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HomeMy WebLinkAboutMiscellaneous - 138 AMBERVILLE ROAD 4/30/2018 138 AMBERVILLE 210/108.0-0077-0000.0-) j North Andover Board of Assessors Public Access Page 1 of 1 BORT" Forth. Andover Board. of Assessors. i Sroperty Record Card Click Seal To Retum Parcel ID:210/108.C-0077-0000.0 FY:2013 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales Summary 11' Residence Detached Structure Condo 138 AMBERVILLE ROAD Commercial Location: 138 AMBERVILLE ROAD Owner Name: ALGER,STANLEY F III Owner Address: 138 AMBERVILLE ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:6-6 Land Area: 0.25 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3684 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 627,500 591,600 Building Value: 453,100 416,500 Land Value: 174,400 175,100 Market and Value: 174,400 Chapter Land Value: LATEST SALE Sale Price: 599,967 Sale Date: 11/27/2002 Arms Length Sale Code: Y-YES-VALID Grantor: PULTE HOME CORP Cert Doc: Book: 07310 Page: 0176 http://csc-ma.us/PROPAPP/display.do?linkld=2259510&town=NandoverPubAcc 3/19/2013 Residential Property Record Card PARCEL ID:210/108.0-0077-0000.0 MAP:108.0 BLOCK:0077 LOT:0000.0 PARCEL ADDRESSA38 AMBERVILLE ROAD FY:2013 PARCEL INFORMATION Use-Code: 101 Sale Price: 599;967 Book: 07310 Road Type: N Inspect Date: 101061201.1 Owner: -- ----- _ g _ _ __ __-_.-___N_1_"._.__-­ s Date: 10106/201.1 Tot Fin Area-3684 Sale Type. P Cert/Doc: Traffic: Entr '' ~' ALGER,STANLEY F III Tot Land Area: 0.25 Sale Valid Y Water. Colle t I X Tax Class T Sale Date 11/27/02 Page: 01.76 Rd Condition N Mea'Collect a RRC Address: - -- - Grantor. PULTE HOME CORP Sewer. Inspect Reas: 138 AMBERVILLE ROAD - C NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% ! Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 9 Main Fn Area: 1698 Attic. NBHD CODE: 6 NBHD CLASS: 6 ZONE:VR Story Height: 2.00 Bedrooms: - 4 Up Fn Area: .r,m. 1986 r. Bsmt Area: 16564 - Seg Type Code Method `S Ft Acres Influ Y!N y Value Clas§� Roof.-- _rG- -Full ___3--'AddPnA�ea. W wFnBsmtArea:' M� 1 P 101 S 1 0798 +0.250 8 174,438 ry ' Ext Wall '_ AV` Half Baths: _ Unfin Area BsmtGrade: . VALUATION INFORMATION �. Masonry Trim: Ext Bath Fix: 1 T&fFin Area` 3684 l Current Total: 627,500 Bldg: 453,100 Land: 174,400 MktLnd: 174,400 Foundation: CN Bath Qual. `L RCNLD 453098 Prior Total: 591,600 Bldg: 416,500 Land: 175,100 MktLnd: 175,100 o - - Kitch.Qual LEff Yr Built: 2000 Mkt'Ad': Heat Type: FA _ Ext Kitch. _ _ $Year Built. ----2002 - -Sound ae. �- lu --' Fuel Typei--"0-,*' Grade GV' Cost Bldg:_ 453;100- Fireplace: 1 Bsmt Gar Cap: Condition: T G Att Str Val .._.. - Central AC: Y BsmtGar SF Pct Complete 100 _AttStr Val2: AttGar SF: 440'%G6od P/F/E/R: /1/95 Porch Type Porch Area Porch Grade Factor W 120 SKETCH PHOTO WFMY 10'120 Sq.PLO 14 Sq:R _ r FUIFM/8 20 1656 Sq.Ft 32 22 Q"0.75/G 12 440:Sq. 20 R 20 `• 18 _ FMY 27 44 Sq.Ft 14 Sq.R 138 AMBERVILLE ROAD Parcel ID:210/108.C-0077-0000.0 as of 3119113 Page 1 of 1 11014 D.ate ....... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING, Thiscertifies that................... ................. ................. .......................... has permission to perform toe- ........ ............................. ..............................4A.V y plumbing in the buildfing of...-qA#-)........ ....................................... at.! ......a.... ..\�or th Andover, Mass. .. .. ............................... Fee.,.3p.,.W...Lic. No.c.3.4..if Check# FUMBIN 14 PECTOR MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO= PERFORM PLUMBING WORK CITY E MA .DATE C / 0 PERMIT# JOBSITE ADDRESS S OWNER'S NAMEC`�L*,) P OWNER ADDRESS TEL l=FAX�� TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW:® RENOVATION:0 REPLACEMENT: PLANS SUBMITTED: YES N0[] FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 to 11 12 13 .14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SIN TOILET i l vG t Ci- URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meeb the requirements of MGL Ch.142. YES Q NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application true and apourat a best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will cal n mpl' oe rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME Richard B es Jr. LICENSE# 15435 I A RE MPD JP® CORPORATION Q# 3498 PARTNERSHIP®# LLC®# COMPANY NAME Nurotoco 1 of MA d.b.a Roto-Rooter ADDRESS 175 Maple Street CITY Stoughton ���STATE MA ZIP 02072�� TEL 781 1781-297-7049 FAX 781 341 8817 CELL 617-2124589 EMAIL Richard.B mes@rrsc.com ROUGH PLUMBING.INSPECTION NOTES BELOW FOR OFFICE USE ONLY NAL IN ECTION N TES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES t The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Nurotoco Of MA d.b.a. Roto-Rooter o Address:175 Maple Street City/State/Zip:Stoughton,MA 02072 Phone#:1-781-297-7049 Are you an employer?Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 66 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' insurance.t 9. ❑Building addition comp.[No workers' comp.insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑■ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no 13:❑Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have ' employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below it the policy and job site information. Insurance Company Name:Old Republic Insurance Co Policy#or Self-ins.Lic.#:MWC 11826400 Expiration Date:4/1/2016 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as.civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce f, under� ns and penalties ofperjury that the information fed abov is tr a and correct Si nature: ( Dater Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." 'An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more ' of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter t52;§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." - Additionally,MGL chapter 152,§25C(7)"state`s"Neither the com-m6nwealth nor any of its political subdivisions shall _ enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bur leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MAA 02114-2017 Te1.#617-7274406 ext 7406 or 1-877-MASSAFE Revised 7-2013 Fax#617-727-7749 . www.mass.gov/dia t PLi>MBEf�5 Al D" GASF I TT ISSUES THE FOLLOW I ' E°t OEUSE. L t' N'SLT AS A MASTER P # 3 R t1A0. P BYRNES JF3 1368 SPRlIdG ?SLu k W ' tt I B:EWATER �4A 02379-1 0 6 07404. _ IN ;'• • • a,: „PLUMBEfSki Cr11S�lTTERS w 3 , ISSUES THE FbLLOWI Nfi� C 1 EEN5€ L I ttI=ACS E`0 k A JdURREY Atd,�PC fB`SR ` ' RGItAtt), P BYRNES� JR A 0368 S) R.II a rs W1 dbEWATER A 02379 277 ofofl6 ;. 207905 m._ mli oIsfiNOLtMtOI* MBOARWOP • • • • 111=1 Mill P PLUMBERS AIO GA5FITT R-, 1 SSUES TIE tFOLL©WItNG L I'EEWSE IrRD As A Prl 11MB 1 � � ` ' r fJ r RIGHARID 'RYR'N£S 4J} {7 �t1120TOGO..OF h1#SSkCtfUSET S £Y I 36$ SP& S t °. t �_j n SU 1 �" .�t.a:w�a u�lll 1,��3.�a�i ► n ,. Ar�ORI� :CERTIFICATE OF LIABILITY .INSIRANCE_.: ; THN3 SATE IS 1"!P*AS.A-Xg-.ER�OF INFOINIIIA?M'.iD] LV AND CONFER$*No: . OER?1tat./11'E DOES NOT AFFNtMATNELY tM NEGATIVELY AMEND, EXTEND OR ALTER E fJ fN 1f1E CERf1FiCATE.NOLDE L TRIS BELOW.. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A COVERAGE AFFORDED BY THE POLICIES REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, CONTRACT BETWEEN THE �tJINO INSURER(111).AUTHORMED . IMPORTANT: 8 wi N:ertlllN ft—the holdor b Nl11 ADDITIONAL INSURED,the poiky(bs)must be endonied, M�1BROG11TtON 13 WAIVED,slNtileet to the terms Nub C l �fhs PoNGy,certain polhdes may require an erldofeaNlT@et A C@NtINCBiB holden In Neu Of each sndorsww s statement on this artiNcate ON eat WoMer rights to thePIKIDUCER MARSH USA[W. . S25 VINE STREET,SURE 1600 ARRM CINCOtItATt ON 45202 A1tn:dIIdmeHWkW cam: �0408RRSC.GAUNF1a1s o0M9 iNsuRgtA:Old R kwaq WIC' 15=RbT0�ta0TBi COIY�AWY a:Nam UnlooFtro hB CD P1 PA 24141 . STOUGHTOM,tM OW72 areNNNEn c o Mdrmt 2 COVIERA GESF, CERTIFICATE NtkNBER. OE�:SS REVISION 'THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BgOW HAVE'BEpr NUMBER:S. . INDICATED. NOtVNTHgTgNDUIGANY REQUIRMENT,TERM OR CONDIN OF 0, CONTRACT TO THE INSURED NAMED TERM THE POLICY PERIOD CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED.BY EONTAACT OR OTHER bOCIJINENT W i RESPECT TO WHICH'THIS . EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOYVN MAY HAVE BEEN REDUCEDDESCM �HEREIN IS.SUBJECT TO ALL`THE TERMS, . UCED BYPAID CLAIMS. LTR ITYrEDPpfiaRANCE A ar1ERAl MWIY6t1132 ' 000A OU01W5 LIMITS 00A eomm L muff 11001 BICE s 2000.MO CU11144U E.0 OCCUR i 755.000 • M�i7W ,,,, :. s,600 FERBDNhLaADVINANIY i 2,000,tgp QE•AGCNtMTELMNr11PPLNNUtPDt A° tS i BOOO,MO `X POLN:v we !NEC—"•CONP/OP AGO :_ A AuroelOatlEuuflurY MWIB219S1 04IOt12014 04101Cl015 i X ANY nuro ` SA00,000 SCHEDULED 90WILYINA1RYperson) i ' AUTOi X' HtEDAVW X AUTNOf�AMED e00LYDWRY(Ysrsooidm0) a i B X UNBRELLAU2245eX OCCUR 104 09!0112016 i GXCMLMB'• CIAMi�YIADE MCNOCOIRRENCE i. S,000OOp X 2b000 Aoors GATE i 5,M0000 A WOMMM COWENSATIC N. AND5 A _ IeYPLOMWLN1aIM' C occummINNIndafty IM RR . YN❑ NIA IN 0(TX) 04101/2014 04101/2015 EL E101 ACCIDENT i 1 If dsto:bs uida 04/0112014 04IO11Z015 a EL DBEA8E.pA iof . 1000000 EL.DBEAW-P000YLMff I 1AOOA00 DESCWPMN OF OMATMI LOCATNWN I I VMCLES(ADaoh ACORD IM.AddNk"bm ft ached^N mors EVIDENCE OF COVERAGE ' ' ^ dl. ." CERTIFICATE HOLDER CANCELLATION ROTO•ROOTER SERVICES CO. 175 MAPLE STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED'BEFORE STOUGHTOKAM 02072.1130 THE .EXPIRATION DATE THEREpOF �NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY rra►YISION8. AUTNon=gEPREt WATWE of Marsh USA Mc. Manashi Mukh0" AGORD 26 2010105 ®'1888.2010 ACORO CORruNATION. All rights reserved. ( 1 The ACORD name and logo,are registered marks Of ACORD 10001 Date . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .P. . 0 . . . Gam.�--. . . . . . . . . . . . . . . . has permission to perform . re—no-lacko—A . .L�.Le'. . . . . . . . . . plumbing in the buildings of. . - .'. eeW . . . . . . . . . . . . . . . . . . . . . at . . .���?-2 . . ,North Andover Mass. 4 . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A��PERMIT TO PERFORM PLUMBING WORK CITY _t�D/ VI. �1. ORo"e� �L MA. DATE. (J—f 3 r PERMIT# ) JOBSITE ADDRESS 3 /�VY� 2p'" y(f e A&NER'S NAME S of POWNERADDRESS Ile TEL FAX TYPE OR OCCUPANCY.TYPE: COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL❑ PRINT NEW:❑ RENOVATION:L1� REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO ❑ CLEARLY FIXTURES Z FLOOR BSMT 1 2 3 4 5 6 7 8 9 j 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIUSAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN DISHWASHER FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK d LAVATORY ROOF DRAIN SHOWER STALL SERVICE!MOP SINK TOILET f URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which,meets the requirements of MGL Ch.142.- Yes E) No❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 BOX ONLY: OWNER ❑ AGENT ❑ Signature of Owner or Owner's Agent 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 Cha ter 142 of the General Laws. PLUMBER NAME Peter J. Crane SIGNATURE � �J ���-✓'' LIC# 21805 MP❑ JPQ CORPORATION ❑# PARTNERSHIP ❑# LLC ❑# COMPANY NAME Crane's Plumbing & Heating ADDRESS: 70 Douglas Street CITY Haverhill STATE I.1A ZIP 01830 EMAIL annacrane.ac@verizon.net' TEL 978.771.1155 CELL 978.771.1155 FAX t�. ������G ��v 6 ��/ �7 � The Commonwealth of Massachusetts - Department of Industriql Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizatiorAndividual): O& Address: D' City/State/Zip: )14� Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. �• E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g ❑Building addition [No workers'comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roofrepairs insurance required.]f employees.[No workers' 13.[i Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box mist attached an additional sheet showing the name ofthe sub-contractors and their workers'comp.policy information. j I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: ,/ ! t� Date: oc Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not producedacceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Conuponwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston}MA,02111 TQ1,#617-727,4900 eget 406 or 1-877:MASSAFE Revised 5-26-05 Fax#617-727-7749 wwW-Mass,goV1dia y� i - t I I I I 'Fold,Then Detach Along All Perforations -COMMONWEALTH OF MASSACHUSETTS B G ARD PLUMBERS AND Gk�FITTER:i p C LICENSED AS A JOURN,':MAN P1 UMBER i ISSUES THE ABOVE LICENSE TO: PETER J CRANE TY, E ro _J 70 DOUGLAS ST � i HAVERHILL MA 0183t� 6741 Z:21805 05/01/14 1.5G5G:' 21 ;6562 Fold,Then Detach Along All Perforations .J 1, Date.!`..�"�:'. ..... V'0 T11 TOWN OF NORTH ANDOVER 3r �.,� _...,.• of PERMIT FOR WIRING SACNUS� This certifies that .......................%.........a„....................................................... has permission to perform ..,. .......................................... wiring in the building of...:........... ................................................... at.....��� ...................................:..�...................... ,North Andover,Mass. 01 Fee V` .. ..... Lic.N .....o `.... .... ( �, ... • � ELECTRICALrfNSPEC�'OR Check # t 7504 h T Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. Occupancy and Fee Checked '60 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 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: City or Town of: NORTH ANDOVER To theI spect r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 138 A4f4 JEjZV1 LL,E / pp4, Owner or Tenant V2. j- ¢,1�/ 14 L,6 F-4,2 Telephone No. Owner's Address --5Au s✓ k iso u m Is this permit in conjunction with a building permit? YesNo ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Propo ed ectrical Work: �t Completion of theollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires 13 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o mergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets 1 q No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g a No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mumcipat ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water Kms, No.of o.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 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: (When required by municipal policy.) Work to Start: V 7 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 S, BOND ❑ OTHER ❑ (Specify:) I certify,under the pains�and,penalties o perjurythat the informal'An his pplication is true and complete. FIRM NAME: 12tsrj� [2 _ LIC.NO.: Stier Licensee: l Signatur LTC.NO.: (b (If applicable,enter "exe t"in the license nu sber line ,�! Bus.Tel. No. Address: " y :�f [V `-f 03—* Alt.Tel. No.: 4{�5$S39 *Per M.G.L c. 147,s. 57-61,security work re uires Department of Public Safety"S"License: Lic.No. 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. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $---3Z) '- Signature Telephone No. t ` .. J M' The Commonwealth ofMassachusetts Department of Industrial Accidents Ob"ce of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Na1nt:(Business(Olmization/individual): A Address: City/State/Zip: r4'�1 UUCP/ /rC�0 "( L Phone.#: F2.E3 ou an employer?Check the appropriate box: am a employer with 9 4. 0 I am a general contractor and IF[]Remodeling ect(required):. mployees(full and/or part-time).• have hired the sub-contractors onstruction am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' . ❑Demolition [No workers'comp.insurance comp.insurance.$ 9. 0 Building addition required.] 5. C] We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their myself. ' 11.❑plumbing repairs or additions y [No workers comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 12.0 Roof repairs employees.[No workers' 13.[]Other camp.insurance requiredJ *Any applicant that checks box#1 must also fill out the section below showing their workers,corrrpensatian policy information. t Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such. employees. that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. [f the sub-contractors have employees,they must provide their workers'comp.Policy number. am an employer that isproviding workers' information. compensation insurance for my employees Below is the policy and job site Insurance Company Name: Policy#or Self-ins.Lic.M 4c-1�0-? -U pr 'n� Expiration Datic'�/.�L Job Site Address: 11-2.j1 ,/A,' yo City/State/Zip: Nb c)ue-vu Attach a copy of the workers'compensation policy declaration page(showing the policy number and ezpiradondat4V8�T Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up t$$1,500-00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine n el to$250.00 a day against the r''olator. Be advised that a copy of this statement may be forwarded to the Office of Investi ations of the DIA for insufan a coverage verification. I do hereby ce r nd penalt sof perjury that the information provided above is true and correct Si tore 7 (� Date: Phone#: � Offlefal use only. Do not write fn tats area,to be completed by city or town ofJlclaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: JUL-06-2007 09:15AM FROM-C G INSURANCE +1 683 884 6363 T-13T P.001/002 F-287 - -- -- ---. —---. .. --- -- — —- --- ----• - . .. . — ".— 07/06/ZO07 ' (603)898-6500 FAX (603)870-9444 THIS CERTIFICATE iS ISSU D AS A MATTER OF INFORMATION C & C Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 288 Forth Broadway ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. Salem, NH 03079 Danielle Lane INSURERS AFFORDING COVERAGE NAIC# Richard A. Parent INSURER A-, Maine Mutual-Group DBA. Parent Electric Co. INSURER& GUARD INSURANCE CROUP 2S1 Pleasant Street INSURER C: Esping, NH 03042 INSURER D. INSURER F.: COVERAGES ^= r.-SAES OF I-SU`R4NCE USTeD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ;ABY �•� �T\7 T-Fig.!OR CONDITION OF AW CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY xri::.t\.-#dE;%SUR~NC=AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POL'CIrS AGCZC.;T-L:btfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Lam, TYPE O%Dt$URANCE POLICY NUMBER DATE MUVDWYY IF POLICY EXPIRATION DATE MMIDD LIMITS wBILAT SC2091S669 02/21/2007 12/21/2007 EACH OCCURRENCE - s 11000,00 X,:;XMIR:: GENERAL LL;BILRY UAFAAGS III RM I ED PREMISES feeoccvrence 3 $0,00 I C-AaMS M:,DE 1XI OCCUR NED EXP(ALLY one oemm) S S1000 A ' PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE 3 21000,000 1 GZV_AGG:*3ATS LIMIT APPLIES PER PRODUCTS-COMPIOPAGG S 21000,000 I n°OLICY i7,M Loc AUTOMOBILE LLUNLny couewsD SINGLE uMrt s Ax'—tI.o (Esaccidenlj I I ALL O:S`:ED.:uTOS BODILY INJURY S AUTOS (PefDamon) BOD{LYINJURY S IPeraacloenq PROPERTY DAMAGE a (Pef BCLidwo) CA:-RAG:LJ.:g:TTY AUTO ONLY.EAACODENT S AM. "" EAACC S O'MER7WW AUTO ONLY: AGG S E7LG 35La6dR,�w L7i.5LLdt7 EACH OCCURRENCE S QAWS MADE AGGREGATE a _ s >A293QM ti4tiv PAWC80SIGS 02/22/2007 02122/2003 RYLIMrf;I I ER E3NLOYFRS'LIA=.ITY g Amy PR3?I '.R?i R'Ic`:R al[tu IVC E.L.EACH ACCIDENT S 100,00 O=F. 26t_IG R <C:V7e7' E.L.DISEASE-EA EMPLOYEE S 1.0010 Ilya.fd&=e,u SPECT L PROVIS %2 xo.