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HomeMy WebLinkAboutMiscellaneous - 134 MEETINGHOUSE ROAD 4/30/2018 '{249 BUILDING FILE EDIT GeoTMS FOUNDATION PERMITS DRN ISSUED JAN 05 Date Permit Number Project Address Foundation permit cost Building Permit cost 73-115 Turnpike St Eaglewood Retail #3 12/14/04 414 Properties $3,335,578 73-115 Turnpike St Eaglewood Retail# 1 12/14/04 419 Properties 2,493,632 Eaglewood 73-115 Turnpike St 12/15/04 420 Properties ketail#2 2,548,132 Meeting House 134 Meeting House 12/15/04 422 Common Road Unit 86 $ 250.00 Meeting ' House 122 Meeting House 12/17/10 427 Common Road Unit 83 $ 250.00 3ov� Meeting House 130 Meeting House 12/17/05 428 Common Road Unit 85 $ 250.00 Meeting /,p House 144 Meeting House p 12/22/05 436 Common Road Unit 88 $ 250.00 c3G�P e Meeting House 144 Meeting Houser / 12/23/05 437 Common Road Unit 88 $ 250.00 �� ` (✓ U 1! / Meeting / i House 126 Meeting House 12/23/05 438 Common Road Unit 84 $ 250.00 / i Page 1 of 1 i McEvoy, Jeannine From: Cheney, Skip Sent: Wednesday, March 02, 2005 12:09 PM To: McEvoy, Jeannine; McGuire, Mike i Subject: Meetinghouse Condos Please post building permites for Meetinghouse Commons @ Smolak Farms to Map 104.0 Parcel 28 Thanks Skip 3/2/05 ' � s CERTIFICATE OF USE & OCCUPANCY l'C)'1VN OF cif R TI1 ,XNI)(.`rVER Building Permit Number 422 (12/15/2004) Date: Jule 21, 2005 THIS CERTIFIES THAT THE BUILDING LOCATED ON 134 Meetinghouse Road MAY BE OCCUPIED AS Single Family Dwelling—2,957 s.f. IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING `61 -E AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Tara Leigh Development Carterfield Road North Andover, MA 01845 Aalo �`�� Building Inspector i { NORT 0 of t jekndover - � o a t" �`y sdower, Mass. Z. i T % f ;y IAKE , �e " COG NIC NE WICK � r 7d�0RATEDpPa\y`5 i i�L4 r FVN. I PERMIT T 7 ` BOARD OF HEALTH Food/Kitchen t Septic System , A l! THIS CERTIFIES THAT............M 't j,�( vE• LLf* BUILDING INSPECTOR .............................. .................... Foundation has permission to erect........ .ae>............ buildings on Utv..-k%,... ... ..... .....M.�1{. �- � Rough ��(�-Q►�...- >��? �U� to be occupied as . SOA-LC... ;4. provided that the person accepting this permit shall In dvery respect conform to the terms of the app.li ion on file m.. • �............a.. ......�... .. Chimney ........... . . -Laws relating to the Inspection, Alteration and Construction of Final this office, and to the provisions of the Codes and By Buildings in the Town of North Andover. VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTOR 0 PERMIT EXPIRES IN 6 MONTHS N STS ELECT CAL INSPECTOR CONSTRU 0 .N............................... _ . BUILDING INSPECTOR Ap #� Occl.cpancy Permit Required to Occupy Building In 0—r — GAS nvsPEc R Display in a Conspicuous Place on the Premises — Do Not Remove Rough (�-�' No Lathing or Dry Wall To Be Donee' fit` Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT C:.S U �' O 5�.�-l� Burner Street No. SEE REVERSE SIDE Smoke Det. j' ' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 422 (12/15/2004) Date: July 21, 2005 THIS CERTIFIES THAT THE BUILDING LOCATED ON 134 Meetinghouse Road MAY BE OCCUPIED AS Single Family Dwelling—2,957 s.f. IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CGDE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Tara Leigh Development Carterfield Road North Andover, MA 01845 /fL4w X�� Building Inspector ` NORTH Town of No. -6022. .,�........ In L„K6 = dover, Mass., 'OD Ek. 1!; 2odgr- COCMICMEWICC. Ft- p.. • . O 7 RATED BOARD OF HEALTH PERMIT T DFood/Kitchen t Septic System U �1 A BUILDING INSPECTOR THIS CERTIFIES THAT Mr�`T�.1.1,sQ�1�1.1��+►'bE... .1Mr.! .!s..1Z.I-.C.................................................. Foundation has permission to erect........ ............ buildings on �.1+��1,......g(a-..�.. 1�!!. 'k4.�x+ ... !�!e� Roughet"" (9(Z(0 f- to be occupied as............ �.N4Ljr...1!rWw�:.�.1. w 1:.L..tti►C ... ..... .q.5. ..5. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the applic ion 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. PLUMBING INSPE�R VIOLATION of the Zoning or Building Regulations Voids this Permit. Z —� J' PERMIT EXPIRES IN 6 MONTHS o ELECTRICALINSPECTOR "UNLESS CONSTRU NS TS IN BUILDG INSPECTOR his— O..r Occupancy Permit Required to Occupy Building GAS INSPE, R l � Display in a Conspicuous Place on the Premises — Do Not Remove Rough / No Lathing or Dry Wall To Be Done FIRE DEP , r Until Inspected and Approved by the Building Inspector. Burner 14 Street No. IFSEE REVERSE SIDE Smoke Det. � f Town of North Andover Building Department NORTH 400 Osgood Street North Andover Ma 01845 �0 IN Vl Lll ruluV VGl, ivjLabbawi UJGLLJ V 1 O'tJ 2 _ (978) 688-9545 Fax (978) 688-9542 cu.•c.Nw.cw AOgA7lD �SSAGHUS�� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION i A l ADDRESS 41 Use O LOT NUMBER ,? 7Z, SUBDIVISION —ME DATE REQUEST FILED SZ 12� S DATE READY FOR INSPECTION -7// 6 • TEN 10 DAYS NOTICE PRIOR TO CLOSJNG DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE CO D WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENT - ($25.) DOLLARS WILL BE CHARGED IF THE STRUC DOES NO ET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHORIZATION Location �lA✓,I No. Yozc). Date M 3?O90 TOWN OF NORTH ANDOVER t`•O •,�O O 60 w 9 Certificate of Occupancy $ 1 «�ii:n. 4 i -TS°•,c►,u9 <�' Buildin /Frame Permit Fee $ st Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # M ✓ ,Building Inspector { Location UN t l*6L—/S• 12agD No. AZ2 Datel�/�� �- T—C-U Q0/rri 0 N NORTq TOWN OF NORTH ANDOVER 3?0�,,``D '•,hO O F w 9 i y Certificate of Occupancy $ C MUS E Building/Frame Permit Fee $ SA Foundation Permit Fee $ �� Other Permit Fee $ TOTAL $ Check # � t r J 17910 kms, Building`Inspector .! TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING .,. " . ..,tx x", _.'..•.a ,_,•;} ,,w.,,:: �;:;�.3„:�, ,.�: _.::• ; `��W MP3 * 4.„�.;x=°=.�. r,�•:�v=�� Vii. ,', BUELDIr GG PERMIT NUMBER: O'LL DATE ISSUED. 2.00 SIGNATURE: Building Comitissioner/In for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 'd2aLm 1.2 Assessors Map and Parcel Number: O ,�9 S 1 s Map Number Parcel Number tn- r, C1 1.3 Zoning Information: 1.4 Property Dimensions: R I c H .401R) MI AC UOP W lDWW Co Koo 3 d 7- 6( 7 S' Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Reqyired Provided fNJ 1A 1601 + �d v 1.7 Water Supply M.G.L.C.40. S4) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public Private ❑ Zone Outside Flood Zone Municipal On Site Disposal System ❑ V J SECTION 2-PROPERTY OWNERSI-IIP/AUTHORIZED AGENT nISZOriC District Yes 1 0 r 2.1 Owner of Record Name(Print) Address for Sernc Sig a Telephone 2.2 Owner of Record: Name Print Address for Service: O t Si ature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Su rvisor: < Not Applicable ❑ s Licensed Construction Supervisor: Z � License Number t r A►,o �' wn Address /S-)Z)6 > 6?;?r Expiration Date a K Sig Telephone r. r 3.2 Registered Home Improvement Contractor Not Applicable ❑ ,Company Name y AM 11, 14 Registration Number r Address r r� Expiration Date �^ Signature Telephone Y♦ 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 Descri tion of Pro osed Work check all applicable) New Construction)K Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: .'1�. 0 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to bepC "USE ONLV Completed by pen-nit applicant 1. Building (a) Building Permit Fee O C3D Multiplier 2 Electrical (b) Estimated Total Cost of �ti 6D7� " Construction FbN • 3 Plumbing Building Permit fee(a)X ) 4 Mechanical HVAC Oz3O , la oR fb .—. 'ALS av (i=aN j � 5 Fire Protection 3 Q 07� O '�2 6 Total 1+2+3+4+5 heck Number ^v i, SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN e OWNERS AGENT OR CONTRACTOR APPLIEST t FOR BUILDING PERMIT _ D I r I, 0 as Owner/Authorized Agent of subject property 1 tHereby authorize to act on My be ;in all ers relative to thorized by this building permit applicatio Si e of Owner Date CTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, A as Owner/Authorized Agent of subject property i Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief P e I � �y Si e of Owner/A ent Date NO. OF STORIES i SIZE XS BASEMENT OR SLAB gM�► SIZE OF FLOOR TBA BERS 1 7 Z 2 Z 3RD SPAN ' DRyIENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS " HEIGHT OF FOUNDATION THICKNESS /,01/ SIZE OF FOOTING r f X r� MATERIAL OF CHRvINEY 2_6G IS BUILDING ON SOLID OR FILLED LAND s , IS BUILDING CONNECTED TO NATURAL GAS LINE 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*********************** APPLICANT / _ f /P-A 2ZL&/UY m J L L C PHONE` 77 07-21 .Z' LOCATION: Assessor's Map Number ��yC PARCEL 3 SUBDIVISION MA04, 46W LOT (S) [ALL-56 STREET d4 QfFd�lk ST. NUMBER **********OFFICIAL USE ONLY **�► REC90MENDATIONS OF T WN AGENTS: 37 C SERVATION ADMINIST tOR DATE APPROVED o? Q DATE REJECTED COMMENTS leSOf N PLANNER DATE APPROVED DATE REJECTED COMMENTS FOO INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEP IC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT /0_27—oel_ Ll FIRE DEPARTMENT_9//✓_,,,_`,f S veA,,,.v1 ,'/a / X0 02,E a RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm � ,_� i I� Y �e &m.'a/a o�/�aeoac/auaPGYa BOARD OF BUILDING REGULATIONS License- CONSTRUCTION SUPERVISOR NU►nber4CS' 055417 ''Birthdafet�4/05/1�J60 E �if�es°04/05/2tlff$ Tr.no: 21033 Restricted: 06. THOMAS D ZAHOIIRWIKO' 121 CARTERFIELD RD N ANDOVER, MA 01845h' Acting C mis oner f p The Commonwealth of Massachusetts d Department of Industrial Accidents Mice of Investigations Boston, Mass. 02111 ,�•' Workers'Compensation Insurance Affidavit Name Please Print Name: 7G C iYl Location: � (1$6 4Ci APhone # I am a homeowner performi all work myself. I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone# Insurance Co. Policy# Company name: Address Clty: Phone It Insurance Co. A P01icV# Failure to secure coverage as required under Section 25A or L 1 2 can lead to the imposition of criminal penalties af,a fine up to$1,500.00 and/or one years'imprisonment_as v�tell.as_civil,penaltlesin f -of-a.STOP WORK ORDER..and..a fine of.(.$100.0.)-a day against-me. I understand that a copy of this statement may be forwarded t th ice of Investigations of the DIA for coverage verification. 1 do hereby certify under the psi nd penalties of pe0 t t the information provided above is true and correct. Signature Date Print na e Phone# ��f Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensi ❑ ❑Check if immediate response is required Building Dept ❑ Licensing Board C] Selectman's Office Contact person: Phone#. ❑ Health Department ❑ Other Town of North Andover of jko-r#j Office of the Zoning Board of Appeals ;� •�' Community Development and Services Divist ;zi4 e F 27 Charles Street T N-i-14 C U North Andover,Massachusetts 0184:5 N� T H ;N .i)V D. Robert Nicetta Teleph X4:4 66��995�1 3 3 Building Commissioner 1�} i jj 5 11- October 15,2004 N t-� Thomas D.Zahoruiko, 121 Carter Field Road o North Andover,Massachusetts 01845 -0 'ti N RE: Meetinghouse Commons at Smolak Farm o r South Bradford Street DU:�zj o U-)C-- �� North f� h Andover,Massachusetts Oi845 .._ _� ,.- w _. Dear Mr.Zahoniiko: w Regarding your request for the Zoning Board of Appeals to approve the pre-construction items of your decision that you submitted: Upon a motion by John M.Pallone,and 2°d by Richard J.Byers,the Board voted to issue a Finding that the Thomas D.Zahoru0co letters of September 27 and 28,2004,outlining the pre-construction items required by the Comprehensive Permit,2-1-033,granted for Meetinghouse Commons at Smolak Farms,have been met. Mr.Pallone amended the motion to specify the Regulatory Agreement,and indicate that the approval of the Deed Rider is a pre-condition of the Occupancy Permit. . Voting in favor: John M.Pallone,Ellen P.McIntyre,Joseph D.IaGrasse,Richard J.Byers,and Albert P.Manzi,III. �6 p hz� Ellen P.McIntyre, it Zoning Board of Appeals cc: D.Robert Nicetta ZBA file 2001-033 M104CP316t28 Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 THOMAS D. ZAHORUIKO MEETINGHOUSE COMMONS LLC 121 Carter Field Road, North Andover, MA 01845 Tel: 978-687-2635 Fax: 978-689-2310 Mr. Robert Nicetta Building Commissioner Town of North Andover 400 Osgood Street North Andover, MA 01845 December 14, 2004 Dear Mr. Nicetta: Attached please find the first building permit application for the new ch. 40B Meetinghouse Commons project. This