HomeMy WebLinkAboutMiscellaneous - 122 CORTLAND DRIVE 4/30/2018 122 Cortland Drive
Unit #36
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CERTIFICATE OF USE & OCCUPANCY
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Building Permit Number 551 (2/27/2006)
Date: July 25 2006
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 122 Cortland Drive Unit
e #36
MAY BE OCCUPIED AS Single Familv Dwellin IN ACCORDANCE WITH
THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING COD
OTHER REGULATIONS AS MAY APPLY, E AND SUCH
Certificate Issued to:: Meeting goose Common
i
121 Carterfield Road
North Andover MA 01845
i
Building Inspector
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i
lown of
No. 0,
Aindover
AK
' Ao dower, Mass.
-��- � --
'Q COCt+ NE �
BOARD OE HF�T T
..PERMIT i
Food/'Kitchen
Septic System Ij
THIS CERTIFIES THAT...01.f4*41,61lems. ........ �... .... ...
BUILDING INSPECTOR i
.15. .has permission to erect..... . a ,
!1�..................... buildings on j• X � # Found t cm
to be occupied as. �t1.M I6.
provided that the ! '
provi person a�i ....�•�•�� • -f�+r111.�,��.N ..........
pt ng this permits l in every respect con I'm to the terms of the Chimney
this office, and to the provisions of the Codes and By-Laws lacing to a Inspection, Alteration and
in
Suildings in the Town of a1 .l
North Andover. f 0 ��G of
VIOLATION of the Zoning or Building Regulations Voids thisPermit. WF ��o/ PLUMBING,INSP IY�R ;
D 33 rRough /,
oma_
-, 1 CONS' UC �� RT ELECTRICAL INSPECTOR
.
Rom
Sen`ice
BUILDING INSPECTOR -
-'F-n-aT-
Required to Occupy Id
GAS IN 1
Display in a Conspicuous Place on the Premises — Do ,ough
Not Remove � - r
No Lathing or Dry Wall To Be Done n
Until Inspected and Approved by the BuildingInspector. FIRE DEPAR „I
T IBurner
i
, SEE REV Street Mi. i
Smoke Det.
' 7
° D
iDate..................................
1 NORTN
°f<�``°:•�"� TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
F • i �i�i,�. i
CHU
I
This certifies that .....................8.4z/1'! ........................................
has permission to perform
/U Ifo vrr
wiring in the building of ...7-;. ....r-.......Am .......:..
7-,4,#Aat...... ........................................... ...... ..... ... .. ,Njo�rtfh Andover,Mass.
` Fee: y'3.'.7 Lic.No....... ...... ". ./..1. ..j �G,'.........
' ` �r� ELECTRICAL INSPECTOR
Check # /01 d M
G5 :�7
1 Pemdt Na
Dl�J MPREYE1�i}1►OGV*L4T7�01�SS17(,aaw
Oocuptnry
Fees Chafed
fAPPUCA77ONFOR PER ff TOPEWORMELE=CAL WORK
UL WORK TO BE MFORMW IN ACCORDANCE WrM THE MASSACHUSM ELEMICAL COAG,527 CMR 12:00
PLEASE PRIM IN INK OR TYPE ALL IINPORMATTON) Da DKIC
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number)
Owner or Tenant ' �M E
Owner's Address Z ��-� . fU 0..-, A'. '
Is this permit in conjunction with a building permit; Yes No a (Check Appropriate pP Priage Box)
Purpose of Building ! 1 Utility Authorization No T`
Existing Service Amps .. Volta Overhead Underground No.of Meters
New Ier C> Amps 12 Volts Overhead Q Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ".a.)SI1
Na bf uta Oad a No.of Hot Tube No.of Trt>vdo=n Tow
ltvW
Na of Liphd�t Axons Swimming Pool- Above Below Qtaa KVA
t. r j I ted
Ho,of Recepuck Outten No.of Oil$mate M.of Fi mpaq U&ft Bawy Uaia
of Switch ootwu _
i No.of On Boman
No.of RW4= No.of Ak Coad. TOW FIRE ALARMS No.of Zorm
I Tout
No.of Diepwde No.of Had Told TOW Me.of DNeetion ted .. .
