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HomeMy WebLinkAboutMiscellaneous - 130 NUTMEG LANE 4/30/2018 (2) % utme g Ln 13 ,, a 38 Parcel 18 �. I i i Po Box 55098 Boston,MA 02205-5098 617-951-0600 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: ROBERT BERBERIAN and REBECCA BERBERIAN Property Address: 130 NUTMEG LANE,NORTH ANDOVER, MA Policy Number: HMA 0271542 Claim Number: BOS00050087 Date of Loss: 2/19/2015 Company: Safety Property and Casualty 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. Marc Chizauskas Claim Examiner 2/20/2015 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3526 Fax: (800) 297-5212 Email: MarcChizauskas@Safetylnsurance.com 7 4 97 Date..I.1-13J.i J.... . Of NO DTk ,q• o? TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION SACMUSE . This certifies that . 1`. .�. . :S. . . . . . . . .!. .. . . . . . . . . . . . . . . . . . . . . has permission for gas installation . �� �. . . < <�i . . . . . . . . . . . in the buildings of J3 . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . ... North Andover, Mass. vv ` Fee.3.v. Lic. No.. . d 3.�. tet. . . . . . . . �N!S��Ei��C�GA; Check# 16002, �aN- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING k1riCity/Town: 14, MA. Date: / Ld 3 /0 Permit# Building Location:h O --4 L/t ),ii-e 1 Owners Name: ��' '26-eye- yl1 i Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential [�- New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No❑ FIXTURES Cd Of w rn Lu v = W m = O w w 0 ca H N O x co W Z I— Z O W = L' R O H c°—n w W Lu m o a a � o 0 w x > z w Q W x W � X Q W W w z m x W � W z W W W > V W Z O J P H O Z J 0 LL N � W FW- W z W �- cn J Q Q m w O z 0 ~ z ►SUB BSMT. BASEMENT -isrFLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR -i'FLOOR 8 FLOOR Check One OnlyCertificate# Installing Company Name: tL , S �vL ❑Corporation Address: 4—t) i X I` y n r"City/Town:/U : d ir`^^Mate: "T r c7 ❑ Partnership Business Tel: 2-0 Fax: S - Q ❑-F6m/Company Name of Licensed Plumber/Gas Fitter: S /Al ,'vzl I-z-4---c INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes • No❑ If you have checked Yes,please Indic the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑;I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of he Gen rat Laws. Typq,of License: By - lumber Title ❑Gas Fitter gignature of Li sed Plumber/Gas Fitter ❑Baster City/Town ❑Journeyman License Number: APPROVED OFFICE USE ONLY ❑ LP Installer Location A4 z),-4, /,U, No. Date �oRTM TOWN OF NORTH ANDOVER �? ~ SOL f A Certificate of Occupancy $ ,.1 CHUSEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check ✓ Building Inspector ��� � 9 _ PLAN OF LAND I'Lo A, i3 0 —a cq o / /N A ND 0 NO, MA 55* SCALE 1" = 40 APRIL 25, 2001 HAYES ENG/NEER/NG, INC. 60.3 SALEM STREET CML ENGINEERS & WAKEFIELD, MASS. 01880 LAND SURWYORS M. (781) 246-2800 / CERTIFY THAT IH/S FOUNDATION /S LOC47FD ON THE GROUND AS SHOWN, AND THAT /T CONFORMS TO THE SEwor REQUIREMENTS OF THE ZON/NG BY-LAWS OF THE TOWN OF NO. ANDOVER. / FURTHER CERTIFY THAT THIS PROPERTY DOES NOT LIE W/TH/N A n000 HAZARD AREA (ZONE A OR V) AS SHOWN ON FLOOD INSURANCE R4TE MAP COMMUNITY PANEL NUMBER 250098 0010 6,• E T/VE DATE.• ✓UNE 15, 1 ���P`,H O F M4ss�� DATE' yG -------J -I Z,00�---- --- - - ------ -PEi-ER•d- PRO ONAL LAND Lj�REN y #33604 �2 007 S ssURIX, R' A`� w 0 ` V •� oo �5w+�' .5 � a 06 g� �ST�N S zs ON J\1� o FOOS NOAT 80 " 5 Ilk LOT 2 \ \ � LOT 1 � 25, 01J S.F. ZONE• R-3 \ �os� .9� M/N/MUM SETSACKS.• �\ \ NOTE LOT PERIMETER TAKEN FRONT = 30' ��y�S \ FROM A PLAN BY SIDE = 20' 2���\ NEW ENGLAND ENGINEERING SERVICES, REAR = 3O' \ DATED ✓UNE 12, 2000 a \ MIN. L OT AREA = 25,000 S.F. \ MIN. FRONTAGE = 125' Date...!' .�. . ................. � t NORT/y " TOWN OF NORTH ANDOVER 0 � A PERMIT FOR WIRING s oma+ _ ,�•"a ;,SSACNUs� - This certifies that ...........v..r......A......J............. ..^........ ;7...................................... -has pennissibn to perform ......1.39..... ....... �.�.��............. ........... ... wrong in the buildingof......�.....�.!yr.r.4..l......... ......................... rat....... ....................................................................... .North Andover,,�Mms. Fee....9.57 r:..n.57........ Lic.No......t?) ............... ..!i � .,�!.�r�.�. t ELECTRICALINSPECTOR— Check # � fi � 9 Commonwealth of Massachusetts Official Use Only -K7/ Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK f All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: lA 00 City or Town of: ALA —e Dv&4ze To the Inspect r of Wires: By this application the undersigned gives notice 6f his or her intention tno o perform the electrical work described below. Location(Street& Number) "l�'rr Z, l Owner or Tenant 711491,f -c , «.�g�N Telephone No. DL6.1 j92- Owner's Address C3 0 la n!/g4&- 4&y-,!f Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building F-4 i Pg-"cL4 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: Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed LuminairesNo.of Ceil.-Susp.