request is for a conventional single framed condominium dwelling unit. Mr. Nicetta, at this time I am requesting only the issuance of the foundation permit, in order to try to begin work before winter conditions become too difficult. The foundation plan and details as well as the front elevation for this Unit#86, The Vineyard, are included with the application. We are still working on some details of the interior, and respectfully request that you allow that the complete set of plans be submitted prior to requesting the building permit itself. All other materials, including Form U, Building Permit Application Form, Insurance Affidavit, and Contractors License are also included. As always, please contact me with any questions or concerns. Thank you for your assistance, support, and cooperation. Sincerely, mas D. Zahoru• o, Manager eetinghouse Co/mons LLC • I THOMAS D. ZAHORUIKO MEETINGHOUSE COMMONS LLC 121 Carter Field Road, North Andover, MA 01845 Tel: 978-687-2635 Fax: 978-689-2310 Mr. Robert Nicetta Building Commissioner Town of North Andover 400 Osgood Street North Andover, MA 01845 February 15,2005 Dear Mr.Nicetta: As a follow-up to the foundation permit 4422 which you issued to me for Unit 86, Meetinghouse Road, on December 15, 2005, attached is the follow-up complete set of plans and Masscheck report which you indicated you needed to issue the building permit. I have also enclosed a copy of the original permit application documents for your reference, including transmittal,Form U,Permit application form, license, ZBA correspondence,and foundation permit. Please let me know if you require anything further in order to issue the building permit for this Unit. Thank you for your help and consideration. Sincere , homas D. Zah ruiko,Manager Meetinghouse Commons LLC vt O Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lb Data filename:Untitled TITLE:The Vineyard 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:02/16/05 DATE OF PLANS:02/15/2005 PROJECT INFORMATION: Unit 86 Meetinghouse Commons North Andover,MA COMPANY INFORMATION: Meetingohuse Commons LLC COMPLIANCE:Passes Maximum UA=468 Your Home=436 6.8%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 1580 38.0 0.0 47 Wall 1:Wood Frame, 16"o.c. 2304 13.0 0.0 149 Window 1:Vinyl Frame,Double Pane with Low-E 447 0.340 152 Door l: Solid 42 0.340 14 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 1580 19.0 0.0 74 Furnace 1:Forced Hot Air,90 AFUE Air Conditioner 1:Electric Central Air, 11 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 the 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. f r Builder/Designer Date i i i MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release Ib DATE:02/16/05 i TITLE:The Vineyard at Meetinghouse Commons Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: I Above-Grade Walls: [ ] I 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: I 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: I Floors: [ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: I Heating and Cooling Equipment: [ ] I 1. Furnace 1:Forced Hot Air,90 AFUE or higher Make and Model Number [ ] I 2. Air Conditioner 1:Electric Central Air, 11 SEER or higher Make and Model Number I Air Leakage: [ ] I 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. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment I must be provided. [ ] Insulation R-values,glazing U-factors,and heating and cooling equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. 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 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 T must be insulated to the levels in Table 2. 