Nffm TOM KW Wdasis Davi=
No of Diihwuhin Spent Ata Hewty KW No.of Somft Davica
No.of Self Ctirn WW
Debwomisommft Devim w
No.1 of Dwfete Hudos Derives Kw Load Motdeipd Other
Corm dom
No.Of Water Hattan KW No.or No.or
S Balk*
No!Hydro Mss W 74a No of Motor TOW HP
I
DTHER-
I
t ktstt0= guars 1DfCqstrmataofMaatodxsMGUWLsivB
Hm eaaaentliettitl►humhL►iB tftQarpi*— aibskeragiWi t Yg4 ��Np
ltmesdxridridvaidpnoofot Min
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d=kkqsM1_ t'
irt,"'iJicF+PICE 7 1:3 Or7I•lpR 0 nsseSpez*
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FWMNAUE
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OWMCSNWRANIEWAMIam tita teLioawdnpt t emmr&- o,a$e
acdtMetm4+s�eaamdr'spearitappicsYnwaitegtiiategaitanet
(Please check one) Owner Agent
Telephone No. PERMIT FEE I-SJ e71,3.
11�17l1f1MUlflVj'rv�[1�.�4rL17 Pmmttrk
BQARDOFFlREPRL''VSY7nVRBgjL477M327C71 kiz-�
LoLupancy/<Fees Checked
7
• '�I'PLICA 9 71ONFOR PERMITTOPERFORMELECTRICAL WORK "
.,
ALL WOE To BE PFMFORMBD IN ACCORDANCE WnH THE MASSACHUSSTS ELECTRICAL CODE,527 cMR 12:00
,ASE PRINT IN INK OR TYPE ALL INFORMATION) Da iosc-
Town
of North Andover To the Inspector of Wires:
The undersigned applies for a permit to Perform the electrical work described below.
Location(Street 3 Number) (
Owner or Tenant
i
Owner's Address12,j V1 ��•� . f�(? t A.
Is this permit in conjunction with a building Pen dt: Yes M No 1:3 (Check Appropriate Box)
tGJd �
purpose of Building -S t C 1 ✓ Utility Authorization Not
Existing Service Amps Vo1b Oveztuead ® Underground No.of Meters
New Se-j-Z> Amps12t��lolts Overhead Q Underground No.of Meters7'
Number of Feeders and Ampacity
Location and Nature of Ftoposed Electrical Worts L" i w I--t.0 J X65
` No,of Liwh O lists No.of Hot Tube No.of TrstWbmmn TOW
KVA
Pio.of LIBltdea slum Swimming Pouf Above Below amearm KVA
nd and
Na of Receptacle Outlets No.of Olt Bamees 1:3No.of Emagency t3tadn$Boaq Units
r
of Switch outiete
No.of du BOmera
No.of Rxµ" No.of Air Coad Tota FIRE ALARMS No.of Zones
Toru
- A Of Dltpoastt No.of Hat TOW TOW No.of Dow iaa and ...�. i
Po Tont KW Wdad"Devices
.of Dishwashee Space Asp Hestina KW No.of Souodhla Devices
No.of Self comained
Det<ctionlSounAng Device
D+Yen Heating Devices Kw L.acd MWddpd ® OdW
Comectione
of Wrier Heaves KW No.of No.or
'Slim alitalls
usye Ibbs No.of Moon Total HP
I Hrdm M
Pm=iD de tepwn is dMeastdaedls(;=W
ks4W%Lit *baxrePtiyi>dftQU#—ftYBq ®/rp
idedvttlidprocidstr Once� )FyouhsvedtadmdYE�pkaert�Caleftetypecfaby
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BLET OW
Do GM �
1 Dile
I dVal>Ccfb amW Wads$
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asklm pow.