• E.L.DISEASE•POLICY LIMIT S 500.0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS a I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OMCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVORTO MAIL Town of North Andover 1D_DAYS WRITTEN NOTICE TO THE CERTIficATEHOLDERNAMED TOTHE LEFT. Building Department OUT FAILURE TO MAIL SUCH N0710ESHALLIMPOSE NOOBLIGATION ORLIAMLLTY 1600 Osgood Street OF ANY KIND UPON THE INSURER.ITS AGENW 2EPR A North Andover, MA 0194S AUTHORIZED NTAn ACORD 25(2001/06) FAX: (976)688-9542 OACORD CORPORATION 1988 • 3810 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 43 CHU This certifies that ....... ........ .......................... r has permission to perform .......15-0 .. .... ..... e- ...........................I........ .... wiring in the building of........ ...... ............................... at.... ..... ..�........... ..... ..............g...North Andes l)..�...... Lic.No/ /�*. ....Fee ............... ... z ...../...........,..M...W....... LEcrRICALINS ECTOR Check # o /0 dr 4- i The ConrmonweQlthOf A10-SSOChUSCUS P,,. 11 N. """ "�I Department of Public Safety O`�„n'^n f•• CI`.r4.A 1 y 3/90 1,,-- 61. 41 130ARD OF FIRE PREVENTION REGULAIiONS 527 CMR 12-00 APPLICATAll-orkION IoFORTePERMIT rdance WTOlih � rPERFOERMELECTRICAL WORK calCode. 521 CMR 12.00 (PLEASE MUTT Lll IMC OR TYPE Ai.i, TNFORIMTI011) Date City or Town of To the L The undersigned applienspector of Wires: s for a permit to perform theelectrical work described below. location (Street bdumber) '��j��7 ra r r/,`�/e L!a y �g yf'- 1p�[i Orer or Tenant_ � i"If� `-d 12L� L�7- c0c'z Owner's Address Z� 7 •�U i2 t1P ttC[ �l ZOO Is this permit in conjunction with a building permit: Yesito ❑ (Check Appropriate Box) Purpose of Building_ I E"-P. Utility Authorization 110. Fxisting Set-vice Amps / Volts Overhead ❑ UnA rd N g ❑ o. of tletcrs 11ev Ser-vice 1-9—(:) Amps 11Sj /ZA0 volts Overhead ❑ r } Undgrd ❑� tlo. of tb_te;s l 11—ber of Feeders and Ampacity 3 — 7— w Location and Nature of Proposed Electrical WorkLi Ito. of Lighting Outlets ito. of Not IubsTotal 110, of transformers KvA tio. of Lighting Fixtures Above In- Swlmming Pool grad. ❑ grnd. ❑ Generators Z __ KVA Y K No. of Receptacle Outlets ilo. of OLL Burners ilo. of Emergency Lighting ` Battery Units 3 No, of Switch Outlets • No. of Cas Burners FIRE Al"JIS - No. of Zones i ito. of Ranges Total Mo. of Detection and i No. of A[r Cond.Heat tons 110. of Disposals ito. of Total Total In[tiating Devices W PCPs J Tons Ku ito. of Sounding Devices D Ho. of Dishwashers r Space/Area Heating FV ito. of Self Contained Detection/Sounding Devices = Ito. of Dryers heating Devices i Etunicipal a. Local❑ Connection❑Other LL No. of Water Heaters KW No, of to. 0 LOW Voltage I Si ns Ballasts Wiring4 No. Hydro Massage Iubs ito, of Motors Total IIP OILIER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES® NO 0 I have submitted valid proof of same to this office: YES L� NO El If you have checked YES, please indicate the type of coverage by checking the appropriate box. ItISURANCE ® BOND [I OTHER ❑ (Please Specify) Exp I- t i o Tate Estimated Value of ElecUlcal Work S `COQ WILL CALL. Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME JAMES E. BUCIIANAN ELECTRLC LNC. -- — Lic, to.A15616 Licensee JAMES E. BUCIIANAN Signature LIC. NO. E32062 Address P.O. BOR 544 SU'P1'UN MA 01590 . Tel. it 508—$G5-3335 . Tel. No, OWNER'S INSURANCE WAIVER: I am aware that the LicenseJKA Insurancecoverageor is sub- stantial equivalentas required by Massachusetts Genery signature on this permit application waives this requirement. Owner Agntne) Telephone ito, 1­0Signature of Owner or Agent PEIUiIT FEF. $ Oy 3 i, 56 Date.....w... ..��....�... pORTF1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SACMU This certifies that U Q `h C E'? < C .,�.............................................. has permission to perform `I1 r.('C1.... e wiring in the building of........//...C•.`4....�.�......' .. .!! ..0 $.....:.................... at........1 lJ� V`//o North7d.ovW .. qq � JJ r . -z, LECTRICAL INOR Check # v 3 J 17 °✓ JAMES E.BUCHANAN ELECTRIC,INC. PLEASE DETACH BEFORE DEPOSITING CHECK NO. 0 10H 3 Egg,},. . • • • LOT#66 NU HOME 06/06/02 329.00 .00 NEW HOME PERMT 329.00 TOTALS 329.00 .00 329.00 l i �] The Commonwealth of Massachusetts ofties Use Only Perwtt :b. _ £ Department of Public Safety �ccupaMy b roe Checked BOARD OF FIRE PREVENTION REGULATIONS SZT CZAR IM 13/90 (tg"e blaok) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL. WORK All work to he performed In accordance with the Mar.cachusetu Electrical Code, 527 CMR 11!00 (PLEA,SE PRINT IN INK OR TIFF All. INTORMA.TION) Date_ City or Town of—Nfff-��_1 � To the Inspector of Wires: The under31gntd applies for a permit to perform the electrical work described below. ' location (Street b Humber) I j �{ c o 4- Owner or Tenant? fes `` Q _ `' " �,� 40 1 7 `'�f Owner's Address Q�� I 1 Ci (�Yl�' :j ���1_ )<_ i .� l C 1 ux Is this perc-ait in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building �4 rn_e­ Utility Authorization Existing Service Amps — I— —Volts Ove::ead ® Undgrd❑ No, of Meters ..� Heves d.•C' Y Amps J;�_Y& Volts Overhead ❑ Undgrd W No. of F,eters j Number of Feeders and Ampacity 11 L i'l L,ecation and Nature of Proposed Electrical Work No. of Lighting Outlets Total 8 6 tin. of Hot TIIhS � INo. of Transformers KVA No, of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No, of Receptacle Outlets No. of Oil Burners -� No. of Emergency Lighting Battery Units No. of Switch outlets No, of Gas Burners FIRE ALAR:IS No, of Zonen No. of Ranges Total No. of Detection and r g No. of Air Cond. eons Initiating Devices No. of Disposals No. of Heat Totzl Total No, of Sounding Devices Pumps Tet .... KU g No. of Self Contained f Space/Area NNo, of Dishwashers space/Area heating V K11 Detection/Sounding Devices Municipal OtherNo. of Dryers Heating Devices KW Local❑ Connection[] No. of Water Heaters KW No, of ^ 95�T 1L,yow Voltage S1 ns Ballasts No. Hydro Massage Tubs No, of Motors Total IIP OTHER: INSURANCE COVERAGE: • Pursuant to the ,requirements of Massachusetts General Laws I have a current Liabilit insurance Pal.lcy including Completed Operations Coverage or its substantial equivalent, YESC& NO [] I have submitted valid proof of same to this office. YESX NO 0 If you have checked YES, please indicate the type of coverage by checking the appropriate box. l INSURANCE MA BOND ❑ OTHER❑ (Plense Specify)_ Estimated Value of Electrical Work S (Expiration ate ���..� \��; 1 � C I'i i t Work to Start Inspection Date Required: Rough Final Signed under the penalties of perjury: FIRM NAME ZkV`n ?S C a �nr�. S=` LIC. N0,EI I ALJ C Licensee t (ime �=_ t?il!'�1Gl�cLpL Signature_ _ LIC. NO. Address Bus. Tel. No. 0 Alt. Tel. No, OWNER'S INSURANCE WAIVER: I am aware r.hat the Licensee does n t have the insurance coverage or is sub- scantial equivalent as required by Hissachuset�s General Laws, d that my signature on this permit application waives this requirement. Owner Agent (Plea check one) Tom? ,d,nnn No. PERMIT FEES 3Z Town of North Andover g g Partment �° ,t�"° �*' Buildin De �."o . '• c 27 Charles Street W. North Andover,Musachusetts 41845 (978)688-9545 Fax(978)688-95.42 � 4�taR+rwwas ' °��rso r►P�5 �SS4CHilS�� . APPLICATION FOR CERTIFICATE OF OCCUPANCY/=EC LO ADDRESS f.V ? gym. CSR r/e if LOT NUMBER �� SUBDIVISION 'v r?P %ls�f DATE REQUEST FUM _ l[_ -L3 sla DATE READY FOR INSPECTION- KE MQR TO CLOSING D ALL WORK AND SIGN OFFS MUST BE COMPLETED WITHIN THIS T]IVM FRAME. A RE INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL$E CHARGED.IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICA;L USE ONLY ROUTING CONSERVATI � DATE 00Z PLANNING DATE 11 f 6 Z D_P.W. —WATER METER ATE'— D.P.W. TE_D.P.W.MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED TO TBE INSPECTION RE VEST DATE. NAT /DPW A RIZATION Location 13P ��- A2- � p �+ No. 21 Date O" c�9" Mp0 TOWN OF NORTH ANDOVER .. A Certificate of Occupancy $ �ss,cNusEt Building/Frame Permit Fee $ , Foundation Permit Fee $ Other Permit Fee $ - TOTAL $ 9,30 Check # 15821 �' - /f '$uli ing Inspector AUG-06-2002 02 :53 PM MARCHIONDA&ASSOCIATES 781 438 9654 P. 01 I 4 124,00' N44-42780W •- 390.74' AMROAD N44.42-38-W 390.74' t" 544'42'38"E 100.00' �- Q v I T N 27.2' I I # 22.8' 1 g Iv g EX. FOUNDATION ELEVATION=174,33 r t t--17A LOT 66A h° 11015 S.F. 391 a 0.25 Ac. RsRl�gl�,� tX N46'15'21"W 103.76' / STr:"HFN M, --f ,, S46"15'21"E 100.00' 4 d NG. �;St3�ltd r � WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT THE BUILDING IS LOCATED THIS PLAN IS INTENDED FOR ZONING AS SHOWN, THE STRUCTURE SHOWN CONFORMS PURPOSES ONLY, IT WAS PREPARED TO THE ZONING LAWS RELATIVE TO REQUIRED SETBACKS OF FROM EXISTING PLANS AND RECORDS THE MUNICIPALITY WHEN CONSTRUCTED ALSO, ACCORDING WITH THE STRUCTURES SHOWN LOCATED TO THE F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, \ BY AN INSTRUMENT SURVEY. THIS PLAN COMMUNITY PANEL N0, 250098 0015 C SHOULD NOT BE USED FOR PROPERTY DATED 6/2/1993 , THE STRUCTURE IS NOT LOCATED LINE DETERMINATION. IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE. CERTIFIED FOUNDATION PLAN LOT 66 FOREST VIEW ESTATES MARCHIONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR PULTE HOME CORP. OF NEW ENGLAND 62 MONTVALE AVE. SUITE I STONEHAM, MA. 02180 257 TURNPIKE ROAD SUITE 200 (781) 438-6121 SOUTHBOROUGH, MASSACHUSETTS 01772 SCALE: 1"--30' DATE, 8/06/02 Tk `�iqr o c i Y •a �;i 'sSACNl15� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON /0/ 138 4 0 he K'o U/�lf I� MAY BE OCCUPIED AS ��� �i<'L�/h/l kleSIN ACCORDANCE WITH THE PROVISIONS OF E MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. /0,P&0"S-3 is 8,47 s .Z/ /, a// .4 ch F CERTIFICATE ISSUED TO c � Building Inspector i I AORTH Town of Andover 0zL*1dover, Mass., 2 COCMIC HEWICK V A�RATEO '9S BOARD OF HEALTH PERMI .T T Food/Kitchen�� Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... . Av � ...... � 1�'. ' undation Jv�' buildings �.La.. . . C /� has permission to erect...............I............ ........ gs on .�.... . . ..... pef to be occupied as L..... /.. /. .. ........... 1�....... ey ......................... ...... ........ provided that the person accepting this permit shall in every respect conform to the terms of the applicMon on file in Finalr /_ /�-/3-O this office, and to the provisions of the Codes and By-Laws relating to the 1 spection, Alteration and Construction of �� ( `- Buildings in the Town of North Andover. ''O8 C14 ��O PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS �( ��U` UNLESS CONSTRU ON T SELECTRIC C C -goof .... ... ..... ................... ..................... BUILDING INSPECTOR .F1,17z1-111- Occupancy Permit Required to Occupy Building GAS INSPE R 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 µ Street No. Smoke Det. SEE REVERSE SIDE /f�6?� Location , 66 --� 138 b, 6ow/1, P No. Date NORTN TOWN OF NORTH ANDOVER Of�i`ac ,a,yC " Certificate of Occupancy $ ss�cHustt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ®Aal k e Check # a D 5-I 15730 ✓ 'Building Inspector Toff oFYc SII � ... D.N DEP 'win• .: .'' APPLICATION TO CONSTRUCT REF RENOVAT .OR DEMOLISH.A ONE OR:TWQFAM Y DWRLLING B1JIIJDWG PERNIlT NUMBER: DATE ISSfJED:` I SIGNATi3RE: �. BuMniz Commiss'on" r of BWUin Date S> CTIONT I-SITE INRORMATION 1.1 Prepatty Address 1.2 A =sw Map and Pared Number. ( .s,��'c�Y�/ie�-�� cS'• .�7� � I-fip rrumbw PamdN%unber 1:3 Zceieg 1nfamatian: 1.4 .P�ope�jel?imegaipps: Zaain Dustriet d Use.`. 1.6 BUIMING SETBACKS ft . Front Yard . Side Yard. ' . Maui Provided Provided n2 eg' �. r.sw e s narl.am std ri. l eizau tiaan: a- 2-7pQs Sita Dig�F.33,seoan D SUCTION T-PMWERT Y•OUT4XRSEMA ORAW,&GENI' 2l'OvAeuof Reeowd PL A, M e fz Qp .. . Nam(Print) �t/r7r P Address for 3ervie a/?�.Z. Telepboae 22 Owner of Recwd Name Prmt Address for Suview Tale SECTION 3-CONSTRUCTION SERVICES 3.1 Liconsed Construction Supervisor Not Applicable ❑ Licensed'ConstructioneSupervlsor. L �i•C/I7� Sr ���c�.[,/�j� Laccase Number d6 Cv? 6a a Expuadon Date Signa T one ,. 1.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address. d Signature Telephone Expiration Date g SECTION 4-W0UMS COMPENSATION G:L c IS! §.25c Workers Compensation lnsysanoe affidavito*be coXrtpl*,apd.Subxnittati shtli:#H s . Failure to provide this affidavit will result in the denial.ofthe isscaeosoRlwbutldin it S" ed affidavitAttwhed Yes:.....X No...,... SECTION'S titHt of 'd Wot' .c ecce- 1�a' ricable I New Construction y" Existutg Buildntg: RePur(§) 0 Alfii rel oas(s) 0. Addition Specify 0: Accessory Bldg. Q Demolition 0 Other. 0 Brief Description ofFroposed Work SECTION 6-ESTIMATED CONSM7iCTION COM" Item Estimated Cost(Dollar)to be Com leW byit UgLxcZ 1. Bwldmg `� 12 2 Electrical (b3 Esttmarted�pte}Cost tsf C cq Son . 3 Plumbba 4 1dool ical AC -S B e:Protectioa 6. T*W (1,+2+3+4+&. 'Cliec �sitiT r SECTION 7a OWNER AUTRORIZATION TO$E C01bIPL& D N OWMRS AGENT OR CONTRACTOR APPimFOR ftmDIM PERMT L as Owner/Authorized Agent of subject property Hereby authorize to ad an My bebop in all matters relative to work authorized by this building permit&pplicatioii Signafte of Owner Date SECTION 7b OWNMAUTSORMD'AGENT 71ECLARATI014 1, D&U Id C+1 as OwnWAuthorizedAgent of subject Ply Hereby declare that the statements and information on the foregoing applicatiorrare tine and accurate,to the best of my knowledge and belief Print Nash Si of OwnerfA env DaU-.' NO.OF STORIES SIZE / BASEMENT OR SLAB SIZE OF FLOOR TMMS 3 JC SPAN DOMTSIONS OF SILLS DMENSIONS OF POSTS DMENSIONS OF GIRDERS -Y// HEIGHT OF FOUNDATIONTfitCKNBgS / IV SIZE OF FOOTING 7 7 ZelKW g MATERIAL OF CHIMNEY ME'1 IS BUH-DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Al A FORM - U - LOT RELEASE FORM ly`�`'� V` INSTRUCTTONS: '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, i■■■r■rrr■rrr■■..r■rr.rr■ra■r■■■rrpprr•rr••■r■■rr■.■rr■■■r.a■■■■■■■■■rr.■■■■■r■ ' APPLICANT PUl o e- C'okA. ©T AgJxAtd PHONE ex'7;ks-, ASSESSORS :tit AP NUMBER f LOT NUMBER. �% SUBDIVISION FQc� ��i i �' LOT NUMBER STREET ASMeel//`/e ee!5 STREETNUNIBER �■rrr■■■r r■rr a r r■•.r....rrrr.rr.■■.■rrr■■iri■■r■rrrr■■■■r.■■rr.r.■r..arrt•■■ OFFICIAL USE ONLY 1-9-04.9................... .■■r.•rrr■■r■■r..■r■r■r■r■■■■••r■rr■rr■■r■r■ RECO.MNIEND. y ,NS F TO AGENTS ...✓■• ■■■■r■r•••■■■■■■■•■■■■r r•.■■•.r•■ ■•■ ■■■■■■ DATE APPROVED S� CONSERVATIO .D STRAT R DATE REJECTED COtvQvfE`+TS )W fP: 215 j ®WW A5 wr (06 DATE APPROVED Ia TO R DATE REJECTED COMMENTS S DATE APPROVED FOOD INSPECTOR-hEALTH DATE REJECTED (U DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED C OivMENt'S PUBLIC WORKS-SEWER/WATER CONNECTIONS D AYPERhffT d DATE APPROVED DE. DATE REJECT® COiviMEVTS RECEIVED BY BUILDING INSPECTOR DATE i APIR-08-2002 02 :50 PM MARCHIONDA&ASSOCIATES 781 438 9654 P. 01 uy rur\=' 17-+-00 t � \ �0 17 X2 2 ol clq 173X2 173X '' -2/ 23' {=164.8 o a / „h \� TF= 1740 V' x CF= 1 �6-5 BF= 161 ,3 .173X0 X l DECK ` 173X0 f- � -' LOT 66A,/ N 1_ 11 , 015 / SF 1 : PULTE HOME CORPORATION RES VES THE RIGHT TO MAKE F1 CHANGES TO THIS PLO?PLA � IN ORDER TO ACHIEVE PROPOER SITE DRAINAGE. MEET SETBACK REOUIREMENTS. AVOID LEDGE OR ACCOMMODATE THE CONSTRUCTION OF THE HOME IN THE MOST OPTIMUM WAY. THESE FIELD ADJUSTMENTS MAY BE MADE WITHOUT CONSULTATION WITH THE BUYER IN ORDER TO EXPEDITE THE CONSTRUCTION OF THE HOME. PROPOSED SITE PLAN LOT 66A FOREST VIEW ESTATES MARCHiONDA & ASSOC.,L.P. NORTH ANDOVER, MA ENGINEERING AND PLANNING CONSULTANTS PREPARED FOR 62 MONTVALE AVE. SUITE I PULTE HOME CORP, OF NEW ENGLAND STONEHAM, MA, 02180 257 TURNPIKE ROAD - SUITE 200 SCALE:1'AZO' (617) 438-6121 DATE: 4/8/02 SOUTH80ROUGH. MASSACHUSETTS 01772 Forest View Estates Drawing Date: 6/25/02 7/ 1/02 14:51 HYDRAULIC DESIGN INFORMATION SHEET Job Name: Forest View Estates Location: Amberville Road - Lot *66A N. Andover, MA Drawing Date: 6/25/02 Remote Area Number: 1 Contractor: Superior Plumbing, Inc. Telephone: (781) 461-1541 169 Jefferson Stret Dedham, MA Designer: W. C. Davis Calculated By:SprinkCALC CSC Systems & Design Construction: Combustible Occupancy:Residential Reviewing Authorities:Fire Department SYSTEM DESIGN Code:NFPA Hazard: 13D System Type:WET Area of Sprinkler Operation sq ft1 Sprinkler or Nozzle Density (gpm/sq ft) 0.100 1 Make:VIC Model:V3610 Area per Sprinkler 190 sq ft1 Orifice: l" K-Factor: 5.60 Hose Allowance Inside 100 qpm I Temperature Rating: 155 Hose Allowance Outside 0 gpm I CALCULATION SUMMARY 2 Flowing Outlets gpm Required: 161.6 psi Required: 79.6 @ Source WATER SUPPLY Water Flow Test I Pump Data I Tank or Reservoir Date of Test I Rated Capacity 0 gpm I Capacity 0 gal Static Pressure 100.0 psi I Rated Pressure 0.0 psi I Elevation 0 Residual Pres 78.0 psi 1 Elevation 0 1 At a Flow of 1540 gpm 1 Make: I Well Elevation 0" I Model: I Proof Flow 0 gpm Location: Lot #65 Source of Information: F & W Partnership - Metheun, MA SYSTEM VOLUME 22 Gallons Notes: Single Head Calculation. of ALLAN yG CAMERON FIRE PORTEC11ON N0. Forest View Estates Drawing Date:6/25/02 7/ 1/02 14:51 HYDRAULIC CALCULATION DETAILS HYDRAULIC FLOW LOSS QTY DESCRIPTION LENGTH C ID gpm psi TOTALS Hydr Ref W Required at Hyd Area 1 62 47.2 psi 1 1'i" x 11�4" CPVC Reducer 2 ' 120 1. 610 62 0.4 1 11�" Thrd 90 Ell CI 4 ' 120 1. 610 62 0.7 1 Pipe 11W" 40x25 CSC 5' 120 1. 610 62 0. 6 1 1'i" Thrd 90 Ell CI 4 ' 120 1. 610 62 0.7 Elevation Change 710" 3.0 1 11-�" Thrd Globe Valve CSC "F15" 0' 0 1. 610 62 0.0 1 11-�" Fingd Back Flow Valve Watts "70 0' 0 1. 610 62 0.0 1 11�" Thrd Globe Valve CSC "F15" 0' 0 1. 610 62 0.0 1 1'W" Thrd 90 Ell CI 4' 120 1. 610 62 0. 7 Fixed Flow Flow Loss 100 gpm 1 Pipe 11-�" PVx15 CSC 50' 150 1. 602 162 26. 1 Hydr Ref R1 Required at Source 162 79.6 psi Water Source100.0 psi static, 78.0 psi residual @ 1540 gpm 162 gpm 99.7 psi SAFETY PRESSURE 20.1 psi Available Pressure of 99.7 psi Exceeds Required Pressure of 79.6 psi This is a safety margin of 20.1 psi or 20 % of Supply Maximum Water Velocity is 13.0 fps Forest View Estates Drawing Date:6/25/02 7/ 1/02 14:51 LEGEND HYD REF Hydraulic reference. Refer to accompanying flow diagram. _ K FACTOR Flow factor for open head or path where Flow (gpm) = K x -\/P SIZE Nominal size of pipe. ID Actual internal diameter of pipe C Hazen Williams pipe roughness factor TYPE Type or schedule of pipe # FITS number of fittings as follows: 90 - 90 deg Ell 45 - 45 deg Ell T - Tee LT - Long Turn 90 Ell SPEC - Fitting other than above or fitting with hydraulic equivalent length specified by manufacturer. Pt Total pressure (psi) at fitting Pf Friction loss (psi) to fitting where Pf = 1 x 4.52 x (Q/C) ^1.85 / ID^4 .87 Pe Pressure due to change in elevation where Pe = 0.433 x change in elevation Pv Velocity pressure (psi) where Pv = 0.001123 x Q^2/ID^4 Pn Normal pressure (psi) where Pn = Pt - Pv Pdrop Pressure loss in pipe rise or drop to an open head. Phead Pressure at an open head. ELEV elevation from branch tee to open head. PIPE pipe length from branch tee to open head. FITS fitting equivalent length from branch tee to open head. NOTES: - Pressures are balanced to 0.001 gpm. Pressures are listed to 0.01 psi. Addition may vary by 0.01 psi due to accumulation of round off. - Calculations conform to NFPA 13 edition. - Velocity Pressures are considered on branch lines and cross mains - Path #1 is from the most remote head back to the water source. - Later Paths are from the next most remote head back to previously defined paths Forest View Estates Drawing Date:6/25/02 7/ 1/02 14:51 REMOTE AREA #1 PAGE 1 FLOW # OF LENGTH PRESSURE BRANCH LINE (GPM) PIPE FITS FEET SUMMARY TO HEAD HYD REF OUTLET SIZE 90 45 PIPE VELOCITY Pt Pt Pn ELEV ID T LT FITTINGS LOSS PSI/FT Pf Pv Pdrop PIPE K FACTOR PIPE C TYPE OTHER TOTAL ELEVATION Pe Pn Phead FITS PATH 1 FROM HYDRAULIC REFERENCE 2 TO W (PRIMARY PATH) HEAD 2 30.7 1" 0 0 4'7" 10.3 fps 30. 