Assessors Map and Parcel Number: L )CL r LJb6 s (s�✓� 1,06 /�5 d, Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Provided —ReqWred 1.7 Water SupplyM.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record / / 4-e-��5 �c—kV4� Name (Print) / Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone S� 4 ION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ g f5l-/ Licensed Construction Supervisor: �S� Gl T License Number dd ess il!ignature / Da � z Expi hon Dat Telephone 3.2 Registered Improvement Contractor Not Applicable ❑ %Home Company Name / kegistration Number Address — / / tO�-2 lv Expi ation D to Si nature Telephone z SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 14 Specify h S Brief Description of Proposed Work: ` 0 SE ION 5 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant {}MCIALUSE ffNLY I. Building C ! 3 y ��` (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction % 3 Plumbing Building Permit fee (a) X (b) C�o 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 020ly,Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, �,JJ 11 /14� i>S as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief / (tet/ /7//%'f r,,,= Print . a inature of Owner/A ent Date „ NO. OF STORIES ..., . SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS iST2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DilvENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4" OCT -13-2000 17.38 CABOT CORPORAT I CIA 978 6708095 P . 02.'02 COR / IFI o r AAN AO. pori fAV PJA d oalb. Mm S MZ*VW f$ S"1 04008 FAX 0 LOT 6 ME ssp, PP -23 l; % r"'S> PP -24 EDGE OF FLA0= du; iCFrf T NF(wib t, Na sm4 rsr NN•,i "�'� SCALA' I' -m 60' I HEREBY CERTIFY TO TOWN V* NOR7H ANOOkO, MA 64114 ING 0EPA1PlrT N' r NYHA r wr EXlswo mumAT/ON DRAWN ON THI$ PLAN IS L 00A TED AS SiYOM ANO NAY lr DoS Gouty Y ro mr MINIMUM 8111ZVIVO SEMACKS rO P pnjipriP TY 1 !I Vj'C' �a�3 14t 5 ryz�lo" w ��g•qd R � 2dD.D0' L 14. 16' WEBSTER WOODS LANE DA It APRIL 25, 2000 UINIMUM .SETBACKS. - FRONT — .30 FEET We' - 3d FEEL' GCAG 7f7 «L T TOTAL P.02 ,r � . ,ry '` .,� '` � '� t��_ �' _ •� � � _ s t � i � �•; j.. r ., .( � i! �*• I � � ' � , 'r 1 f' � ' ,� 1 � -L � 1 �� T f � ! � r k r, r ' � •�� e a � ��. ,1 1 . r �, . l., � �. - � .. ,\ .. !, h ... MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 TITLE: SCOTT REBECA SPECE CITY: Haverhill STATE: Massachusetts HDD: 6413 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 10-31-2000 DATE OF PLANS: 10/31/0-0 PROJECT INFORMATION: SCOTT REBECA SPECE 115 WEBSTER WOODS IN NO ANDOVER MASS COMPANY INFORMATION: COTE AND -FOSTER CONTRACTING INC. 20 AEGEAN DRIVE UNIT 15 METHUEN MASS 01844 COMPLIANCE: Passes Maximum UA = 174 Your Home = 169 Permit # Chucked by/Date Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 1152 30.0 0.0 40 WALLS: Wood Frame, 16" O.C. 1124 13.0 0.0 92 GLAZING: Windows or Doors 45 0.350 16 DOORS 42 0.500 21 ----------------- ------------------------------------------------------------ 10 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/Designer Date �- .. � ; , ` ti �., a � Yr K• { r. f � .. • x 4, •r r J_ • e � r i. i �. A i � ,. { � � - it M1 � � && & 70den CONTRACTING BUILDING • REMODELING September 6, 2000 Building specifications for Scott and Rebecca Spechte for a finish basement at Websterwood Lane, North Andover, MA. Permits — Building, electrical and plumbing permits included. Framing — Ceilings strapped, walls 2x4 with pressure treated sills. Frame in boilers, new '/z bath, walls on top of concrete, walls in cabinet area and storage area. Debris — Removal of all debris caused by said project. Plumbing — Supply and install one sink and faucet, one toilet, existing plumbing to ready in concrete. Electrical — Itemized list enclosed. Insulation — Already existing. Wallboard —'/z" blueboard on walls and ceiling with skim coat plaster. Heating — Work off existing unit and trunk work for feeds to new area. No air exchange unit is priced if needed. Painting — Two coats paint on walls and woodwork. Tile — Floor of/i bath to be tiled. Carpet — Allowance of $1160.00 for labor and material. Vanity — Vanity and top (mirror) allowance - $600 Finish — Sixpanel molded doors, 2.5 inch colonial trim for windows and doors, 4'/< inch baseboard with 1 1/8 inch base molding. Total Materials and Labor: $34,420 20 Aegean Drive 9 Unit 15 0 Methuen, MA 01844 a Tel: 508-682-6518 0 Fax: 508-682-1221 Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM f ttORTF1 '9 O �t�ao QN, O to ?, �4r R�Tio In accordance with the provisions of MGL c 40 s 54, anda 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 MGL cl 1, s150a. The debris will be disposed of in /at: 6,111 w��e r� Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. l irc vvrlu//v//vvcau// w IWGJJdIi//UJCIIJ Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' Cocompensation for �� my employee//s working on this job. Company name: CA Z554—Cy— n A)9441f Address -- v City' i`�7/�2w� Phone #: GGP2 ,Lji- Company 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 $1,500.0o 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 maybe 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. Signature Date Print name Official use only do not write in this area to be completed by city or town official' OCheck if immediate response is required Building Dept Contact person._ Phone FORM WORKMAN'S COMPENSATION hone # r ❑ Building Dept p Licensing Board F-1 Selectman's Office F-1 Health Department F-1 Other I G I CCA I G { � ✓lie t�omvriraruisea� ��/�aooaclauaei2a �' h BOARD OF BUILDING REGULATIONS s License: CONSTRUCTION SUPERVISOR I C = = Number CS 050854 . -� 1. ! Birthdaie:,:11/10/1964 `j Ex_ plresc 91/1012002 Tr. no: 3588 k-.nns�ru�uvn -.