FBIRRMNAME 4-ft,k,AALA-r _.iyt L.G�1-C� ��L> ��i G� Lx=Na
MrasTUNa
1'2d, AtT�r �n 3�s-ter<<�z i
'SMXAN[BWAMIan dWdrL,aw ft- Cw&,Worlto*rthd*abtiste iodbpMwdmmGimaiLswa
v,�ietmysgneftamdtspts<rr'tappic�vtai�esiiare�i�mt .
(Please check one) Owner Agent _ o
TeStanalure 31 UVner Or ARM[ am� �
MIT lephone No. PM FEE
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d� � � �-
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r
Date....�f........................
NOR7M
°f'"`°:•'"° TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
SACHUSE�
This certifies that e�6 7
has permissionto perform ........ ........
wiring in the building of s ...............................
at...... .L.eC"'e�� orth Andover,Mass.
.................... ...................................
Fee...`?..5..' Lic.No. CV4)................. .......
ELECTRICAL INSPECTOR
Check #
7059
i
Official Use Only
Commonwealth of M46sachusetts
Department of dere Services Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (I(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
I
All work to be performed in accordance with the Nlassachusetts Electrical Code(MR EC).527 CM12.00 '
(PLEASE PRINT LN'INh OR TYPE ALL INFOR.11IATION) Date: / /— o - 0*
City or Town. of: ✓-ems To the Inspector of U'ires: '
I
By this application the undersigned gives notice of his or herintention to perform the electrical work described below.
Location (Street & Number) /�02 04: ,�
Owner or Tenant " �7
i ?art t%� i� Telephone No. �7�aQ�� 7S 7/
Ow'ner's Address
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service _ Amps _ / —Volts Overhead ❑ Undgrd ❑ No. of Meters
New sefw;ce Amps ,)11 s 'syer•itraci❑ iludbrci ❑' No. of iV(eters ,
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of Security System
Completion af the following table may be waived by the Inspector of Wires. I
+ No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trt rans Total J
_ sformers KVA _ I
No. of Luminaire Outlets No. of Hot Tubs Generators
KVA
i -
No.of Luminaires Swimming Pool Above ❑ In- ❑ o. o Emergency Lighting j
grnd. rnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones I
No. of Switches-t- No. of Gas Burners No. of Detection and
Initiating Devices
No. of Ranges No. of Air Cond. Total Tons g No. of Alerting Devices
No. of Waste Disposers Heat Pum Number Tons KW No. of Self-Contained
Tota'I P ."' ....................... Detection/Alerting Devices
No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No. of Dryers Heating Appliances KW Security Systems:*
No.of Devices or E uivalent
No. of Water KW No. of No. of Data Wiring:
Heaters Si ns Ballasts No.of Devices or Equivalent
1 No. Hydromassage BathtubsNo. of Motors Total HP Tclecon:'mu nications Wiring: '
No.of Devices or Equivalent I
OTHER: X97-,1 d 1AtD_
—�-- r �� attach additional detail if desired, or as required by the Inspector of kvires.
Estimated Value of Electric I Work: ,��J ' (When required by municipal policy.) r
Work to Start: 4TsJ�p Inspections to be requested in accordance with MEC 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 offce.
CHECK ONE:-INSURANCE Z BOND ❑ OTHER ❑ (Specify:)
I certify, under the parts anti penalties of perjury, that the inform �ontlusplication is true and complete: -
FIRM NAME: ADT Security Services, Inc. .LICNO.: 1533 C
Licensee: Stephen Provenzano Signatur LIC. NO.: 2624D j
(If applicable, enter "exempt"in the license number line.) Bus. Tel. No.: 603-594-5900 .
Address: 18 CLINTON DRIVE HOLLIS N.H. 03049 Alt.Tel. No.: 603-594-5930
*Security System Contractor License required for this work; if applicable, enter the license number here: SSCCO016331
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below, 1 hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent.
Owner/Agent (�
Signature _ Telephone No. FPERMITFEE-. $ 'TO.
I
s�cHugd� j
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
i
Building Permit Number 551 (2/27/2006) Date: July 25, 2006
1
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 122 Cortland Drive Unite (#36)
MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH
THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH
OTHER REGULATIONS AS MAY APPLY.
