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HomeMy WebLinkAboutMiscellaneous - 12 NANTUCKET DRIVE 4/30/2018 ll� N � , I a `. �// S f 1 I� �i it I 1 i f �� Town of North Andover tkoRTH O �i�eo Building Department �� y�:, �..'6 °o 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 iy M O ..� . . 'pq COCMC WKM`y 7 �R�Tto 1PP '(5 �SSACHU$ APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS y 2 It ci I r- LOT NUMBER / SUBDIVISION DATE REQUEST FILED _ S 12;2_ /V 3 DATE READY FOR INSPECTION �/o? Z IQ TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER MET19k ATE D.P.W. UST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P TA INSPECTIOAREST DATE. IGN TURF/ UT ORIZATION r _ Safety insurance 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: THOMAS K YAMEEN and KATHLEEN M BRENNAN Property Address: 12 NANTUCKET DRIVE,NORTH ANDOVER, MA Policy Number: HMA 0105541 Claim Number: BOS00037351 Date of Loss: 4/29/2013 Company: Safety 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. Gena Laws, Chapter 139, Section 313 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 5/16/2013 Safety Insurance Company Homeowners Claims Unit P. 0. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 j Fax: (617) 531-8891 Email: AllanLeavitt@Safetylnsurance.com N° 3 3 , 6 Date.......... ................... i f NORTH 1 ?°•t�``°- "� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING �,SSACMUS�S �' This certifies that .....'.. � has permission to perform � "�� � wiring in the building of........................................................................ at l/. '``.............f.Y::.:.-�- ... �'� �_/.........North Andover,Mass. Fee.�. . ....... Lic.No. '............................................................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Date....d..i<�:. - °f�"`° '��"° TOWN OF NORTH ANDOVER °L p PERMIT FOR WIRING �,SSACsm CThis certifies that ...... A.I..........��"��•����..7Z.. has permission to perform ..........?.en.d.-.Z.77*..... ! ............ wiring in the building of....... ................................................. �'. at.......... ,.!?✓ -.?. ,North Andover,Mass. 1.. -........ k t Fee..`.--lr...�r..�':. Lic.No..? .......... .:..........u,...........��" ........... , ELECTRICAL NskCTOR� Check # . 6994 a. Commonwealth of Massachusetts UI'ticini Use Only Q1 Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Ray.9rosl cleatve hlnnkl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORM All work to he perlbrmod in accordance arida the tvlassachuscus Electrical Code(&-113Q.527 C�iMR 1''.011 (PLEASE PRIrVT LV WK OR TYPE ALL ItVFORM.471UN) Date: �U' `�—� 6a j Cih' or Town of: �/>�,?Z /� 1 -�G. To the laypector gl'6Virtt.�: j By^this applicltion the undersigned saves notice o'his or her tntentton to perform the electrical %vork described below. Location (Street & Number) , Owner or Tenant s Telephone N�.�i' Owner's Address Is this permit in conjunction with 11 building permit" Yes..❑ No (Check Approprintc Box) Purpose of BuildingUtility Authorization No. ExistinService Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters g New co _ Amps ! Volts Overhead❑ Undgrd ❑ No. of mete,. Number of.Feeders and Ampa city Location and Nature of Proposed Electrical Work: Completion ol'the following table may be waiyed by the inspector plWires. o.Of ota No.-of-Recessed Luminalres No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No: of Luminaire Outlets No. of Hot Tubs Generators KVA Above n- Mo. of Emergehey l;ag a ung No. of Luminaires Swimming Pool rnd. ❑ rad. ❑ Battery Units 4 No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No, of Zones o.or Detection an No. of Switches No. of. Burners Initiating Devices Na. of Ranges No.of Air Cond. Tons Total No. of Alerting Devices eat Pump m_ uer ons o No. of Waists Disposers , of-Sell-Contained p Totals:r,*-'*-**'- •""_'......w.