� 'Restricted To: 1G WILLIAM T FOSTER 65 COACH DR DRACUT, MA 01826 A Administratoor O ^C 0 0 1 w O 6 z ;mc:F .. o M V y .0 m. . o O ; cm te O c C. E CoL GO y... O a N ea O H A O m O O RC2 r: O ® y m 0 O CD rL. w C c •: O Q v ? w y m acs 0 0� v N O 0O R CI COej C Q � � � m C •p = m soa O N COD Z -0Z y.r r •fyA C.R C Z E oc �v,c .2 .y o C.3 CD W OoC C,* a IDCL o 10 _ A a ` ti % o Fm s 4" C 4—in u p O w . a a� cn o 9 a O w O w vz C U is G w ® Ra O w iu q w" a (�i O a chi is w a 0 ¢ O n: co G w z w a �' v a m 8 cn v o a E cn w O 6 z ;mc:F .. o M V y .0 m. . o O ; cm te O c C. E CoL GO y... O a N ea O H A O m O O RC2 r: O ® y m 0 O CD rL. w C c •: O Q v ? w y m acs 0 0� v N O 0O R CI COej C Q � � � m C •p = m soa O N COD Z -0Z y.r r •fyA C.R C Z E oc �v,c .2 .y o C.3 CD W OoC C,* a IDCL o 10 _ A a ` ti % o Fm s 4" C 4—in O U h Vj • o z Oz cv �O � c O h O O V V � Z ac 0000 ev ev rU W _ o w O 6 z ;mc:F .. o M V y .0 m. . o O ; cm te O c C. E CoL GO y... O a N ea O H A O m O O RC2 r: O ® y m 0 O CD rL. w C c •: O Q v ? w y m acs 0 0� v N O 0O R CI COej C Q � � � m C •p = m soa O N COD Z -0Z y.r r •fyA C.R C Z E oc �v,c .2 .y o C.3 CD W OoC C,* a IDCL o 10 _ A a ` ti % o Fm s 4" C 4—in co O co 0 Z O H .y L CL O CDca3 CL O s= CO2 C cc C cc CL 3� co ® C- C *" C c cc O O Z ts CDCLCO2 C '0'^ vJ U) irw w w O U Vj A z Oz cv �O � U J� Z W � rU W WWW co O co 0 Z O H .y L CL O CDca3 CL O s= CO2 C cc C cc CL 3� co ® C- C *" C c cc O O Z ts CDCLCO2 C '0'^ vJ U) irw w w Location No.y Date , Ma�Th TOWN OF NORTH ANDOVER a�Oi �•�,o ',h�0 ICS C ► 9 Certificate of Occupancy $ s�►cnusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ =-1.1 ed TOTAL Check # Building Inspedo"r— TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING e tl€oa. er Ufiid Use 4n1 , BUILDING PERMIT NUMBER: DATE ISSUED: r� SIGNATURE: Building Commissioner/Inspecto of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 0 4- (0 1.2 Assessors Map and Parcel Number: Map Number Parcel Number L(}OD C g ( �� 1.3 Zoning Information: R12 - Zoning District ProposedTJse 1.4 Property Dimensions: Lot Area (s6 Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: Public Private 0 Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print— Address for Service: $ Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: r Licensed Constriction Supervisor: Address 7 —S�3po Signature Telephone Is<fe ss -7- 5-7760 Not Applicable ❑ 06 d G 9 .2 3 License Number Expiration Date 3,2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone r Lon WON `tea) z M 90 nn ic r M r r z G) ark . y SECTION 4 - WORKERS COMPENSATION (XG.L. C 152 � 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. Signed affidavit Attached Yes ...... V No ....... ❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction A Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: deg e SECTION 6 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OMCM USE: ONLY 1. Building ., (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical HVAC' 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH.DING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I,as (r/Authorized Agent of subject Property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief / Print Na 9 /ye�ad Signature of Owner/A e Date NO. OF STORIES SIZE BASEMENT OR SLAB ND RD SIZE OF FLOOR T VIBERS 1 s 2 3 77, SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE A FORM - U - LOT RELEASE FORM 3-- )S— cq f INSTRUCTIONS: This form is used to verify that allnecessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. �iit■■fffffiiiffiffffiiif tiffttt■i tiffffiii■■iiiiffiiit■■ffifffffiiif iiifff■ APPLICANT `P5, r e'V— PHONE 67-5'7 - 5-76 y ASSESSORS MAP NUMBER /v 6. E� LOTNUMBER 1(o-3 SUBDIVISION 0a v M4 Fc- -- S fi LOT NUMBER STREET STREET NUMBER �iistssssssssssssssssssfo..SSSSitttfifssfifffiiifssfiifffsfif■ ■iiffsitfsss■ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED 22O o./ CO SERVATION ADMINISTRATOR 4 It /1 _ DATE REJECTED DATE APPROVED TOWN PLANNER PUBLIC WORDS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTNIENT DATE REJECTED COMNZENTS RECEIVED BY BUILDING INSPECTOR DATE REJECTED CONUVIENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED CONMIENTS PUBLIC WORDS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTNIENT DATE REJECTED COMNZENTS RECEIVED BY BUILDING INSPECTOR ;FROM-l'NeKENZIE ENGINEERING GROUP,INC PHONE NO. : 6179412662 Mar. 21 2000 01:04PM P4 u r C/) m m C/) 0 m y d ■ -m CO) CD n z y CLr c Q� c co) >CO O CD CD CL c� =r `C d CD CCD O CCD C. CD rA CD CZ O y CD I C y O Q y = dOC O y EO�mn n Q ycinC 3 m Z ?