Certificate Issued to: Meeting House Common
I
121 Carterfield Road
i
North Andover MA 01845
i
Building Inspector i
7
I
NORTH
own of _ over
. = dover, Mass., 2L d�
COCKICMEWICK
7,9 RATED
`S E BOARD OF HEAL'T'H
PERMIT T Food/Kitchen ,� r
Septic System V A
BUILPING INSPECTOR
THIS CERTIFIES THAT...)%441.0 . OII,f i�/ C~j" .... . .......6#PV* (
................. oundatit
! �:.1..... .�jo.N�....... ..,.. ough
has permission to erect........ !IR..................... buildingson ...... ... .. ,us
t' �� I
to be occupied as ,5a.1*. �..... t. 1.1. + !,
..... .. ...................................................................... Chimney �
provided that the persona If
this permit sblll in every respect con rm to the terms of the application on file in
this office, and to the provisions of the Codes and By-Laws r lating to a Inspection, Alteration and Constructi of
Buildings in the Town of North Andover. f PLUMBING INS R
VIOLATION of the Zoning or Building Regulations Voids this Permit. �. Rough r
n Z('�G L
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTO
UNLESS CONSTRUCTI STARTS - _ f
4
BUILDING INSPECTOR
ma
,(<_ 7—
Occupancy
—Occupancy Permit Required to Occupy Building GAS INSPECTOR.
ough G�' / 6/l
Place on the Premises — Do Not Remove I
Display in a Conspicuous n ? ,
No Lathing or Dry Wall To BeDone FIRE DEPART741T
Until Inspected and Approved by the Building Inspector. Burner
- ,
Street No.
' ' SEE REVERSE SIDE Smoke Det.
,I
Y
,•l
ppRT#j
d '% X67 •rO
to
� Oq x.irt«iw+eb
-�A 4roo
�SS{CHUS��
APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION '
Building Permit# �S
ADDRESS/LOCATION OF PROPERTY : 122
Map /d 1 C Parcel3 1 Lot Number j/►v )T 3 6
SUBDIVISION c",/&ms
DATE REQUESTED FILED/READY FOR INSPECTION -7�2 1(0
6
CLOSING DATE ON PROPERTY: 6l
I j
FIVE 5 DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORK AND SIGN-OFFS MUST BE MPLE ED WITHIN THIS TIME FRAME. A RE-
INSPECTION FEE OF TWENTY DOLLA S$20.0 ) WILL BE CHARGED IF THE STRUCTURE
DOES NOT MEET ALL APPLICABLE- DES.
SIGNED
ROUTING
CONSERVATION
PLANNING
DPW -WATER METER nA i
SEWERNVATER CONNECTION_
NOTE
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO
SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST
DPW w
Signature
i
File: OC form revised 2008
i
Date.Y. !'�� 'Cf�... .. ..
MOFTM
3? y` TOWN OF NORTH ANDOVER
O44wadlaiadif& A
• PERMIT FOR GAS INSTALLATION
• o ,' i
{ Zl
This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
has permission for gas installation . .!�!'�W. . . . . . . . . . . . . . . .
in the buildings of . .7A.4 A.. . . . . . . . . . . . . . . . . . . . . .
at . .�a. . . . . .��? � d. . . . . . . . . . ., North Andover, Mass.
Fee. . . . . Lic. No.CX f.q 9.7 . . . . . . . . . . . . . . . . . . . . . . . . . .
GAS INSPECTOR
Check# 6co ?/
5579
,1ASSACHLSKM U NOMI AP`PUCATON FOR KIM TO DO GAS FITTING'.
(Type or print) Date 7�o�r: i,(,
NORTH ANDOVER,MASSACHUSETTS
i
Building Locations /.fid? �t�T�z►^l� Permit#
Amount OG
Owner's Name /��eG�/ G1-ys� xv
wrs2 S'
New1 Renovation Replacement Plans Submitted a
I
p d
z 0
a 3 4 g a 1. o
SUB •BASEM ENT
BASEMENT
1ST. FLOOR
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
lyt STH . FLOOR
6TH . FLOOR
7TH . FLOGR
8TH . FLOOR W. t H
(Print ort'�
type) r / C one: Certificate Installing Company
NameIola/J1 r j /���'lr' Corp.