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) U�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 Piping System Types Ranpe F 2"Runouts 1"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 NOTES TO FIELD(Building Department Use Only) North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accorda lith the provision of MGL c 40 S 54, a condition of Building Permit Number G is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: 4 L01i (Location of Faci Sign tune f Permit Applicant 05 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector RECEIVED FEB 1 6 2005 BUILDING DEPT. ME.E.TINGHOU5E.COMMONS at 5MOLAUAKM5 Unit Specifications (Attachment B) Structural Features • 10"Poured Concrete Foundation,20"x10"footing,3000 PSI • Damp proofing,perimeter drains • (2)2x6 pressure-treated sills,sill sealer insulation • 2x4 KD exterior wall studs @ 16"OC • '/s"wall and roof sheathing • %"Advantech T&G sub floor • 2x4 KD interior wall studs @16'OC EneraFeatures • Tyvek or equivalent House Wrap/Weather Barrier • R-13 Fiberglass Wall Insulation • R-19 Fiberglass Floor Insulation • R-30 Fiberglass Ceiling Insulation • Paradigm High Performance Low-E Insulated Windows with Screens,Integral Grilles and Tilt Wash feature • Energy Efficient Hot Water Heater Exterior Features • 25-Year Warranty Architectural Roof Shingles • Ice and Water Barrier at Eaves and Valleys • Soffit and Gable or Ridge Vents as required • 4-Panel Front Door with Sidelights,Schlage"Plymouth"Brass Handset • Raised Panel Garage Door with Door Openers • Asphalt Driveway • Paver Front Walkway • Clapboard and Shingle Siding • Brick Chimney,gas fireplace • Loam and Hydroseed areas disturbed during construction • Landscaping per plans Interior Features • 200-Amp Electrical Service • Forced Hot Air Heat and Central Air Conditioning System • Copper Water Supply,PVC wastewater • Telephone Jacks Installed in 4 Locations • Cable Television Jacks Installed in 4 Locations • Closet-Maid(or equivalent)Closet Shelving • Bedroom Closet Fluorescent Lights • Smoke Detectors and Fire Sprinkler System • Washer and Dryer Hookup • Hardwood Floors in Kitchen Dining Room Living Room&Foyer • Ceramic Tile in Bathrooms • Carpeting in Bedrooms • 4-Panel Solid Interior Doors with Schlage"Flair"Brass Lever Sets • Oak Handrails with Painted Balusters • Stairs to have Oak Treads with Pine Risers • 5 'h"Baseboard Trim • 3 ''/z"Window and Door Casing trim • Skim coat Plaster,Smooth Walls,Textured Ceilings • (2)coats Linen-White Flat Wall Paint Meetinghouse Commons Unit Specifications.wps 1 MEETINGHOUSE COMMONS at SMOLAK I=AKMS Unit Specifications (Attachment B) • (2)coats White Gloss Trim Paint • (2)coats Urethane on Natural Wood Trim • Central Vacuum System • Pre-wired for Security Alarm Kitchen • Cabinets per plan with Crown Molding,Light Rail,counter lighting • Granite Counters • Stainless Steel Undermount Double Sink • Kohler"Coralais"Chrome Pullout Faucet,Soap Dispenser • GE Appliance Package to include:Oven/Range,Microwave,Dishwasher,Trash Compactor and Disposal Baths • Kohler White Fixtures • Kohler Faucets • Solid Surface Sink tops with integral sinks Ling Included: • Recessed cans in Kitchen • Recessed cans in hallways • Recessed cans on front porch • Rear Spotlight • Exterior garage light Allowance for Purchase of: • Dining Room Chandelier • Foyer Chandelier • Kitchen Island Fixtures • Bathrooms Fixtures ALL MATERIALS,SPECIFICATIONS,MODEL NUMBERS AND SUPPLIERS SUBJECT TO CHANGE OR MODIFICATION AT ANY TIME. ANY CHANGES WILL BE INDUSTRY EQUIVALENTS AS DETERMINED BY TARA LEIGH DEVLOPMENT LLC and/or MEETINGHOUSE COMMONS LLC. Meetinghouse Commons Unit Specifications.wps 2 . J 1� i s r r��nr2 Z4 K 3 - �3 ;Z 2 X �o 2� `22 7 � mcg q RTH Town o - Andover 0 dover, Mass., �— T O - LAKE �� T COCMICIM ICK 7�S RATED SACHUS FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ...........MDMA i444-P-0- it..'��..... ................................................... has permission to excavate and pour foundation at ..0 •*p for the purpose of...1:/XM�rJtl�ar.: �?.�w�i1.. .•.��..�a:/JZ...3.t�i .....l .Il.R!<•�f...� Z�.tA� -.:.. The person accepting this permit must return to the office of the Building Inspector a cbrtified plot plan show of building thereon before Foundation will be inspected. 'R, 2r \�s� �- c T4-M% �%T a�..S�.ti, mot-�3 3 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. 055067 As ........................................ ....................................... SEE REVERSE SIDE BUILDING INSPECTOR �.1ORTH qC ovm Of No. *,22. o _„ �.. .' Andover * ZO - LA dover, Mass., I�CZ' . 