-C H '� o ,,,� 0 .df O N T ,� a. o CD O of C N! N � O O C a > > 3 mIm.pig p .0 •-M p L. C2 : CD ?� c C N C a p �CC2 CL O CW:Z CD mmN: :O CD 7 c�� : c CL .dig CA O ON 1 N p CL C D � ,� C H �O ca C SCVC N FU Q%lb to= CnD m ��N ACD QuO p ® o CD CD o C° wad pN : CD CL"S: O Z d z 7 CD w a 0 w ; IT G a r N O C x 'd r w G x G a � Cq U n' cn n � ►ti 4tz O O O 7d z 0 I I 0=3 0 9 O C 3457 Date. Z. � jl..`..G ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .. ..... r /9:�. has permission for gas installation . %L: :� in the buildings of ... 11 . S J. .r ......................... . at f % 5 �.1k.<�.t. L . I....... (. , North Andover, Mass. Fee -2?.,... Lic. No. ;.(! . ?.2 . L ....`............ . / GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Y MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO E1S FITTING ��Type or print) Date �p` 1900 NORTH ANDOVER, MASSACHUSETTS Building Locations Permit 9 3 Amount S J Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) Gerry Keefe Plumbing & Heating Check one: Certificate Installing Company Name 6 Lawrence Street ❑ Corp. TOWkSbUry, MA 01876 Address ❑ Partner. Business Telephonerm/Co. Name of Licensed Plumber or Gas Fitter e {e INSURANCE COVERAGE Check one: 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. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owners 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 ❑ 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 pertormed under Permit Issued For this application will be in compliance with all pertinent provisions of the ilassachusetts Stajoas Code ant Cppter,)9of thS General Laws. By: Title CityiTown :APPROVED (OFFICE (ISE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber / G 7 ❑ Gas Fitter Licttnse i,4umoer �_ivlaster ❑ Journeyman Date. ./:7/.2.. < � N2 4463 TOWN OF NORTH ANDOVER as 0 PERMIT FOR PLUMBING This certifies that .. �1- . /.'� r .... ................ has permission to perform ....... ....��.n .-'< ......... plumbing in the buildings of ... `./,P I!r.S, . /. t ................ at. e-,. . I,,�.u4, .J..• L��—North Andover, Mass. Fee .3 / rl.... Lic. No..h/. ?.?. Y .... Q— ..t /.� _cr ,.......... . JPLUMBING INSPECTOR Check # 2 2 t WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING t��G3 (Type or print) NORTH ANDOVER, MASSACHUSETTS ,! Date U0 Building Location 7 Owners Name d//t&z� Permit # Amount .3s S Type of Occupancy New Renovation Replacement 13 Plans Submitted Yes No FIXTURES (Print or type) Corry Keefe Plumb Installing Company Name y _ 6 Lawrence & Heating Check one: I 'Corp.et 876 Certificate Address (55081694-1012 Li Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy M 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 E] 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 Plum g Code an C to 1 ofneral Laws. By: ignatUre ot LICenSeQum er Type of Plumbing License Title City/Town icense?u� er Master ® Journeyman ❑ APPROVED (OFFICE USE ONLY • • "• ��iii�iiiiiii��i ilii (Print or type) Corry Keefe Plumb Installing Company Name y _ 6 Lawrence & Heating Check one: I 'Corp.et 876 Certificate Address (55081694-1012 Li Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy M 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 E] 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 Plum g Code an C to 1 ofneral Laws. By: ignatUre ot LICenSeQum er Type of Plumbing License Title City/Town icense?u� er Master ® Journeyman ❑ APPROVED (OFFICE USE ONLY w '*N2 2458 .r NORTF, O 9 Date... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that.(...." :��.......................................................... r j has permission to perform.,.......:...../,....................................................... wiring in the building of ...... r? . - at Zl! J .......1''�-f ry ....- cr-c .... , North Andover, Mass. Feb ....... Lic. No��?_ '. ......................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THECOMMONWF 1,THOFh14SAaWSE77N DEPARTARRNT OFPUBLICS4= BOARD OFFIREPREYF VT70NREGUTATTONSS27GR 120 Office Use only Permit No. rus -9 Occupancy & Fees Checked 0 A1rrr1L-ATIONFORPFRIVU1 TOPERFuRMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 ,ter. / D ^ D (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover The undersigned applies for a permit to perform the electrical work described below Location (Street & Owner or Tenant Owner's Address To the Inspector of Wires: MAP PARCEL Is this permit in conjunction wi Purpose of Building Existing Service New Service r,9oo a building permit:, Yes No lr.te— (Check Appropriate Box) W,'i i Zo Utility Authorization Amps / Volts Overhead E] Underground No. of Meters Amps ,�b /02 Volts Overhead [= Underground 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 Transformer Total KVA No. of Lighting Fixtures Swimming Pool Above M Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners. No. of Emergency Lighting Battery Units No. of Switch Outlets f No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and ,�o. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal _ Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP ,arloeCo�age. P►aster#totheregtmarla�sofMaSsada�C,alaallaws �� a omatliabllityhtst.rarveFolxyhdu1lgConlpleie Operalioris CCowrWcritsskstantiale4 vakrt YES NO Vest>b T,&dvalidprodofsametotheOfCa YES Yf K uhaxdtadmdYES pleame' the Fofco (Wbydledorlgthe ffloprkbCK INSURANCE 01BOM C)III�Z ® (PlesseSpa* EstimatfidVakudEkcha %k $ WctktoStart 7�i-c)'L> Ir FozimDa'eRetms4rd Rough pu (•�Gl Find ? `� Sigledundat�iel of (" � _ £C/ --- _ Lioai9eNo l / °� > / FIRMNAME ?Q�/ Btsu>es,TeLNa gg 3 d g Z X-77 AItTeLN . �( S OWNER'SINSURANMWAMER,IamawdMAltflMLi wdoesmttOMtbeir>staanoeoMCritssulsurtalaclt>n'a] asm4audbyNhmdmg&G=mlLam andt vlrrrf ratlueatthispenzutapp} rlwdi�thisrac�matgrt (Please check one) Owner Agent Telephone No. PERMIT FEES Signature ot Uwner or Agent Date... N2 2040 ........................ X"'.7 '., TOWN OF NORTH ANDOVER 0- PERMIT FOR WIRING Thiscertifies that ..... . ...................................................................................... has permission to perform- ................................................ wiring in the building of ....... %. ............................................... at //4 ..... /......- 0 ...... A North Andover, Mass. I .... .... .. .. Fee. 1L ..... ...... Lic. No . ..................... ....................................................... ELECTRICAL INSPECTOR Nheck # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 1l1G WIrlir1V1 vrrl;. l 111 L", rltLa ]til llV+JLil ALP DEPARTMENTOFPUBLICS MY Permit No. ? 1-/U BOARD 0FMEPREVE(W0NREGUMTl0ANR7CMR12* UVAA Occupancy &Fees Checked PPLICATIONFOR PERW TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date_ , Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street � Owner or Tenant Owner's Address Is this permit in conjunction with a buildkg permit: Yes �No (Check Appropriate Box) Purpose of Building �P�J�`�GL C 'P Utility Authorization No. 1 Existing Service Amps/ _Volts Overhead 1:3 Underground 1:3 No. of Meters New Service Amps �� Volts Overhead M Underground 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 Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground 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 No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained _ Detection/Sounding Devices LocalMunicipal Other tio:'if Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER histrmtoeCo�aage Pinst>ancbthetegt>aarerts�Getit3-alLaws IhaNeaauutLiabtliiyhtwancePbhLYnitdMCarrpkie Cova'agcriisstilytWeWhdat YES NO a Ihawsubmmmva6dpo0f0fsfne1DtheOffioeYES rJ NO r7 Ifyuhmedrdced YES, pkm thetWofbowagebydcddrgtre appcpd*bCX INSURANCE E]r BOND ODER (Plea9eSpecify) b:piafimD* EAm&dVahredUechicalwark $ *uk t) Stat S Inspection DatReqesled Raul Feral Signedunda'fi of FiRMNAME �c G+ar ;� C�i�r� z� G /r�G �y'1G1��1 L;ceNa % 9 r' Lioasee�1l l/id �/ _ /�/'h�� Sigmae�� Bus¢tessTel.Na F .&h% % .� > i'y!P E L� AI. TU Na lc�t�--36F—y OWNER'S PWRANCEWAIVER, lam awda dAtheU=wdo not ethe itanvet eorilsst>bsoerttralaqxvaiafasre#WbyM%mdmsdtsC,a=JLam acrd � trry sigtrataeon this pearrit t�rfic�ion vvai� this tec�rlaTti (Please check one) Owner Agent Telephone No. PERMIT FEE $�5 - Location �� r `,? S �' ajav-zr L v- No. ) -/S— Date _Z �v 0:'� NORTN TOWN OF NORTH ANDOVER ��.ao ;•q.0 t Certificate of Occupancy $ cMuBuilding/Frame /Frame Permit Fee $ 1 Ss•►sE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 13 7 9 3 ` Building'fnspector APR -27-00 THU 9 - 44 8 . E . Cumm i n-9 s Assoc. i aat ---s P . 01 I CAFR nFlEv or PLAN $X CUMMINGS & AS$001A rES P-0- BOX 007 PLAIMW, AI.�N. 03 8'B rEI EPHON/E (60W48240,05 0106 FAX (600V"3`B,2 A0f6r 5 LOT 6 53,220 SF, aspa p ��fl I' �tH Of MQ SqC ALBERT T TAUpl. Na 36869 a SCALE I " = 60' 0 a�•� � V `fir v �G 1 PP -23 f PP -24 EDGE OF FLAGGED t^ WETLANDS \ l HEROY CER17FY Tp TOWN OF NORTH AwovER, MA eulz J/NG L7EPARTMENT NA T THE 4F.YWING FOUNDA TION DRAWN ON THIS FLAN lS LOCATED AS SHOWN AND THA T /t pOES COMPL Y TD THr MINIMUM 641ILD/NG SETBACKS TO PROPERTY LINES, NN- 1 NN-�o p NN -12 NN C \ NN -13 NN -16 NN -1E ► 82.50' �.. L_53.34 S 17'06'10" W R- I Zu" R - 200 00' L - 14.16' WEBSTER WOODS LANE DA TE: APRIL 25, 2000 MINIMUM SETBACKS., FRow - 30 FEET SIDE - 30 FEET REAR - 30 fEET Location k07 -b 14-joodlS /N• No. l YS-- Date `1/-/3 -Dd 40RTh TOWN OF NORTH ANDOVER O:�t.