(Paddle) Fans No.o Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- E] o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesNo.of Gas Burners No.of Detection and f� Initiating Devices No.of Ranges No.of Air Cond. Total Alerting No.of Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.o Self-Contained Totals: 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 Equivalent No.of WaterKW No.o No.of Data Wiring: + Heaters Signs Ballasts No.of No. or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: �z (When required by municipal policy.) Work to Start: 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 office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: Signature LIC. NO.: (If applicable, enter "exempt"in the license number line) Bus.Tel. No.: Address: Alt. Tel. No.: *Security System Contractor License required for this work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. 1 am the(check one)❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. L\ j Basement Area Drawing-130 Nutmeg Lane-Thomas R.Swain Scale-Approx 1/4 inch=1 foot approximate-not all components drawn to scale 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 # 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 1 � 2 22' 6" '",v __. 2x4 or 2X4 sideways(1 1/2") walls with drywall or blueboard 3 .6'10 ` Doorways/windows 4 j 5 6 7 8 9 10 20'3" 11 [WorkshopArea 12 ; 13 .13' 5" 14 15 f 16 17 18 #1 100 am sub- anal 19 20 11' 4" 21 22 22' 6' 23 Electrical: Panel and plugs 24 com leted on last 4" 25 7' . 26 E]110/20 amp shop&basement outlets-GFI Stairway 27 LV El J IV 29 24' 6" 30 31 32 33 Light fixtures or connection 34 Light switches EM 35 (J 220/20 amp plugs 36 37 38 IScale 1/4" =a roximatel V 'D Y. 681,39 40 Last Rev:9/1/2006 ;Storage Area 6 41 42 oor activated light swittir 43 44 ,Electrical panel 45 46 47 13'2" . • 48 Date.. . . .. ...... . ..... .. . i f NOFMI 1 3? �` TOWN OF NORTH ANDOVER O i A PERMIT FOR GAS INSTALLATION _ y SACMUSEt� This certifies that . . . . . . . . . . . . . ! . . . . . . . . . . . . . has permission for gas installation... . . . . . . . . . . . . .`.. . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . at A.- �} . . . � . .jr F. . . , North Andover, Mass. Fe 40. . Lic. No.. . 2%. . .�. . . . . . . . / GAS INSPECTORrr Check#.?U,y 5431 MASSACHUSETTS UNIFORM APPUCATON FOR PERM TO DO GAS FITTING (Type or print) Date 1 C NORTH ANDOVER,MASSACHUSETTS Building Locations Permit# Amount.� Owner's Name New❑ Renovation a Replacement ❑ Plans Submitted ❑ o a z o H F a a > 040. w a O O r� O 0 vFi o SUB -BASEM ENT 1 B A S E M ENT IST. FLOOR /` t 2ND . FLOOR f 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR (Print or type) C e one: Certificate Installing Company Name Q - 'v oy" o 'a i cc t-v Lj Corp. '+ Address ��`�� �M( o � i- 33� ❑ Partner. CLP,c.---�- y6a,, U Gott Business a ep one ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter — 'Z��\A 0.,1 U— l INSURANCE COVERAGE- Check one: I have a current liability Insurance policy or it's substantial equivalent. YesEl No❑ If you have checked Yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the;Massachusetts State Gas Code and Chapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter Title ® Plumber (13Q�' Title City/Town ❑ Gas Fitter License Number Master APPROVED,OFFICE USE ONLY) Journeyman Date.6- .r) r-"4P' TOWN OF NORTH ANDOVER 1-11 1 PERMIT FOR PLUMBING S�AGMUSE� This certifies that . . ��-�*- ! . .`. .. . . . . . . . . . . . . . . has permission to perform . . /,,. . . . . . . . . .... . . . . . . . . . . . . . . plumbing in the buildings of,:< . . -s ,r4!. . . . . . . . . . . . . . . . . . ., North Andover, Mass. 7 Fee-.r-2. .'Lic. No4.j: 3-. ... . . . . . . . . . . . . PLUM8[�NG IINSPECTOR ! v Check #� _ - ✓ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS n C t Date t ©�Ofo Building Location 1�� }J� Owners Name 02e-An' J1�A�a _ Permit# v t� Amount Type of Occupancy S New ® Renovation © Replacement E Plans Submitted Yes ❑ No ❑ FIXTURES Z � w o Z o W w x 0-0 a C ASF; BA9?vENr i ISS FLOOR za FLOOR 3M FLOCIR 41H 11fm sm HAOOR 6IH Hj00R 7IH FLOOR SIH FLOCK (Print or type) Check one: Certificate Installing Company Name QZK"Xk�' teLA,- 2tiC, El Corp. Address -s El Partner. CM� SMA - O Business Telep one C( <K-Cis-L'7 - .ML, Firm/Co. r Pame of Licensed Plumber: f\4- L Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: y Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance ignature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State e Plum ing Code,and Chapter 142 of the General Laws. By: Signature Of icense um er Title Type of Plumbing License City/Town - -.�� ❑ icL'ense um er Master � Journeyman APPROVED(OFFICE USE ONLY 6333 Date./................4........ t N0►t7M TOWN OF NORTH ANDOVER " _ p PERMIT FOR WIRING � s � '��•'a ,SSACMUSES This certifies that 1 t has permission to perform ... -' �-�^ � -^'' ................................ .................................. wiring in the building of i......,:- ...........:. .......... .................................... at. —�. ..�.... `:" �'"'' ,North Andover,Mass. ..... ...........ii..................... Fee`- ..r�....... Lic.No../34�7fl�.. ............................................ ..... ELECTRICAL INsncroR Check # ����� /�J/ urp� U11t @01"1011U10101 Uf MUSSUE1IUBettg Permit NOfllce Ua6 O y19tFnrtlntnt of Public haftl tl Occupancy b Pee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMA 12:00 390 (leave blank) J APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In Accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL NFORMATION) %Xv or Town of nate To the Inspector o1 Wires; The udersigned applies for a permit to perform the electrical work described below.Locallon (Street b Number) 30 A L Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No �� El (Check Appropriate Box) Purpose of Building _ Utility Authorization No, Existing Sil Amps _ J Volts Overhead ❑ Undgrnd ❑ No. of Meters _ New Service Amps _1 -______Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampecity Location and Nature of Proposed Electrical Work <' UraR e,�7` Pi�t��� (Ile •[ Ji7ri/Z fin. of Lighting Oullntri No. of lint 711 No. of Tlanalormere Tblai fin. of Llpfrling PlAlurnta �- -Ahnve --_._— KVA Awl►nndn0 f'rtoi IH� _ grad. U grad. U Oene►aloia I(VA No. of Receptacle Outlets No. of Oil Burners 1Jo °I Emergency Lighil No. of Switch Outlets 8 Battery Units No. of(las Burners / FIRE ALARMS No. of Zones 'lo. c1 ger,9.a , / No of At, CAM Total No. of Defection and R No. 01 Disposals tons Initlat"bevies$ NO.Of Heat liblaf Total : . I - Pumps Tbns KW No. of Sounding Devices L No. of Dlshwashere No. 01 Sell Contained No. of Dryore Space/Area Healing KW OetacticnfSounding Devicss Hosting Devices kVN Local Municipal Other No. of Water Heaters KW No. o1 No. a Connection Signs 91611-6. Low Vollege No. Hydro Massage TLb! Wiring No. of Motors TI HP OTHER: ' /oo ,gM)o INSUr7ANCE COVQRAGE: Pursuant to the requlrernents of Massachusetts i have a current Llnblllly insurance Policy have submitted valid general Laws Including Completed Operations Coverage or its substantial bquivelent. YES checkin proof el same to the Office. YES NO p 11 you have checked YES.pill Indicate thi type of coverage by g the appropriate box. = C NO C ( INSURANCE 8pN0 C OTHER C (Pious* Specify) =�O Esllmsted Valve of Elecirleal,Work: Work to slam '1-6 ( ------- / (E►tpltatl0n Otle) Signed under the)-fnaitiea of p ri inspection pate Rsquesled: pough FIRM NAM Signslur UC. No. -/;;I AddressGG_ Uc. _ 9ve. Till. No.%7,P 3?,,2 —j Quiled y I nsssthNCE WAIVEp;1 am swore Il l the Licensee does not have the lnsuraneeleo ara�s or Ns evbslantlal a —�— quired by MassechuseIts General t awe, and that my signature on lfils pe►mM eppticatlon waives this r Iplease check one) quhratent as to. equiremern. 0�►ngr Apert (Signelure of Owner or Agonl) TblephOne No. PERMIT FEE s vv , t Location / � ��log40 No. Date Qy �ORT� TOWN OF NORTH ANDOVER 0� . o . ,•t• BOG f41 9 Certificate of Occupancy $ �0 �SSAC11USEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 50 t Check # t�0 Ito Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING 7=7 , W1 rn BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/I RTf&—tor of Buildings Date SECTION I-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 13 o Az 03 4-dA60 F 7.15000,C> Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diaric—t Proposed Use Lot Areas Frontage(ft) 1.6 WELDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Recpired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: > Public 0 Private 0 Zone — Outside Flood Zone 0 municipal 0 On Site Disposal System 0 --1 SECTION 2-PROPERTY OWNERSH]UP/AUTHORIZED AGENT Historic District: YesNOM 2.1 Owner of Record Name(Print) Address for Service �7Z Sigfkfure Telephone Qk 2.2 Owner of Record: Name Print Address for Service: 0 Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: 0 License Number "n Address > Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Namern Registration Number Address z Signature Telephone Expiration Date G) 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 ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beOFFICIAL USE ONLY Completed by permit applicant I. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of ODo; Construction 3 Plumbing O, Building Permit fee(a)x (b) 4 Mechanical (HVAC) 5 Fire Protection b Total I+2+3+4+5 $ Z O 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 1, 7�T7/tS 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 _ 7/�2`2�� Signature of Owner/A I ent Date =� NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS " DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE f MORT{M, p•,�•o MO 40 TOWN OF NORTH ANDOVER s,KNus BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION Number /� Street Address Map/Lot HOMEOWNER �l /� 5/y I,_r 75'� Name Home Phone Work Phone PRESENT MAILING ADDRESS (36--) /Nin 71 f �i•�r�r�/=�'c ��� d l�3�5 City/Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1.) DEFINITION OF HOMEOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be,one or two family dwelling,attached or detached structures attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL Doorway 5' 3' Basement entry 6' 6►' Furnace 10' 2" 14'90:155 low,' 8" 311011 . 1IQ 12' 51, . 1 61 411 Water 1 ` Heater -- 71 7►►3191, I i Stairway Laundrn hum 21211.' 3' 10" i i �...,I now I Refrig Shelving Cabinets Kitchen sink Pivot or slidin doors Cabinets Ven Shelving i i 81811 1 14' 10" f 4 2. 