Address dl=�' Partner.
business" e ep one G; - L, , `7 0 Firm/Co.
Name of Licensed Plumber or Gas Fitter zop///1'
I
LNSURA,NCE COVERAGE Check one:-
--
I have a current liability Insurance policy or it's substantial equivalent. Yes D` Noll
If you have checked Les,please indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity Bond
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of'the
Mass.General Laws,and that my signature on this permit application waives this requirement. '
Check one:
Signature of Owner or Owner's Agent Owner Agent
t 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,ill plumbing -vork and installations performed under Permit Issued for this application will be in
Compliance with all pertinent provisions Cif the Massachusetts State ,as Cu e and Chapter -42 of the General Laws.
`Signature of Licensed Plumber Or Gas Fitter
By. D Phtmber ,46
Tae
CitvJcwn Gas Fitter License'Num er
Master
lourneyntan
APPRU�`ED.r. cE
i
Date.
"oR,,, TOWN OF NORTH ANDOVER
of•,,.° ,.'dao
p PERMIT FOR PLUMBING
,SSACMUS�
This certifies that . .,r lf� �. . ?f/-/. . . . . . . . . . . . . . . . . .
has permission to perform . . .!. ov . . .. . . . . . . . . . . . . . . .
plumbing in the buildings of . . . `t. . .��C - . . . . . . . . . . . . . .
at . . . . ./17a. . . . . . . North Andover, Mass.
Fee. ,�f . . .Lic. No.. n.(i . . . - - - - - - - -
PLUMBING INR
Check
65'70
MASSACHUSETTS UNIFORM APPLICATION FO
(Type or print) R PERMIT T
1VORTH ANDOVER,MASSACHUSETTS OD .
DO'PLUMBING
. Z 0ding Location H
f Owners Namehl
Date X /
"r/� G,ll�hGyt Permit#
T e of Occur)anc Amount
New Renovation
Replacement ry
. Plans Submitted mut
ted Yes
� No p �
FIXTURES
� I
w
COD
O � x �
CIO
w Q w z;: c
IqUOM q
3FUNJOCR
1 41H HjOM
� srx
61H HDM
7IIi I+I,oCIt
8II3FI,p� I
(Print or type)
Installing Company Name ;
41
� J Check one:
o�
Address ,, Corp. Certificate
� � � // �
Business e ep one
Y S� a Partner.
Name of Licensed Plumber: 0 Firm/CO.
Insurance Cov--e-r,-age—'o
Indicate the type of in coverage by checking the appropriate box:
Liability insurane plicy
Other type of indemnity � �
Insurance Waiver:.1,the undersigned,have been made Bond ❑
three insurance aware that the licensee of this application does not have an
Sig re
Y one of the above
Owner El Agent ❑
I hereby certify that all of the details and information I have submitted(or entered)in above a
best of my knowledge and that all plumbing work and installations
compliance.with all pertinent provisions of the Massachuset Stat lumb'ng Code and Ch application are true and accurate to the
performed under Permit Issued for this application will be in
By: C r 142 of the General Laws.
Signa g 1 icense um er
Title Type of Plumbing License
City/Town
APPROVED coMcE usE oM.,Y ice se m e Master El �
Journeyman _
i
Location l Gni rf # ✓e--
No. Date ' a
�oRTM TOWN OF NORTH ANDOVER A
F? .. os
Certificate of Occupancy $ '
P Y
Building/Frame/Frame Permit Fee $ � 1
s+c14US 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # _1L
13995
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,
���00�" ;.,� � t5��� � �s ... �. a.x v � t �,� 1, �ta�." ,a,,; ffia�z�� y '� �`.r ,,,., k�"•�..