•° :• 1yo A Certificate of Occupancy $ °s Building/Frame /Frame Permit Fee $ s+CNuse 9 A Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / `1 0 3 13744 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OlYTWO FAMILY DWELLING fair Qf€� Use BUILDING PERMIT NUMBER: DATE ISSUED: e 66t�� SIGNATURE: oie" Building Commissioner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 40 t 1.2 Assessors Map and Parcel Number: X06 163 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: RA 53, dao iS� Zoning District ProposedfJse Lot Area (so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Re red Provided 3Q / � 3 ' 347 301 / 7c) 01 1.7 Water Supply M.G.L:C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone 0 Municipal A� On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSIILP/AUTHORIZED AGENT 2.1 Owner of Record �-- C�7 zw—/ Name (Prin4 Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ a, C Z ss e�`% Licensed Construction Supervisor: C s 0 G y .23 License Number Address s 51Y10 1jJ C) Expiration Date 15-,30 0 Signature Telephone 65-7- X60 3,2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone z M 90 0 r M r r z G) SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 4 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ...... V No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction duExisting Building ❑ ' Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: kzC) Eg" X( -2, sv,7 rte_ (�1 %xl Z et- rSECTION SECTION6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by pennit applicant OFFICUL.USE ONLY 1. Building 2 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) J f7 q, 4 Mechanical (HVAC) 5 Fire Protection ' 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATIO TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf. in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 77b OWNE'RIAAUTHORIZED AGENT DECLARATION I,as (t/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief l� Print Na 3 /V/ 0 Signature of Owner/A e Date / NO. OF STORIES 02 SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS /S/_2NIDr3 SPAN luee 044 DIMENSIONS OF SILLS y DIMENSIONS OF POSTS Y `' 15f e e DIMENSIONS OF GIRDERS 2(, f ,� HEIGHT OF FOUNDATION 7 r d �� THICKNESS d 77 SIZE OF FOOTING X �> MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND Sol- TA IS BUILDING CONNECTED TO NATURAL GAS LINE �S Y FORM U - LOT RELEASE FORM INSTRUCTIONS: This farm 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. PLIC ANT FILLS OUT THIS APPLICANT C /� �Ofr'Sf LL0— PHONE (:j7 -63nc7 LOCATION: Assessor's Nlap Number 106-13 PARCEL SUBDIVISION ci�.�c�/,� �'C7��'S f LOT (S) �P��Pr t,rb1 Lam ST. NUMBER STREET lJ USE R COMMENDATIONS OF TONIN AGENTS: /CONSERVATION ADMINISTRATOR DATE APPROVED `1 COMMENTS 'roe,,�> DATE REJECTED cle^, f--� COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE REJECTED DATE APPROVED DATE REJECTED_ DATE APPROVED DATE REJECTED_ PUBLIC WORKS - SEWER]WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9197 jm DATE The .Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, plass. 02111 Workers' Compensation Insurance Affidavit Name Please Print I Name: Location: City Phone # 0 1 am a homeowner performing all work myself. 7 1 am a sale proprietor and have no one working in any capacity I am an employer providing /workers' compensation for my employees working /conn this job. C 4 �C, �v/L� (`mm�-mrnif / �`�''.S / T/ _�✓7J Address 3% Sv ffor77 S v �' f f- City" k04 �Ylc�oy�� a 0 ies-i5 Phone#"6925) G $ 7-s'30(D Insurance Co U/Ii �'� / �Ci �ir SSS. �� Policy # Al Gil PV_ 2 5</ 3 C/ 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 cf ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the OIA for coverage verification. I do hereby certify under e p iris fp alties of perjury that the information provided above is true and correct. Signature — Date l6X Print name tit Phone # Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensina ❑ Building Dept ❑Check if immediate response is required ❑ licensing Board ❑ Selectman's Office Contact person: Phone 4: El Health Department 0 Other BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: kec N U, 17 1) S -I-,e r f7 1-- -4 16; F 1 C Al Location of Facility SioWermit Applicant -0 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 0 ' � ! � { �� 'COanunzoouuea.`cs� a� i�pFklcac12uJe�J � � ► i DEPARTMENT AF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE j Number: Expires: Birthdate: I CS OWN- 05/09/2000 0510911954 Restricted aiti 00 ALAN G RUSSELL 400 MA IN '$T GROVELAND, NA 01834 f t i I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I 1 Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non -Electric Resistance) DATE: 3-16-2000 DATE OF PLANS: March 6, 2000 TITLE: Lincoln PROJECT INFORMATION: Lot 6 Campbell Forest Subdivision North Andover, Ma. COMPANY INFORMATION: Campbell Forest, LLC / Mesiti Dev. Corp. 231 Sutton Street Suite 2F North Andover, Ma. 01845 COMPLIANCE: PASSES Required UA = 594 Your Home = 591 Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value ------------------------------------------------------------------------------- U -Value UA CEILINGS 1752 30.0 0.0 62 WALLS: Wood Frame, 16" O.C. 2356 11.0 0.0 210 GLAZING: Windows or Doors 542 0.350 190 DOORS 94 0.490 46 FLOORS: Over Unconditioned Space 1752 19.0 0.0 83 HVAC EQUIPMENT: Furnace, 92.0 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/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Lincoln DATE: 3-16-2000 Bldg.I Dept.I Use I I CEILINGS: [ ] I 1. R-30 I Comments/Location I I WALLS: [ l I 1. Wood Frame, 16" O.C., R-11 I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] i 1. U -value: 0.35 i For windows without labeled U -values, describe features: I # Panes Frame Type Thermal Break? ( ] Yes Comments/Location I I DOORS: [ ] I 1. U -value: 0.49 I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 92.0 AFUE or higher I Make and Model Number I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm -in -winter side of all non -vented framed 1 ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can [ ] No 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only) ------------------------- I FROM : MCKENZIE ENGINEERING GROUP,INC PHONE NO. : 6179412662 Mar. 15 2000 11:57AM P2 •r' r, a , 0 r - Lm:53.34' iV If • 7• 1 g TER WOODS !A r NN.. -V 82. NN -19 17 NN -20 — NN -16 NN -21 NN -15 22N NN 1141 WiW NN -1 / NN -9 NN -1 0 MN -13 w 1VN-7NN ialil-12 NN -3, l ! j N-5 � 'yam PP -25 . :. ...:::.... .... ff 1b m 2 7S\ pp— in w ' PP ZN -4 r PP -21 so• / 4,3,5s t R 40, P-20 3 1pF1N�1� l lap's f G � � . 