6►► 6►►� \J . H � Basement Area Drawina -130 N_utmea Lane-Thomas R.Swain Scale- 1/8 inch = 1 foot approximate-not all components drawn to scale 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 2x4 or 2x3 walls with drywall-outside walls insulated with 1-2"solid insulation 2 22' 6" 3 . 6110, Doorways/access panel 4 5 New cabinet installation 6 . 401 811 7 8 9 3' 3" 10 20'3" ea 11 Workshop Ar 12 Doorway 3' 5Basement 13 13' S" _ ' entry 14 14' 15 60"Double door 16 17 18 1#1 50 amp sub-panel Furnace 19 20 10' 2" 14' 8" 1 21 2, 5„ 22 22' 6" I Water 23 Electrical: 3' 1001 Heater 24 1) 50 amp sub-panel for workshop area j C I 6' 4" 25 2) 220/20 amp circuit plugs L �" 10 7' 7" 26 20 amp shop&basement outlets-GFI O Laund Sink&pump 212" 27 30 amp/220 oven circuit S Stairway FiA 28 {20 amp microwave circuit E Pivot or sliding doors 31911 3' 10" 29 GFI countertop 20 amp circuit 24' 6" T 30 Refrigerator outlet _____ RefrigShelving 31 15 amp lighting circuits Cabinets 32 Kitchen sink 33 Q 110/20 amp GFI plugs 34 35 F—] 220/20 amp plugs I Doorway-367 1pivot or sliding doors Cabinets Oven Shelving 36 ;k: 37 38 .14' 10" 39 8" 4' 6" F40 Storage Area ;768' 41 42 H 43 .41 . .21 611 .1 44 IV ,Electrical panel 45 46 47 131211 ORth�4 O Town of NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT: # DATE UNIT NO.: FLOOR: WING: BUILDING NO.: l,"E REMARKS: Excavation-depth and soil conditions Framing- Other: Date: `� T 12`(-91 Date: —�` �� Date: Inspector nt 66,— Inspector & Inspector Footings and foundations and drains- Insulation- Other: Date: `'�` a r Date: '7-13 �� Date: Inspector Inspector _Zff—J� Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: / Date: a` e Date: G Inspector Inspector Inspector Electrical-final a Plumbing and/or gas-final Other: Date: % " U Date: 9 / 9 v Date: Inspector Inspector Inspector Fire Dept- oil burner,tank,stove,s oke detectors Final inspection Cert' 'cats of Use and Occup c Date: ���d� Date: Z� , C of O# Inspector J ./)1/! Inspector /14�`t�— Inspector Form#995 Action Press,685-7000 i F S aS4CHUy� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER � Building Permit Number qcl�, Date THIS CERTIFIES THAT THE BUILDING LOCATED ON (��l v� lVa�V F MAYBE OCCUPIED AS7,4011 IN ACCORDANCE WITH THE PROVISIONS OF YHE MASSAC USJTTS STATE BUILDING COD AND SUCg OTHER REGULATIONS AS MAY APPLY. i0 GOM5/ 3)4"-5/ CERTIFICATE ISSUED TO Z'�f641RIOyA)b � ADDRESS / Scam b 1�1�G��P�i�• Building Inspector JA E) Lt Town of Andover __ No. q - -- h 43_9r� / COCMICM W,o dover, Mass., ,••t DRATED WP L' C S H BOARD OF HEALTH PERMIT D Food/Kitchen Septic System /t/v 0 �G �� �� �L BUILDING INSPECTOR THIS CERTIFIES THAT. .... ...................................t ..... * 0& oun ation ,,�/I��!l 1��-�-- has permission to erect.................. ..... buildin s on to be occupied as� .�QQ. .. ! �� .��. .{3. .. //.v ... � ... ..� Chimney .. provided that the person accepting this permit shall in every respect conform to the terms the app ication on file in✓ Final .�.this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M319 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. R,�; �" PERMIT EXPIRES IN 6 MONTHS ELECTRIC IN $C O UNLESS CONSTRUCTION START w �.._ f ......... ...........�..... a y��'I l ....... 7 ` BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPE TOR Display in a Conspicuous Place on the Premises — Do Not Remove Rougha 00.1,? No Lathingor D Wall To Be Done Until Inspected and roved b the Building n FI DEPARTMENT p pp y u g l spector. Burner // ' DLIX PERMIT FEE� yCJv7�` street No. 13.0 lvuT�-..6 � SEE REVERSE SIDE LESS fm EEE Of ---��— � Smoke Det. DUE FRAME PERMIT$ /fS�?, — B J t- 3 ji V 4, TOWN OF NORTH ANDOVER 6 0 PERMIT FOR WIRING 4Ar.D SAC14U This certifies that ....... ................................................ has permission to perform ............../V.-O�' /-/0/71E- ......................................................... wiring//in the building of....... e5.�"4. ........ /............ ....... .....�North Andover,Mass. Fee..�`:':�. Lic.No...//ZeY.. /' .... .................. I . ELECH(ICAL INSPECTOR Check # Z�2 WHITE Applicant CANARY: Building Dept. PINK:Treasurer Intit-UJMV1UJrrra.[...ltnUrIYJA3�_"(,t 4tJ&_N IIJ uruceuseonty��� DEPARTAMWOFPUBIK& FETY Permit No. BOARD OFFIREPREYEV7YONREGUL 4TIOAS527CMR 12W Occupancy&Fees Checked PAPPUCATION FOR PERMIT 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 CV! 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) /&Y / #, 136 0, Lam_ Owner or Tenant *7777"co-7677 Owner's Address 6 b eu< v �. Roc, Ct Is this permit in conjunction with a building permit: Yesffi No r7 (Check Appropriate Box) Purpose of Building �'i i�t,, c(wol("Al h Utility Authorization No. 02-01M Existing Service Amps`/� Volts Overhead ID Underground No.of Meters New Service �cia Amps 12-11/z`eo Volts Overhead M Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work AJ Qt t 1 No.bf 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.ofEmergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal o Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP • OTHER- 0 hsurdr=CoAaage Laws lh'veawmzt+Lmxkh,&==FnhcymAdmgCar>pl'lee ,atiatsCovaageoritsakstr6aieWiva YE NO Iha,,esubmittedYalidptoofofsamelotheOlfiae YES [` ] NO Ifwuha%ed-edWYFS,pleZetrdi�thetypeefoaeageby�gthe WpoprialebCDC �y INSURAT�ICE BOND M OTHER F-1 ftaseSpecify) EVualion Dole Esdm&d ValuedEkoncal Wait$ Wak to Start /-/6- O l I speclicrl Da*FxWested Rough /.,tet l l C at( Final Signed unciert�ie Rmhi s ofpeljtay. FIRM NAME lioasee �Ll•tS t%u.t�r klo c_r_ Signaue r, LioaseNo //`3 i 7i4 N BtsinessTeLNa Ak.Tel.Na OWNER'S WSURANCEWAIVER,Iamaw=dotheL=se 42OMq�It ethertmsaioe absst lapwdiatas raqtmW byMmxhuseilsCerrdLays and that mysigrU� ernthis pemnit tsar unites flus regrtirsnar< (Please check one) Owner M Agent 0 ` ' Telephone No. PERMIT FEE v ? / N-0 J � � Date.