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North Andover Beard of Assessors
roperty Record Card
Parcel ID :210/045.13-0006-0000.1Z FY:2013 Community: North Andover
PHOTO
0 arm 4,
Available
Location: 18 ADAMS AVENUE
Owner Name: CONROY, DAVID M
Owner Address: 18 ADAMS AVENUE
City: NORTH ANDOVER State: MA Zip: 01845
Neighborhood: 0 Land Area: 0.00 acres
Use Code: 102 -CONDOMINIUM Total Finished Area: 1548 sgft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 178,700 188,100
Building Value: 1.78,700 188,100
Land Value: 0 0
Market Land Value: 0
Chapter Land Value:
httv://csc-ma.us/PROPAPP/disi)lay.do?linkld=2252889&town=NandoverPubAcc 3/19/2013
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Location h(-- /�1m's
No. S Date��
M°RT„
TOWN OF NORTH
ANDOVER
3 �
_
f w
x
Certificate of Occupancy
$
s�CMU sEt�'
Building/Frame Permit Fee
$ '
`
Foundation Permit Fee
$
Other Permit Fee
$
t�J'
TOTAL
$
/00,3
Check #
r 9
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
7 U* OW t , 1 ., . .. 7,: . I:.. . . . .
BUILDING PERMIT NUMBER:
DATE ISSUED: 1-36 -000 f
SIGNATURE:
BuldingCommissioner/in for of Buildings Date
1. 1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number
Parcel Number
1.3 7"ingInformaticn-
1.4 Property Dimensions:
5NZ) �
Lot Area (A)
Fronts gj- (it)
1.6 BUILDING SETBACKS (ft)
Front Yard
Side Yard
Rear Yard
Required Provide
Required
Provided
&qWrCd
Provided
1.7 water SVfflyM.G1.,C.40 54)
Pobtic )1d Private 0
1.5. Flood Zone Information:
Zone - outside Rom Zone _X
18 Sewerage INSPO-sal System:
M=iC*d 0. Site Disposal System
Z - MUrLKIT
2.1 Owner of Record
Name (Print) Address for Service:
9 -7q - C,
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Si nature Tele hone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor Not Applicable 0
LiceedConstructiol pervisor:
License Number
Address 31
Expiration Date
Telephone
3.2 Registered Home Improvement Contractor Not Applicable U
Company Name
Registration Number
Address 7
Expiration Date
Sien.,4 Telephone
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Jan -off -U1 U1 :04V I4Ur-Lr"1 ArIUUVer UUrrl. ueV. noes outs 5004e 11.ol
SECTION 4 - WORKERS COMPENSATION (IVLG.L C 152 6 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with ibis application. Failure to provide this affidavit will result
in the denial of the issuance of the build' unit.
Signed affidavit Attached Yes ........ No ....... 0
SECTION 5 Descrintion nf Prn—df W^vb i—_..
New Construction ❑
Existing Building ❑
Repair(S) ❑
Alterations(s) fI
Addition Cl
Accessory Bldg. Ii
Demolition fJ
Other Al Specify S "
Brief Description of Proposed Work:
zz
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completed by pennit applicant
OFFICIAL USE ONLY
I. Building
1
d
(•) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plurnbing
Building Permit fee t.) .c (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5 O C'Ss;Sa
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1•— , as Ov mer/Authorized Agent ol' subject property
Hereby authorize to act on
My behalf, mall matters relative to work authorized by this building pennit application.
Signature of (htitter — -- Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
1, as OvmerlAuthorized Agent of subject
property
Hereby declare that the statements and infonnation on the foregoing application are true and accurate, to the best of my knowledge
and behel-
-- —
_
Print Name
Signature of Ommer)A ent Date
NO. OF STORIES SIZE �• )C 1'� ' 01 �'
13ASEMF.N'f OR SLAB
Sl./T OF FLOOR T[MBERS I 2No ; RD
SPAN
DIMENSIONS OF S11.LS
DIMENSIONS OF POS ['S
DIMI{NSIONS OF GIRDERS
Ftl•:IGHT OF FOUNDATION THICKNESS
SIZI: OP FOOTING X
MA [TRIM, OF C'HNI LNl?Y
IS F3U1l1)NG ON SOl.fl) OR FILLED LAND
[S I31.1fLDING CONNEC'fl:D TO NATi,'RAL GAS LIlQI_
SEF -20-99 03:53P North Andover Cote. C)ev_ 508 688 9542 P.03
FORM U - LOT RELEASE FORM l ,a f .�� SbN c^ 00 KA
nz
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*********************'*******APPLICANT FILLS OUT THIS SECTION-**********
APPLICANT �— PHONES
LOCATION: Assessor's Map Number � PARCEL C�
SUBDIVISION \ LOT (S) _;�_
STREET O.i�`5ST. NUMBER
*�y***
*********OFFICIAL USE ONLY*****************
S OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS /W
TOWN PLANNER
COMMENT
FOOD INSPECTOR -HEALTH
SEPTIC INSPECTOR -HEALTH
COMMENTS
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED_
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
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0r 11 F I 4
A Greenhouse FrnrYourSoul.
100 Otis Street • Northboro, MA 01532 • Phone (508) 393 - 0400 • Fax (508) 393-0340
The enclosed permit package is for the proposed building of a three -season sunroom
on a new wood deck. There will be no Electrical Work or Plumbing Work.
Included in this Permit package:
® Proof of Supervisor License and Home Remodeling Licensee
• Proof of Workers Compensation Coverage
• Debris Removal Plan
• Homeowners Permission to represent them in securing this permit
• Signed consumer information form for Sunrooms
• Engineered Plans for the sunroom
• beck ' raming Plan
• Plot Plan locating all set -backs and septic system
Thankyou in advance for ,your assistance. Please call with any additional
information you need.
Best Regards,
Rose Ding
508-393-0400 ext. 223
Sep -20-99 03:53P North Andover Com. Dev. 508 688 9542
North Andover Building Department
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision 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 properly licensed solid waste disposal facility as defined by MGL
c11,S150A.
The debris will be disposed of in:
(Location of f=acility)
Sig ature of Permit App scant
CT_ :::�)I
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
P.04
Hca 20-99 03:53P North Andover Com. Dev. 508 688 9542 P.05
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Name Please Print
Location
C�ty Phcre
�-`-1 I am a homeowner perrorming all work myself.
aI am a sole proprietor and have no one working in any capacity
12§ X1 1 am an employer providing wor'k'e'rs' compensation for my employees wo�rking`on this job
�
2§�Gornoanv name: ---
Address
Phcne #:' , C)� 61 , C
Pnlicv
Company name:
Address
Citv: Fhone #:
Insurance Co Fo1iicv #
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition or c: renal penalties of a fine uo to 31,Su0.v0
andier one years' imprisonment as well as civil penalties in the form of a STOP WORK ORCER and a fine of (5100.00) a day against me. I
understand that a copy of this statement may oe forwarded to the Office cf investications of the CIA fcr coverage vecficzticn.
I do hereby certify under the pains
Si
Print
the information provided above is true and correct.
1— ` -
Official use only do not write in this area to be comoleled by city cr town cf9ic:al'
City or Town aermit,'Licensing
❑0heck,yimrnediaie response is regwred
contact "erson:
Building Dept
Licensing Board
Ej Selectman's Office
❑ Heafth Department
0 Other
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G.�NS.UN It- , ORM,A;�TION:
.. - �...a�rn.�-+...:�c ....� ..
R ate uil�ing,Godc (j8UMR,�,Appen' , ,# ecE�ozif .1
The Massachusetts State Building Code (780 CMR) includes provisions to ensure that houses and
house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION
FORM is to be filed as part of the building permit application when a builder/contractor or homeowner,
constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a
special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR,
Appendix J, Section Jl.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a
"sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only
intended to assist homeowners in becoming aware of some of the important energy conservation and year-
round comfort considerations involved in selecting and utilizing a "sunroom" addition.
The connection of "sunroom" structures to residential buildings may create comfort and energy
consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In
the selection and construction/installation of "sunrooms", included below is a non -required, open-ended Iist
of product and design considerations that a homeowner may wish to consider before actually
constructing/installing a "sunroom". It is recommended that consumers carefully review these options with
their designer, builder, or contractor, it) order to minimize potential energy consumption and/or house
discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired
are important considerations.
PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS"
• Solar Orientation and Natural Shading
• Type of Glazing
• Insulating value
• Solar heat gain
• Frame matcrials
• Glazing to frame sealing and gasketing materials/ seal durability and/or
weather tightness of the sunroom
• Adequate ventilation - Operable windows and fans
• Applied Shading Systems
• Insulation level in floors, walls, and ceilings
• Possible Sunroomisolation from the main house via a wall and/or door or slider
xieStii.9 Raiff Vooliiib Methods: Efficiency, Zoning and Controls
Homeowner Acknowledgment
The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner (not the
owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FORM prior to
issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential
building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read
the information in this document concerning sunroom comfort and energy conservation.
Print Name
Owner Address (if different than project location)
It_J-1_LIAY)
Date
Address of Permitted Project 61`v
`— -TF0 —(60�) — L -
Owner s telephone number
6. .
Eaeeption: sunroom Additions /:Consumer .Notification Sunrooms, as defined in 780.CMR .
Appendix 12:0 15r tYi h41 10N4i m ail t o exec ip , trcani the domplianec requlremonts set forth in 780
CM1.1.211 1.1.211 and J 1;1.3 provided that the actual property owner (not_ the owner's agent or
representative) of the structure onto which the sunroom addition is being made, provides a signed
copy of the Sunroom "CONSUMER INFORMATION FORM" (found in 780 CMR, Appendix B)
to the Building Department. This signed "CONSUMER INFORMATION FORM" shall be
submitted to the building official as a requirement of building permit issuance, and shall remain as
part of the construction documents. If such sunroom additions are separated from the main house by
a wall and are conditioned spaces, then a readily accessible manual or automatic means shall be
provided to partially restrict or shut off the heating and/or cooling input to the sunroom addition
space. That portion of a wall that separates the sunroom addition from the existing
building/dwelling unit, if an existing exterior wall, shall be allowed to remain and neither that
portion of said wall or any fenestration within said portion and common io the sunroom addition,
need comply with the thermal envelope requirements of Appendix J.
780 CMR J2.0 DEFINITIONS
SUNROOM: An addition to an existing building/dwelling unit where the total area (rough opening
or unit dimensions) of glazed fenestration products of said addition exceeds 40% of the combined
gross wall and ceiling area of the addition.
Property Owner Must Complete and Sign This Section If Using A Builder
I, D&/ L D ,M C_O1J R t)\� , as Owner of the subject property
hereby authorize Betterliving Patio Rooms (d.b.a. — Patio Rooms of America) to act on
my behalf, in all matters relative to work authorized by this building permit application
for (address of job)
6--12 , N O A 0 a 0 U C A
lI--1.1-1000
Date
Owner or Builder (as Agent of Owner) Must Complete and Sign This Section
as Owner/Authorized
Agent hereby declare tdt the statements and infon ation on the foregoing application for
(address of job) ��S� are true and
accurate, to the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
Print Name
Signature o Owner/Agent Date
r
Sat
OF AMcRICA
A Greenh nm Fbr Yoursout.
100 Otis Street • Northboro, MA 01532 • Phone (508) 393 -0400 • Fax (508) 393-0340
visit us at. www.patios.com
HOME LMPROVEMENT CONTRACTOR LICENSE
N
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100VE4EN7, CONTRACTOR .
�,., Registra��ien= 125158
� E �raZ. �? 10i2172001
�l Typ,.: Private Corporatio
PATIO RCHS OF BOSTON INC
HUM NALONE
G�cemc o �� `fri TIS ST
ADMINISTRATOR
}iORiNBCROUO Hl O1`32
CONSTRUCTION SUPERVISOR LICENSE
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AQ02. CERTIFICATE OF LIABILITY
INSURANCE
7-:rr:(nnmro0
PROD'Jc:ER
THIS CERTIFICATE IS ISSUED AS A MATTER O�
INFORMATION
.Ins=:pn McKc 1n_
ONLY AND CONFERS NO RICHTS UPON THC
CE'fiNPiCATE
JP McKeone Insurance Agency, Inc.
RIO, Boy: 333
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLEC:IE:S IS L.OVV.
___.._..,_.-.--
Ann Arhor, N/1i 48106-0333
INSLJRF.RS AFFORDING CovERuC
I
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INSURcU
Patio Rooms of Boston Inc
;;NsuRer;a. Hartford Ir,surancs of fJJiowE•st
((//�•-. it �`r•� � ��� 1 \ -' !�-�`-�L�
John Esler---
1Cx) Otis St
i wSUR�R c:
nittl-irlboro MA 01332
THF POLICIES .>= INSURANCE LISTED 3ELMN HAVE FE=N ISSUED TO THE
INSUR=D NAt.1E0l ROVE =0? THc POLICY PERIOD (NOICAT71). NOI
VAI. MS IANDING
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ANY OUR [,1ENT, = a,I, OCL CONDITPDN O= ANY :;O IN- OR CTH^•' 0' .. °T '� -'^'_ E - /
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lhA`' P= ffAIN T- . INSUP..4NCE == 7ROcll BY ;HE ?OL?ChS cSCnI'.cC HER'tlti ;^ r^--0 1 y= s
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08/01/2000 03/01/2001 iTORY LIrJIr$I1:r,
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Dc$CRIPNUN OP Oi%r:R4ilOi:S/I;iCATIONS,VEHICLEa'rEXCWSIONv A DDED BY ENDORSEE'.=NVS PECIAL PROVISIONS
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ACORD 25.5 V191) I lc✓r•I 'l aau
3HOULD ANY Or TrIt ALOVL DESCRIBED =,;AN1L;tLLU1 BW l,FF
i ll.=_ FXPIRA I ION
DATE THEREOF, THE ISSUING INSURER WILL eND=AVOR TO Mda
BAYS WRITTEN
NOTC= TO THE CEP.TIFICATE HOLDER NANIF:p TO TME LEFT, RUT; AIL :1R!'
to OCI SO SHALL
tNPYNrt
C O OBLIGATION OLIRMLITT OT ANT KINC Uf-ON IHt: Ir;SII I!IJt,
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ACORD 25.5 V191) I lc✓r•I 'l aau
Y
In accordance with the provisions of MUL c 40, S 54, a condition of building permit
Number is that debris resulting from this project will be disposed of
in a properly licensed solid waste disposal facility as defined by MUL e 111,8150 A
The debris will be disposed of in: Patio Rooms of Boston, 100 Otis Street Northboro
(Name and location of facility)
(Signature of permit app scant)
Date:
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