6 P--17 5.3,201 F .-' `� --�lot (CBA X0, 010 S.F. � 'j,", FROM MCKENZIE ENGINEERING GROUP,INC PHONE NO. : 6179412662 Mar. 15 2000 11:57AM P2 7• 8 rER Wooas ! A r NN -19 N-20 -17 I NN- 2t NN -16 ( DO •o! -i f NN -15 f 22NNN 44 tea NN --1 / NN -9 (qN-13 w NN -2 NN -10 0-12 q N-5 / , �4 / l..:r: ..1.:N: PP -25 :.:.,...,:: PP -24 Z PP t 1 "� /11, xe i " N ` C - x z PP -22 \ 1 1- 4 An N w PP -21 'a• 4,5,56 P-20All "P p -16 D 6 lo (CSA T3, 10, . 1X2r•124� � � � Growth Management Bylaw Exemption Statement Town of Nortft Andover Building Department This form shall be used to assist the Building Oepartment in their determination of exemptions under section 8.7.6 of the Town of,Ncrth Andover Growth Management Bylaw. The building applicant shall provide all of the necessar/ information as requested 'below. Name of Applicant on Building Permit (belcw) Address of Property for Fen ,it (below) ad Z/6— Map and Parcel :33 Purpose of Application (check below) Phone Number of Applicant: • _,4 Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit far which this fort is completed does comply with the ECEMP70N section 8.7.6 of the North Andaver Growth Management Bylaw. I also understand providing this farm does not absolve me cr any party to this permit from the requirements of obtaining other permits required prior to the issuance of the �'uiiding Permit. Further I understand that my interpretation of the E <ENIPTiON status is subject to review by the Building Oepartment and is only offically accepted when the Building Permit ig issued. Based an section 8.7,6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement. restoration, or reconstruction of a dwelling in existents as of the effective date of this by-law, provided that no additional residential unit is created. The lat(s) were/was created prior to May 6, 1986 are exempt (ram the provisions of ;his Sec;;cn 9.7 of the Zoning Ty—law. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conaitions of 8.7.6.care met and/or represents Dwelling units for senior residents, where ec=pancy of the units is restricted to senior persons through a property executed and recorded deed restriction running with the land. For purposes of this Section "senior' shall meanpersons over the age of 55. t This application is a part of a development project which voluntarily agreed to a minimum 40". permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable aces and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in ccmmon ownership with an adjacent parcal an the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(Le. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accammodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved forth U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate informat! or checking off of an above item which does not comply, whether done to my knowledge or not, i grounds r refusal by the Building Oepartment to issue a Building Permit. Signature of OwneA=iqzldd' Agent who signed the Attached Building Permit Clate This form must be attached to the Building Permit upon application far such permit TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 DRIVEWAY PERMIT Date: 3 - / 5 - o Telephone (508) 685-0950 Fax(508)688-9573 LOCATION: BUILDER: phone: � OWNER: r 21G �el� o� f Z-�� phone: 6 07- 5 3o The North Andover Superintendent of Highway Utilities & Operations MUST be notified of the grade and set -back from street established in any driveway entry onto any street or way maintained by the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval of such entry. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. Remarks: Approval: N2 954 V APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. Application by the undersigned is hereby made to connect with the town water main in ��e��e/ �/�� G Street, subject to the rules and regulations of the Division of Public Work/s.. j The premises are known as No. �C� Ctir e ✓S�e�c�J�S ( �r� Street or subdivision lot no. Owner Contractor u 1 Wei r c Address Address Applicant's Signature PERMIT TO CONNECT WITH WATER MAIN The Board of Public Works hereby grants permission to to make a connection with the water main at subject to the rules and regulations of the Division of Public Works. Inspected by Date Board of Pu lic Works By 1 See back for rules and regulations 1. e J APPLICATION FOR SEWER SERVICE CONNECTION ��f zn--2c> North Andover, Mass. ko Application by the undersigned is hereby made to connect with the town sewer main in /i(/!?COal�e%(N G�Ci /�t�z� StreeE;- subject to the rules and regulations of the Division of Public Works. / The premises are known as, No. l �� e, "�j " (9oe", za Z-11 Street or subdivision lot no. Owner Contractor Address Address Applicant's Si ature PERMIT TO CONNECT WITH SEMAIN The Division of Public Works hereby grants permission toy "`o�� Z- L G to make a connection with the sewer main at vv ��w�� Z!