BUILDING PERMIT NUMBER:�� DATE ISSUED: I X
ic
SIGNATURE: �
Building Commissioner for of Buildings Date
SECTION 1-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number: I O
J ZZ Cd2TLaAWD E>R)\J 36 IbgC
Map Number Parcel Number
WAWW,
1.3 Zoning Information: 1.4 Property Dimensions:
S IF f) Co*JD0 30.Z ,0<--
Zoning District Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft j
Front Yard Side Yard Rear Yard
Reqpiro Provide R red Provided R ' ed Provided
v
1.7 Water Supply M.G.L.C.4t1.1 54) 1.5. Flood Zone Information: 1.8 ewer%e Disposal System: I
Public Private ❑ Zone Outside Flood Zone Municipal X On Site Disposal System ❑
'SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No m
2.1 Owner of Ird
Ae Zu LI t)- AAA
'Name(Print) Address for Service
- j
ature Telephone f
r
2.2 Owner of Record:
1
Name Print Address for Service:
Signature Telephone
90
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: ) Not Applicable ❑
licensed Construction Supervisor:
12 a (� AL,
License NumberMn
Address `j- �l/ �A&
Expiration Date
tgnature Telephonero
�I
3.2 Registered Home Improvement Contractor Not Applicable ❑ ®®
I, 6
Company Name rn
Registration Number � r
Address r
Zi
Expiration Date /�
Signature Telephone G)
f
i
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.....X No.......❑
SECTION 5 Description of Proposed Work(check all applicable)
New ConstructionExisting Building ❑ Repair(s) ❑ Alterations(s) Q T Addition ❑
1 i f
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
S I Cd &Z6 FkAJAI&- W R&erJ1 E
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY
Completed by permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing 17, &-cro Building Permit fee(a)x (b)
4 Mechanical HVAC )Z G ft
5 Fire Protection
6 Total 1+2+3+4+5 De Check Number
R y' SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
., OWNERS AGENT OR CONTRACTOR APP L S FOR BUILDING PERMIT
1, as Owner/Authorized Agent of subject property
rt
r
Hereby authorize to act on
My behalf,in a atter ela ' e to ork authorized by this building permit applicatio 1
e of Owner Date
ECTIOONN 7b OWNER/AUTHORIZED AMG_E11i DECLARATION
Al
as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name ^ Z
S' ature of Owner/Agent Date
NO. OF STORIES L SIZE
BASEMENT OR SLAB g
SIZE OF FLOOR TIMBERS 1 '2-.,,q 10 2 V 3
SPAN jam'. / A4
DIMENSIONS OF SILLS 7.k
DIMENSIONS OF POSTS 3
DIMENSIONS OF GIRDERS lb
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING ", X d!�
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
- - - - - _ _ _ - - � NbRTIy - - -
0- - - 0 g over
0 V"
No.
=y= = dover, Mass., • 2�`'' df
I� COCM.C�A.."ICK\y1.
7�S RATED p'Pa �C�
� BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT...A.111.41.1k. ..�ONSA♦........
����... ....10 .�.
............................... Foundation
w4has permission to erect.... WAR..................... buildings on ......�.. r I 1 ft. Rough
I
to be occupied as �1.o �. 410 K Chimney
provided that the persona pting fiepTit �11 in every respect con rm to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws r lating to a Inspection, Alteration and Constructio of
Buildings in the Town of North Andover. t 0 ��G �' Z �i A if �D/ PLUMBING INSPECTOR
3
VIOLATION of the Zoning or Building Regulations Voids this Permit. I` 0 Rough
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI STARTS Rough
.. . . .. ... ..............
Service
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.
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
( I i
APPLICANT M l Y1 w Q , (n�S L C. PHONE 6 28-087 1Z 636
LOCATION: Assessor's Map Number /4 PARCEL 3 r
SUBDIVISION (" LA loL m/nonj LOT (S) 3
STREET ��'� IQ ��� ST. NUMBER
***-�OFFICIAL USE ONLY *****
RECO NDATIONS OF TO AGENTS:
I
CO ERVATION ADMINISTRATQ DATE APPROVED
DATE REJECTED
COMMENTS
TOWN PLANNER • DATE APPROVED
DATE REJECTED
COMMENTS LjQ B
* , I
IV .
