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Miscellaneous - 172 MIDDLESEX STREET 4/30/2018 (2)
N q o Eq J sJ J Date ../ /s' /. .. . NORTH TOWN OF NORTH ANDOVER pf Sao ,e,'40 e� t ° OL PERMIT FOR MECHANICAL INSTALLATION s s i • �J l This certifies that has permission for mechanical installation .. ?'t V i% -! .... .......... in the buildings of .. ���/ �,;, .�.... �a..� .- .................. . at ... .... 4'... . , North Andover, Mass. Fee. ... Lic. No.q f45 ...... ...... ............. . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts _ISheet Metal Permit Date: l 1 _ Permit # Estimated Job Cost: $_ %S/ 00© Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO X Business License # Ea Applicant License # Business Information: Property Owner / Job Location Information: Name: S�a�c'G 1 Cool i n a:fi s' Tnc. Name: L U Cr Street: 9' N,� r j1'l rd jpJ�' S-tr- i�" street: City/Town: �J ����n, /Y!A oI,pO/ City/Town: A7\, -►'j -- Telephone: _-Ur t - 9 3 �13 ,2VE Telephone: (3) L - D -7 0 —6 5-�. Photo I.D. required / Copy of Photo I.D. attached: yES NO - ,.A , / 'I 1 unrestricted license staff raw 3 -restricted to dwellings 3 -stories or less and commercial up to 10,000 sq. ft. /2 -stories or less Residential: 1-2 family X- Multi -family Condo / Townhouses Other Commercial: Office Retail Industrial — Educational Institutional Other Square Footage: under 10,000 sq. ft. -X-- over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: i< Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney / Vents Air Balancing Provide detailed description of work to be done: L7�— I INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 YesX No ElIf you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box®(I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Date By Title Cityrrown Permit # Fee $ Duct inspection required prior to insulation installation: YES NO Inspector Signature of Permit Approval Progress Inspections Comments Final Inspection Comments Type of License: UMaster ❑ Master -Restricted ❑Journeyperson Signature (of Licensee ❑Journeyperson-Restricted License Number: qb. / ❑ Check at vs ww.nw=.wy1dM Y� Central Coaling & Heating Inc. A�f 9 14ORTH AAAPLE STREET WOBURN, h4A 01801 May 1, 2015 Brian Lehi 172 Middlesex St. N. Andover, Ma. (916)276-6557 Deborahlebl@2mail.com AC Installation Proposal Equipment: Page i of 4 Manager: Vale Colburn 1 Carrier FX4DNF025L00 H I Carrier 24ACC618AO03 PEABOOY AREA 1 Carrier (878) 631-4422 Programmable Thermostat WOBURN AREA r (781) 833-8288 � NEWTON AREA -0 E• (617) 9-3366 � 28 YOUR comlfoo\ Manager: Vale Colburn 1 Carrier FX4DNF025L00 Fan Coil Unit I Carrier 24ACC618AO03 1.5 Ton AC Condenser 1 Carrier TC -PAC Programmable Thermostat I April Aire 2000 Series High Efficiency Air Filter System Rating: AHRI# 7019648; SEER 16.0; EER 13.0 Work Included: • Installation of equipment listed above • The refrigeration lines and condensate drains will be covered in slim duct on the outside of the house. The routing of the lines will be field coordinated prior to installation. • Installation of a new galvanized steel duct system to air handlers for the second floor The new duct system will be installed in compliance with building codes. • A supply and return will be installed in each bedroom and in the second floor bathroom. • A main return will be installed in the hallway. • Locations of the supply and return grills to be field coordinated prior to installation. • Insulate all ductwork to standard building codes. • Pouring of new concrete pad for condenser. • Power and control wiring to the existing service. Upgrade of the electrical panel is included in this proposal. • All permits and fees • Start up. check system and explain operation. Your Comfort is Our Priority... Since 1966 Serving The Boston Area , (781) 932-9017 fax www.centralcooling.com • u� 2 of 4 • Warranty on all material and labor for 2 complete years including maintenance after the I" full year of operation. Carrier has a 10 year warranty on the parts. Work Not Included: Fire Caulking, carpentry, cutting and or coring; of masonry and warranty of existing equipment. We propose hereby to furnish material and labor - complete in accordance with the above specifications, for the sum $15,325.00 dollars. 1/3 deposit upon acceptance, progress bills to be submitted at the end of the month to be paid on the 10`x' of the following month, balance due to the service technician at the start up of the system. Past due balances will be charged 1 1/2% interest charged per month which is an annual percentage rate of 18% on past due amounts. Rebates: Carrier Instant Rebate This system is eligible for a $75.00 instant rebate from Carrier Corporation (must be purchased by June 30, 2015, installed and paid in full by July 15, 2015.) We are being reimbursed directly from Carrier for providing you this rebate. This is being offered to you as an "instant rebate" that will be deducted from your balance due. Cool Smart Electric Company Rebate The above system is eligible for a $250.00 rebate for NStar Electric or National Grid customers only (subject to available funding.) To claim eligible rebates the system must be purchased, installed and paid in full by 12/31/2015. Rebate applications must be received by the electric company before 1/31/2016. It is the customer's responsibility to pursue available rebates. After system is paid -in -full, Central Cooling & Heating will provide the customer with the appropriate invoice and rebate forms (please allow us 1-2 weeks from the date we start up the system to provide the invoice and rebate forms. System must be paid -in -full before we can provide the required invoice.) Central Cooling & Heating Instant Rebatefor Q11V Testing The above system is eligible for a $200.00 instant rebate. We are being reimbursed directly from the electric company for performing a QIV start up of the system including an air flow test. In order to get the rebate, the new system must be tested with the outside temperature above 60 degrees. The testing may be done at a later date, after we install your system, pending on the weather. This is an "instant rebate" that will be deducted from your balance due. Electric Utility Account # (required for rebate): t u l%O VD'0V� 0-t*xd &V to Your Comfort is Our Priority... Since 1966 Serving The Boston Area (781) 932-9017 fax www.centralcoolingcom Authorized Signature; Dale Colburn Date: May 1, 2015 Payment terms, warranty information and home owners responsibility are listed below Note: This proposal may be withdrawn by us if not accepted