�..� .....1...... f NORTH, "oo� TOWN OF NORTH ANDOVER 0 p PERMIT FOR WIRING ,SSACMUSE� I n This certifies that .................................. ............. ...(......................................... has permission to perform . (q.ir ...........7. ••• wiring in the building of .:.� P � 7- .....................................�' S //.............. ...... .../.1..(....�. at f �,.U /�!l " . .North Andover,, ass? 3 . Lic.No. ..�� .......... ... .. ".d'ts........!r..!.... Fee..................... LECTRICALINSPEtTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer THECOA1MOAVEIL7HOFMASS4(YIUSL7TS Office p y. DEPARMENTOFPUBLICS4MY Permit No. BOARD OFMEPREVEMONREGMTIOAS527CMR 120 Occupancy&Fees Checked VAPPUCATION FOR PEIZIVIIT TO PEUORMELECIT2ICAL 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) Dat�� V 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) /-30 IU W-IV f L-V7 Owner or Tenant 9a /V/3 G Il ,- JZ caxl- S 7- Owner's Owner's Address Is this permit in conjunction with a building permit: Yes© No (Check Appropriate Box) Purpose of Building l e S Utility Authorization No. Existing Service Amps Volts Overhead a Underground M No.of Meters New Service Amps Volts Overhead r-1 Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Y G i- L No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA and ound No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of$witch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP s ! OTHER' eyC ly. ! Iti%=xeCaaage Rasua�tbtheregtmana>��GarialLaws IhmeaaxmtLmbdtykia==Pb}itym&&gCan>kte C Ar,Wc'itsskstxmaleWivalat YES NO Iha%ewbmtledvatidpafofs&ne1otheO i=YES U NO a Ifjoubawdv*WYES,Iimewdx&thetYPecfwmrWb5'd=kgglhe j INSURANCE U BOND MHM a Z` Est nWed Vaiwdf�7a±xd Wt&$ WakoSta�t Z.. _ _ItspactmD*RaWmWd Ragh Final Sigt�edutxie<�iePt�altres ... FIRMNAME lioaseNa �/S C Lioaisee ,L�d, !-� D. ✓=/�f/1�/y sig� � .�� Iio�eNo 2.7- 4f D ,r/ �l Bus¢=TdNa _ -(. 72–6 777- Add=-2 7 /moi l//i.r����T f��vr✓_�►�.�_ /�/A) /9 X e V AiTeLNa OWNER'SINSURANCEWAVER;I.amawatelbattheLioet>sedmLntheitr ratnet>aerdgeorilssibstantialegtrivale�tasta#WbyMamf sMCmeralLaws andthatmysigttatuteontbispemri<app�tialwai�itt�tacgl�Iterlt. 1 (Please check one) Ownera AgentV v Telephone No. PERMIT FEE$ vvv Location 12 No. i l� Date N0ft, TOWN OF NORTH ANDOVER Certificate of Occupancy $ c►+u9 Buildin /Frame Permit Fee $ st Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f` Check # ' `� Building Inspect�� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR.RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING :Tlb;Sectimifor Offdd-Dee tht BUILDING PERMIT NUMBER: 2�2 J DATE ISSUED: m SIGNATURE: Building Commissioner for of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Xc-5 3 r C5 ,/3 X33 Zoning District Proposed Use Lot Area(st) Frontage(ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Re red Provide Re red Provided Re redProvided 3) (�-v 20 I 9-0 v 1.7 Water S ly AG.L.C.4O. 54) 1.3. Flood Zone Information: / 1.8 Sewerage Disposal System: 'v Public Private 0 Zone Outside Flood Zone (tY lfunicipal k"' On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name nt) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Z m Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable C Licensed Construction Supervisor. t, / � License Number wn Addr eo Expiration Date Sig alure Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name M Registration Number r Address r Z Expiration Date n Signature Tele hone �• l SECTION 4-WORKERS COMPENSATION(NLG.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.......e No.......0 SECTION 5 Descri tion of Proposed Work(check all applicable) New Construction 2' Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by rmit applicant 1. Building (a) Building Permit Fee ©� Sp 0 Multiplier Oti'�fi 2 Electrical (b) Estimated Total Cost of oZ 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 BUILDING PERMITER I. /). y/ ��`., '� O��� (wn uthorized Agent of subject property Herebv authorize 4,�v 411,VO t to act on My h l:in all matterp r lative to work authorized by this building permit application. /7y7 —ce Siflidt6re of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1. 2d'e/ S-J. /diel ct ,as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print a Si ature of Owner/Aeent Date NO. OF STORIES a SIZE v BASEMENT OR SLAB ,, SIZE OF FLOOR T13VMERS 1 -'ND `,Z � 3 SPAN J Q DMENSIONS OF SILLS /V ,c DM4ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY i. IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE C S pw {4p woe_ FORM - U - LOT RELEASE FORM Lo4- 3 r 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. APPLICANT OirvrO nd'CP PHONE tt7 7V9'-a0 7? ASSESSORS MAP NUMBER LOT NUMBER /F SUBDIVISIONLOT NUMBER STREET 1vU-7-N STREET NUMBER some...... ..m......