FOOD IN ECTOR-HEALTH DATE APPROVED
N ) DATE REJECTED
N /
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS O N 'S aVV E R
PUBLIC WORKS - SEWERIWATER CONNECTIONS���
i
DR1V WAY PERMIT _Z
FIRE DEPARTMENT �4,
RECEIVED BY BUILDING INSPECTOR _DAT.E—
Revised 4137 jm
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g ✓1� �no.,z .u� o� aaaac�u�aella
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 055417
Birthdate: 04/05/1960
- Expires:0410512006 Tr.no: 21033
Restricted: AO
THOMAS D ZAHORUIKO
121 CARTERFIELD RD " oner
N ANDOVER, MA 01845 Acting C
I
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
���\;`\'` "", Boston, MA 02111
t - www.mass.gov/dia
l Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
$,M n ',
Address: 2,� ✓V
City/State/Zip: /� cs�•r OJ
�� Phone #: �(
Are you an employer?Check the appropriate box:
1.El am a employer with 4. ❑ [ am a general contractor and I Type of project(regilired):
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
2 I am a sole proprietor or partner- listed on the attached sheet. + 7• ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance.
[No workers' con insurance 5. 9. ❑ Building addition
p. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152,§1(4),and we have no 12,0 Roof repairs
insurance required.] t employees. [No workers'
comp. insurance required.] 13.❑ Other
*Any applicant that checks box#l must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showine the name of the sub-contractors and their workers'comp.policy information.
am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: i
Policy#or Self-ins. Lic.#: Expiration Date: i
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal pienalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORp and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance covera rification.
I do hereby certify under th ains and pe alties f perjury that the information provided bove is true and correct.
Si nature:
Date:
Phone
ofTcial use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
I
s ,
Permit Number
MECcheck Compliance Report Checked By/Date
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
Data filename:Untitled
TITLE:The Portsmouth at Meetinghouse Commons
CITY:North Andover
STATE:Massachusetts
HDD:6322
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE:02/23/06
DATE OF PLANS:2/07/06
PROJECT INFORMATION:
Meetinghouse Commons
North Andover,MA 01845
COMPANY INFORMATION:
Meetinghouse Commons LLC
COMPLIANCE:Passes
Maximum UA=477
Your Home=447
6.3%Better Than Code
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R Value R-Value U-Factor UAi
Ceiling l:Flat Ceiling or Scissor Truss 1628 0.0 30.0 50
Wall 1:Wood Frame, 16"o.c. 2356 0.0 13.0 186.
Window 1:Vinyl Frame,Double Pane with Low-E 379 0.340 1291
Door 1: Solid 35 0.340 12 :
Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 1628 0.0 19.0 70
Furnace 1:Forced Hot Air,90 AFUE
Air Conditioner 1:Electric Central Air, 10 SEER
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 Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with thel
mandatory requirements listed in the MECcheck Inspection Checklist.
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
i
1
MECcheck Inspection Checklist
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
DATE:02/23/06
TITLE:The Portsmouth at Meetinghouse Commons
Bldg.
Dept.
Use 1
Ceilings:
[ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 continuous insulation
Comments:
I
Above-Grade Walls:
[ ] 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 continuous insulation
Comments:
Windows:
[ ] I 1. Window 1:Vinyl Frame,Double Pane with Low-E,U-factor:0.340
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break?[ ]Yes[ ]No
Comments:
Doors:
[ ] I 1. Door 1: Solid,U-factor:0.340
Comments:
Floors:
[ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 continuous insulation
Comments:
Heating and Cooling Equipment:
[ ] ( 1. Furnace 1:Forced Hot Air,90 AFUE or higher
Make and Model Number
[ ] I 2. Air Conditioner 1:Electric Central Air, 10 SEER or higher
Make and Model Number
I
Air Leakage:
[ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
[ ] I When installed in the building envelope,recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture
and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944
L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled.