within 30 days. • centra( Cooling and Heating, Inc, agrees to provide a Two (2) year warranty on parts and labor to repair or replace (a( our option) any defective materials or equipment. Service agreements are available. • This agreement does not include improvements to your present system except as specifically outlined in your contract. If it is not stated in writing in the contract, than it is not included! • Central Cooling and Heating, Inc. will endeavor to render prompt and efficient service; but it is expressly agreed that the company shall in no event be liable for damage or loss arising out of the performance of this agreement • it is mutually agreed that this agreement does not cover any work required because of negligence, misuse of equipment, or because of fire, flood, acts of Cod, shortage of electrical or water supply, sabotage, or damage caused by freezing. • The company and the customer agree that any alteration or devialion from the specifications set forth in the contract agreement, including extra costs will be executed only upon written orders, and will become extra charge over and above the contract price. All agreements contingent upon strikes, accidents. or delays beyond our control. • All cooling and heating warranty service to be performed during normal business hours M -F 7:30AM— 4:OOPM. Emergency heating warranty service will be provided only if heat is off completely • The homeowner agrees to have the work areas free and clear of personal belongings, construction materials etc. if this is not the case when our crew appears onsite, you will be billed the necessary time needed to safety move the articles to make the +vork area accessible. • Owner to carryfire, tornado and other insurance. Central Cooling and Heating, Inc. workers are fully covered yp Workmen's Compensation insurance • Central Cooling and Heating, Inc. adheres to sound environmental practices relating to the procedures governing refrigerant recovery, recycling, and reclaiming stated in the Federal Clean Air Act. Buyers Rights Option is Notice: Any holder of this consumer credit contract is subject to all claims and defenses which the debtor could assert against the seller of goods and services obtained pursuant hereto or with the proceeds hereof. Recovery hereunder by the debtor shall not exceed amounts paid by the debtor.hercundcr. Buyer's right to cancel: You may cancel this agreement or purchase by mailing a written notice to the seller postmarked not later than midnight the third business day after the date this agreement was signal. You may use this page as that written notice by writing " 1 HEREBY CANCEL:* at the bottom and adding your name and address. The notice must be mailed to 9 North Maple Street, Woburn, MA 01801. Option 2: Under the Mechanics lien law, any contractor, subcontractor, laborer, material man or other person who helps to improve your property and is not paid for his labor, service or materials, has a right to enforce his claim against your property. Under law you may protect Yourself against such filings, before commencing such work of improvement, an original contract for the work of improvement thereof, in the office of the county recorder of the county where your property is situated and requiring that a contractor's payment bond be recorded in such office. Said bond shall be an amount not less than fifty percent (50%) of the contract price and shall, in addition to any conditions for the performance of the contract, be conditioned in full of the claims of all persons furnishing labor, services, equipment or materials for the work described in said contract. To expedite installation, I hereby waive my right to the 3 -Day Recission Law. Your Comfort is Our Priority... Since 1966 Serving The Boston Area (781) 932-9017 fax www.centralcooling.com Cay�r 3 of A C(7 rs� 1 0 CCO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 5/8/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Risk Strategies Company 15 Pacella Park Drive, Suite 240 Randolph, MA 02368 www.risk-strategies.com CONTACT NAME: Risk Strategies Company PHONE FAX Est AIC No MA �e ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Gemini Insurance Company INSURED Central Cooling & Heating, Inc 9 North Maple St Woburn MA 01801 INSURER B: Arbella Protection Ins CO INSURER C: Admiral Insurance Co INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: 2481'1292 REVISION NUMBER: 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 BE 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. INSR I LTR TYPE OF INSURANCEAM ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD LIMITS A V COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR VCGP080267 11/30/2014 11/30/2015. EACHOCCURRENCE $ 1,000,000 DAMAGE TO Ea occurrence) $ 50,000 -PREMISES MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ✓ POLICY F PRO JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS ✓ AUTOS NON -OWNED ✓ HIRED AUTOS ✓ AUTOS 1020009316 11/30/2014 11/30/2015 O(EaMBINEDtSINGLELIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROaccident)PTYDAMAGE $ C ✓ UMBRELLA LIAR �/ EXCESS LIAB OCCUR CLAIMS -MADE EX000013930-01 11/30/2014 11/30/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 0048681113 11/30/2014 11/30/2015 �/ STATUTE ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT IS 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Install of new galvanized steel duct system for the 2nd floor CERTIFICATE HOLDER CANCELLATION ------- -------------- HVAC Work Brain Lebl 172 Middlesex Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. North Andover MA 01845 AUTHORIZED REPRESENTATIVE Michael Christian ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.; 24613292 Nancy Brennan 5/8/2015 4:06:59 PM (EDT) Page 1 of 1 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 9 North Maple Street Woburn, MA 01801 Central Cooling & Heating, Inc. Phone #: (781) 933-8288 Are you an employer? Check the appropriate box: 1.0 I am a employer with 70 4. [] I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance. t 171 We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Q Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12.1-1 Roof repairs 13.H Other HVAC *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 is the policy and job site information. Insurance Company Name: Arbella Protection Insurance Company Policy # or Self -ins. Lic. #: 0048681113 Expiration Date: 11/30/2015 Job Site Address: / 7a Hi bl)lt s eic S% City/State/Zip: / • /T�'1 °�L CYST 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 certify uti der t e p ns and penalties of perjury that the information provided above is true and correct Signature: I Date:, - Phone #: 781-404-2310 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 produced acceptable 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-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 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-7274900 ext 7406 or 1-877-MASSAFE Revised 7-2013 Fax # 617-727-7749 www.mass.gov/dia 14, _;r2.lzl q '5F J COMMONWEALTH OF MASSACHUSEITS, SHEET METAL WORKER'S.. MIAISSUES THE FOLLOWMG LICE AS, A BUS I'kESS --DOUGLAS A HAMILTON CENTRALCOOLING AND'..HEATING,,"INC 9 N MAPLE ST WOBURN,:, MA 01801 r'l nRl 1-f o.11 Ah ql All 1, 111- .1i.