■ ■oonoun moan.om......e..................■ ■o.........e■ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS '., . •r.....�on ■...o....o■............................... ■e■ ■eomonsoon �` n`S DATE APPROVED 0 CONSERVATION ADNM UTRATOR DATE REJECTED CONQ,fNTS r DATE APPROVED TOWIf FCXNNffR DATE REJECTED CONIlvtENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS QA-- PUBLIC WORKS-SEWER/WATER CONNECTIONS r DRIVEWAY PERNIlT Z_— L-� 6 DATE APPROVED F EAR DATE REJECTED COMM IENTS RECEIVED BY BUILDING INSPECTOR E rFER Sp 4 Building Value Calculation - for Property at..... fddre � Itt # � N LanParcilt1,' Room Length Width Sq.Ft. Cost per Sq.Ft. Total Cost Kitchen 27 14 378.00 65 $ 24,570.00 Living Room 16 14 224.00 65 $ 14,560.00 Dining Room 17 14 238.00 65 $ 15,470.00 Family Room 24 23 552.00 65 $ 35,880.00 Study 14.5 14 203.00 65 $ 13,195.00 Laundry 10 12 120.00 65 $ 7,800.00 Garage 24 36 864.00 35 $ 30,240.00 Entry 16 14 224.00 65 $ 14,560.00 Basement Finished - 65 $ - Deck - 10 $ - Screened Porch - 35 $ - Breakfast Nook - 65 $ - Bedroom 1 24 13 312.00 65 $ 20,280.00 Bedroom 2 19 14 266.00 65 $ 17,290.00 Bedroom 3 22 14 308.00 65 $ 20,020.00 Bedroom 4 14 14 196.00 65 $ 12,740.00 Bedroom 5 14 14 196.00 65 $ 12,740.00 Bathroom 1 12 10 120.00 65 $ 7,800.00 Bathroom 2 10 9 90.00 65 $ 5,850.00 Bathroom 3 14 11 154.00 65 $ 10,010.00 Bathroom 4 11 10 110.00 65 $ 7,150.00 Bathroom 5 16 14 224.00 65 $ 14,560.00 � oa dU TMEGo_ ffir 144» 0s0,rrzoo k' L LOT 25,01 S.Fe LOT 2 \ \ AY' \ '9 AMP M MAM 193 hM A COAOWZ[Y \ / \ ,�\ LOT 3 ob AMP M AVM 104 DOWLo W. t \ COA M J. ROY + c ✓�ie �aa»moxu�eall�c a�G��a� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 009802 Birthdate: 08/24/1939 Expires: 0824/2001 Tr.no: 3567 Restricted To: 00 PAUL J STHILAIRE 5 HANSON DR MERRIMAC, MA 01860 Administrator 00-35.000 d enclosed Space (MGL C.112 S.60L) 1A-Masonry only 1 G-1&2 Family Homes Failure to possess a cement edition Of the Massachusetts State Budding Code is cause for revocation of this license. I / DIG SAFE CALL CENTER: (888)344-7233 I i The Commonwealth of Msssa&use is 1 Department of Industral_.:.:ccrcenis C Gtirce of lnvesticetions Ecston, Mass. 0' . il - � NCrkerc' CCMPensadCn Insurrce.-.ncd.:�/rr � lame Fle3se ,,=nnt me' Lcc-ticn: 9l -Da S CO°!2 A Ci;i Ama-"ye 2 )44 4/f-/o F"cr.e = R7� '7�/��- 0 © rra 7� CI aa hcrnevwr,er per c.iinc all wcr'k rr.yse!f. I ani a scle .crcpnetcr and have ne cne ,,Aicr'<ina in any cacac::,,/ ` 21 I aril an em.bcyer--rcvidirc wCr;<ers' ccrnpensaticn icr my eTFleyeees wcr:URC cn this fcb. Camcanv name: j�9� -d v G'!4 nO w C P -a- D S d� / �'�X r Address q 4 "'0 da C/o All Cihi.. diymit m/g-�/a c+^cre! all Insurance Co. r U4,t d 6-noo 10. Fr�lici T �li.� tv C 135 ' � Cemcanv name' Address Cihi' =hcne'' Insurance Ce. Failure to secure c.-verage ss recurec ureer Sr_-ccn 21A or v1GL t 92 can leap to the:mcosiiien ar crmir. !penalties ci a nne uc to S1._CO.CO anefcr are years'imcrscn^rent as .ve:!as cvii penalties in the-.crrn c a S CF`NCRK CRCE.=a:c a dre ci(S.CO.CO) a pay 43irst rare. I uncenatana that a cwy ai;.`is staerrent.may to fcrNarcec to the Gr9c�cr Invesugancrns cr:tte CIA rcr czveraga ver>r:c=tics. I do herecy cz.,t y uncar.•he Gains and renalties of;e.jury that:he inrcnraticn:rcvided accve is a and ccs- Sicnature , � L /0-UC) Print name e-- �� A� .d r,^,cne T � � Gtncal use cnry Cc net wrae in this area to to ccmc,erec cy c::/cr Cay cr i avn p�•mrt/L ca^s:nc cujiCirc Cert 1 [C.`e:•!c;irrrmec:ate resx.^se Is�ecuYed L�censlnc 3 carte ^a^e r' realill Ce,''crGTErrr Town of North AndoverNORTH O��tLe° ,6'94+ �O Building Department o 27 Charles Street * _ North Andover Massachusetts 01845 V (978) 688-9545 Fax(978) 688-9542X4,9°°oe..Ar 9SSgcHus��c DEBRIS DISPOSAL FORM 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: �c)n-S 7 0 a—f;4?A-, Facility location Signature of Applicant oa Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Y f Growth Maar-,2eenent' EyNaw Exemption Ste emerL Town of North Andover Euiicirc Department I Mitis form shall be•used tC assist the_utidird recartment In their aiate'miraLCn of exe.T.c::ens under section j,,',?•-fthe Tcwn cf.Ner,`,,Andcver Grvmh,bianaremerr dyl'aw. 71e buiieinc applicant snail--mvtde all Cf!`e^ecessarr:r,fcr-a' as reauestec ce!cw. INa re cf,odic_,rt Cr Su;icirc :nri ,it i­eic%Aj) Adtdress Cf, rCC=r'/ :Cr rer"•i(teiCw) w yin av,y.�f -k- JlDFvtl CIo/V �e7`" l �vf•+tiG's /td'try Mac and Clf ACCIIc ttcn (C-eck be!ew) Fhcne NurrCer cf Apclitw,rt • ZSircie Far,iiy Twc Fam!!Y 979/ 7 !ri-GO h7 I the undersigned applicnnt;cr the above prceery attest that the attac.ed buiidirg cerrrit °car whit:s form is =mcieted does=mciv with the E<OAF i ICN sec:icn 3.7.5 of the Ncrh Andover GrCwih Managernertt Eylaw. 1 also understand providing this form does not abscive me cr ary par,/ to this permit from the recuiremerts of obtaining other permits recuired or'cr to the issuance cf;he _ui!cirg Pemit. Further I understand that my interpretation of the E<E.vIF ITICN S atus is subie�..'