0 30.0 30.0 0. 16 gpm/sq ft 1 .109" 1 0 510" 0 .219 2 . 1 0.0 0.0 K= 5. 60 30.7 120 PV 0 917" 0" 0 . 0 30.0 30.0 REF A4 30. 9 1144" 0 0 9'5" 13.0 fps 33.2 33.2 PATH 2 1.400" 1 0 610" 0.169 2. 6 1.1 K= 5.37 61. 6 150 PV 0 1515" 0" 0. 0 32. 1 REF B2 1'V" 2 0 26'7" 13.0 fps 35. 8 1 .400" 1 0 1210" 0. 169 6. 5 61. 6 150 PV 0 3817" 1113" 4. 9 REF W 61.6 gpm PATH 1 K= 8. 96 47.2 psi PATH 2 FROM HYDRAULIC REFERENCE 1 TO A4 HEAD 1 30.9 1" 0 0 417" 10 . 4 fps 30. 5 30.5 30.5 0.16 gpm/sq ft 1. 109" 1 0 510" 0.222 2. 1 0.0 0.0 K= 5.60 30.9 120 PV 0 917" 0" 0. 0 30.5 30.5 REF A2 1:�14" 0 0 10111" 6.5 fps 32. 6 1. 400" 0 0 0" 0.047 0.5 30.9 150 PV 0 10'11" 0" 0.0 REF A3 114" 0 0 115" 6. 5 fps 33.1 1. 400" 0 0 0" 0.047 0.1 30.9 150 PV 0 115" 0" 0.0 REF A4 30.9 gpm PATH 2 K= 5.37 33.2 psi Job Water Required Hose Allowance Drawn By Forest View Estates Static Pressure: 100.0 psi Pressure: 79.6 psi Inside: 100 gpm SprinkCAD Amberville Road - Lot#66A Residual Pressure: 78.0 psi Total Flow: 162 gpm Outside: 0 gpm Central Sprinkler' N.Andover, MA Flow: 1540 gpm Safety Pressure: 20.1 psi (800)495-5541 Remote Area: 1 Date/Loc: Lot#65 140 120 1004 11 Supply 80 P 00 gpmhose S 1 60 40 20 100 150 200 250 300 350 400 450 500 Flow (gpm) i 1 Growth Management Bylaw Exemption Statement T-twn of Rarttt'Arldaver Building Department This form stmall be.used to assist the Building oepartmnt in their determination of exemptions under sectlan a.7.6 of the Town of,Narth Andover Growth Management Bylaw, The buildinc?applicant shalt ppvide all of the necessary information as muested below. Name of Applicant on Building Permit(below) Addresg of Propam for.Fermit(t;elow) Nlap artd Fame!: Parpc� a 9f •plication(check below) P e mraer of Appy nt: ingle Family _Two Family A Q41 I tine t ir_ signed appilzartt for a above property attest that the attached building permit tar which this fermi is casnpleted dace comply with the EXEMPTION section 8.7.6 of.the North Andover Growth Managetnamt Bylaw, I also undtorAand providing this form does not absolve moor any party to this permit frofrt the acquirements of obtaining other permits re_q ilred prior to the issuance of the Budding Permit. FuAW I understand that my Interpretation when the Bei d IIONs status �issued.subject to review by the Building 0opmwient and is only oftiaally 41=110ttcd 9 easrlmd on sadon 8.7.8 of the North Andover Growth Bylaw the above lot and the work as applied for on the above let, in the building permit appli aticn and associated attachments,complies with one or more of the fkatia>dng setdions as lndiated by a check mark exist f as of tin aim o ecaffacdve dam of rtes bylaw.Provided.pigmit for the enlargement th#t o 2001=restoration.slendal unit is uor reatad n of a dwelling in The lag*)werdweo Qeao m prior to May G. 1,206 are exempt from the provisions of this Sec icn a.7 of the Zoning 1ytaw.. This appUgttert is(or dwelling units for low andlor macerate income families or individuals,where all of the CaRtlana.d tt,7.B,care met Indict represents oweling units for senior residents,where occupancy of me units is MaUtc:ad to senior persons through a pmpedy,"gauted and recorded deed restriction running with the land. For pulp of itis Sedon*$enior'aitaq mesa piarsana ever the age of 66. ,hit applicatlea is a part of a dewlvpmodt prglea which vaiuntardy agreed to a minimum 40%permanent r cedr Thisclon density,(biddable lots),below the densdy,(buildagle Ietsj,permitted under zoning and feasible given the emvirwo attal condhlana of the treat,with the surplus land gQusl to ac least ten buildable acres and permanently designated.as spam spage andlot farmland.The land to be preaerved shalt be protected from development by an Agriat0921 Pnmasfwdcn t4eattiction.Conserratian ftentridon;dedication to the Town,or other similar mechanism approved by the ptanntag 6aatd that will ensu*its protection. This application repmsenta a treat of land musting and not held by a(Developer In common ownership with an a ppevetopparcal anment Schede g provisions for the puurpose gffadve datg of this S*Wjcn 1.7 le oaf coconautic ig arm singteahmily don fromwelling unit on the This application represents a lot which is ready for budding pennib.(l.a.all other pemnite from all other boards and have ban raeeiwd and the praiea is in compliance with those permits) and the Development Schedule data net.aaammmodase ktstring a building psnmit In that Year,one building permit will 6e Issued per Year per Deopmertt tthtil suds tithe as the Oevelapment Schedule accommodates issuing bolding permits. Appllesat must supidlf ePpt'ev'ed tcrtm U with ti'►is mCJifriPT10N, .., .. . Pieasa provide any and all information that would assist the Building_Department in making a determination' that your application Is allowed one or more of the above EXEMPTINS. ey signing below I attest to rhe accuracy of the information provided and that the attached building permit is allowed an LXEt1 iPTION as tdf ed above. Further I understand that the submittal of misleading and or inaccurate in ion. or the checking off of an above 1t which does not comply,whether done to my tinawledg not.' grounds for fusel by the lid' . epartment to issue a Building Permit. �;anacure nr ser or Auth nice Agent Wko s the Attached Building ermit Oate 1h is form must be attached to the Building Permit upon application for such permit. i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 077396 Birthdate: 03/0211962 Expires:03/02!2004 Tr.no: 77396 Restricted To: 00 DAVID M STILSON 222 SEAMES DR •.�. MANCHESTER, NH 03103 Administrator BUILDING DEPARTNIE�IT DEBRIS DISPOSAL FORM In accordance with the provisioas of MGL'C 40 S 54, a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11,S 150A The debris will be disposed of in: Location of Facility • Signanue of Permit Applicant i Dau NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building las;xmor i Yft:�iti De, i;ruup Fax:97�3-55r81e0 Jun 13 2000 12:54 P. 19 The COMMOnwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workars'Compensation Insurance Affidavit Please Print Name: Li7�iQOrt, ' I ern a home vyner pi rnonning all work myself. )I -am a sole proprietor and have no one working in any capacity - J I am an employer providing workers' compensation for my employees working on this job. C:orn any name: r :Address o--S e J Q4: EwT�}�.�GGGIH 11���, l� /71,� Phone# Insurance Co. /� '.,�=i c_ /r✓ �c S /,vim'. C' Policv# 5G �3u l l y Cornparly name: address City- Phone t Insurance Co. Fdlurc to secure coverage as required under Sewan 25A or MGL 152 can lead to the imposition of criminal•penalass of a rine up to 31,500.00 ariaW ono}lydm'imprisonment as we l as civil penaJti=in the form of a STOP WORK ORDER and a Bne at(S1t30.00)a day agatrut me. I unaa-marsd mat a ccpy vi this smernent rry y be(orw Med to the Office of Invastrgad,oM of the CIA for coverage vWriftcation. as nerdy ixrYrly ur Nix the pains anU penalties of perjury lhet the infarrnedron provkW above is true and Comic(. Signature Date Print name Phone# QHicL wl use only do not write in this area to be completed by city or town official' Building Q Dept❑ Buildingept p Licensing Board p Selectman's Oface �r,r c Person: Phone C7 Health Nparbrient Other.- f var�x.+ranrs COMP>~asr7lt7N Sent By: PULTE HOME CORP; 1 401 739 6457; Aug-6-01 4:52PM; Page ill CERTIFICATE O F INSURANCE ISSUE DATE: 8/6601 THIS CERTIFICATE IS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pulte Home Corporation of NE COMPANIES AFFORDING COVERAGE 205 Hallen Road,Suite 211 COMPANY A Pacific Employers Insurance Company Warwick, RI 02886 COMPANY a Legion Insurance Company COMPANY C COMPANY 0 Ace American Insurance Company COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13S ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EFFECTIVE EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER I DATE DATE – V _ GENERAL LIABILITY GENERAL AGGREGATE $15,000,000 COMMERCIAL GENERAL LIABILITY GL4-0292043 511/01 5/1/02 PRODUCTS-COMPIOP AGQ $15,000,000 ON AN OCCURRENCE BASIS i — I ! PERSONAL&ADV.INJURY $15,000,000 EACH OCCURRENCE $15,000,000 ADDITIONAL INSURED: FIRE DAMAGE(Anyone fire) 41,000,000 MED.EXPENSE(Anyone person) $5,000 AUTOMOBILE — I - _ `COLLISION DEDUCTIBLE — — COMPREHENSIVE DEDUCTIBLE LOSS PAYEE: _ ! I COMBINED SINGLE LIABILITY LIMIT $1,000,000 CAL HO 7662773 + 5/1101 ( 511/02 j (Owned.Hired&Non-owned) ADDITIONAL.-INSURED: EXCESS LIABILITY EACH OCCURRENCE AGGREGATE WORKER'S COMPENSATION and WLR C4 3091748 511/01 511102 STATUTORY LIMITS EMPLOYERS'LIABILITY EACH ACCIDENT __..................