- SHEET.AETAL 'WORKERS. ISSUES. THE FOLLOWtNGi'ICENSr7,� AS 'A AASTER—UNRESTITITTEU':;:� D01UQLAS A HAMILTON CENTRAL COOLING & HEAT -9 14ORTH MAPLE STREET WO BU R N MA 01801-1713•• 46�} 12/1 132022-- ol-lialt 1. -19, lm; 7 AV$E T$ U q: A A-, OF AIAS SaEND 4d M=R NONE S5295406�"! 7 w* I DOG �19E A l xg N 3- - "%uQWQ9 A A a TO LIBERTY ST N ANDOVER, RA 018453357 5 DO 12-17-20URev 07-115-2)" w: 'Central {:;;: olin�; Load Short Form �,t � Heating Inc: Entire House Project,information For. Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Job: Date: Apr 29, 2015 By: Dale Colbum HEATING EQUIPMENT Make n/a Trade n/a Model Designa AHRI ref. Htg Clg Infiltration Outside db (°F) 1 88 Method Simplified Inside db (°F) 68 75 Construction quality Average Design TD (°F) 67 13 Fireplaces 1 (Average) Daily range - M Inside humidity (%) 50 50 Moisture difference (gr/Ib) 47 28 HEATING EQUIPMENT Make n/a Trade n/a Model n/a AHRI ref. n/a Efficiency n/a Heating input Sensible cooling Heating output 0 Btuh Temperature rise 0 °F Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Space thermostat n/a COOLING EQUIPMENT Make n/a Trade n/a Cond n/a Coil n/a AHRI ref. n/a Efficiency n/a Htg load Sensible cooling 0 Btuh Latent cooling 0 Btuh Total cooling 0 Btuh Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Load sensible heat ratio 0 357 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) 1st d 644 17236 6078 301 301 (Rest of House) d 644 15146 7220 357 357 Entire House d 1288 32382 13214 658 658 Other equip loads 0 0 Equip. @ 0.93 RSM 12289 Latent cooling 2237 -AI ^ Anon 97,307 4AC77 I V I /ALJ LOO ITJG! uuu - Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015 -May -0811:16:55 wrightsoftw Right -Suite® Universal 201515.0.02 RSU15857 Page 1 JCC -I\ P:\Sales\Dale ColbumlLoad Calc\Lebl DL.rup Calc = W8 Front Door faces: N - 'Central Cooling Load Short Form � & Heating Inc. ry (Rest of House) Project Information For: Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Job: Date: Apr 29, 2015 By: Dale Colbum HEATING EQUIPMENT Make Trade Model AH R I ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 80 AFU E 0 Btuh Des-ign InTormation Btuh Htg Clg Infiltration Outside db (°F) 1 88 Method Simplified Inside db (°F) 68 75 Construction quality Average Design TD (OF) 67 13 Fireplaces 1 (Average) Daily range - M Inside humidity (%) 50 50 Moisture difference (gr/Ib) 47 28 HEATING EQUIPMENT Make Trade Model AH R I ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 80 AFU E 0 Btuh 0 Btuh 0 OF 357 cfm 0.024 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Trade Cond Coil AHRI ref Efficiency Sensible cooling Latent cooling Total cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio 0 SEER 0 Btuh 0 Btuh 0 Btuh 357 cfm 0.049 cfm/Btuh 0 in H2O 0.82 110 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) baby 110 3274 1870 77 92 bath 72 1432 443 34 22 clst 72 1929 476 45 24 guest 144 3704 1989 87 98 mstr 156 2705 1899 64 94 stair/hall 90 2101 542 49 27 (Rest of House) d 644 15146 7220 357 357 Other equip loads 0 0 Equip. @ 0.93 RSM 6715 Latent cooling 1534 14 8249 357 3r,7 TOTALS 644 15 6 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. ^.` + wrightsoft" R ght-Suite® Universal 2015 15.0.02 RSU15857 ACCA PASales\Dale ColburnToad Caldl-ebl DL.rup Calc= MJ8 Front Door faces: N 2015 -May -0811:16:55 Page 2 Central (�:ooling Load Short Form & Heating Inc. 1st Project information For: Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Job: Date: Apr 29, 2015 By: Dale Colbum HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 80 AFUE 0 Btuh Ddsignlnf6rm��iibnl Btuh Htg Clg Infiltration Outside db (°F) 1 88 Method Simplified Inside db (°F) 68 75 Construction quality Average Design TD (°F) 67 13 Fireplaces 1 (Average) Daily range - M Inside humidity (%) 50 50 Moisture difference (gr/Ib) 47 28 HEATING EQUIPMENT Make Trade Model AHRI ref Efficiency Heating input Heating output Temperature rise Actual air flow Air flow factor Static pressure Space thermostat 80 AFUE 0 Btuh 0 Btuh 0 OF 301 cfm 0.017 cfm/Btuh 0 in H2O COOLING EQUIPMENT Make Trade Cond Coil AHRI ref Efficiency Sensible cooling Latent cooling Total cooling Actual air flow Air flow factor Static pressure Load sensible heat ratio 0 SEER Area 0 Btuh 0 Btuh 0 Btuh 301 cfm 0.050 cfm/Btuh 0 in H2O 0.90 6078 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) Room7 644 17236 6078 301 301 1st d 644 17236 6078 301 301 Other equip loads 0 0 Equip. @ 0.93 RSM 5652 Latent cooling 703 /SAA .171]70 C-2GG '2n'1 in'I I V 1 {ALJ V" 1/GJu v--- vv, Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. ,` + wrightsoft- Right -Suite® Universal 2015 15.0.02 RSU15857 ACCP. P:lSalestDale ColbumtLoad Calc\Lebl DL.rup Calc= W8 Front Door faces: N 2015 -May -08 11:16:55 Page 3 'Central C(..)(ling, Project Summary & Heating Inc. w.Entire House Pro-ect"W&M' ation 1 For. Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Notes: Job: Date: Apr 29, 2015 By: Dale Colbum Weather: Lowell, MA, US Winter Design Conditions Summer Design Conditions Outside db 1 OF Outside db 88 OF Inside db 68 OF Inside db 75 OF Design TD 67 OF Design TD 13 OF Daily range Relative humidity M 50 % Moisture difference 28 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 31047 Btuh Structure 12912 Btuh Ducts 1335 Btuh Ducts 303 Btuh Central vent (0 cfm) 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 32382 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 12289 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 1 (Average) Structure 1770 Btuh Ducts 467 Btuh Heating Cooling Central vent (0 cfm) 0 Btuh Area (ft') 1288 1288 Equipment latent load 2237 Btuh Volume (W) 10304 10304 Air changes/hour 0.70 0.30 Equipment total load 14527 Btuh Equiv. AVF (cfm) 120 52 Req. total capacity at 0.70 SHR 1.5 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a AHRI ref n/a Coil n/a AHRI ref n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0 cfm/Btuh Air flow factor 0 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat n/a Load sensible heat ratio 0 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015 -May -0811:16:55 Wrl F1t50ft 9 Flight -Suite® Universal 2015 15.0.02 RSU15857 Pagel ACOA P.ZalestDale ColbumtLoad CalctLebl DL.rup Calc= MJ8 Front Door faces: N ' *Central ('.booing Project Summary Heating Inc. (Rest of House) Project Information l For. Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Notes: Job: Date: Apr 29, 2015 By: Dale Colbum Weather: Lowell, MA, US Winter Design Conditions Summer Design Conditions Outside db 1 OF Outside db 88 OF Inside db 68 OF Inside db 75 OF Design TD 67 OF Design TD 13 OF Daily range Relative humidity M 50 % Moisture difference 28 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 14565 Btuh Structure 7081 Btuh Ducts 581 Btuh Ducts 139 Btuh Central vent (0 cfm) 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 15146 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 6715 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 1 (Average) Structure 1285 Btuh Ducts 249 Btuh Heating Cooling Central vent (0 cfm) 0 Btuh Area (ft2) 644 644 Equipment latent load 1534 Btuh Volume (ft') 5152 5152 Air changes/hour 0.70 0.30 Equipment total load 8249 Btuh Equiv. AVF (cfm) 60 26 Req. total capacity at 0.70 SHR 0.8 ton Heating Equipment Summary Cooling Equipment Summary Make Make Trade Trade Model Cond AHRI ref Coil AHRI ref Efficiency 80AFUE Efficiency 0 SEER Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 357 cfm Actual air flow 357 cfm Air flow factor 0.024 cfm/Btuh Air flow factor 0.049 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.82 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015 -May -08 1Page 5 Wrl htsofta 9 Right-Suite®Universal 2015 15.0.02 RSU15857 Page 2 ACCK P:GalestDale Colburn1oad Cald l-ebl DL.rup Calc= MJ8 Front Door faces: N 1 `Central Project Summa Job: & Heating Inc. Date: Apr29, 2015 1st By: Dale Colburn For. Brian Lebl 172 Middlesex St., N. Andover, Ma Phone: 916-276-6557 Email: Deborahlebl@gmail.com Notes: Weather: Lowell, MA, US Winter Design Conditions Summer Design Conditions Outside db 1 OF Outside db 88 OF Inside db 68 OF Inside db 75 OF Design TD 67 OF Design TD 13 OF Daily range Relative humidity M 50 % Moisture difference 28 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 16482 Btuh Structure 5912 Btuh Ducts 754 Btuh Ducts 165 Btuh Central vent (0 cfm) 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 17236 Btuh Use manufacturer's data n Rate/swing multiplier 0.93 Infiltration Equipment sensible load 5652 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 1 (Average) Structure 485 Btuh Ducts 218 Btuh Heating Cooling Central vent (0 cfm) 0 Btuh Area (ft') 644 644 Equipment latent load 703 Btuh Volume (ft) 5152 5152 Air changes/hour 0.70 0.30 Equipment total load 6355 Btuh Equiv. AVF (cfm) 60 26 Req. total capacity at 0.70 SHR 0.7 ton Heating Equipment Summary Cooling Equipment Summary Make Make Trade Trade Model Cond AHRI ref Coil AHRI ref Efficiency 80AFUE Efficiency 0 SEER Heating input 0 Btuh Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 301 cfm Actual air flow 301 cfm Air flow factor 0.017 cfm/Btuh Air flow factor 0.050 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.90 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015-May-081Page 5 .� Wrl htsoft" 9 Right -Suite® Universal RSU15857 Page 3 AC•K PASales\DaleColbumU.oadCalc\LeblDL.rup Calc =MJB Front Door faces N L 141 L ;. w ?X V� V ,\ L P L� ;. w ?X V� L f c S10 0 7564 Date.. f/-V// ......... . � Of NORTH ,•b of TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SACH This certifies that.. ,/ ....... .,,. .......... has permission for gas installation ...... // .//? ............... . in the buildings of ... ................................ at .17.z ...l:rf.I. t(.� / : ........... I North Andover, Mass. Fee.. O..l . Lic. No.. 2. .. ...... �'?� ._ 4 .N, ... Co4S INSPECTOR Check # ' V FIXTURES MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:-0—,6�?�/,, MA. Date: �� Permit# Building Location;/ %� 0%i, Lp/ z2L!� Owners Name: f,(/ ,, Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No ❑ FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes -ET -96-E] If you have checked Yes, please indicate t pe of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aoent By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type—of—License: BY lumber Title ❑ Gas Fitter Signature of L'ce d lumber/Gas Fitter ❑ Master APPROVED OFFICE USE ONLY ElLP Inst lan License Number: Installer l aCd W Y H W U 2 W = W W CO 2 O W W J V N H Z O Z N I- w W Lu Z m 0 W a a Ix W O Lu o w x W H N 0 Z W N W C7 W = N W O F- p= LL Z V W W Z >- w O to J H J Q _Z I— Q O m Z J W O l7 Z W O W W ~ Z W W I— V o o C�7 =_ O a H>>> O SUB BSMT. BASEMENT 1 FLOOR 2 Nu FLOOR 3 FLOOR 4 FLOOR -9 'FLOOR 6 1FLOOR 7 1 HFLOOR 8 1 HFLOOR Check One Only Certificate # Installing Company Name: -� Address: l // G��� � City/Town: ./�'r/1' �/l"w&' i State: Ll Corporation Business Tel: 5W r� S-';� — V70 d� Fax: g Z e C, C? a/ Qr ❑ Partnership _ /Company 6�/t4- A4. Name of Licensed Plumber/Gas Fitter: / INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes -ET -96-E] If you have checked Yes, please indicate t pe of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aoent By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type—of—License: BY lumber Title ❑ Gas Fitter Signature of L'ce d lumber/Gas Fitter ❑ Master APPROVED OFFICE USE ONLY ElLP Inst lan License Number: Installer l j` E) 1eu6is LU ' G to • F N: .� . W J ND Ln cn CL 1 n Q U ao (!i 0, o N Q Z w a � 2 o.' w r+ LLo O J 1i O - ',7 o Q F- J cn Q W N w Q a a 3:`° Z W M W Z � j Cl) W %4Jo d .: H 1 LL � _v a 3 O CX .. W I U U ND E 4 7 nn i 4 , 7 Date . ,/9. 4.. . */.,(.".) .. . TOWN OF NORTH ANDOVER n PERMIT FOR GAS INSTALLATION N This certifies that ... /.�. !/.. ............. . has permission for gas inst/p1 tion ...601. 4n .............. in the buildings of ................................. at J.7. ... .. ! ......., North �ndoverr, ass Lic. No.:) Q631..� .. ..... .... ..; GAS INSPECTOR Check # NUASSAG SEM UNHDRXI APPUCATON FOR PERIM TO DO GAS FITTING (Type or print) Date iG IAVle- NORTH ANDOVER, MASSACHUSETTS Building Locations 7 ► �' ��l �' �/ Permit # Amount $ �_ �•• Owner's Name � � New Renovation F1 Replacement EV Plans Submitted (P moor type) �� J� AZ171 Checkone: Certificate Installing Company Corp. F1Partner.. IIFITm-/Co: :Name of Licensed Plumber or Gas Fitter��--- INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked yg�i, please indicatp,tbe-type coverage by checking the appropriate. box. Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: Tam aware that the licensee does not have the Insurance coverage required by Chapter 142 of true :Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the - hest of m} knowledge and that all, plumbing work and installations perrorniod under Permit Issued for this application will be in compliance with all pertinent provisions or the Massachusetts State G, • and Chapte�),4-fof the General Laws. By: Title CityiTown APPROVED (-omcF USE ONLY) Signature of Licdfisal Plumber /Or Gas Fitter 0 Gas Fitter rcense 1 um er 0 Master journeyman U x rn n U w a C4 0 o N �. 0 Cn CA N N `' '' z z o H 94 w W W �" a C4 C11dd p��i W U a �� OU Ux., � 0 p7 O fes+ A Cti A � F SUB-BASEiMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR . 4T IT. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR t STH. FLOOR (P moor type) �� J� AZ171 Checkone: Certificate Installing Company Corp. F1Partner.. IIFITm-/Co: :Name of Licensed Plumber or Gas Fitter��--- INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked yg�i, please indicatp,tbe-type coverage by checking the appropriate. box. Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: Tam aware that the licensee does not have the Insurance coverage required by Chapter 142 of true :Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the - hest of m} knowledge and that all, plumbing work and installations perrorniod under Permit Issued for this application will be in compliance with all pertinent provisions or the Massachusetts State G, • and Chapte�),4-fof the General Laws. By: Title CityiTown APPROVED (-omcF USE ONLY) Signature of Licdfisal Plumber /Or Gas Fitter 0 Gas Fitter rcense 1 um er 0 Master journeyman Lle 12 3 t Dae... 1 A, /.- TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... A- 5.:c �� .............SX5 ............. hav permission to perform ......... A. /.a (4-1 .......... ...................... wiring in the building of .... . .......................................................... ................... at ........ ..... ..... ..... ,g Andover s Feo..-d. j ... Lic. No. ................... . ..... . ... . . ...... .. ...... .. .... E Ic NSPEG" 101, Check # [rM Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Use Permit No. Occupancy and Fee Checked tev. 11/99] (leave hlank) 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 TYP ALL FO ATION) Date: p� �p City or Town of: To the Inspecto ofWires: By this application the undersigned gives otrce o his pr )igr intention to prxf�;rn the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Telephone No' Is this permit in conjunction with a building permit? Yes ❑ No 2 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps New Service Amps Number of Feeders and Ampacity Volts Overhead ❑ Undgrd ❑ Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o Detection and o. Initiating Devices No. of Ranges No. of Air Cond. Total. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Kit Security Systems: No. of Devices or Equivalent No. of Water KW No. o No. o 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. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of E e tric 1 Work: (When required by municipal policy.) Work to Start:MaInspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under dietpaind and penalties of perjury, that the information on this application is true and complete. FIRM NAME:SecLlri:tyLIC. NO.: 1 r q 1( Licensee: John S. Bassett Signature LIC. NO.: 15330 (If applicable, enter "exempt" in the license number line.) VBus. Tel. No., 60. 594 5928 Address: U Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Li , see 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 Signature Telephone No. PERMIT FEE: $ Location Ne• f q 7 Date r Check # 4 -2 % `14.1-"7 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ x1z,v 9 TOTAL $ Building Inspector 14 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT r APPfICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ON; FAMILY DWELLING �OR�]TWO BUILDING PERMIT NUMBER: J DATE ISSUED: SIGNATURE: zac(C".�— BuildinECommissioner/lATector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address:1.2 Assessors Map and Parcel u ber: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Private 0 Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner 000ff�Reco. Name (Print) t Addressr Service: . t� [ / Signature irl, Telephone 2.2 Owner of Record: Name Print Address for Service: SiZnature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: 5 �� (� \� � �-� c9.���C J Address Signa re Telephone 9� Not Applicable ❑ License Number 60 -77)3 z— Expiration Date X3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date i Signature Telephone OU SECTION 4 - WORKERS COMPENSATION (M. G.L. C 152 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Pro osed Work check all applicable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: n � `� 2 i 1-�-� �� � west-� �X� � •-�% �� � c ��� `-� ��r � 1��� _ SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by Rennit a licantAi OFT`ICIAL USE.f9h'LY 1. Buildinga �„ j�U 6 Building () g Permit Fee Multiplier 2 Electrical (� U (b) Estimated Total Cost of Construction 3 Plumbing 9 Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 7 c _ as Owne /Authorized Agent of s ject property Hereby authorize �l(iv P� to act on My behalf, in all matters relative to w au orized rs wilding permit application Signature of Owner- 71, G Date SECTION 7b OWNEMAUTUORIZE04GENT DECLARATION 1, ,as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si attire of Owner/A ent Date sm NO. OF STORIES SIZE 2 2 W BASEMENT OR SLAB SIZE OF FLOOR TRVIBERS 1 2 3 SPAN / f DIIv1ENSIONS OF SILLS r a-) DlIv]ENSIONS OF POSTS Dll�,IENSIONS OF GIRDERS N . HEIGHT OF FOUNDATION THICKNESS p SIZE OF FOOTING r `/ X MATERIAL OF CHDANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE b The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name % % ,LJ 2e / /141—r Zi C° Location: % F am'a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity EfI am an employer providing. workers' compensation for my employees working on this job. Company name W Insurance Co. Z/ L", �% u .Q Policy Company name: Address City Phone #: Insurance Co. _ Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the infonnaU rovided above is true and correct. Signatures '''� ��� r\^��r'n- -' Date UO Print name \JJ ��it�\�c�.����`>� . ���s��,� Phone # 7 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone #: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION i Town of North Andover • �� �O RTS • Building Department 27 Charles Street _ North Andover Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 0 I W"K. Q *�TEO /+P�tw•��� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of. Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: Facility Signature of Applicant 4 (1 R lC* Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. . ^ . Registry of k*Ms Northern Dist�ict Of -Essex Countv MA 01040 Ba'(LE � 30 Rec: �nst 11486 # 31 Rec: �nst 11487 Total # 3% ."rmunt check 04/18/01 JC �� '-- ru*N 36.0O ~`p^cs 1.50 Type NOTC 30.0O THANK YOU/ /nmxas I Burke 67.50 67.5O 3�) RECEIVEDTown of North Andover :„ORT" 1 f+` y0 JDTD ��Rvelop he Zoning Board of Appeals �+ C�lnent and Services Division 2�0� MAR 2 William J. Scott, Division Director-„,rye'�.�ig 1 A 9: l 27 Charles Street 'Vs C” D. Robert Nicetta North Andover, Massachusetts 01345 Telephone,(978) 688-9541 Building Commissioner Fax (978) 688-9542 This Is b) certify that twenty (20) days Any appeal shall be filed Notice of Decision have elapsed from date of decision, filed within (20) days after the Ahout filing of peel. Year 2401 oata t' /k ?e)al date of filing of this notice Joyce A. Bradahaus in the office of the Town Clerk. Property at: 172 Middlesex Street Town Clerk NAME: Michael & Wendy Boyle ADDRESS: 172 Middlesex Street North Andover, MA 01845 DATE: 3/13/2001 PETITION: 004-2001 HEARING: 3/13/2001 The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday, March 13, 2001 at 7:30 PM upon the application of Michael & Wendy Boyle, 172 Middlesex Street, North \I�QJ Andover, MA requesting dimensional Variance from Section 7, Paragraph 7.3 of Table 2, for a side setback in order to allow for the addition of a kitchen and bath and for a Special Permit from Section 9, I Paragraph 9.2 for the extension of a non -conforming structure on a non -conforming lot within the R-4 rti• zoning district. The following members were present: Walter F. Soule, Raymond Vivenzio, John Pallone, Scott Karpinski, Ellen McIntyre. Upon a motion made by Ellen McIntyre and 2°d by Scott Karpinski the Board voted to GRANT a dimensional Variance for relief of 3' on the West side and to GRANT a Special Permit in order to allow for the addition of a kitchen and bath on a non -conforming structure on a non -conforming lot. In accordance with the Plan of hand by: Scott L. Giles, PLS, #13972, 50 Deermeadow Road. North Andover, MA dated: November 28, 2000 and January 30, 2001. Voting in favor: WFS/RV/JP/SK/EM. The Board finds that the petitioner has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the zoning Bylaw. The Board finds that the applicant has satisfied the provisions of Section 9 Paragraph 9.2 of the zoning bylaw and that such change, extension or alteration shall not be substantially more detrimental than the existing structure to the neighborhood. Furthermore, if the rights authorized by the Variance are not exercised within one (1) year of the date of the grant, it shall lapse, and may be re-established only after notice, and a new hearing. Furthermore, if a Special Permit granted under the provisions contained herein shall be deemed to have lapsed after a two (2) year period from the date on which the Special Permit was granted unless substantial use or construction has commenced, it shall lapse and may be re-established only after notice, and a new hearing. Town of North Andover �— Board of Appeals., ,J A-_�° (4ORTH REGISTRY OR DEEDS ond `rivenzio, acting Chainnan Ivll/Deci� 1! - LAWRENCE, MASS. `'� 17 d / ATTEST: A TRUE COPY. ATTEST: A True Copy Town Clerk FtWf `7 R OF OM — �/�g T_06ilEilt4llfUCfif� 4�v �[-CYd1fL!-'lilf;W.�-f.� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 007732 Birthdate: 09/08/1940 Expires: 091082001 Tr. no: 4536 Restricted To: 00 VERNE S FOLLANSBEE�ii ' 50 GREAT POND DR BOXFORD, MA 01921 Administrator FORM - U - LOT RELEASE FORM INS TRUCTIONS - This form is used to Irerify that all -necessary approval /permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the i. -I -3o--o / applicant and or landowner from compliance with any applicable requirements. 1.aa,.as,.aaa...a.................s,.s.....s,■............,.........mum was ,.. APPLICANT \ 4 I " PHONE C1 �' (� (� 2,1 )1-7/ ASSESSORS MAP. NUMBER LOT NUMBER V SUBDIVISION LOT NUMBER STREET Ja Z son��C_r y ........ STREET..NUMBER 7 .Z :`sees . OFFICIAL USE ONLY o. wage OWN Wawa now sa.aas.aae.se■'es■.............................................. RECONINIENDATIONS OF TOWN AGENTS geese.aewas a0a■...................asses.......aeeeese.ee.ees,s.es.......,..■ ATE PRO CONSERVATTONADMIN1STRAT0A, 4 I �� ?� JE CTE COMMEN"Is DATE APPROVED TOWN PLANNER DATE REJECTED COMIv1ENTS DATE APPROVED FOOD INSPECTOR -HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR Cl) m a] U) 0 m = y CD .O C � d � O c') z co) CD o = r a, mmC C d =• CO) O n c v CD CD O .7 Q d CD CD 0 CD C OCD V� d O y CD CD a N O � z CD CDCD0 no0 mC .o CO) coal C& m ymar ?s N ._-►� "dim N T m a?cm, m ...� f C'. = C=D ma �o o O N m =r N ` �E:♦ m O N : �• :� -� C7 o Cl - co CA W N C.CD d C L N H O O m M O • :� ` CD o n CDot a ,R m ^► m J�CD: d d CLS 5 CA co c CD o� Q 0 c °° `;� oil d w z w 7 S. C � Z w r C "C r tz GO W C °° G a o Gy r- Cl) b r O a m x Q 0 c NOft7ry Zoning Bylaw Review Farm -1F�py. Town Of North Andover Building Department 27 Charles St. North Andover, -MA. 01845 S"`""Phone 978-688-9545 Fax 978-688-9542 Street: '762- /clWe S e- )c St Ma /Lot: / Applicant: /Y)1G awl d3 y IF— Request: o? V a a,e A i' iu"J Date: F Please be advised thataner review of your Application and Plans your Application is Mi / DENIED for the following Zoning Bylaw reasons: Zoning for the above is checked below. Item # Special Permits Plann Site Plan Review Special I Access other than Frontac Frontage Exception Lot Sr Care Retirement it Elderly Housinc Large Estate Condo Specie Planned Development Disti Planned Residential Specie R-6 Density Special Permit Watershed Special Permit g Board Item Notes Setback Variance Item Notes A Lot Area 'ermit F Frontage Variance for Sign 1 Lot area Insufficient Special Permit 1 Frontage Insufficient Earth Removal S ecial Permit ZBA 2 3 Lot Area Preexisting Lot Area Complies e S 2 3 Frontage Complies 1 Preexisting frontage E S 4 Insufficient Information 4 Insufficient Information B use 5 No access over Frontage 1 Allowed +� e S G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 5 Special Permit Required Insufficient Information 3 4 Preexisting CBA Insufficient Information S C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 4 Left Side Insufficient Right Side Insufficient e 3 4 Preexisting Height Insufficient Information y e S 5 Rear Insufficient ( Building Coverage 6 7 D 1 Preexisting setback(s) Insufficient Information Watershed Not in Watershed L S e S 1 2 3 4 Coverage exceeds maximum Coverage Complies Coverage Preexisting Insufficient Information =1 e S 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 5 Zone to be Determined Insufficient Information 2 3 Sign Complies Insufficient Information E Historic District K Parking 1 2 In District review required Not in district 1 2 More Parking Required Parking Complies 3 Insufficient Information for the above is checked below. Item # Special Permits Plann Site Plan Review Special I Access other than Frontac Frontage Exception Lot Sr Care Retirement it Elderly Housinc Large Estate Condo Specie Planned Development Disti Planned Residential Specie R-6 Density Special Permit Watershed Special Permit g Board Item # Variance rmit Setback Variance Special Permit Parking Variance :ial Permit Lot Area Variance 'ermit Height Variance Permit Variance for Sign Special Permit Special Permits Zoning Board Special Permit Special Permit Non -Conforming Use ZBA Permit Earth Removal S ecial Permit ZBA of S ecial Permit Special Permit Use not Listed but Similar Permit Special Permit for Sig n Other Supply Additional Information A per,-. ..Cw c! - `Phe above review and attached explanation of such is based on the plans, request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative' shall be attached hereto and incorporated herein y referen The uilding de ent will retain all plans and documentation for the above file. he --Building Department Official Signature Application Received Application Denied Denial Sent : If Faxed Phone Number/Date: Plan Review Narrative I3 The following narrative is provided to further explain the reasons for the action on the property indicated on the reverse side: Referred To: Fire "I ><I Zoning Board Conservation Department of Public Works Planning Historical Commission Other BUILDING DEPT ZoningBylawDenia12000 T0: Members, Zoning Board of Appeals FROM: Michael McGuire, Local Building Inspector # (Co DATE: February 21, 2001 RE: Petition of Michael & Wendy Boyle 172 Middlesex Street For an addition to the rear of their structure. Please be advised that upon review of the above noted petition it was observed that 1 stall of the detached garage to the rear of the property will be rendered unusable due to the close proximity of the proposed addition. It appears that the proposed addition will be within 9 feet of the garage which may not give the petitioner ample room for the entry or egress of the garage with a motor vehicle. Whether this has occurred to the petitioner I do not know although I will be forwarding a copy of this correspondence to the petitioner as well. This department has no issue with this but felt that it should be noted. Cc Michael & Wendy Boyle file Notrrh t O Zoning Bylaw Review Form Ma /Lot: Town Of North Andover Building Department Applicant: 27 Charles St. North Andover, MA. 01845 Request: Phone 978-688-9545 Fax 978-688-9542 Street: r7 6? ialdle 5 e )c S -T Ma /Lot: --20/6) Applicant: InCG .,e_I d3 r-) y l F— Request: '/� Xa a' e a,e A , 1 -z'9, ) Date: 162—//-0 D Please be advised that -after review of your Application and Plans your Application is / DENIED for the following Zoning Bylaw reasons: Zoning for the above is checked below. Item # Special Permits Planning Board Site Plan Review Special Permit Access other than Frontaae Sr)ecial P r-rontage Exception Lot Special Permit Common brivemay Special Permit _ Congregate Housing Special Permit Continuing Care Retirement Special Pe Ind Housi Large Estate Condo S Planned Development Planned Residential S R-6 Density Special P Watershed Special Pe Item # Variance C- '-+ Setback Variance Parking Variance Lot Area Variance Variance Permits Zoning Board ermit Non -Conforming Use ZBA Permit Earth Removal special Permit ZBA :t Special Per it S ecial Permit Use not Listed but Similar Permit Special Per for Si n Other Su ly Additional Information The above review and attached explanation of such is based on the plans, request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein/try referenn The uilding dep ment will retain all plans and documentation for the above file. —�8uilding Department Official Si nature �'7_�/ C �) 9 Application Received Application Denied Denial Sent: If Faxed Phone Number/Date: Item Notes Item Notes A Lot Area F Frontage 1 Lot area Insufficient 1 Frontage Insufficient 2 Lot Area Preexisting y e S 2 Frontage Complies `1 e s 3 1 Lot Area Complies 3 Preexisting frontage 4 Insufficient Information .4 Insufficient Information B Use 5 No access over Frontage 1 Allowed Ll e- S G Contiguous Building Area 2 1 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 5 Special Permit Required Insufficient Information 3Preexisting 4 CBA Insufficient Information je g C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 4 Left Side Insufficient Right Side Insufficient e ' 3 4 1 Preexisting Height Insufficient Information y e S 5 Rear Insufficient 1 Building Coverage 6 Preexisting setback(s) S 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D 1 Watershed Not in Watershed e S 3 4 Coverage Preexisting Insufficient Information e S 2 In Watershed j Sign 3 Lot prior to 10/24/94 1 — Sign not allowed 4 5 Zone to be Determined Insufficient Information 2 3 Sign Complies Insufficient Information E Historic District K Parking 1 2 In District review required Not in district e S 1 2 More Parking Required Parking Complies 3 Insufficient Information for the above is checked below. Item # Special Permits Planning Board Site Plan Review Special Permit Access other than Frontaae Sr)ecial P r-rontage Exception Lot Special Permit Common brivemay Special Permit _ Congregate Housing Special Permit Continuing Care Retirement Special Pe Ind Housi Large Estate Condo S Planned Development Planned Residential S R-6 Density Special P Watershed Special Pe Item # Variance C- '-+ Setback Variance Parking Variance Lot Area Variance Variance Permits Zoning Board ermit Non -Conforming Use ZBA Permit Earth Removal special Permit ZBA :t Special Per it S ecial Permit Use not Listed but Similar Permit Special Per for Si n Other Su ly Additional Information The above review and attached explanation of such is based on the plans, request for or information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department. The attached document titled "Plan Review Narrative" shall be attached hereto and incorporated herein/try referenn The uilding dep ment will retain all plans and documentation for the above file. —�8uilding Department Official Si nature �'7_�/ C �) 9 Application Received Application Denied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for the action on the property indicated on the reverse side: Referred To: Fire Health Police X Zonin Board Conservation De artment of Public Works Planning Historical Commission Other BUILDING DEPT ZoningBylawDenia 12000 Location / I-nl I nD( FSEX 5 I No. r Date 3 16 9 Z I If 4 Y� TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ZC 6.0 Sewer Connection Fee $ I'Water Connection Fee $ TOTAL Building'In`spector Div. Public Works PERJIIT NO..D ,� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. L ,..,�PAGE 1 MAR` +40. LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK -'PAGE ZONE SUB DIV. LOT NO. A 4A A LOCATION Z /-7a S 4r PURPOSE OF BUILDING Azo OWNER'S NAME A NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME a4 q % SPAN DISTANCE TO NEAREST BUILDING -- DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS sY SEE BOTH SIDES PAGE L FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED .3 % 6 % q,j SllqfjATURE ^ OF OWNER," AUT'yIO)RIZED AGENT F E E ZQ V-0 CONTR. TEL. _ CONTR. LIC._ PERMIT GRA ED 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST ` / Q 40 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN 'NV -1d 101d S3oV1d3U SIH1 'a350dW1213df1S '013 's3ovu -VE) 'S3HO210d H11M 'SONIa-11(19 d0 SNOISN3Wi❑ 1OVX3 aNV S3NI-I 10-1 WOMA 3ONV1SIO CNV 10-Id0SNOISN3W1a 1OVX3 MOHS1Sf1W N01103S SIHl AONVdnoo0 l abOD3b JNIa11na 'JNIIV3H ON _I PIC I +'L P -L 1.w.13 JIN0313 110 SWOON dO SVJ SM31V3H 11Nn `J.1.H 1NVIOVM ONINO1110NOJ MIV MOdVA 80 8.1.M lOH _ SM313VM OOOM SIOJy 'SW8 1331S WV31S NMA dIV lOH 030803 3JVN8M SS3l3dld _ S10J '8 'SW8 Mw11 ISIof OoOM ONIMH ll I ONIWVad 9 00VO 3111 MoOl3 3111 S38n1X13 Nd300W ON1300d 1108 83MOHS 11V1S 13AVMO F MVI `JN113Wnld ON 31VlS NNIS N3HJ11X S30NIHS 000M AMOIVAVI S310NIHS 11VHdSV 13SOlJ M31VM (33HSIV13 1389WV`J I'XI3 Z) WM 131101 08VSNVW X13 V HIV9 dIH 318VJ oNiownld OL dooa 5 jiNoN �I 3MOI83dns _i Mood ONIMIM 3WVH NO 3NOIS AMNOSVW NO 3NOIS M30NIJ MO ':)NO:) _I 80013 R 'Sd1S J111V 3WVM3 NO )IJIM9 ABNOSVW NO XJIM13 —� £ 1 13 V83 NO oJJniS AMNONOSVW NO OJJn1S 3111 'HdSV `JNIOIS 'MA NOwwo-D O.rnOMVH `JNIOIS SOIS39SV ONMIS 11VHdSV HldV3 S310NIHS DOOM 313dJNOJ ONICIIS SOMVOIWVID SHOOIA 6 �I S17VM IF N3HJ1D1 NM300W S3JVld 3813 V38V JI11V 'N13 V3MV .1.W.9 N13 W008 0VIH I.W 8 ON % 1/1 '/i lln3 V3MV 1N3W3SV8 E £ L _ 8 NIjNn llVM AMO SM31d M31SVld O.MOMVH 3NOIS MO X01813 3NId 'X.18 3138JNOJ 3138JNO5 HSINId a0Ia31NI 8 NOIIVdNnOd Z NOu:)nH1SNOo SIN3WI"dV _— s3J133o Aliwy3 IIInW 531801SI kIIWV3 316NIS AONVdnoo0 l abOD3b JNIa11na OFFICES OF: APPEALS BUILDING C:ONSEIWATION HEALTH PLANNING NOwTH OF �2 Town of a NORTH ANDOVER ;tSs�cHud�40 DIVISION OF PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIREM'011 120 Main Street North Andover, Mi1SSM-1111SC1IS 0I84G (6 1 7) 685.4773 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a prop 150A-erly licensed solid waste disposal facility as defined by MGL c 111, S The debris will be disposed of in: (Location of Facility) Y Signature of Permit Applicant F Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Z 0 OR w U K C (_ S y' C mcr S T cn m „ -, o m L 3 y O w A � m o r�r z A ? °c ' a co °w o o0 y A m O ? ? nom+? �! r C d rA w C i w A A O 0 3 o A .: rA m O �p m O a � � n o n i z v O 7 A no T r'4�ri z 40 w p r WE v 00 T cn m „ -, o m 3 m o o ? °c co m ? ? nom+? C C m > 3 o O n i z v vo z ri T m C O 0 r'4�ri z 40 w p r WE v N° 3 5 Date..../. � ...� �.5........ 7' 1 °, <"`° :•� "� TOWN OF NORTH ANDOVER it '` " ` °L p ...I. IT* PERMIT FOR WIRING This certifies that ......... ...... ............:..!..:..:....1........:..........'........................ has permission to perform ... ..�..:. ................................................................... wiring in the building of ......... ..:.../.......................................................... t ........('........................................ .............. � North Andover, Z// ver, Mass'. %' ,, ' Fee..:'..�........�.. Lic. No .��......:.......�...........:.............. ELE 7RICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TILE ibUAii%1'i1'FALTHOFAUSSACHLSEM office Use only DLP4R771ZEA70FP WJC&4FE7Y Permit No. C� Bc)ARDOFFIR£PJ?DE 770NREGUTA710AS527CM12,00 �e — _ occupancy & Fees Check an�zrcA77ONFoxPiERAErTOPERFOR ELE=cWORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 Cr IR 12 - 41-1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date _ .Z Town of. 'V- —/?, —/l, To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. , AP PARCEL Location (Street & Number) /7 Z s e ,4. S� OHner or Tenants Owner's Address Is this permit in conjunction with a building permit: Yes fn o (Check Appropriate Boa) Purpose of Building -1 % , ., 1 / "'5 Utility Authorization No. Existing Service G 'dcmps:z / -, Va OverheadOLT — g ground No. of Meters Ne -w Service Amps / Volts Overhead Underground � No of Meters Number of Feeders and Ampacity y Location and Nature of Proposed Electrical Work ZZ i �c No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below M Generators KVA ound and No. of Receptacle Outlets U No. of oil Burners No. of Emergency Lighting Battery thuts No. of Switch Outlets ` U / No. of Gas Bumcra FIRE ALARMS No. of Zona No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total PUMPS Tons KU' Initiating Deices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of self contained Dctectim!Sounding Deices Local a Municipal a Other No. of Dr%m Heating Deices KW Comrcction-. of Watcr Heaters KW No. of No. of Sims Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTTER 1 ` • • • .. • `il 1 G ni i • .�`C `il � - s • • s . s 1 1 .` 1 •• •• 1 i ri ur .• • ' s� • .0 • • ..�s• • 4 `y rt :• � •�► • • • nr•• s 1 • •• • � 1 • • it - .•1• � • 1 • • ► i• i• ••b � •1 1: i - • .• :..� • .:• � • 1 Werk to Srm 7 - aZ lrsl»ID� Rid Sigidu>31TrRrmhlrl of FffZMNA ' ESQ Vahic&3xbml Wak $ /"Z / /-- Final .i • At TeINa O\i,,,, Z'S lN5 J12A'JC E WANEl2 I am aware that dr LAMM drr�, ntt hne the L � a> a stistx ,l e<}>n:d-� as rtx}moj b�'1vt u Laws and dxt rrn she cn dris pm7t 4* -"n W ores this roqm'mm l (Please check one)Owner Q Agent S Telephone No. PERMIT FE tpiaturc ol Uvmcr or AScnt