.:C re'!ie'N tv the Suiidirq Cepa ,, ent and is only cfFcaily at=pted when the Euiiding Permit iq issueo. Eased can se w:cn 9.7.E of the Ncnh Andcver Growth Eylaw the above lot and the•NC k as acciied 'Cr cr. the above lot, in the building permit acclic3ticn and assccated attac:;ments, =mp!ies with cre cr mcre of;he following sections as indicated by a ctecit mark. This is an acplicnticn fcr a building permit far the enlargement, restoration,or rec--rst;ac^cn of a;.weilirc;r existents as of the erre=ve date of'.his by-taw, provided;hat na additional residential unit is=ated. The Ict(s)weretwas eeated pncr tc May 5, 1995 are exempt from the previsions cf;his Sewcn 3'-of'he�nma Sytaw T'nis application is fer unveiling units fcr low and/or moderate inczme families or individuals,wrere all cf;he cznottions of 9.7.5.c are met and/or recresenm Cwelling units fcr senior residents,where cccucancy of the units is restmced to senior persons thrcugn a prccerty executed and recorded deed restncicr running with the lard. Fcr purposes of this Seen"senior'snarl mean persons over the age of 95. t This application is a part of a development prciec.1 which veluntanly agreed to a minimum 40%permanent recutrcn in density,(buiidaole lots),be!dw the density, (buildable Ictz),permitted under_ning and feastbte given the environmental cnditicns of the frac,with the surclus land equal to at least ten buildable aces and permanently designated as ocen seat andlcr farmland.T'ne land to be preserved shall be protected from deve!ccment by art Agricultural Preservation Rescsctcn,Cznservaticn Restric en, dedication to the Tcwn,or other similar,mechanism accroved by the F!annirg Eaara that,Niil ensure its prctec cn. This application represents a trap of!and existing and net held by a Cevelecer in crmmcn cwnersnic with an aclacent pard an the-iffecive date of this Sacion 8.7 shall receive a ane-time exemption from the=!tinned Growth Rate and Cevelcement SCeduling provisions fcr the purese of ccnsttuctng one sinc!e famtiy(tveiling jnit on ;he parcel. This acpticatiert represents a!ct which is ready fcr building permits,(l.e,all other permits from all ether boards and C:mmissians have been received and the prcjec:is ;n =mciianca with those permits), and the Cevelcement Scneduie does not ac=rmmcdate issuing a building permit in that Year,one building permit will be issued per Year per Cevelapment until suds time as the Cevelccment Schedule ac.rmmodates issuing builcing permits. Applicant must succty approved fans U with this E(EMPT!CN. F!ease provide any and all information that wculd assist the Euiiding Cecarmtent in making a deteminaticn' that your application is aiicwed one or more of the above E:CEN1FTiCNS. Ey signing below I attest to the accuracl of the information provided and that the aitaG,ed buiiding Cem^it;s allowed an E;<ENIF i CN as cited above. Further I understand that the submittai of misleading arc cr irac=rate information, or;he c.necaing off of an above item which does not ccmoly,whether acne 'c my owl e^ car net, is grounds fcr refusal by the °uiiding Cepartment to issue a EuiidingPermit. �l 7 G G Sicnature-crowner cr Autncnz_c 1gent,Nno stoned the Attacnec Eudctnc =emmu Cate i nts farm must be at--c^ed to the 3udding Permit uccn application ;car suet permit 1043 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. 1 Application by the undersigned is.hereby made to connect with the town water main in 14 Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. tl A Street or subdivision. of no. 74 l — QQ 75 Owner Address . 5 Contractor Address ' App)cant s Signature s t Zc90•e2e? Y PERMIT TO CONNECT WITH WATER MAIN TheBoard of Public Works hereby grants permission to` e . i to make a connection with.the water main,at /V �rn LAM& Street i subject to the rules and,regulations of the Division of Public Works. Board of.P.0 it Works. By. Inspected by Date See back for rules and regulations 1638 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. 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. The premises are known as No.. z? Street or subdivision lot no. 7-4? — —T,Io-/:m e� Owner Address Contractor Address li ant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to Alzllel- to make a connection with the sewer main at AL6Street subject to the rules and regulations of the Division of Public Works.. Division of Public Works � e By Inspected by Date See back for rules and regulations e F I. TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)685-0950 DIRECTOR Fax(978)688-9573 � µORTIy 3�O ,,LEO t ,69ti0 OL F to p * r y K SSgCNUSE< DRIVEWAY PERMIT DATE LOCATION I �DtJ��t� CSC Ke [� BUILDER phone OWNER X �er/ hone 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. r MAScheck COMPLIANCE REPORT k Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Release 2 k Checked by/Date k CITY: North Andover STATE-: Ma-ssachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family-, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-31-2000 TITLE: ABBOTT VILLAGE SALEM ROAD PROJECT INFORMATION: PAUL ST HILAIRE 9-6 HASCOMB ROAD ANDOVER MA COMPANY INFORMATION: J&J HEATING & AIR COND 17 ARLINGTOV' ST DRACUT MA COMPLIANCE: PASSES Required UA = 809 Your Home = 779 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value --------------------------------------------------------------------------- CEILINGS 2451 30.0 0.0 WALLS: Wood Frame, 16" O.C. 3477 11. 