$9,l)DO,000 MA,NVI SCF C4 3091815 i 511101 i 5/1/02 I DISEASE-POLICY LIMIT $1,000,000 DISEASE-EACH EMPLOYEE $1,000,000 PROPERTY I I f REAL AND PERSONAL PROPERTY,INCLUDING WHILE LOSS PAYEE: IN COURSE OF CONSTRUCTION: PER OCCURRENCE LIMIT MORTGAGEE: — I SPECIAL FORM(INCLUDING FLOOD AND EARTHQUAKE) j DEOUCTIBI.FPER OCCURRENCE- OTHER DESCRIPTION OF OPERATIONSlLOCATIONS/VEHICLES/SPECIAL ITEMS Residential construction,North Andover,MA CERTIFICATE LA N Town Of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 27 Charles Street BEFORE THE EXPIRATION DATE THEREOF,WE WILL ENDEAVOR North Andover, MA 01845 TO MAIL 22 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. AUTHORIZED ^ REPRESENTATIVE /� JUN. 3.2002 2:27PM PULTE HOME CORPORATION OF NE NO.057 P.9i15 i i N � Permit Number MECcheck Compliance Redort Checked By/Date M�4achusetts Energy Cada' MECcheck Software Version 3.3 Release; b Data f ename:F:\FILES\CST\CConservI .. SCHECKILot66fv.cck TITTE Lot#66 Wellington Elevation#i CITY:North Andover STATE:Massachusetts HDD:6322 CONSTRUCTION TYPE; 1 or 2 Family,.,Detached HEATING SYSTEM TYPE:Other(Nonj�lectric Resistance) DATE: 06/03/02 PROJECT INFORMATION: Forest View North Andover,MA, Co_vrnaNY INFORMATION: Pulte Home Corporation NOTES: Cus..t1 er purchased elevation#1,a pall an window I.L.O.a 2852,a transo package,and(3 0 walls out bays a',I.0,a twin and(4)single windo s. i COMPLIANCE:Passes Maximdm UA=550 Yom Horne=532 3.31/6 Bitter Than Code f Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 1216 38.0 0;0 36 Ceiling 2:Flat Ceiling or Scissor Truss 660 38.0 0,0 20 Wall l:'Wood Frame, 16"o.c, 576 13,0 0,0 47 Wall 2: ood Frame, 16"ox. 396 13.0 0,0 32 Wall 3:Wood Frame, 16"o,c, 576 13,0 0.0 47 Wall Q:Wood Frame, 16"ac. 576 13.0 0.0 47 Wali 5: ood Frame, 16"o,c, 1080 13.0 0,0 44 Windo : 1936-2 casement w/transom: Vinyl Frame,Double Pane with Low-E 18 0.310 6 Windoij1P4:28310:Vinyl Frame,Double Pwith Low-E 11 0.340 4 Windo2852:Vinyl Frame,Double Pane',with Low-E 58 0.340 20 WindovT:2046-2:Vinyl Frame,Double Paine with Low-E 19 0,340 6 . Windo�:6-0x6-8 slider w/transom: Vinyl Frame,Double Pane with Low-P45 0,300 13 Windot�:2852-2:Vinyl Frame,Double Phe with Low-E 171 0,340 58 i { F JUN. 3.2002 2:29PM PULTE HOME CORPORATION OF NE NO.057 P.10i15 Window: 1852:Vinyl Frame,Double P4b with Low-E 19 0,340 7 Window:31052 picture: vFrame,Double Pane with Low-5 21 0.340 7 ily Windo : 1862:Vinyl Frame,Double Pijd�with Low-E 46 0.340 16 Window:31062 picture: Vin) Frame,Double Pane with Low- 49 0.340 17 h 3072 11E,/2 round w/1852 Hankers,Palladian window: C Viny Frame,Double Pane with Low-9 36 0,340 12 2-Sx6 service door:Solid 18 0.180 3 Door:3-00-8 w/2 sidelights:Solid 33 0.280 9 Floor :All-Wood Joist/Truss,Over Un nditioned Space 1216 21.0 0.0 54 Floor 2�:All-Wood Joist/Truss,Over Unnditioned Space 429 21,0 0,0 19 Floor 3:All-Wood Joist/Truss,Over Unognditioned Space 242 30,0 0.0 8 Furnace 1:Forced Hot Air,81 AFUE COMENT; The proposed building design described here is consistent with the building plans, specifications,and other calculations sul Mitted with the permit application. The proposed building has been designed to meet the Massachusetts Eno Code requirements in MECcheck Version 3.3 Release Ib and to comply with a mandatory requirements listed$'!the NE,Ccheck Inspection Checklist. " I The heating load for this building,and thoo.cooling load if appropriate,has been determined using the applicable Standard Design Conditions fo d m thy, ode, The HVAC equipment selected to heat or cool the building shall be no greater than 125%of he 1 gn to dspecifi din Sections 780CMR 1310 and J4.4. l r; a Builde�/Designer Date i G SII 'I! u I i p li i I i i i h i II �I I � ' . - -- --' --� - - -------'-Area Calculator:CuuiUin�������ym*KK' _ �� ��l -^-- -' -'-- -- --'- ^- -^ � _ . � � m � m - CD Assembly Type Width x Length Gross Area Comments/Description 2 Flat Ceiling or Scissor Truss 22�-U' 39-U' 660.00 ft2 second floor ceiling area � - ' I Flat Ceiling or Scissor Truss 38!-0" 3Z--9' 1216.DO Tff—second floor ceiling area 12 13 16 181 0 19 q 20 M 21 22 23 24 1251 1261 :z' �* � � Ceiling Area Total: 187e.00 (A 06/03102 13:12--52 �� - - - - - - -------Area Calculator:Walls:WellingtonElevationl-tot66fv-.._- - --- - - - - - - - - C N ' m m N Assembly Type Width x Height = Gross Area Comments/Description N 1 Wood Frame,16"o-c- 38=D" 32'-0" 576.00 f12 front elev. 2 Wood Frame,16"O.C. 38-0" 2-2'-0" 395.00 112 front elev. 3 Wood Frame,16"O.C. 32'-0" 18'-0" 576.00 ft2 right elev. 3 4 Wood Frame,16"o.c. 32=0" 18'-0" 576-00 112 left elev. 5 Wood Frame,16"o.c. 60'-0" 18'-91 1080.00 M rear elev. 6 � 7 9 0 10 3 71 11 n 12 13 0 14 15 D 16 p 171 z 18 0 �3 19 z 20 71 21 22 23 24 25 26 z 0 CD cn Exterior Wall Area Total:3204-00 06/0310213:12:53 1/1 i Area Cal culator:Windows:WellingtonElevation I Lot66fir- ---- -- -- ---- - -- C N m 0 N Library Unit Total Comments/ Action NameAssembly Type Quantity Width x Height = Area Area U-Factor SHGC Description N 1 1936-2 casement w/transom Vinyl Frame,Dou 1 3'-11" 4'7" 17.95 17.95 ft2 0.310 Superseal Low EArgon CD 2 28310 Vinyl Frame,Bou 1 2=9" 3'-11" 10.77 10.77 ft2 0.340 Superseal Low E Argon 3 3 2852 Vicryl Frame,Dou 4 2'9" 5'3" 14.44 57.76 ft2 0.340 Superseal Low EArgon 4 2046-2 vinyl Frame,Dou 1 4-1" 4-7" 16.72 18.72 f12 0.340 Superseal Low E Argon 5 6-0x6-8 slider wl transom Vinyl Frame,Dou 1 5'-11" T-T' 44.87 44.87 f12 0.300 Superseal Low E Argon r 6 2852-2 Vinyl Frame,Dou 6 5'-5" 5'�" 28. 4 170.64 ft2 0.340 Superseal Low EArgon M 513 : - -- 2_ = X34 uper52 - 8 31052 picture Vinyl Frame,Dou i 3'-11" 6-3" 20.56 20.56 f12 0.340 Superseal Low E Argon 9 1862 Vinyl Frame,Dou 4 1'-10"Ia-3" 11.46 45.84 ft2 0.340 Superseal Low E Argon rri 10 31062 picture Vinyl Frame,Dou 2 T-11" F-3" 24.48 48.96 ft2 0.340 Superseal Low E Argon 0 11 30721/2 round w/1852 Vinyl Frame,Dou 1 6'-0" 6'-0" 36.00 36.00 ft2 0.340 Superseal Low EArgon o Hankers,Palladian window 12 2D 13 H 14 z 15 0 16 17 Z M 18 19 20 21 22 23 24 z 0 CD M Window Area Total:491,33 06/03/0213:12:50 1/1 - -- Area Calculator:Doors.WellingtonElevationl Lot66fv -- -- - _-- - -_ -- ---._._. -- _� --- - -------- -w N CD CD ro Library Assembly Type Quantity Width x Height = Unit Total U-Factor SHGC Comments/ N Action Name Area Area Description 1 2-8x6-8 service door Solid 1 2'-B" 6'-8 17.78 17.78 it2 0.180 Garage Service Door m 2 3-0x6-8 w/2 sidelights Solid 6'-8" 33.33 33.33 ft2 0.280 Front Entry w/2 Sidelights 3 3 - 4 5 C 6 r 7 M 0 9 3 10 M 11 0 12 _ 13 0 14 D J17 H z O z 21 22 23 24 25 z O CS) Door Area Total:51.11 vi 06/03/02 13:12:51 1/1 i -Area- Calculator:Floors:WeilingtonElevationl Lot66fv - C N m CD ro Assembly Type Width x Length = Gross Area Comments/Description 1 All-Wood Joisb Truss, Over 38-0" 32'-0" 1216.00 ft2 floor area over basment ry Unconditioned Space w 2 AII-WoodJois#1Truss,Over 22'-0" 19-6" 429.00 ft2 floor area over basment 3 Unconditioned Space 3 All-Wood Joistf Truss,Over 11'-0" 22'-0" 242.00 f12 floor area over garage Unconditioned Space 4 C S r -a m 9 rl n 10 O 11 70� 12 0 13 D 14 H 15 Z 16 0 17 1s z m19 20 21 22 23 24 25 26 z 0 CS) cn v -o • cn Floor Area Total: 1887.00 i 06/03/0213:12:54 111 1 AFFIDAVIT on oath do ( authori ed agent of applic and/or owner) hereby depose and state : ( PLEASE CHECK AT LEAST ONE BLOCK) l I am the of jj (position with applicant) ( applicant) C -&a Q. i Cc the applicant upon whom Order of Conditions L&) -2P 61S have been placed upon by (DEP or NACC number) the North Andover Conservation Commission. Z I am the cf (position with owner) (owner) the owner upon whose land Order of Conditions have been placed upon by (DEP or NACC number) the North Andover Conservation Commission . 3 . I hereby affirm and acknowledge that I have received said Order of Conditions, ' and have read the same and understand each and every condition which has been set- forth in said Order of Conditions . 4 . I hereby affirm and acknowledge that on this day of 199_. I inspected said property together with any and all improvements which have been made to the same and hereby certify that each and every condition set forth in Order of Conditions are presently in compliance . I7 S . I hereby affirm and acknowledge that this document will be relied upon by the North Andover Conservation Commission as ' well as any potential buyers of said property which is subject to said Order of Conditions Signe and r the pains and penalties of perjury this day of th nt of agFr i4 t or owner) ct� �h / ORT1y Town o �� : 0 . Andover No. NO_ ndover, Mass:, ? COC HICHEWICK V 44 0"4ATED P`' C �SSA C HUS�� IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT ...... ....v �.... .,, .,.,. . ..... o , ......... .. ......................................... 1/.� .•......................... . ......... has permission to excavate and pour foundation at ..RL6. ... ...... ... ,.. _, out //1& for the purpose of... .. �.. �11�... 1t.. ,/. ftM ..Jim-no, Ravd4AThe person accepting this permit must return to the office of the Building Inspector a certified plot plaow IFof building thereon before Foundation will be inspected. 'D �/ /��• am_ 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. BLDG. PERMIT FEE= ,� — OOW 004 C LESS FDA I-a P DUE FRAM£PERMIT= — BUILDING INSPECTOR NORTpq Town Andover of � 4 0 VA No. 3 f * __ . _ A CK WICK dover, Mass., COCMIC KE � ADRATED PPa\ 5 BOARD OF HEALTH Food/Kitchen PERMI ..T T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT v. ..._. ....... .......