2CP (1 COC KICKE WICK 1 �dS0 ATE F'P�`��5 •,��� • ��. Iij� ?.00 i 77 FRough F HEALTH ERM P IT T THIS CERTIFIES THAT M 9 SPECTOR has permission to erect.......Ste?.ae'�............ buildings on t.kk.� S to be occupied as �.iQ.L �qwp �-.P-Velf:.L1.4i. —� o2.Q57 Provided that the person accepting this permit shall indvery respect conformtothe ..........terms of the applicat non file...... m.. this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction in Final Buildings in the Town of North Andover. of VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTOR Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRU N S TS ELECTRICAL INSPECTOR Rough ..... ... .. Service . .. . . .. .... ....................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. 4 Of SNOW .11 i NOTES: dL 1) THE BOUNDARY INFORMATION SHOWN HEREON WAS 00 w` / TAKEN FROM A PLAN ENTITLED "PLAN OF LAND, MEETINGHOUSE COMMONS AT SMOLAK FARMS, SOUTH BRADFORD STREET, NORTH ANDOVER, 'DISTURBANCE25' NO 0° w� / MASSACHUSETTS"; SCALE: 1 " = 80'; DATE: \ / ZONE _ ? JULY 20, 2001 BY THIS OFFICE. RECORDED AS PLAN #14828 IN THE ESSEX COUNTY NORTH DISTRICT REGISTRY OF DEEDS. AL \ / 2) THE INTENT OF THIS PLAN IS TO SHOW THE AS- "' ��FRCo 20Ne I \ o BUILT LOCATION OF THE FOUNDATION ONLY. POO` N �— A / O odJ,��o00 / / MAP 04C LOT �S / 1 HEREBY CERTIFY THAT THE FOUNDATIONS SHOWN HEREON ARE THE RESULT OF A FIELD SURVEY MADE ON PIC as FEBRUARY 16, 2005. Z ¢ w F�VND UILT �pytN OF Rf4,? \ I Z - a UNfT ATIpN \ Q o z o TOP; 86 JG CHRISTOPHER i- 1g4.2 p/ FRANCHER rM \ \ = No. 36116 \ \ 3 $ ip� OQ \ p V U V J `n °' LICENSED LAND SURVEYOR DATE _ _ _ _ _ -ROAD — — — _ _ _ CERTIFIED FOUNDATION PLAN // UFI "�� -� MEETINGHOUSE COMMONS - UNITS 85 & 86 MEETINGHOUSE ROAD " - 64.46' g, NORTH ANDOVER, MASSACHUSETTS 47'O, 506'53'58"E S10*42'34"W� PREPARED FOR S00'45'10"E 138.84' '� 63.45' 509'10 34„E 75.47 �� Sob'12 01 E S06'S1 00 E 518.51 '03"W - TARA LEIGH DEVELOPMENT, LLC 49.35 185 HICKORY HILL ROAD 00 46.84 S09'27'56"W S13*54'19"W 55.75 35.20 NORTH ANDOVER, MASSACHUSETTS SO4'48'24"E _ _ GRAPHIC SCALE MAP 1 o4c LOT 24 nw� 103 Stiles Road, Suite One ro 0 25 50 100 1 6.35 _— Salem, New Hampshire 03079 o T= p (603) 893-0720 i — ENGINEERS• PLANNERS•SURVEYORS o MHF Design Consultants, Inc. (IN FEET) SCALE: 1" = 50' DATE: FEBRUARY 17, 2005 DRAWING G DRAWN BY: CHECKED BY: PROJECT NO. a 1 inch = 50 ft. NO. DESCRIPTION BY DATE REVISIONS JAC CMF 108800 1088CFP.DWG r b.r SI 4 i2 to� LI I -IR .9 N ILL] TI I I - ] [=- I ILO [E i t r L u E VEED F F B 16 2005 BUILDING DEFT. f- 1\O NT L LF—UAT I O" T6 Vinegard at Meetinghouse Commons, Nortk Andover, MA o1845 nit #86 Scale: 1/4" = 1 'O" Date: 02/1 5/2005 Sheet t Meetinghouse Commons LLC, North Andover, MA 4 V B-0 12-0 ( ( OP 7, 1 S rxl%u LI i b-3 i i P ° � f� Al A'T<a� g-z 3-7 O - � ast�aw .�lN1Nf� 6R�EJ►7 RoGt+t 17 ?r t 0 V—go ,x t ft A o S �- NAV— 6�ocrst( �� � 3E.DRoo?►� � a � z-v p FOYEkt. �L�X ROON\ ol'EN�a - FoY£R -O (2.O O _ t � 2-c faR GA AA GE � N 8 ' ! 0 cr,vekca foWcu I � Ll �Cckx 0� The Vineyard at Meetingkouse Commons, 48-0 Nortk Andover, MAO] 845 nit #86 1 F 1 RS-1' FLOOR S�CO�N� F`.00•R Scale: 1/8" = PO" Date: 02/1 512005 jheet 2 Meetinghouse Commons LLC, Nord,Andover, MA 22d 2 (06 _ v ' i DMtoP I r''1'rRS F oR •b�GK { Nok ' W AlKuaT I oil O D t i I i T {{ ,, ANCHOR — i� SI'R AP ok BaLT' O lk W ALCuT 2- s — — QUOS+►J6 !O" X 2otr ,9 WALL !0" '� 7`f0`r m t� 110� 4Si t+ ;MLT ER ,9! FAa K Arc. O -4 EY%AIAY a 'a- v (-10 - - 8 v 1 o i oR P%tJ. 14" ?C•SLAR, 3000PSI '- D, Ito ' get Li o J 0�o t V k �EgR1t.1G SotL O r N N O N N .a I r M p M I' q_� 9_3 _ o FNortk egard at Meetinghouse Commons, _O Andover, MA O1845 nit #86 1/8" = 1O" Date: 02/15/2005 Sheet 3 lON / B ASEMV—N T house Commons LLC, North Andover, MA r i I 22 -O o ` , S p 0 QD M , q I Y i' O cv FNorrtt6 ec{ard at Meetinghouse Commons, F 1125T ZDEG1� SF C O N17 'D 4E C Andover, MA O 1 845 nit #86 1/8" = 1'O" Date: 02/15/2005 Sheet 4 house Commons LLC, North Andover, MA z 1"bow a boo K S CH is tluUc i - tr+YRy 68 '12 X 83 < D-Z f-Nz RY 3 i/2 x 93 D-3 160.bEk ITPAMSOM\ X q�'��{ - - - - D-4 82' 2 r— A ouau tiomr, a4'/j x 65'/x} o $ bout U xuu6 *huLL 68 x 65 1 Ll C ,DouskUtiomc 34 thA x r, k 16 G E womp muLL 