0 0.0 3 GLAZING: Windows or Doors 441 0.460 2 GLAZING: Windows- or Doors 42 0-.490 DOORS 75 0.600 FLOORS: Over Unconditioned Space 2451 19.0 0.0 1 HVAC EQUIPMENT: Furnace, 92.0 AFUE ------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design described here is cofigistent with the building plans, specifications, and other calculations submitted- with the permit application. The proposed building has. bgen deigned to meet the requirements of the Massachusetts Energy Code. The eating load for this building, and the cooling load if appropriate, hag b66h determined using the applicable Standard Design,Conditions found in thb Cbde. The HVAC equipment selected to heat or cool the build} ng shall bd no greater than 125% of the design load as specified in Sectiont 780CMR 1310 end J4,4. Builder/Ilesigner ��d /�� Date Massachusetts- Energy Code MAScheck Software Version 2 .01 Release 2 ABBOTT VILLAGE SALEM- ROAD DATE: 5-31-2000 Bldg. [ Dept. [ Use [ [ [ CEILINGS: [ ] [ 1. R-30 [ Comments/Location 1 [ WALLS: [ } [ 1. Wood Frame, 16" O.C. , R-11 Comments/Location [ [ WINDOWS. AND GLASS DOQRS: [ } [ 1. U-value: 0.46 For windows without labeled U-values, describe features: f # Panes Frame Type Thermal Break? [ ] Yes [ } No Comments/Location [ ] [ 2 . U-value: 0.49 [ For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ J No [ Comments/Location [ [ DOORS: [ J [ 1. U-value: 0.6 [ Comments/Location [ FLOORS: [ } [ 1. Over Unconditioned Space, R-19 Comments/Location [ [ HVAC EQUIPMENT: [ ] 1. Furnace, 92 .0 AFUE or higher Make and Model Number [ J [ 2 . Air Conditioner, 10.0 SEER [ [ AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When [ installed in the building envelope, recessed lighting fixtures [ shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or [ gasketed to prevent air leakage into the unconditioned space. 2 . Type IC rated, in accordance with Standard ASTM E 283, with no more than 2 .0 cfm (0.944 L/s) air movement from the the [ conditioned space to the ceiling cavity. The lighting fixture [ shall have been tested at 75 PA or 1.57 lbs/ft2 pressure [ difference and shall be labeled. [ VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ( ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] i Ducts shall be insulated per Table J4.4.7 . 1. DUCT CONSTRUCTION: [ ] 1 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 1 using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] 1 Rated- output capacity .of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR. 1310 and J-4.4. SWIMMING POOLS: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from jnon-depletable sources. Pool pumps require a time clock. HVAC PIPING INSULATION: [ ] HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in. ) : PIPE SIZES (in. ) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2 .5-4 Low pressure/temp. 201-250 1.0 1.5 1.5 2 . 0 Low temperature 120-200 0.5 1 . 0 1.0 1 .5 Steam condensate any 1. 0 1 . 0 1.5 2 . 0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1 . 0 refrigerant below 40 1.0 1.0 1 .5 1 .5 CIRCULATING HOT WATER SYSTEMS: [, ] I. -Insulate circulating hot water pipes to the following levels (in. ) : - f PIPE SIZES (in. ) NON-CIRCULATING j CIRCULATING MAINS & RUNOUT HEATED WATER TEMP (F).: RUNOUTS . 0-1" 0-1.25" 1.5-2 .0" 2 .0+ 170-.180 0.5 1.0 1.5 2 .0 140-160 0.5 1 0.5 1.0 1.5 100-13-0: 0.5 0..5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- ORTFy Town o �� : ; Andover No. �OLAKE o. ndover, Mass., C OC HICHEWICK ADRATED O?aL Cl 7SSACHUSE IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT Amel O�/t 4......................... .m:,4 . ... .......... Y �/�+ has permission to excavate and pour foundation at�......�.......'.... / .... .. .. .. .`t. ...... tV ... . 4 for the purpose o /fl. .46�� ......r. I !fq.. The person accepting this permit must return to the office of the Buildin Ins ector a ed lot Ian show 9 P P P of building thereon before Foundation will be inspected. ISI 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 UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. ... .. . . . . .. ........................ BUILDING INSPECTOR NORTH Town of Andover O "4 No. 9 Q ~ _ c'omo- 91� AdoverMass. � a COCMICKEWICK RATED P'Pa,`�� S H BOARD OF HEALTH PERMIT Food/Kitchen Septic System ll BUILDING INSPECTOR THIS CERTIFIES THAT.A N... oo44....... .. ................. .fUG.......Q ..... ...V`I f� ..� '✓ Foundation has permission to erect..................,................... buildings on . (� �. �i Rough . .. ....... .. .. to be occupied as�.�. Q �.. 1 �{3.... /� rr......Sr .. l�i�t ..� Chimney provided that the person accepting this permit shall in every respect conform to the terms the app ication on file in� Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M38 14/0 7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR CRough ...... .... 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.