* P- ....Xo i...oc.....'................................ undation .� 1014o"..h.coup.t. has permission to erect............... .......:. ........... buildings on . A.�...0ough to be occupied as /. .� �. .. .0 !/.�11.................... �� ' y �� r%e provided that the person accepting this permit shall in every respect conform to the terms of the applicl n on file in Final this office, and to the provisions of the Codes and By-Laws relating to tpection, Alteration and Construction of Buildings in the Town of North Andover. mi? 01407 he I sA19f3toMEOW PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONT , ELECTRICAL INSPECTOR UNLESS CONSTRU ON T S C Rough ... ................... ...�� • Service ... ..... . .. ..................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. i[--SEE REVERSE SIDE Smoke Det. SPECIFICATIONS PRODUCT ACTION REQUEST - P®A®TRW CODES �RA��r�N� INDEX � Wo. GENERAL REQUIREMENTS' PAR'01121 DESIGN CODES 1.00 SPECIFICATIONS,SCHEDULES,&INDEX 1. Work padormaa sh,ll comply with the blawirg'. BATE: ori/zl/ol 2.00 FOUNDATION PLAN z A. these general none,unless olhenrise noted on plans or prod.ct BASED ON C.A.E.O. ONE & TWO FAMILY DWELLING CODE 1995 EDITION apaoircocone. 2.01 OPTIONAL FINISHED BASEMENT Cj R. M'C 6C.bl,wool and strafe Chill ardw....r and r h.ti- ACTION REQUESTED: RESPONSE: pp a9. BASED ON B.O.C.A. BASIC BUILDING CODE 1995 EDITION 3.00 FOUNDATION DETAILS O Q.1' C. In areas where the dr.wings do not address'Octhodology, 7 the contractor shall be bound to gedo m in tricomvbanw with I.Retr w house pe,Pulte atanderds. , I.Redraw hoose Per Pahe,tondo-de.loo=_haebl 4.00 FIRST FLOOR PLAY 7 „ manufacturer's speaifi:ations and/or recommendabons. 2.create MR¢rf"o- o1 pled., ant wild,hoof o a mi 2.Cr..too m-nate fir-9 plan for unit with roof t-.sees.19,001 4.01 SECOND FL003 PLAN 3.Lr¢ate new Po�ndatign glen uainp atael beams In beaement. 3.Greeted new foundation t I beam.in basement.:2.001 J2.. the athero'notes ane typical detcila apply thraghout the pen u.ng s w¢ 5.00 ELEVATION 1 J. caress mnErase doles«mown. 5.01 ELEVATION'11 W/OPT.BAY WINDOWS 3. OIedrepari The contractor shall c ri and coordinate E..i au arowmi when in the opinion of t,E contractor,a discravi 5.02 ELEVATION#1 F/OPT.BRICK W before ha mall g eithy a A.ru,to IT,Architect for preperad;aatmedl BUILDING CODE ANALYSIS a C a exists o hall wird mew i 5.03 ELEVATION 2 4. Omissions: In the event certain features of the construction 5.04 ELEVATION#2 W/OPT.DAY WINDOWS o ore not fully shown on the drawings,their construction shoo be of USE GROUP, R-4 5.05 ELEVATION#2 W/PARTIAL BRICK Ica home Character ga foe ammr CandMaha that are strewn or acted // // //// CONSTRUCTION CLA55: UNPROTECTED in Al won:'i mo be Performed-n a pr-ski manner and / �� // �� N7 ELEVATION#2 W/BRICK a.CcomgnCe w in stonaord pray«and Consistent with mgr.r.cwrer s �1.f,� (((��� / G� HEIGHT d AREA LIMITATION, z,roar mnx'mum H6r 35 FEET 5.07 ELEVATION #3 nd suppliers rEcommandsd nstalla'an crocedures EMERGENCY E5Cl1l ESRE55 OR RE56UF N'NDOWS FROM 5LEEP N6 ROOM5 5.08 ELEVATION#3 W/PARTIAL BRICK 6 0 mens ons shall be read or call and never scaled 54ALL RAVE A MINIMUM OF E.7 50.FT. All drmenswrs are.the rough a lass noted atnarw�sa. At drawings 5.09 ELEVATION 13 W/BRICK y. are at I"=4'- (1/4'=1'-0').,lass noted eVarow- GARAGE/HOUSE CEILIN61 WALL A55EMBLYA 1/2"GYPSUM BOARD OR 5181 OYPSJM BOARD m REQUIRED-WALL S 'CONCRETE/FOUNDATIONS 8 MUNI W(20 MIN.GARAGE/HOUSE DOOR. ' `' INTERIOR STAIR PROTECTION' LATER OF /2e G SVM BOARD 10 ALL S REALES IN ACLE551oLE EAS 0.00 01 REAR AND RIGHT SIDE ELEVATIONS The Concrete mp sireins hhall be as eggWagata t� 7.00 BUILDING SECTION DESIGN LOAD51 LIVE LOAD FLOORS 40 PSF 1lgT a P Site uaQ �/{J 6 LIVE LOAD ROOF 35 PSP(MIN.TOP 60R0) 7.01 BUDDING SECTIONS F.01/2 ngs 3000 -1 4'(+/-I") ! DE AO LOA01 FLOOR AREA 12 PEP slob on 3000ONO 1/2-1 4'(+/-1/2) - DEAD LOAD ROOF 11 PSP 1TRU55E51 8.00 FLOOR FRAMING PLAN'S-OPTIONS grade 3500(DT)GARAGEOELK5=40 PSE Walls 3000 7 2-1 4' +-1 0" WIND LOAD=IB PER` / ) z. Cot to work,naN wnrom,m gd agairamama er ACI-118-89 �� sA R Lonos=40 PEE 8.02 FLOOR FRAMING PLANS-OPTIONS and A0 301-72,speclf-fans Tor structural whore's fD'buldili A / smOW LOAD•35 P5F 8.03 FLOOR FRAMING PLANS 3 NI reinforcement,d in place told,vice sleeves ane lacer inserts L„/ rad'be o,i&i 95 aoarad in place beta t concrete is placed Ito -V /// , ATTIC VENTILATION' 2099 5F.1300=1.00 5F.REOURED 8.04 FLOOR FRAMING PLANS pr.aid B' bwkdin wmpaalwn at 6'layam at gd sorbs ✓ 8.05 FLOOR FRAMING PLANS oda laotings. BocMi11 to be of approvad matadal, RIDGE VENT=56 LF.X.085 FREE AREAiLF-4.16 5F. 8.08 FLOOR FRAMING PLANS 5. Were Cos foundation notes for reinforcement requirements. -OPER VENT:120 L.F.X.045 FREE AREA/LF•9.40 S.F. 6. Tool edge of Carl,.joirts and at cos to wsu icht,, - TOTAL:10.16 5F. 8.07 FLOOR FRAMING PLANS 7. Al sxti slob-an-grad,concrete atoll camom not lies than 5% 8.08 FLOOR FRAMING PLANS or mart t°°"7%air t°°mi°m t' MINIMUM R•VALUES OF OPENIN65r GLAZING' Adam R Volue:136 8.09 FLOOR FRAMING PLANS 1�FW.Al depths are snow,on the aaCtwna Nnieas otherwise ODOR5: M R Volvo=14.97 8.10 FLOOR FRAMING PLANS naiad fooling,shop to,,.minimum of 12'into original s6p k Valu¢•1.9 9.00 ROOF FRAMING PLAN-CONV./TRUSS aneisiurbed sot aha a minimum o 24'nshi finished grade SKIL16HTS: F Vow¢=M7 9.01 ROOF FRAMING PLAN-CONV. � 36°-Frederick Ca AID.@ Horsham township,PA;City of Frederick.MD and NJ; 42'-Rh".Iswni -Mass). Where required.,tap roeengs m ratio of 9,02 ROOF FRAMING PLANS-CDNV, 2 b.Momol to f v<xwd. 2 Where conditions aarabp i quiling changes in'....dims, VOLUME CALCULATIONS, BASEMENT z255 of 10.00 TYPICAL FALL SECTIONS such changes shall be made as directed of the Geotechnical Engineer. FIRST FLOOR 14996 cf. 11.00 STANDARD INTERIOE/EXTERIOR DETAILS J. Soil imesaiga:ion and report: All aadh work,c.mpacMon 5ECOMO FLOOR 15206 cit. !1.01 STANDARD DETAILS supervision shal be done per recommendations of ,it GARAGE vestgotom report. Concrete smo and-oi wlc0cions ore based Roof 12209 Cf. 11.02 STANDARD DETAILS ,do 2000 pan value. 8 fine,its test Baring,indil lassar M,I. TOTAL 59238 CS, 11.03 STANDARD DETAILS 1-/- bf Aramt.ol so mm h«tsaC tuatma modifications.ea be mod¢. 1�I °y n s' - !1.04 STANDARD DETAILS ,PEN 0PT ioJWM A 6761 CS 11.05 STANDARD DETAILS Lombe Grade OPT.FLORIDA RM. 4454 cit. 1200, STANDARD FIREPLACE DETAILS 1. Al joists,rafters,and headers shall be.unless oiblo se T�, rete.,Nerd-At Iz with arae msewmg mmim.m glwwobl<so-essts 14,00 MECHANICAL/ELECTRICAL SYMBOLS&SPEC'S rad modalua of elaatibi 14.01 BASEMENT MECBANICAL/ELECTRICAL PLANS _ a. ydreme fiber s,ress. Fb=850 PSI(Rapetr member) e. Honxonfal shear: FV_ psf - 14.02 FIRST FLOOR MECHANICAL/ELECTRICAL PLANS C. Compracdcn parpaddicumm r grnie: Fe=acs PSI ABBREVIATIONS 1403 SECOND FLOOR MECHANICAL/ELECTRICAL PLANS ►� o. M.dulua or a1°sticity: E-1.300,000 PSI 15.00 OPTIONAL BllNROOM 2. Hem-lir a'ey be substituted,substituted species shall meet- A.B. .,.R.11 ,'i0. ONAC FEF REFER 10 REFERENCE 15,01 OPT.FLORIDA ROOM w or exceed teg.iremenis noted abort. AF.F. wed-FINISH FLOOR GALV. GALVANIZED REIN'. RE INFORLXIG,REINFORLEp SPF slvd grade pra>eA'ws(2 x 4 or 2 x 6) - An'. ADJACENT/ADJU5TABtf GL. GENERAL CONTRACTOR ftl RE0URE0 10,00 OPT.FRONTLOAI 3-CAR GARAGE c AFT. ABOVE FIN15H Ti GEN. ODOR& RMS. RJOMS Fb=676 psi ALUM. ALUMINUM 517. GYP5VAs RN6 RANGE 10.01 OPT.SIDELOAD 3-CAR GARAGE a F'1=70 psi AN IF ANCHOR 6.L. GLUE LAM - R.O. E)Li OPEIJING F6=425 Ds N16LE N. BSER 17.00 OPT.WOOD DECK Fc=675y ARCH ARLHITELmRAL RNO ROUND 17'01 OPT.WOOD DECK W/FLORI R E = 1,200,000 psi A AT 'D HARDWARE Fa.W.. HARPOOOD Sc. SAWwr 2.,00!7- w0o0 ENCNEERED FR.E0 sYs10Xs OP. BOARD oRi HEIGHT Y.1. 5L1EMA11c HORI20NTAL.NORRONTALLY 'L,D MFYJ T'Truss diagrams snow design infenf 0* Truss manufa.turer to BLDO. DUaOwG Wt HOUR BX,F SIELP T Cl spans,dimensices,pitches,etc and subrril shop BM 6EAM OR HEADER EIT ^ I uT/A� r�R� d'awings prl.r to fabrication. ETM BO"TOM {B HOSE 010 _IM SIMILAR G. BLOCK INS 55. 5TAINLE55 STEEL 12- ELK Fica,Ir,saes ERG. BEARING ID. INSIOE DIAMETER STL STEEL T Foor musses:pre-engineered ti-se. F1o0:buss OR, OR ILK INal IN GROL'NV STRICT. STRULTLVR. pp�l manufacturer to supply shop dm.b,,,and erection dr.wings.Shop drawings PRAT sweleFNT IN511L. INSULATION SUER. 5J5%ENED. g is must be scaled by a pro(assional engineer registered it she INA. INTERIOR SAC SIDING GLA55°DOR Y gvweming;Nria LJ. `°HTRDL JOINT LB. IN510E L°BAER REVISION TRACKING d'clon' ti CENTERLINE NO. SQUARE 2. Floor Trusses shall he dasianed to limit deflec!ion to L/466 CM.U. CONCRETE MABONRT MATT JT. JOINT TB TOWEL BAR for live load°rad for a dead load of 40 PSF+'6 PST. Rooms consisting COL. COLUMN TBG TONJJE AND GROVE K" iia of different lengths the deflection or the sWoot soon sholl govern. COnr;. LONCREtt K51 KIPS PER 50UARE IWLX Bo DAiE NOTES LNQ, DATE NOTES 0.AFAfleets - - GOND. CONDITION T65 TOP OF GRAVE 5LA5 pan shat govern. TFW TOP OF FOUNDATION WALL 01-1i1 06/21/01 UPDATE 014G5 _J.ist " CONT. COMInui IF will LIGHWEI6N1 7ttP TYPICAL / g jail j ppy ( LON51. CONSTRUCTION LT. LIGNi F 1. I-b'sL Fre-en-engineered joists.1-ami t manufacturer to sV 1 T TREAD engineering<glculations scales by o professional en inter r feted 1 CTSK. COUNTERSUNK LVH. LOWER IR TDWi LROD g alis CO. CA5E0 OPENING L1. LAUNDRY'UB iRPL TRIPLE 3 in the 9...ninq jurisdlcbon.Connections and detoia shall be ae shown CAST. CANTILEVER �`r bra .mdaus. C.T. CERAMIC TILE MA5, MASONRY U.K O. UNLESS NOTED OTHERWISE 3. Flier F-jy5\shall be designed to Grail deflection lv L/480 0.6. GELLING MAT. MATERIAL ire bad and for,dao6,O of 40 PSF+12 PSF. Rooms consisting LM' CAAIR 1A ILLD MAx. 'As UM VERT. VERTwAL 'different lengths the deflectitiU-sharlesf span shall g.vem. C.R. CHAIR RAIL VIF. ou .1E INFIELD LITS X00 MEDIUM DEN511Y OVERLAY W NITH �. the shorest span,holt govern. D Pi W/ WITH MGLX, MECHANICAL MIlI. MINIMUM Rao'it Roof d P;NNT W0. MASONRY OPENINO W. WOOD 1. Rawl trusses: Pre-Engineer«poled s. Root truss manufacturer to supply DBL 011 F WWF. wELDEO WIFE FABRIC shop drawings and erection dronnect ins by a is shot t be engineer registered DIA DIAMETER wT- W'ET'" WDORW/0 VANOO, DIRECTION W'NOW WINDOW a the governing jurisdiction.Connections Ord dela.,sMll be as shown OV DOM IANC. NOT IN CONTRACT On Dlgns. OR. DOOR Ni51 NOT 70SCALE OW " WASHER C ON CENTER DWG. DRAWING DPER OPERATOR w Da DoTAIL .1 DPN5 OPENING GR055 F/N/5HED DTL TAIL OP aP ICN. SDUAREFDOTAGES SDUAREFODTAGES EA EACH O.SH. OR ENTEO STRAND BOARD CRAWN 6Y. E.J. EMPAN51ONJONT °Z' ouNrc FiRSTFLGOrP /649 F/RSTFLOOR /C✓9 ELIC E_ECTRILAL Iia ONE SHELF SECONOFLOGR /B79 SEGGNOFLOOR /879 ILEV. E_EVA710N 6WrorAL 33PB 5(/BTOTAL 33PB cA7E:a'ea/as ♦ EQUIP Fou-101PL PRECAST OPT F/N1%,-,19541r I/G RE\'Nc.l DATE D. PARTICLE BOARD 550 EKXY,T GARAGE 461 REL RGi�M EEx RINN PLI'B. PLATE EEE4LH ENO 01-121 08/21/01 EXTERIOR PIAL PANEL M N $TAY /96 . PLYWOO . FlG FLOOR COVERING CHANGE �9 Put RILA'ED TOTAL 3148 BATH Sf PD. FLOOR DRAIN PR. PAIR STDRAGE /74 JOB NVMBER FON FOUNDATION PROD. PROJECT/FROJECIEO PSI F0UM5 PER E.C.IN. FLR FLOOR P5F FOUNDS PER SOFT. TOTAL 333P S�I FP FbREPLle P.T. FR1155kpi TREATED FR, FIRE RATED A1214TB FRM FRAME OUAD. GUAORUPLE GPr FL OR/0.4 RM Z4O FT IODl/IEET OPT SUNROOM _384 SHEET NUNBER FTG FOOTING ---" TOTAL GPI 1,O O SP-CABODWG rev 05/05/9 8/30/94 AHORCV © COP YRIGi 2001 Pulte H-as O FGIdHDA71ON-OPTIONAL e5 50 MASOoro • NRY FIREPLACE - B 3028 4 -- 1.01 (vJt / A 3280]21280•5DHtEWo Ew./ .45 IJ"5 ---- - E - ----- -------- ~4 " 1.REFERENCE PRODUCT OTM 5PECIFILLAr ONS FpoR DECK T.F.W.3•-E 4 N I O F1'+ 5RE A)✓V Lr CON ON 2.DO NOT SUPPORT WOOD DECK NOTE: I W�yIOfAPON z'� FROM ANY CANTILEVER FLOOR SYSTEM. FOR ADDNTIONAL IN ORMAT SHEETS /��� y /./y�� yI 3.PROVIDE GRAIN TILE AROUND OK PLAN OPTIOUS A TIA FOUNDATION AN - A . COND. § W ;) PERIMEi CE OF FOUNDATION 1501,8 15.02 FOR OPT,REAR FLORIDA ftM 54 Yi A5 REQ D AT APPROVED WALE.V4"• -o' OEOTECHNICAL FEPOR', 4.PLUMSER TO VERIFY LOCATIONS FOR ALL TUBORANI5HWR O 6 WATER CL05E-5 FOR ANY VARIIONS. AT 8 FOUNDATION FI•OPTIONAL MA SON'RT FIREPLACE � b'-10" I4'•61" T'-O" i n H -- r 6/0 7.01 (2� t 12 10 w/ -w . ?zHS®EEw A•,� 2J.28 EE. �Nr--- -- - --- - --------------- -I -----------------------_ _ OFRI I E AI OCAPOT I - WP.N. PARTI DATION PLAN - WALKOUT GOND. STD,LOCATION OF OPT.PRECAST MLKNEAD WJ 40'MO M FOUN®ATICIN WALL EO'•O" REF.PTL.A-300. FOJIVATI MA50WT FI a OPTIONAL 8'-B 5'• n MASONRY FIREPLACE 46'-4u r�""'-"---r� I�r_—,�i�-10.00 ;FEW' HEaq IS.00 - --- -- --- ------- ------ _----_ _). -------- ---- --- — FWBHw TDP_-- --_-- --- T TrW,T-B- 3D'z 1 asNT.rvDw-SET o W ° - / ar roN WaLL- �vEal t P WIT a W/o GOND. Al N 70'WA V 12' T W-SET w�. 30'X 12'BSNT.WOW-SET TEUSA W T N WALL- I 30'X17 BSNT.WUW-SET RUSH W/'OR Or rDN I.L - - / I FLUSH W'f lOP 6 RIN WALL- 4P LEV W IT O W/o 7. o, o W/0 O]ND, / SIlT 0 W/0 CON). 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TRIM B FRONT DOOR INT,TRIM B FRONT DOOR INT.TRIM @ OPT.ENTRY AW5911'WIF� EREET"°"SER SCALE I/4°.I'-0' SCALE:I/0.0-0" WALE=I/OW-O' MERICR TRIM a,gBUTIP: REF.SHEET IID5 FOR 5.01 RASI-M"I14TIQd © COPYRIGHT 2001 Pult Homes DF y OF11 J=FRAM II II I�.� II II II n It ° v IITZ I �I I I I y{Y•I _ kl I .r CaT.RIDGE VENT III 1 Z j r FALSE VENT LAST 24'.FE ' I m Q UMLE5 REF: _ ___._-._ – r �_ t•--,i =Q'y 9PECIFILATIONS it .ter IT, 41 rvl l II E III — _ ------------ ------------ BDA$-REF _-- ----------- - ---- ----- I`RO SPEC _– ' - __ _ OPT TRAIbOM I--- -- -- – 1 _M 61-1.0481 RISE (� FRM.SPECS I�—rr —I 77 01 SII I� II II - cPT.LITE _--____ '•' N —AFPROk FINISHED GRADE II f� 17 17 F I I r==L I I I I J I I I I ---- ----------- ---------L--------------------------------------------- - ---_ 0 LEFT 510E ELEVATION INOROUN12 BASEMENT CONDITION. RIGHT 510E ELEVATION INGROUND BASEMENT CONDITION, b E- SCALE:Va'.IlOv SCALE:V4"•II-O' OPT.WOOD FRAME CN'1NEY CPM I.00D FRAM o T G �cuvwET II I II II G li SII ° - u II II I �T /CONT RIDGE VENT / FA1-5E vENT LAST 14° EE ^ I SuaeLEs REF I I i909 _ ALLU11 i I PRODECT ""CFICANOW g II — II I I L00 i3 II � 4"TRTI(TTP) BIDING REF (� PRCMCT SEC • DOwNEPNf wi Imo' IIS iii SFLASHBLK REF. -- )RAWIJ V. PROD.Sf ALL"INDGW P ok`,Tm –_. – ARE ALL ENTRY DTRFOF FRAME WALL. e I.•` DOOR JA1flS - m oATe.enclm n _ CPT LME IC . SFU ...----_. LL NAVE EMEADEO _ - I III BERYkE DR '"' JAt85 W/BRICK V9ER REV No. GATE FR'J.'D-nrL.FLasuIM 0t 12 p � 7 II F- I i ..,.- REx.M/IIOS DONS 4 °nA.B. fFr MICA.WALL SECTION JOB NWBER A F F—r— FF—7 n A--FMIED GRADE� '• -- - SNf qL0 FOR AD9lI0NA'. 5 1 2�`t – - – 1'FOR14710N 4U FCtNDAiIW IDTES ➢1214Effi I ISHEET Nuu SFR REF:FLRT2 RAW – _–_–_-- ____ _____ ___ I _ - IRTEROR IIOIFOR ,L _ ___ NTERIOR iR111113ORR4iIgJ C------ ----------------- ------- – -- --------- -- ---� --- ------ - –– ------------ --L– – -------------- –__–_� REF.SNiFfR09FOR o V.00 LEFT 5112E ELEVATION ENGLISH BASEMENT CONDITION. V,0*1v ' OFJw RIGHT 5112E ELEVATION- ENGLISH BASEMENT CONDITION . �dlylsF.I o�l � RAs'�o�R A„N SCALE:I/4'.ISO” ••�� YALE aM'•I'�O� © COPYRIGHT 2001 Put Homes O Law RIDE£VENT _----------------------------- Fa'_SE VENT LA5i 14°s EE --------------------- j coCO"J I — 9NMGlES REF: So IPRODUCT .� 6PECRICA11CfG I II—�--1 U z h H al�n+ErKArlE ZP. 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APFRCX FIKIS EDP�waarGN W1EB DIZAEO GRADE REF:FLOOR FLANS �` PND 6x1.IIDI FOR SHEET NUMBER EAR ELEVATION-ENGLISH 13A5EMENT CONDITION. I IN'ERIORT IM141 SCALE:I/4::.I:-,, REF.SHEET 1105 FOR e 6.01 —— ——— —— _ ——— — — — — — — FLA5HFG VFGWIAn0A -- — ----- ------------ — --- ---------- ----------------- © COPYRGHT 2001 Pult Homes p�— � o� � CD c7 Q --- FIELD FRAME l F 3 X b r-:cq SE7 FLR F WFF "A . y�..l ,� • ROOF FRAR RERERBIE NERD ROC/'i O .7 N G ROOF atA'iDY 10.00 � 9 O 3'-6 3/4" E.-I _ LANDING O a Ak 0 i I 1 1 qLA. B3 a'-a" i �I m FIELD FRAME 5EDROOM P2 i IST v 10",2".11'-10" + 1 sEr FLR.w'Att. MEAN FL ST-TE REF:FI 1U '4 5T5 PsF. O I 1 = n \ 1 I LIBRARY PWDR _ "�u 1 LIvING 1 TTv10",2".b'O" ®� e - I Farm 1 LIQ I = O 3 o 0. 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PLAN i MECH CHASE P OPT.SINGLE-HVAL SYSTEM g£ a DELETE MELH LHA*@ GBL.HVAC SYSTEM rme T g D0wADD•HANGERS 2-PL5 177311.88 or"7211.83M ADOHANGERS 2-PCS fA IT311.882MIT211.08-2 �<$ d3g� O fYi MECH CHASE a DOL.AVAC 5Y5TEm It 2' let' S 1@41 @2' 5 A_H LOLKS � O 77 5 2x4x11-15 16 0N� vlri / d _ 4oPc5 MATERIAL LIST — w 13' T FIRST FLOOR WALL MATERIAL LIST - -LEVATIONS I W/OPT FRONT BAY WINOCW5 -7 8 LPI-20/26A hJ015T — I--R 3-I 2 x 11'7 B LVL 2 E I -3 6 Z -I M a -T&7-2P-87 11 11 ji�11 1 i[� I 1� w Q-^ @6 4O,9-5613 -6P 16-3P17-IB620' -4 5 f 22-B 632'11635 PI/8 xl I-'/8 xl2 058 RIM BOARD NOTE5: 14-P65 L REFERENCE PRODUCT HANO-ER5151MP50N y✓ 5PELPI[AT 1015 FOR DECK 22-PL51TT311.88 or ITT211.88 .§ " SIZE AND LOCATION 3 3 2-P65 M1T311.88-2 or MIT211.88 2 _ 2.DO NOT 5U PORT WOOD DECK b FROM ANY CANTILEVER FLOOR a IE 5Y5 TEM. 7 vOCAB ONS POR ALL TURB�SHWR 5 3 NATER CL05Ei5 FOR ANY 8gy 5553 ^- fJOTE�I.I-JOIST LAN BE MOVED ^ AMAXOF 5"OFFCENTER - FIRST FL❑❑R FRAMING PLAN: - EL--E-VATI-ON''4#l--W% ❑PT_ _ PR❑NT BAY WIND❑WS E.GI'2-2`.2" 14.2'-""°`' 56ALE=I/411.11,01 F a 11 7/811 LPI 20 wk e 19.2°O.L.U.N.C. a; 0ln mm I LPI REVISIONS DATED 05/22/02 BY CBAO-JC LPI REVISIONS DATED 04/03/02 BY OBAO-JL LPI REVISIONS GATED 03/28/02 BY COAD wRaxry DY. LPI REV151ON5 DATED 02/18)62 BY ORAD RH 1-I/B'OSB RIM JOIST-FASTEN TO EACH OAiE:&BB/M I-L6.OSB RBS J5 1--FAST N TO EACH -v8'OSB RE]nFORCING EACH SIDE-FASTEN TO JOIN DpUHLE I-JOIST BY NAILING 1HR0'JGH WEB JOIN DOUBLE 1-JOIST BY NAILING THROUGH WEB 2K4 SQUASH BLOCK CUT I/16'TALLER THAN THE FLUSH LVL or STEEL BEAR FLOOR JOIST USI I-1QN NAILEPER FLANGE Zz [-JOIST ON END WALLIEACH FLANS£N/100 NAILS B G'e/c STAGGERED WITH 2-ROWS aO AT 6'o/c INTO FILLER BLOCK WITH 2-ROWS Bo AT 6'o/c INTO FILLER BLOCK DEPTH OF THE I-J IST USC JNDER FIFIRST FLOOR BOOR JOIST USING 1-]➢tl MKiL PER FLANGE REFERENCE PLAN REV No. DAT£ • 1 [-HIST OR -K G.A.BOPRD INTERIOR BEARING WALLS fiY E M q SGUA TH BLa[K 7 3/4'OR J/8' I-1/0'OSH B_KO PHLS. I-1/0'OSE BLKG PHLS. 3/4'OR]/H'piB NOTE,USE VEB F[LLEPS t Y'EH 3/4'DR]/8 EA➢n SIDE ENT. 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GLRTTION AT M� CV HEADER EEE FRAMING OSE PLAN C H ---2x4 BEARING SNPSON HHU212-27F WALL JOIST HANGERS BUILT-UP 2x'n UNDER LvL' DOUBLE 2x6 PLATE [A1FiECTION OPTIONAL TRAY CEILING nSECTION OPTIONAL NY CEILING TO FOUNDATION BELGW ., c `ECTION ENTRY FRAMING - ELEy. 2 d 3 / 8.01 III -- --- - -- -- -- -- --- IL. (rrn B x e C!UY AT to 4 IF I II IF; 7 11� 11 �e 11 I �' e �Tw 8 LM6 iR 13/4 �E 7S (2 x0 l3 8 JI B O_ z'-4 1 = N 171 I /2° I �I V 2x ' GEIL JOT elb s. L i 2' 2i 3 LL 4 x� �a PARTIAL CEILING FRAMING PLAN - OPT.TRAY CEILING �-:�:Z CEILING FRAMING PLAN - ELEV. 1 SCALE:I/4'=1'4 SCALE`.I/4'-VrCr - .- i n b ILPY .T Ib'0 � ORA2M BY: ICI GATE. 0/2wol Q di 3/4° 111 LILT RE'J No. OAIE Til al—!z1 oe/21/ol 7x 8 JOB NUUEER 51214 R1214RF2 SHEET WOER PARTIAL CEILING FRAMING PLAN - ELEV.2 4 3 9.01 SCALE'.1/4=1-0 © COPYRIGHT 2001 Pult Homes gT