106 x S7 1l14 b1.1,b ER. 601 AA X 42 -49 f Q. Ttil�n�Sorti onvLL '08 x 30}�Li 1 1 5 bovILLI Hu"G '� ilOv$L�H�,►�s Mu LL J t RA Nso� ►O 1 l2 X 9 l Z4s 0116" O rt��liE:'t,10FZ i7009S ROOF The Vineyard at Meetinghouse Commons, I North Andover, MA 01 845 Unit #86 Scale: 1/8" = 1'O" Date: 02/1 5/2005 Sheet 5 Meetinghouse Commons LLC, Nord, Andover, MA r ,tea a J ALT. RRF?6Rclz i b � 12 iii\t - - -� — — - 1C1 19;0-VI .TOLST3 GEILI���-ooR y �. J� vv►zrr , 0.3It ' STRAP ` Will � �I2" ML�fl.RD r jl STUD i G1.P.aIS�t�1�6UE x - v ° - SLwT�t sat�ty. -riv�iclri• 7�At� LZ)2x6 1T�Zt -T+ 6 AavA�ctccK /EBV►v. PC. slLLsiALER f Bit lD6lmr- L2>2X PT X o my hs R t Q. FA.�m� O -- p LALLY �� 7� rC SI.-kD I TYPICAL S1UTIOAA TYPICAL DgZ.i�\i. PARCH n���\) F egard at Meetinghouse Commons, AnJover, MA O1845 nit #86 varies Date: 02/15/200,5 56eet 6 house Commons LLC, North Andover, MA i t Date. 1 �4, TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING cc2 SSACNUS This certifies that has permission to perform ..4. . �`' plumbing in the buildings of . . .2 No at .U. �!��' 8(01., �(. .Wi� tr�zs� rth Andover, Mass. Fee.J`. .`S�.Lic. No. �E. . . . .. . . . . . .a. : f PLUMBING INSPICTOR Check H 1 4 ' 6469 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN( (Type or print) NORTH ANDOVER,MASSACHUSETTS Y. l G Date S Building Location Q Od 4 Owners N me /!®(//�l L� Permit#" Amount Type o Oc anc New Renovation Replace Vnt Plans Submitted Yes No FIXTURES co Cr Cr w A w SLRB%E R4S VE'4f �nH I l 31M HJOM 4HiHJ0M 6MHJOCIZ 7MHJOCR 8M Hj" (Print or type) Check one: Certificate Installing Company Name (� m S Corp. Address / � � `s� �a �'(f El Partner. Business Telephone R*40 - Firm/Co. 1 Name of Licensed Plumber: Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate box: 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 Signature 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 Mass tts ate lumbi ^nd Chapter 142 of the General Laws. By: Signature of ice's ns�ec P umber Type of Plumbing License Title d/_�,f City/ icensfe Mi er Master Journeyman APPROVED(OFFICE USE ONLYLLLJJJ � Si 2 3 ��U � � �� .5 ,�� � 3 � xD .10.x- Dat . .. HORTM °f o? TOWN OF NORTH ANDOVER s i PERMIT FOR GAS INSTALLATION �9SSACHUSEt .._ This certifies that . ,A o- `, 14 has permission for gas installation . ./V.`u!. .��'... .`-. . . . . . . in the buildings of U n! �a . '. . .� W . at . UNC �'. . . .. �l-e 0(.eNorth Andover, Mass. Fee. ./X$7. . Lic. No.. P4CI�h � ,(/ GAS INSPECT R Check# 5125 MASSACHUSETTS UNIFORMAPPU NFORPERMTODO GAS FnTl'NG (Type or print) Date �( G NORTH ANDOVER,MASSACHUSETT Building Locations �, ,, / 1 4 ��'� Permit# ( r Amount$ I, cfrn -2,0, to LJ i e,, O ner's Name New Renovation ❑ Replacement Plans Submitted � a � w� w a z 0 H OU F x z a H F a z o F go W WW O o a a z N (AU cL O z . w w � � a w , H A H z --t z a N p w o H o a 3 a ° a° �' a a0. H o SUB -$ASEM ENT B A S E M ENT 1ST. FLOOR f 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) J Check one: Certificate Installing Company Name l Ut'h l � � Corp. Address I V Partner. Business Telephone p one 1 Co Lj Firm/Co. ' Name of Licensed Plumber or Gas Fitter , i INSURANCE COVERAGE Check one• I have a current liability Insurance policy or it's substantial equivalent. Yes No[3 If you have checked yes,please' dicate the type coverage by checking the appropriate box. Liability insurance policyIj Other type of indemnity Bond D. 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 13 Agent r 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 C de and�hapt 142 of the General Laws. 41 By- Signature of Licensed Plumber Or Gas Fitter Title Plumber 12 -i ICity/Town Gas Fitter (cense Number ster APPROVED(OFFICE USE ONLY) ourneyman A Date.................J/ HORTI{ °`�"'° :•�"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSA�MUSE� This certifies that ... i� 'r''..........a...................................................... 1 has permission to perform ......>.,. .................................................................. wiring in the building of Z-'`"{ - - =fit "1-421,11' INN � {� ....::. North Andover,Mass. 4 Fee a.. ..... Lic.No........i�PG......