��Me Street - subject to the rules and regulations of the Division of Public Works.. Inspected by Date /A )Division of Public Works By Gl, See back for rules and regulations ,�� 5" A ow/ I /�,o 7-�,e / �/ �111�W,5 TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 J. William Hmurciak, Director Timothy J. Willett Staff Engineer Telephone (.978) 685-0950 Fax (978) 688-9513 Additional conditions for lots 6, 19, and 22, Campbell Forest March 14, 2000 This Division agrees to sign the Form U, and issue water and sewer permits, for lots 6, 19, and 22 in the Campbell Forest Subdivision subject to the following conditions. We agree to sign the Form U for these lots so that the construction of these three homes can begin at this time. The conditions are as follows. No sewer service shall be installed into either residence until all off site sewer facilities are declared "active" by this Division. These off site sewer facilities include sewer lines and a pump station on Campbell Road, as well as sewer lines and two pump stations on Turnpike Street. At this time, the construction of these items has 'not been completed. No water service shall be installed into either residence until all off site sewer facilities are approved by this office. Any violation of the above conditions will void both water and sewer connection permits. No refunds will be granted. c Mesiti Devt ment Corp 'Printed Name Date Division of P&V P&'Works Printed Na Date CC: Bill Hmurciak Jim Rand Mike McGuire Heidi Griffin FORK J IAT RELEUE The undersigned, being a majority of the Planning soard of the Town at North Andover, Massachusetts, hereby carti:y that: �i. The requirements for tha construction of gays and municipal services called for the Performance Hand or S=ety and dated 19 and/or by the Covenant dated all., 19 and recorded in District Deeds, Book *R30 Page or registered in Land Kegisz_ l District as Document Ne. and noted an Certificata of Title No. i..- RegY$tra tion Boot , ?age has been completed, to the satisfaction of the Planning Bcard to aciequatiaaI serve the enumerated lots shown on Plan entitled " CAuhPil Fore t 0� �+►v+f, +lP Sai�didisiDN Plq& section (s) ')sheets 1 `7 Plar. dated peLerAbe(, q I,9 II recorded by the Essex NQQiS�'r i c�- Registry Of Deeds, Plan Book QK re9l3tcred in said Land Registry District, Plan BooX , Platej27 s4 , and said lots' are hereby re}eased from the t resriction as to sale and ::wilding sped_Fied thereon_ Lots designated on said .Plan as follows: (Lot Nucor (s) and strGet (s)) atMested by a RegLstered Land SUrvevnr) I hereby certify, that lot number (s) 1 >9-w b ( A L.1I��-r..., conform pro layout as zhhowr, on Def in 41 I of 2 on o .lo,os UAxabs� Street (s) da itive Plar. e:�tftled rt Registered Land Surrievor H OF �qx s ALBERT T TRUOEL o No.3888fl 0 /STE ON�� LANd S� R,E;Corjj J- 1 n - . neb /1 C. The Town, of wort -11 Andaver, a municipal corporation situated in the Cou:zty of Essex, ro=onWea2t?i of Massachusetts, acting by its duly organized Planning Board, holder of a Performance Bond or Surety dated , 19 , and/or Covenant dated 19 from of tele City/Town, of County, Massachusetts recorded with the District Deeds, Book , Page or eaistered in Land Registry District as Document No. and noted on Certi!icate of Title No. Registration took,' , acknowledges satisfaction of the ter - thereof and hereby releases its right, title and interest in the lots designated on said Play, as follows: 41LI FMC=ED as a sealed instrument this /'7 day of Haj ority of the Pla: ninq .1Board of the Towle of North Andover /1 CobQYQIMXLTB k OF HA58ACHt15ETTS C 19 Then ersonnliy appeared �l (O�1YlJI�.? 2c1�(',� �( �, one D4 the abeve P members of the PIahning -Bcard of the Town of North Andover, Massachusetts and acknowledged the fcregoing instrument to be the free aqt and deed of said Planning Board, befo_e me. Notary Publiq MyjCommissioc� Exnire.s G 2 of 2 4 m x n O Zr O c z v 0 z z 0 aj-I Ln m _< O �. W ❑ ❑ n -1 Z o 0aj , rr ? 41 rt F � �� o 0 m W 3_ c z "M r' Q EcQ M ET m O -V r D m fD - a =� cr a� m Lo n cC �z C a� Ln (� n. 0 V" n❑ y z E N cr F;pz r. 01 0 _:r N E c� a 3 o 4 m x n O Zr O c z v 0 z z 0 y �z o� �z x 4 m x n O Zr O c z v 0 z z 0 m m C/) cn0 m d CA Cl) 10 0 CD n Z y CD O CL r c') d = y O C.) c o CD CDCL o CD CCD O CD C ww CD y� CL = y o to CD S v CO) O CD Z C) O CD 0 CD F CO ?� O �0 = �1 CD -• N C CT CO) FL- Co N C7 CL L C7 m m =rCD O C CL C '?7 =r Cl ?d = CCA CD --4O m y p _ O �_ O m _ CD CD .0 M, . co H a a cc C � H PCJ Om d CA Cl) 10 0 CD n Z y CD O CL r c') d = y O C.) c o CD CDCL o CD CCD O CD C ww CD y� CL = y o to CD S v CO) O CD Z C) O CD 0 CD F CO ?