I
Vapor Retarder:
[ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
I Materials Identification:
[ ] I 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.
i
[ ] Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on ,
the building plans or specifications.
I '
Duct Insulation:
[ ] I Ducts shall be insulated per Table J4.4.7.1.
i
Duct Construction:
[ ] All accessible joints,seams,and connections of supply and return ductwork located outside
conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed
using mastic and fibrous backing tape installed according to the manufacturer's installation
instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted.
[ ] I The HVAC system must provide a means for balancing air and water systems.
I
Temperature Controls:
[ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to
partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided.
I
{ Heating and Cooling Equipment Sizing:
[ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as
specified in Sections 780ClMR 1310 and J4.4.
I
Circulating Hot Water Systems:
[ ] I Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
[ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
[ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
,
L
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) Un to 1„ Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Pining System Types Rane F 2"Runouts l"and Less 1.25"to 2" 2.5"to 4"
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
I
j NOTES TO FIELD(Building Department Use Only)
I '
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meetinghouse Commons LLC, North Andover, MA
WINDOW & DOOR SCHEDULE
'V
Interior Doors, 2-8 X 6-8 unless specified 34 %2 X 82 1/2
D-1 Entry Door, Twin Sidelights 681/2X 83
D-2 Entry Door 381/2 X 83
D-3 Slider w/transom 72 X 96 1/4
D-4 Slider 72 X 82 1/2
D-5 Entry Door, Single Sidelight 531/2X 83
A Double-hung single 34 1/4 X 65 1/4
B Double-hung twin mull 68 X 65 1/4
-� ,- - C Double-hung triple mull 1011/2X 65 1/4
D Double-hung single 34 1/4X 57 1/4
E Double-hung twin mull 68 X 57 1/4
F Double-hung triple mull 1011/2X 57 1/4
G Double-hung single 22 i/4 X 65 1/4
H Double-hung single 34 1/4 X 53 1/4
I Double-hung twin mull 68 X 53 1/4
/t L Double-hung w/transom d 34 1/4 X 79
M Glider 60 1/4 X 42 1/4
N Double-hung twin mull w/transom 68 X 79
P Transom 34 1/4 X 30 1/4
Q Transom twin mull 68 X 30 1/4
S Double-hung 30 1/4 X 49 1/4
T Double-hung triple mull w/transom 101 1/z X 79
U Double-hung twin mull 68 X 49 1/4
ROOF M'MMz X Round stationary 24 X 24
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Mecting6ouse Commons LLC, Nor-t6 An(4over, MA
WINDOW & DOOR SCHEDULE
Interior Doors, 2-8 X 6-8 unless specified 341/2X 82 %2
D-1 Entry Door, Twin Sidelights 68 %2 X 83
_- - - - - - D-2 Entry Door -- - 3 8-1/2 X 83 - - -- -
D-3 Slider w/transom 72 X 96 1/4
D-4 Slider 72 X 82 1/2
D-5 Entry Door, Single Sidelight 531/2X 83
A Double-hung single 34 1/4 X 65 1/4
B Double-hung twin mull 68 X 65 1/4
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D Double-hung single 341/4X 57 1/4
E Double-hung twin mull 68 X 57 1/4
F Double-hung triple mull 101 1/2 X 57 1/4
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H Double-hung single 34 1/4 X 53 1/4
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I Double-hung twin mull 68 X 53 1/4
L Double-hung w/transom 34 1/4 X 79
M Glider 60 1/4 X 42 1/4
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N Double-hung twin mull w/transom 68 X 79
P Transom 34 1/4 X 30 1/4
Q Transom twin mull 68 X 30 1/4
S Double-hung 301/4X49 1/4
T Double-hung triple mull w/transom 1011/2X 79
U Double-hung twin mull 68 X 49 1/4
ROOF VKM\z X Round stationary 24 X 24
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house Commons LLC, North Andover, MA
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- - - -
Scale: varies Date: 02/07/2006 Sheet 6
-. - - - - Meetinghouse Commons LLC, North Andover, MA