` ...... ELEcriuc;ZIN E' R Check # � Ci � 11W LUIMUUty VVrAu n Ur�rfr>t. t,nv wl `,��•-•7w��-�•�, DEPMle7111M70FPUNKSAFEN Permit No. BOARDOFF=MEVEW01V 0MR7aV 12.00 � Occupancy&Fees Checked APPLICATTONFOR PERAff PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCETHE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat 3 t O .- Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electric work described below. Location(Street&Number) Owner or Tenant i ts (_E t JA l e ,,-�€A ii Owner's Address vt Is this permit in conjunction with a building permit: Yes No 0 (Check Appropriate Box) Purpose of Building PC-S t"6,ev A-1 Utility Authorization No.3 f ZZ$ Existing Service AmpsVolts Overhead [3 Underground a No.of Meters New Service , Amps lln�olts Overhead Im Underground 1Zr No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work UT,1_.7 �7777'L No.of Lighting Outlets No.of Hot Tubs No.of Transfortners Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA and and rl No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners i No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons t• No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwasher Space Area Heating KW No.of Sounding Devices r No.of Self Contained Detection/Sounding Devices r No.of Dryer Heating Devices KW Local Municipal Other Connections No.of Water Heater KW No.of No.of Siam Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• ltnuarneCrneage mePutsttantblhEtegtneratSeflVlaleech%-.ne_ lLavvs [ZrItaa=tLiafa�Tt b=meFb6cYatiAVCan crJs bAarialWalat YES NO Ihmes kmWdva5dpcdcfsanealhe0ffim M ET rMV if}ouharedwd tdYFS,pbeQteWofa mWby INK ANNCE LJ BOND Old r EMrxdVakleofl7mwcal Wcdc$ WodcbSUt 3 0 li>S wdmDaleRec}>t�d Rough w"-t C�4-c--e Rrn1 S9Zdundir-TVF"*kksofpeW flRm MELAA- LiareeNo. /1-t Limmm - t 7 Bra TeLNa Ln7, 2- 6Sy Adim t,WSg� p tti�< �• �-�- D,� AIL IdNo, -9�Fr 37ST�Y62 OWNECSINSURANCEWAMikl awaetuftLioanedoamthmtbeinsu ,maNa•WcritsshtarialgivWnas 3pWbyMas &BoGffnWLam atd that my sigrnhae cnttis p wnk application wanes dig togiitanrnt (Please check one) Owner Agent a Telephone No. PERMIT FEE$ - Signature w �. Jim t,ULt+ NUIV"r las n Ur 1nnMM%,nVLMA A v ......, .- -, DF.PA1D11 WOF SVEY c", Permit No. BOARDOFFD�EP1eEVF1V1fOlV 27C91�12N Occupancy do Fees Checked APPUCAHONFOR PERMIT PERFORMELECMCAL WORK ALL WORK TO BE PERFORMED 1N ACCORD THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT 1N INK OR TYPE ALL INFORMATIO Da 3 i O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electric work described below. Location(Street&Number) eYt� Owner or Tenant k)t\-V—� L_E t " l �J ,�E•v"i Owner's Address "'L L <ZTO— (v VC() Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building z a..�r) „g—L, Utility Authorization No.3,ZZ-6-1 Existing Service AmpsVolts Overhead Underground No.of Meters New Service Amps llo�olts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1A.A-,E No.of Lighting Outlets No.of Hot Tubs No.of Transformers Tota! KVA No.of Lighting Fixtures Swimming Pool' Above Below Oerneratar KVA ground ground No.of Receptacle Outlets No.of Oil Burner No.of Emergency lighting Battery Units No.of Switch Outlets No.of On Burners No.of Ranges No.of Air Cond.. Total FIRE ALARMS No.of Zones Tau No.of Disposals No.of Had Total Total No.of Detection and Pumps Tom Kw Initiating Devices No.of Dishwasher Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices ! No.of Dryer Heating Devises KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of sign Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER- losuartaeQNW@t Az�etYblhetagiiar�af e�d>t�aGnl®lLawa �/ IhmaanaiLit t b mtaelbkidit bmoft aibstdnm *dmt YES NO IhmesftnhadmWpoafafs=iDdrO0kz YM ffyouhmedzck dYMpbeirjc*drrA eefwvwpby ]NRA KE LZ BCND OMM E dVai dEbc>WWadeS WbikioSlatt O ItspsctiortDaleRo4restad Raft w�K- C-A,,(.c Fuld Sgvdundir-TXPqffiofpajuy FIRMNAME LxxrwNa /`-C S^l b P� Bl*=TdNa vws o,� �� ►.��� �-�-�-�-,7�..�, „� AItTdNa r ;7WNER'SMURANC'EWAM3kl awaaedadielio wdpmnott dleilagat aNar,lperbaz attdd�atmysigr�ernlhispeen'tappicamlwai�dinregisalnt agivalaltasnaq<itedbyMassK�GalaalLawa (Please check one) Owner 1:3 Agent Telephone No. pgR�FEE signature J � � © t