� _ ' Detection/Alertin Devices No. of Dishwashers Space/Areas Heating KW kcal❑ Conne tion Q Other Heating Appliances Kit Security Systems:* No. of Dryers No.of Devices or Equivalent No. of Water No. o! o.o Data Wiring: KW Ballasts alent 'o No.of Devices or E ury Heaters Signs No. Hydromassage Bathtubs No. of Motors Total HP e ecommun cottons tang: No.of Devices or Ecluivnlent OTHER: /Cj �— o� 40`35 - Ittach ud(litinual detail it clusired, or as required by the InSm,rtur uJ 11'u es. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: s)(9 fns ections to be requested in accordance with NIEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent, The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND C] _ OTHER ❑ (Specify:) I certify, trtrrler t/rr!ptrin•s torr!petu�llic;c of perjury, that the ittfnrnurtiutl nor tlrlr anplierttiurr is truer and complele. FiRM NAME: ADT Security Se vices, Inc. LIC. NO.: l i33 C License • Signator .. LIC. NO.:�f oZ6.j:;? Oappticab(r,enter exampl-in dtic�Ncciise nainisc�r line.! Bus.Tel. No.:�12�-'t��-SQnn Address: 18 Clinton Drive Hollis N H 03049 _ Alt.Tet. No.: 603-594.593(l ''Security System Contractor License required for this work;if applicable,enter the license number OWNER'S INSURANCE WAIVER: I am aware that the Licensee dues not huve the liability insurance coverage normally required by law. By my signature below, i hereby waive this requirement. 1 am the(check one)❑owner ❑owner's anent,. Owner/Agent 4R/Yl1-7'.FEE: s, r. T,•1„nhnnr Nn i Il7MCl1M1TLflYI'Ul''1'Ulil.(i.J9l'�tY PernritNa BQ4RD0FMffPRE1 04WREGUL4nWWC 2nW Occupancy tit Foes Checked .,.%-6 �L 2:42 t Cic 0 /IfS APPLICA,TIONFOR PERMIT TO PERFORMELECTRICAL WORK ALL w=TOBE PlBiFaww m AO xwmNm vm Ili$MASSACHUSSTS BIECPRICAL CoDE,Sty 0a 12.00 / O/ (PLEASE PRINT IN INK OR TYPE ALL.INFORMATION) Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work descnW below. Loc�tiott(5tnaet&Ntmtber) F0)• Lriy& ' r i Owner or Tenant 4p r d Owner's Address Nb&CC /PCG d h7 Is this permit in conjunction with a building permit: Yes NoCD (Check Appropriate Box) PurposeofBuildingMpLB� I/A/7S Utility Authorization No. �w Existing Service "Ampss Volts -Overhead Underground IM No.of Meters Ne►�r She ' ,QAmPS Vo*J) Overfiead Q Und nd No.of Meters I Number of Feeders and Ampacky Location and Nature of Proposed Electrical Work" a;r'C Z !//V rCom..MJS# E. CTO S No.of Lighting Outlets O Ne.of Hct Tubs No.of Traneforoters TOW KVA No.of L Oft Fixtures Swimmingpool Above Below Geonawm KVA voted uod No.of ReteOwle Owlets �.� Na ofoll Bumers Na of Busu arty Lighting Battery Unft Na orswitch outlets Na ofoas.Bumers No.of Raps Na of Air Conti P Total / FIRE ALARMS Na of Zones Tons Na of Disposals No.of Hem Tata) Total No.of Detection and PUMPS Tori KW liddating Devieea Na of Dish washers Space Area Hewing KW No.of sotwing Devices Na ofSol(Cartained Deteoanding Devices -Na of Dryers Heating Devices Kw Local MmcVd Other Connection Na of Water Heaters Kw Na of No.of _ silo i Minds o.Hydro Massage Tubsg No of Motors Total HP ol �I InautrtoeCb►�Rtatlnttbtte�gtiternar$atM�dttae�C�Laws Iha�eaaaat ' lnaltenos ' ��� YIDS ND I11"sv6tttam,- 5dptaef%fsetnebdwOBx YES ND I3ahenetiladaatlYMpbwu ic*um;t zcfmaa@ ydKb gdm ibK r QVWRANCEE rV1 BMD ono ,��►,�, �h avwo�s i WakWwt G I7apaA D*RegteW: Rpt FkW . i' ,SHF N TCT �9C S�� 6Go Liost�eNa lr}/l St FIRMNAM ...�.�......�...�...� LiWWM Bttsluer T&Na X18-OZ•�"7 0WITRSVs61JRANMW fief>almooeao eaia a tt adbyMa Gm�Iaws eadmemnlrs teangesp p�6rnvta sth'sreq neat (Pie=dteck ante) Owner ® Agent Q _ Telepbone No PERMIT FEE$-6:29 44 %2 !a t'60Jig Location ��� �� No. .3 Date �ORT� TOWN OF NORTH ANDOVER • i Certificate of Occupancy $ Building/Frame Permit Fee $ 3 CHUSE s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 14 & 9 4 Building Inspector Je�,in l a q l q%-Z43 j ss v �- a s -a s- "' ANDD VER STREET ,4o v%;,, 4 ( PUBLIC 60' WIDE ) Z W N Nlf WTHOMAS A & �� W TERCSA MAHONEY = W LOT / I Z Q o q I'- 136.12' - � 19.6 0 o 14.0'0 016.0: p�\� o � o 30.8' 25.6' m �� In N 7.0' S �. ., OP p n,) 00 1.0'3.0' EXISTING FOUNDATION M �� 1.0' TOP OF FOUNDATION=229.37' Cn O o 7.0' 25.6 !� N ' o . 35.6' 0 RIE HILL LOT# J,j 14.D' 16.D'^ N�f THOMAS G. 09=1,3,602 f S.F. 19.5' - 136.10' -. N/f THOMAS C. & MARIE HILL Nlf EDWARD G & � MA/LNOT LOT/ 11 JOAN F. hCHAITON A f1f EL LORETTA JO BAITAGLIA I HEREBY ERTIFY THAT THE FOUNDATION ON LOT 13 IS LOCATED-,AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE ZONING -LAW OF THE TOWN OF NORTH NDOVER. \gN OF �q GREGORY, yG PROFES ONL N SURVEYOR g R. CORCORAN Eg 1' No. 3803A DATE:........6. ... j CERTIFIED PLOT DA KINE, Inc. Consu wi meers &land Surveyors PLAN OF LAND IN 1215 MAIN STREET o UNIT 111 TEVKSBURY, MASSACHUSETTS 01876 N.ANDOVER, MASSACHUSETTS PREPARED FOR: CORMIER-ANDOVER CONSTRUCTION CORP. CHATHAM CROSSING 59 CHANDLER CIRCLE ANDOVER, MASSACHUSETTS SCALE: 1"=40' DATE: JUNE 26, 2001 JOB N0.51165-13 FSHEET 1 OF 1 COPYRIGHT 0 2001 BY DANA F. PERKINS, r,c. Location ki/3 ,v 4 t. No. 6-;)Y3 Date S-30-01 �oRTM TOWN OF NORTH ANDOVER 3? � • 0 � 9 Certificate of Occupancy $ Buildin`/ game Permit Fee $ ss� EcNus 9 5' ... Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ��7- 14 U", 6 0 r / Building Inspector Co- TOWN OF NORTH ANDOVER A - BUILDING DEPARTMENT 4#1 4 NA001001* � APPLICATION TO CONSTRUCT REPAIR,RENOVAT5 OR DEMOLISH A ONE.OR TWO FAMILY DWELLINGMEN g s BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: e LO Building Commissioner/Ipgector of BuildinE Date I ■ SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �2 N4,yrv - !� 2 - Qj c�cj' Map Number f Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Gk,- Zoning District Proposea Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.G L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Zone Outside Flood Zone Municipal - On Site Disposal System ❑ Public Private ❑ _j SEC I 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M PI 2.1 Ow r f Record Name(Print) Ad cess for Service: Signature � Telephone 2.2 Owner of Record: C Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 LiceyV Construction Supervisor: Not Applicable ❑ ,¢ ln.a 14 Licensed Construction Supervisor: License Number � !Ad6e'ss r r D o 12 �e�17a -1 Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable Company Name Registration Number r Address e� Expiration Date Si nature Telephone SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Lnsurance affidavit must be completed and submitted with this application. Failure to provide this affidavit wig result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Description of Proposed Work check all a licable New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 0-�,e 3 �2 2or SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be k Completed by perntit a licant r 1. Building 2 (a) Building Permit Fee OD Multiplier 2 Electrical (b) Estimated Total Cost of l D CP 0 Construction 3 Plumbing 0 0 Building Permit fee(a)X (b) 4 Mechanical HVAC %�j 12, 5 Fire Protection 6 Total 1+2+3+4+5 p 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 WNER/AUTHORIZED AGENT DECLARATION 1, ,as Owner/Authorized Agent of subject property Herebv declare that a ements an formati on the foregoing ap lication are ie and accurate,to the best of my knowledge and belief Print Name Sig naturef Owner/A ent Y Date NORIES SIZE CrAMMENTPbR SLAB SIZE OF FLOOR TMOERS / 1 s 2 RD s 3 SPAN DEVIENSIONS OF SILLS Z DUB ENSIONS OF POSTS DBENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDANEY c. IS BUILDING ON&ZWOR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a The Commonwealth of Massachusetts .Department of Industrial Accidents Investigations of Investi Office g Boston, Mass. 02111 f}�M SVe�� Workers'Compensation Insurance Affidavit Name Please Print Na-mw�I Location: /2 14"' Clty Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers compensate n for my employees working on this job. Company low- name: Address City �� Gr !�' ", Phone#• Insurance v Com an .name: Ir :�I Address City Phone#: i Poliev# Insurance Co 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 penaities.!nAheform d a-STOP__WORK_ORDFR..and_.sfine of(.$1.00.00)-asiay.againstme. 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 pai d res of perjury th a inf rm ion proved correct. I Signature .--- Date Print name fL Phone# Official use only do not write in this area to be completed-by city or town official' City or Town Permit/Licensing _ ❑ Building p ildin Dept []Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office :i Contact person: Phone#: ❑ Health Department ❑ Other {i t �I k+ 7 - 7 7- - ..-�.._._...�.�_._........�......_..._�_.. ..,�_ -. ,. .i i Town of North Andover �� t%QRgHF+ 4tt.70 Igo �o Building Department 0 27 Charles Street _ North Andover,Massachusetts 01845 m•~ (978)688-9545 Fax(978) 688-9542 •t,�Ao44TED ACHU i DEBRIS DISPOSAL FORM I 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 MGL cl 1, s150a. The debris will be disposed of in/at: -4"Ie- Facility location I i ign a of Aip)p1locant 0 I Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. G d GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVER BUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw.The applicant shall provide all of the necessary information as requested below. —� ,� 12, 4 Weha-12d" 4�7 PApplicant Property Yaddress Map/Parcel f7� Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 ofthe Growth Management Bylaw.I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required-prior to the issuance of the building permit.Further 1 understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building permit application and associated attachments,complies with one or more of the following sections as indicated by a check mark. This is an application for building permit for the enlargement,restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw,provided that no additional residential unit is created. The lot(s)was/were created prior to May 6, 1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be reserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER 1 UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKING OFF OF A AB� ION CH DOES NOTCOMP ' WHETHER DONE TO MY KNOWLEDGE OR NOT IS GROUNDS F AL BY T ING DEP TO ISSUE A BUILDING P APPLI ANTS SIGN DATEPo' THIS FORM TOATTACHED THE BUILDING PERMIT APPLICATION � � I DPW 350 o � TOWN OF NOi * 9 y. RECEIPT S`sACHUS�t This certifies that... •�V . . ............................. has paid........................ C 6� ............. .®.C�. ........................... for.. X•• .C...f o� y............................. ... Received by............................!..l . (.�/T f.1 1 c Department ....................... . 4`lam .............................................. WHITE: Applicant CANARY:Department PINK:Treasurer DPW 3 51 Date ......P45..1.11'r�........ O�NORT/r,� 3� °oma TOWN OF NORTH ANDOVER RECEIPT SSgCHUs� Cap-At This certifies that.../" . ..... haspaid... ................. .1.. ®...4� ........................................... rl for ......SaA ' Cg Received by................................ . t.. :.. ....... L ...................... Department...................... !: 1.[.�i....... o ................ WHITE: Applicant CANARY:Department PINK:Treasurer k � i s 6a r xFl Nw S rn. • -' ' � wAPPLICATION FOREWATER SERVICE.CONNECTION ,' , ;` .. + s. ,4, { 1 � r :� Cq j'1k 7 ¥c ;�7tp North Andover;"mAss ' Application by the undersigned is hereby'made to connect witliahe town water Ma • (� '-# a , treet; �; < . Y subject to the rules-and regulation's of th_•�e Division, of Public Woks r�:wk `�"�"'e� c_�)#� x� [ 4 7f' The remises are known a's No api Street _j, f•sn i i[bt "'ri''+ -� s t3/t ,art sE or subdivision lot no k s3 s + }. i "$ °t4E'` ° + > x '•" .e' $�}" �1 u: .'-� ¢ ,moi c :..,§r 4 •� 3 a; r L Co-rifracto m <r, .,. a A licant' s. PP gnature y; U PERMIT rT0 CONNECT WITH, WATER MAIN t The Board of Public Works.hereby grantsa:permisson tom o,rrtiakea connection with,thewater main at Street a ." subject to tte rules and regulations of the Division. of Public'Woks �� yt xP +u, �-� yZ, -Board of Public.Works 3 � 'rt • �' p�`� By;3 1nspected.,by N' ^ 2n• 5 k Iq Date �� � a �:, �-: e r .�� ���` � I �,., r== q,:. � f � *. t i z� ¢• kt v "� See back for rules and regulatioris F x q `v/ Nry i t i 1 669 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. 49� — Application by the undersigned is hereby made to connect with the town sewer main in Street, subject to the rules and regulations of the Division of Public Works. n The premises are known as No. _ Street or subdivision lot no. t 2 'Eau C�r c rSGL lie . Owner Address Contractor Address v Applicant's nature t. .r R PERMIT TO CONNECT WITH S WER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at A/"44 � Street subject to the rules and regulations of the Division of Public Works.. Division of Public Works a By G' Inspected by Date See back for rules and regulations 1 f TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. DIRECTOR Telephone(978)685-085C, NORTh Fax(978)688-9573 0 616 tt lf0 y q�O C G A Ic - 9q f �9SSACNUSE��� v. i.Jb DRIVEWAY PERMITS DATE 1r Zp©I LOCATION k Z-( :,. . 1d AtJ i` 0:c�E-� BUILDER hone ---------------- OWNER (Z�l� Cdrm E1'z phone THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. ORTp AUTOMATIC LAWN IRRIGATION SYSTEM PERMIT i OF�t�ao .a1tip F ` p TOWN OF NORTH ANDOVER IL MASSACHUSETTS Too sgCHU �y . ALL INFORMATION MUST BE PROVIDED,BY A LICENSED PLUMBER, PRINTED IN INK AND LEGIBLE.IF NOT THE PERMIT WILL BE REJECTED. DATE: LOT#: 1� LOCATION: 12-- 1 5i ,��/✓ NUMBER STREET NAME BUILDER: NAME TELEPHONE NUMBER STREET NAME TOWN/CITY&STATE OWNER: NAME TELEPHONE NUMBER' = STREET NAME TOWN/CITY&STATE PLUMBER: NAME 'TELEPHONE NUMBER STREET NAME TOWN/CITY&STATE LICENSE NO. EXPIRATION DATE: SERIAL NO. IRRIGATION INSTALLER IF NOT THE PLUMBER INSTALLER: COMPANY TELEPHONE NUMBER STREET NAME TOWN/CITY&-STATE INDIVIDUAL NAME TELEPHONE The plumber,must install the connection to the municipal water supply within the building,the water line to the outside of the building and the backflow device. A registered irrigation installer may then install the balance of the Automatic Lawn Irrigation system. NO irrigation heads will be allowed in the right of way(near edge of pavement).ALL irrigation heads MUST be at or behind the property line.All heads installed in the right of way will be removed immediately upon notification and said plumber or installer will not be allowed to perform any future work on the municipal water'supply, until,the heads are removed from the right of way. Sign below that you have read this paragraph and understand it. SIGNATURE OF PLUMBER DATE THIS PERMIT MUST BE POSTED AT THE CONNECTION/METER LOCATION FOR THE INSPECTOR. INSIDE CONNECTION METER(IF APPLICABLE) BACKFLOW DEVICE RAIN SENSING DEVICE COMMENTS RTI-► Town o _ �...: Andover No. ~ cM 3 - C% No dover, Mass., d/ 0 LAKE co MI C HEWICK V� ADRATED p`Q�,`�5 SSACHUS� FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ....CO.............1*.................�..................................................................... .... ... has permission to excavate and pour foundation at ....4.4 r �aI.o� �'��� for the purpose of...�........•.......mom 7.. A... ��.�.��.�'����..��.,�i�•....,�s1� The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. 1� Y/' 1013 VIOLATION of the.Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UN ESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. F)s. BUILDING INSPECTOR NIRT, E Town of over VFW No. c2 �o�A CoCL dover, Mass., �'�S 'A Od� ORATED H BOARD OF HEALTH Food/Kitchen Septic System PERMIT. . T .. D 'V� I"I'er �,�• �� - BUILDING INSPECTOR THIS CERTIFIES THAT.... ..... A.... ............... ..................... .................................. ......... ...... Foundation 70"ok4l has permission to erect............. ...................... buildings on .. ......... ...... • Rough • �� .�� / v �� 4�wh ,Chimney to be occupied as.6.r...�•�:.��... .s: �i�.:. .. ...�........................... � ... ... ......... .. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Ins ctio Alteration and Construction of Buildings in the Town of North Andover. V 4 /' X PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS 11 1 M464 � Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR �� -I .... Rough' BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in .a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. F0R1dI - U - LOQ' RELEASE FORM F -INSTRUCTIONS. This corm is used to verify that all-necessary approval/permits from Boards and Departments havin�jurisdiction have been obtained. This does not relieve the applicant and or landowner fifom compliance with any applicable requirements. ■■�Y■■■■■rr ■ r■rrr.■■0rr■■■■■r■■■■r■■■ APPLICANT f" ���' PHONE ASSESSORS�1!�AP NUMBER� LOT NUMBER SUBDMSIOIV������� z!�O 3 Yw LOT NUMBER �3 STREET / A� mKh-e STREET NUMBER -)2 �rrrr■r■rr�,rrr■-r■■rr----- rrr■rr■■■■■■■■■■■■■rr■■rr■rr■■r■�rrrr„rrrrrrr■ OFFICIAL USE ONLY ori■■.■■r■■■■■rONE MEMO■r■■rrr■'r,r„■■■■■■■■■■■■■,rr■,rrr■r■,■■,rr.■■■.■...■■■ OMAIENDATTONS OF TOWN AGENTS r'rr ......, r■ ■■r■■r■rrr■r■■■,rr■■■■■■■■■■rr,r■■■■rrrr■■■■■�',r■ ■■.■■.■.■■ DATE APPROVED 4 CONSERVATION ADMINISTRATOR DATE REJECTED CONflA NTS I v Az- h' In t O DATE APPROVED TO DATE REJECTED CONRVIENIS DATE APPROVED -- - :OOD INSPECTOR DATE REJECTED DATE APPROVED C IN CTO - TH DATE REJECTED COMMENTS 5i� PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT • ATE APPROVED Q FIRE15EPARTMENT DATE REJECTED COMMENTS RECENED BY BUILDING INSPECTOR. DATE 9 � II III ob O f �I 99.87' LOT 13 FN11f 1 13,602 sq. fl N/F R. CORMIER 1LOT / 12 19 6' 19.6' Proposed Proposed Unit Unit i rn FF=229.0 FF=229.0 IV 1 #300 GF= GF= 226.0 226.0 0 N QLnW 6�► Q CL 1 1 0.00' 1 'S s EDGE OF PAVEMENT ,, " C.L. I. WATER m 8" PVC 5+ © s• NANTUCKET 5' Z DRIVE � � ��P��N OF MASS9 O 5 Q' WIDE ) I zz Q, DOUGLAS E. 'yc � o o LEES = J v L F— � U =O .493 O O U T 4 DRAINAGE EASEMENT PROPOSED PLOT PLAN DANA F. PERKINS, ino. Consulting Engineers & Land Surveyors 1215 MAIN STREET a UNIT 111 LOT 1 3 TEWKSBURY, MASSACHUSETTS 01876 CHATHAM CROSSING PREPARED FOR: RAY CORMIER NORTH ANDOVER MASS. 59 CHANDLER CIRCLE ANDOVER, MA, SCALE: 1"=40' DATE: MAY 3,2001 JOEL NO.51165 SHEET 1 OF 1 COPYRIGHT 0 2001 BY DANA F. PERKINS, Inc. AScheck COMPLIANCE REPORT assachusetts Energy Code Permit # AScheck Software Version 2. 0 Checked by/Date ITY: Lawrence TATE: 5 (-(/�Massachusetts DD: 62 J "' �3 /flr JCdj,e ONSTRUCTION TYPE: 1 or 2 family, detached EATING SYSTEM TYPE: Other (Non-Electric Resistance) ATE: 5-16-2001 ATE OF PLANS : 5-11-01 ITLE: CONDOMINIUM ROJECT INFORMATION: AY CORMIER OT 13 ANTUCKET DRIVE OMPLIANCE: PASSES , equired UA = 268 our Horne = 263 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------7----------------------- EILINGS 1132 38 . 0 0 .0 34 ALLS : Wood Frame, 16" O.C. 989 19 . 0 3 . 0 53 LAZING: Windows or Doors 185 0 .350 65 LAZING: Skylights 35 0 .410 14 OORS 21 0 .350 7 OORS 84 0 .350 29 LOORS : Over Unconditioned Space 1282 19 . 0 61 VAC EFFICIENCY: Furnace, 83 .0 AFUE -------I---------------------------------------------------------------------- OMPLIANCE STATEMENT: The proposed building design represented in these .ocuments is consistent with the building plans, specifications, and other alculations submitted with the permit application. The proposed building .as been designed to meet the requirements of the Massachusetts Ene'r-gy Code. 'he heating load for this building, and the cooling load if appropriate .as been determined using the applicable Standard Design Conditions found n the Code . The HVAC equipmen.- cted to heat or coo e building hall be no greater than -2�° of n to d cified in ections 78DCMR 1310 uilder/Designer Date AScheck INSPECTION CHECKLIST assachusetts Energy Code AScheck Software Version 2 .0 ONDOMINIUM ATE: 5-16-2001 ldg. ept. se CEILINGS : ] 1. R-38 Comments/Location WALLS : ] 1 . Wood Frame, 16" O.C. , R-19 + R-3 Comments/Location WINDOWS AND GLASS DOORS : 1 . U-value : 0 .35 For windows without labeled U-values, describe features: # Panes-. Frame Type Thermal Break? { ] Yes { ] No Comments/Location SKYLIGHTS : ] 1 . U-value: 0 ..41 For skylights without labeled U-values, describe features: # Panes Frame 'Type -Thermal Break? { ] Yes. { ] No- Comments/Location DOORS : ] 1 . U-value: 0 .35 Comments/Location ] 2 . U-value: 0 .35 Comments/Location FLOORS.: Over Unconditioned Space, R-.19 Comments/Location HVAC EQUIPMENT EFFICIENCY: ] 1 . Furnace, 83 . 0 AFUE or higher Make and Model Number THERMOSTATS : ] Adjustable thermostats required for each HVAC system. AIR LEAKAGE-- Joints, EAKAGE:Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations- or installed inside an_ appropria-te air-tight assembly with. a 0 .5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors . MATERIALS IDENTIFICATION: rZ 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. in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to .R-B.D . DUCT CONSTRUCTION: l All ducts must be sealed with mastic and fibrous backing tape . Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems__ TEMPERATURE CONTROLS: l Thermostats are required for Each separate HVAC system. A .-manual or automatic -means to partially restrict or shut off the heating --arn /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 . MISC REQUIREMENTS : l Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ---N OTES TO FIELD (Building Department Use Only) ------------------------- C n ' OF µOR rH 9ti y9 TSNCNU°+ESS r CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number c�2 V3 Date-6`c9 3 r HIS CERTIFIES THAT THE BUILDING LOCATED ON 3 Ak IVA A)f V C Ie- MAY BE OCCUPIED AS �'� 07 �J� 13F!`f�l > o� �/P1-e y -mow -e !f All IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. , CERTIFICATE ISSUED TO Co^ m ,P r-\ Alv�^D Vu'e2 6--4,S4' Building Inspector NORTH ® over No. _ o�A �oC�,� ,� over, Mass., ORATED pC.1 S H E BOARD OF HEALTH Food/Kitchen a "+ Septic System S-atAj-�PER MIT T �'V r 'rWA4'. CoreD . BUILDING INSL'ECTOR THIS CERTIFIES THATA*-4sw.#%................................................. ......... .......... ......................... Foundation . has permission to erect............. ...................... buildings on ..� ..1•�.../ ,Lo7 +.........D�t. Rough ? ZS '�� I ? F• Chimney" Ljma Fid ,, (A to be occupied as. !. ..... . �.... ......... provided that the person ecceljing this permit shall in every respect-conform to the terms of the application on file in Final /G this office, and to the provisions of the Codes and By-Laws relating to the Ins ctio Alteration and Construction of Buildings in the Town of North Andover. y PLUMBING INSPECTO VIOLATION of the Zoning or Building Regulations Voids this Permit. o h g PERMIT EXPIRES IN 6 MONTHS It UNLESS CONSTRUCTION STARTS ELECTRI ou BUILDING INSPECTOR 7� Occupancy Permit Required t0 Occupy Building GAS INspEdTOR CA , jo-i oft Display in a Conspicuous Place on the Premises — Do Not RemoveF , 7-tj CAN No Lathing or Dry Wall To Be Done e FIRE DEP '�'MENT Until Inspected and Approved by the Building Inspector. Burner Street No. r710 SEE REVERSE SIDE Smoke Det. �i