� O �0 = �1 CD -• N C CT CO) FL- Co N C7 CL L C7 m m =rCD O C CL C '?7 =r Cl ?d = CCA CD --4O m y p _ O �_ O m _ CD CD .0 _o n H 3. CD -�0 1 m m m O� to co c vCA: o. O C_3 Wim: cn '� �=► = m to CD 0 0 03 m ca o .+ COO co Cr1 a a cc CL C3 H PCJ Om CD to cCD 7 C'M 0 CD n to H N G Q z _ _o n H 3. CD -�0 1 m m m O� to co c vCA: o. O C_3 Wim: cn '� �=► = m to CD 0 0 03 m ca o .+ M 0=3 0 0 c co -n �z � � In PCJ 0 ^G 0 z O G W O w O G n w O G r O G r O G CL W W r 0 ti " C/) rD O O a x ::r etc o x M 0=3 0 0 c 4 CERTIFICATE OF USE & OCCUPANCY ` Town of North Andover Building Permit Number / A THIS CERTIFIES THAT Date �` �0 & 0 THE BUILDING LOCATED ON J 61L W 4 6l _eg U)mis MAY BE OCCUPIED AS 11i i / IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO p ADDRESS 3-3v SGAV/ :S-�- C- Building Inspector e f i r�- 0 ra, W--c=r O cr w CD COD fm F =0CL 0 — C2 CL. C2 m C** ® z =r -o CD T. =r CL CL m CD 0 2r 0 CD CA CD 0 'TA =r CD CD a o 0 z•Cc) 0 ca rj aa' CD =r ="c CA OCO CL c =r Er CD - CD r.. C A CD 'm c P4 ® N cr CLW * ccl K" = %.0 CL CL CO) c 0 go Ii. CCD z CO2 CO) CD : Ra � � IC03 =r CD - (A CD in , JE cn cn CD !I; F 1 c D Rr INU C* O co K: R< cn cn 0 N- 10 n z 071 0 tz Cos M CD a Z CA CD CL0 I- tz tz cf) CL z m m M C2 m CD < m CD m C/) CL cr =r m %gc CD Cf) 0 CD m CC) w y■ s CD CL a) CD CO2 to CD S7 CO) "0 CD z CD CD W--c=r O cr w CD COD fm F =0CL 0 — C2 CL. C2 m C** ® z =r -o CD T. =r CL CL m CD 0 2r 0 CD CA CD 0 'TA =r CD CD a o 0 z•Cc) 0 ca rj aa' CD =r ="c CA OCO CL c =r Er CD - CD r.. C A CD 'm c P4 ® N cr CLW * ccl K" = %.0 CL CL CO) c 0 go Ii. CCD z CO2 CO) CD : Ra � � IC03 =r CD - (A CD in , JE cn cn CD !I; F 1 c D Rr INU C* O co K: R< cn cn 0 N- Groq n z 071 0 tz M C) tz tz tz z Cc) IF, r Town of North Andover NORTN _ o .1 LED , Building Department o= 27 Charles Street p North Andover, Massachusetts 01845 4 (978) 688-9545 ` Fax (978) 688-9542 C OC MIC MCWK• p�R�reo �PPy,,�5 �SSACHUS�� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 115 w o Js C —jft ee LOT NUMBER SUBDIVISION DATE REQUEST FILED /// yle d DATE READY FOR INSPECTION �Iaa0 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 FEEP.NTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STWCTUR>z DOES T MEET ALL APPLICABLE CODES. SIGNATURE ROUTING �r CONSERVATIO f' DATE ed PLANNING. / DATE L D.P.W. — WA' 6e T.TU) DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE D AUTHORIZATION Mesiti Dev Group Fax:978-5578160 Jul 17 2000 13:54 P.01 TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 Mr. Kenneth. Grandsta.ff, President Mesio Development Group 231 Sutton St. Suite 2 F North Andover, Ma. 01845 Telephone (978) .685-0950 Far(978)OM-9573 July 14, 2000 Re: Conditional Operation of the Campbell Forest Sewer Pumping Station. Dear Mr. Grandstaff- The Division of Public Works has inspected the sewer collection system and sewer pumping station, and appurtances on Campbell Road related to the construction of the Campbell Forest and Lyons Way subdivisions. We hereby grant conditional approval for use of the system and pumping station subject to the following: 1. Completion of items 1 through 15 as listed on the July 10, 2000 letter to Mr Dennis Bedrosian from Maurice Harpin of Mesiti Development Group, a copy of which is attached. The work will be completed within 45 days of acknowledgement of the receipt of this letter. 2. Satisfactory completion of an as -built plan for the Campbell Road sewerage system. 3. Submittal for our review and approval a copy of the preventive maintenance contract for the pumping station. 4. A performance guarantee shall be provided in the amount of $25,000.00 to insure the proper maintenance and operation of the pumping station. 5. The Division of Public Works will be allowed access to the Pumping Station and will be allowed to reconstruct, repair, replace, add to, service, inspect and operate the pumping station and related equipment. and facilities in the event that Mesiti Development or its agents fad to adequately perform maintenance of the pumping station. n f J 5 Mesiti Dev Group Fax:978-5578160 Jul 17 2000 13:54 P.02 r R 6. Mesiti development shall reimburse the Town upon demand for the reasonable costs ofemer envy repairs to the Pumping Station. g �P 7. Mesiti Development Group and its successors or assigns shall indemnify, defend, and save harmless the Town of North Andover and its Division of Public Works and their respective employees, officials and agents against all suits, claims, judgments or liability of every name and nature arising at any time out of or in consequence of the acts of the "Town" or its agents, employees and officials in the performance of the access purposes covered by this grant of conditional use or the Emla a of the developer and its successors or assigns to comply with the terms and conditions of this grant. Very T . ours, J.Williiffn Hmurc' .E t. Director of Public Works The undersigned acknowledge the receipt of and agrees to the terms and conditions of the above grant of nditional use. a up _.Y K eth "-had Mident Date: