HomeMy WebLinkAboutMiscellaneous - 182 HILLSIDE ROAD 4/30/2018 (9)zM
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e 7� Date.......I..../.N°' 0114 ..�.�
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....1.«..:.:.`.!.`...`. +- f ` lie "k ,? �, w S
..... �............................ .
has permission to perform r . v l ` ' .
%�
....... ..... ........................ ..........................
wiring in the building of ......)e I �.:...�`..J...........................................
¢4 le �f .
�� ....................... ,Mass. o!....... ...... ,. North Andovec
Fee. �.' ......... Lic. No .....1 ...'. ........... C.........
,p ELECTRICAL INSPECTOR
C C9 ---
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
TIM L'QAffi1QNWEAL7Y10FAL4SSQ(,RUSE7' 7S Office Use only
�2��VTOFPIIBIIC.�4F�7Y Permit No. Z7
BOARD OFFIREPR EVE W0NREGUTAT70NS 527CM 12.00
Occupancy &Fees Checked
FORWARD
APPLIC4 Tic FORPE�IIT TOPFJ? FOR MELE=CAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 f
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below. P4AP PARCEL
Location (Street & Number) j Z
Owner or Tenant 1 OVA AJ Z A 0 C2 µ--0 0
Owner's Address -51` . . tom;
Is this permit in conjunction with a building permit: Yes No F-1 (Check Appropriate Box)
Purpose of Building
Existing Service Amps / Volts
New Service Amps / Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work A60,/,t-
No.
60✓w
Overhead 0 Underground
Overhead r --J Underground
Utility Authorization No.
No. of Meters
No. of Meters
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Licfrting Fixtures
Swimming Pool Above
Below
Generators
KVA
ground
and
No. of Receptacle Outlets
No. of oil Bumers
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burlcrs
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
LocalMunicipal
Other
No. of Dryers
Heating Devices KW
Conncctions
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
I _
11
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arrlthatmyogiatmcnimspemnrtappbmbcnwaiwsthism m mt
(Please check one) Owner ® Agent �, l
Telephone No. PERMIT FEE $ �� • y
Signature ot Uwner or Agent
4 Location // //5 i,/. ,
No. - �� g Date
HpRT�y TOWN OF NORTH ANDOVER
� • p O
9 Certificate of Occupancy $
• Building/Frame Permit Fee $
Foundation Permit Fee $
s�CHust
Other Permit Fee j'60k $
m
Sewer Connection Fee $ C
Water Connection Fee $
TOTAL
Building Inspector
,3.54:
Div. Public Works
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FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
******.****-*******************APPLICANT FILLS OUT THIS SECTION!******"""
i APPLICANTt/C) f'l /�02U {�U PHONE 1797-17 7.2
�LOCATION: Assessor's Map Number z} PARCEL
SUBDIVISION LOT (S) 7
i STREET �/? //� lli�L" /��JL ST. NUMBER
USE ONLY**********
RECOMMENDATIONS 0 TOWN AGENTS: o2J / Dvn9 h vie /,,vc/ /foo f
CONSERVATION ADMINISTRATOR DATE APPROVED
AI�(r�DATE REJECTED
COMMENTS IV b We �''°��5 L
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR -HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR
Revised 9197 j
TE
Town of North Andover,.
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
(978)688-9531
Please print. /} q
DATE Z_ J
JOB LOCATION /
27 Charles Street
North.Andover, Massachusetts 01845
HOMEOWNER LICENSE EKE�IPTION
r// 1,
f VAORTH
�Ot4«io ,"1�0
9SSACHuSEt
Fax(978)688-9542
Number Street address Section of town
"HOMEOWNFER" 76 tui Z004--14* ? 5-9- 9'>' �� 4-170 - dao 7
Name Home phone -- Work phone
PRESENT MAILING ADDRESS
/8'q s
City/Town State Zip code
_ The current exemption for "homeowners" was extended to include owner -occupied dwellings
of six units or less and to allow such homeowners to engage an individual for hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Sec-
tion 109.1.1)
DEFINITION OF HOMEOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one to six family dwelling, attached or detached structures ac-
cessory to such use and/or farm structures. A person who constructs more than one home in a
two-vear period shall not be considered a homeowner . Such "homeowner" shall submit to
the Building Official, on a form acceptable to the Building Offfcial, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned "homeowner" assumes responsibility for compliance with the State Building
Code and other applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with 'said procedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICL-%L
Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with
State Building Code Section 127.0, Construction Control.
BOARDS)F APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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Nov.24 ':: 22:58 0000 SANFAX200 series
MORTGAGE PLOT PLAN
EK SURVEY
17 ROYAL STREET, LAWRENCE, MA. 01841 Tel. 308•--975--1.13
MORTGAG0R O �.� DEED REF, 5-57(4 PG. ug,
ADDRESS OF PRINCIPLE BUILDING PLAN REF: X430
_1aZ aI/aSI�` ,•Qp. DATE OF INSPECTION _ �SlAt/� !/� /�4�
t t .ir -/A 30,
QIP_ iU 011e
P. 3
0
3
'e -
107M Ibb mortgage Inspection was prVarbd .��� ' I FURTHER SATE THAT IN MY PROF ONAL
pwotfltdly for rnartpdge purposes and Ar not to o� 7' OPINION the prfnalp),��rrtruaiNrs/s and aco"*o y
4 rolled upot au a Nun" Eft 11AWY RUBEL butt�uAdings, _
to rewpotsu blttty f'br danag.s ee No. �� s with the setback regttkennents of the local
edbnce by anyone other Coon the said mortou xonptt
ing crilnances„ and that no enchroacfirttts
Ind Its UiWgns In ronnectlon 10th Its propooidgI
�fCTI. VJ of mam
jor lrn"vesntsr either way domes
nortgag+ flnandhg to said mortgagor. ° 01 prohwty lines ex0opt as ubxawi.
,IMT*1CAII0N TO: .
�1. Propetty Is not In a Flood Hazard Area.
rlr tztt�tlflbu t is bond on iho 100a�llM of = y tnwkwe 133. Property b In n F1aodl' Nasard �rww
if oth" 01111 doe nbt represent d prapefty VIUMy, themkIri � Fload Fia=ard d3. Iftfftaft +tp»tminsd�fta 0 t.th131 FIWWUI Mnood ood
&34t» shown arm not tb be Xl"d fa' the utabllth►nent of lnsuronce We Mop Pdnoi f Z 5DO f 6 -000& C (,#I?_ 1q.3
property Ithm
2442
Date..l"./
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that
has permission for gas installation
'J.
in the buildings of....�f"Ill�Cf.�—l..%'.............
at .. /. s, .. /`y GAN . /L?., ...... North Andover, Ma
ee sp
,0.. .. —
Fee. � Q .-� Lic. No. ........................ -�
GAS INSPECTOR
WHITE: Appli nt CANARY: Building Dept. PINK: Treasurer GOLD: Fil
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Y
O � ,
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFI ING t
(Print or Type)
NORTH ANDOVER. Mass. Date
l uilding Location �,Z ; j d c� Permit #/ �/,✓L� S
Owners Name%es`e:- Zah car' Lf I lc>
s New 77 Renovation Replacement Plans Submitted
- D io D
�-� FIXTU0
(Print or Type)
Installing Company Name ANDOVER PLG. & HEATING CO.,
Address 57371/2 SO UNION ST
Check one: Certificate
IN .Corp. 2122
Partner.
LAWRENCE, MA. 01843 [_J Firm/Co.
Business Telephone: 508 685-8383
Name of Licensed Plumber or Gas Fitter GEORGE I ADnctc
Insurance Coverage: Indicate t e type of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type of
Insurance Waiver: I, the undersigned, have
this application does not have any one of the
Signature of owner/agent of property
indemnity Q. Bond 0
been made aware `that the licensee of
above three insurance coverages.
Owner 17 Agent _
I hereby certify that ail of the deuils and information I have submitted (or entered) in above application are true and accurate to the best of my
knowledge and flat all plumbing worst and installations pezfomtcd under Permit iuued for this sppGcation witl_be in mpunee with all patlnent
provisions of tho htarrachureUs State Car Cude sn4 Chapter 14: of the Cenezai L►wa.
TYPE LICENSE:
By
Plumber
Title Gasfitter. Signature of Licensed
City/Town- Master Plumber or Gas. fitter
Journeyman 99ft�
APPROVED (OFFICE use ONLY) License Number
MEN
MIMIKNIEM
MEN
MINE,
KMMMMMMEMIMMMMMI
ARM
MEMIMMUM
mom
ME
MENOMONEE
(Print or Type)
Installing Company Name ANDOVER PLG. & HEATING CO.,
Address 57371/2 SO UNION ST
Check one: Certificate
IN .Corp. 2122
Partner.
LAWRENCE, MA. 01843 [_J Firm/Co.
Business Telephone: 508 685-8383
Name of Licensed Plumber or Gas Fitter GEORGE I ADnctc
Insurance Coverage: Indicate t e type of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type of
Insurance Waiver: I, the undersigned, have
this application does not have any one of the
Signature of owner/agent of property
indemnity Q. Bond 0
been made aware `that the licensee of
above three insurance coverages.
Owner 17 Agent _
I hereby certify that ail of the deuils and information I have submitted (or entered) in above application are true and accurate to the best of my
knowledge and flat all plumbing worst and installations pezfomtcd under Permit iuued for this sppGcation witl_be in mpunee with all patlnent
provisions of tho htarrachureUs State Car Cude sn4 Chapter 14: of the Cenezai L►wa.
TYPE LICENSE:
By
Plumber
Title Gasfitter. Signature of Licensed
City/Town- Master Plumber or Gas. fitter
Journeyman 99ft�
APPROVED (OFFICE use ONLY) License Number
c
C
Nov.24 22:58 0000 SANFAX200 series
MORTGAGE PLC)` PLAN
_ EK SURVEY
17 ROYAL STREET, LAWRENCE, MA, 41841 Tel. 508--975-1413
MORTGAGOR DEED REF. sl(o PG. —.:2'
ADDRESS OF PRINCIPLE BUILDING PLAN REF:-`" IWO
Ni�.Sr DATE OF INSPEC110N - 90 6 14
301
0
N�
-form flee
X8.3► •io�
0
P. 3
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407—F
10TH 'this mortgage inspeation wm prepared ����N ''-; 1 FURTHER SKM THAT IN MY PRCFEMONAL
pootArdly for tnWtgdye purposes and to not to o� 7' a OPINION the grin M etruature/s and am"ooy
nitsd a* a st,twsyt EX-111tV1~Y ftcapto 1butbundings, —A eA4
RUDEI
0 I�f 1<ity � doMa a • No. 389$U V3 With the setback nsq*r sntx of tho Wool
rliamoo by dnyons other on tfie said mt�rt�a ea `� xoning or4nunoes, and that no enohrdachmwdv
and ate asst" h aonnectton rith It r prgm*od-�FcistE�`�° of major improvements either way darous
natperoe flnanafiQ to said mortgagor. s'oNAI Lk 10 prbpwty lines except an ate.
3MYMCA'110N M
d't. property Is not h o Flood Hazard Area.
30% uw lfttW is .b4oad on th• loon of mmy Mwkon 13 z Property I: to a F oQ4 kMWd Arra,
,f ath" and duo not riprowt. d prtpu ty oUmy, therntotyl ` lAfottn4lltxt 1>a MiutAdwt! io �� Fled HcixW
�Kbbtb� 9hnwrt ors -net to be iJtNsd fa' rho w�trsbilir}�rnont of Flood tlumrd data tnlned $oro = f�adoroC Mood..
-ftbtIrbPety lines,
lnsuranas Rett• Map Pdnal f z � 9� oo* C VIZ 1q3
c o 0
Date ......Ute.. . -z. ......:�
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
01
This certifies that ........ ... `... r ................ J.................. .................................
has permission to perform{ `-�-
..:i......................................................................... ,c
wiring in the building of . �.. �
at............................................................................... . North Andover, Mass.
Fee ...Nf .....
..... Lic. No .............. .... `. .....'� .....17....................
G ^ ELECTRICAL INSPECTOR
Check #
45.5
TBE COA MONHEUTHOFMASSACHUSETTS Office Use only
DEPA)U31EVT0FPUXJCS9FE7Y Permit No. S
BOARD OFFIREPREVEVHONREGUTA77ONS527CNIR12VO
Occupancy & Fees Checked
APPLICATION FOR PEI UTO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 �� I� .
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dater 03
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) l � Z "( 'LJ_ Cz;- t (�'C yc�(
Owner or Tenant `Z s'}"VL 0
Owner's Address
Is this permit in conjunction with a building permit: Yes �No M (Check Appropriate Box)
Purpose of Building iLC S 't—cUtility Authorization No.
Existing Service Amps�Volts Overhead Underground E No. of Meters
New Service Amps / Volts Overhead Underground r__J No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work 71 77 A7 7 t IF
No. of Lighting Outlets
lo
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool
Above
Below
Generators
KVA
to
round
round
No. of Receptacle Outlets 3 S
No. of Oil Burners
No. of Emergency Lighting Battery Units
No! of Switch Outlets
Z%
No. of Gas Burners
FIRE ALARMS
No. of Zones
—�s
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
_
Nub. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
No. of Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No_ of Motors
Total HP
OTHER -
Coverage. Ptlt�mt>otheiagtritanarisofMassadn9elcsGalaalLaws
ItimaamatLdAtylr�na =Pobc7'ir ddngCornplt CDvewcr is m
eW art YES /NO
Iba%est>hii*dvafdp ocfofsa 1odrOlii= YES 1,171
Fyouha%edrdkedYES,pYwnica ethet Wofcoveragpby
chec�Igthe box
INSURANCE OTHER Ff=Speafy)
IFxpila6mDaie
EAm*dW0dCiDSW S l6 �A 3 I�g�� Rough cx� mal VahteofDactric$
FIRMNAME
U�ce,S .
Lice ee LA �( �c .A <: c� M ��o.� �t-� +, Sig►>aaue\J�� — x Lioa>seNo Z r—
BttsQrtessTel No. 20?
A�lchess,—g `^-1 .v v owl 5 fy`f i Sy t ,✓t� Sr L S Alt Tel No.
O)VMR'SIN WAIVER,IamawmdAtheLioewdoesnothavetheira=mcovaageoritsatsutalegnvaialtastegttitedbyMassachtmisGffralLaws
and that n-ry signature on this permit application waives this regtmarl ll
(Please check one) OwnerAgent F-1 o �,
Telephone No. PERMIT FEE $
Igna ure ol Uwner or Agent
Name
The Commonwealth of Massachusetts ,
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Please Print
Location:
City Phone #
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for rry employees working on this job.
Company name:
Address
City Phone #
Insurance. Co. PolicV #
- s
Company name:
i
Address
City: Phone #7
Insurance Co. Policy #
Failure to secure coverage as required -under section 25A or MGI. 152 can lead to the imposition of criminal penalties of.a fine up to $1,50D.00
and/or one years' unpnsorwnerit-as-we[Las-cn44xmakms-wAhelmm-da-STOPY4DW-ORDIRand-arm-ct(sjjDD-m)-aidayagainstmm. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DtA for coverage verification.
/ do hereby cwtfy under the pains and penalties of perjury that the information provided above its true and correct.
Signature Date
Print name Phone.#
Official use only do not write in this area to be completed by city or town afficiar
City or Town Permit2icensing
Building Dept
ElCheck y immediate response is required licensing Board
p Selectman's ice
Contact person: Phone #. Health Department
n Other
Location i Say 1�5I�-� W
No. /V Date .3 - C/ 3
NaRTM TOWN OF NORTH ANDOVER
• OOL
•
Certificate of Occupancy $
0 C2
'sswcNust�� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ a
Check # 3 y
16230 XP`(,;'-
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
h ;.. ... 'TI�i�1 � �a,� �I�at Ilse UIQ
BUILDING PERMIT NUMBER:DATE ISSUED:
D
SIGNATURE: "
Building Commissioner/I for of Buildin2 Date
SECTION 1- SITE INFORMATION
1.1 Property Address:
�$zth1� SIse 9 •
1.2 Assessors Map and Parcel Number:
17EC Z7
Map Number Parcel Number
Q
% . .���dOP12�; .M�
1.3 Zoning Information:
R3--5
Zoning DistrictProposed Use
1.4 Property Dimensions:
2.5, 05 18 7 N
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide RegWred
Provided
Required Provided
36
Z'
30' 3s,
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public 4 Private ❑ Zone Outside Flood Zone
1.8 Se erage Disposal System:
Municipal On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Jah Jft Lfkd)?A �d t 2z 7q►' i&I !j Ar, m,4Name (Priv Address for Service :
17 7 IS'q-�99L
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
� �
Liceri ed Construction Supervisor:
+�
Address y
S r Telephone
Not Applicable ❑
License Number
I
&' (-/, �!/
Expiration Date
3.2 Registered Home 11I``mprovement Contractor
7616AU S .L • a�,Irl L
L')
Not Applicable ❑
/
% �j 7 i 7
-a
Company Name
AA �
/ rs- /V ( 1 Q ,AVS
Registration Number
'r is /
l
Address / (
11 7� b 7 _�.S
Expiration Date
S nature Telephone
T
rn
X
ic
Z
O
v
rn
SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
—Signed affidavit Attached Yes ...... X No ....... ❑
SECTION 5 Description of Proposed Work check all a licable
New Construction [I
Existing Building ❑
Repair(s)
11Alterations(s)
[I
Addition
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Description of Proposed Work:
kv c• ,FHM
Fm�-
a
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICIAL USE ONLY
1. Building/
O
4, ��
(a) Building Permit Fee
Multiplier
2 Electrical
—7 S.40•
(b) Estimated Total Cost of
Construction
3 Plumbing
S_ 6O •
Building Permit fee (a) X (b)
4 Mechanical HVAC
SDS
5 Fire Protection
"Wla
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH.DING PERMIT
I, 1-) r\ Z& .a as Owner/Authorized Agent of subject property
Hereby authorize S to act on
My beh , all matt s re o ork au orized by this building permit application.
An
Sir tore of Owner Date
SECTION7bOWNER/AU HORIZED AGENT DECLARATION
h
I, D t Zd 6tma as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
Print e
Si atur of Owner A ent IV
NO. OF STORIES
'7/ 1AR
Dat
SIZE 1 bxZZ
BASEMENT OR SLAB Sava 6
SIZE OF FLOOR TIMBERS i s 2 p
2 ND3 RD
SPAN
DIWNSIONS OF SILLS Z 2x 6 PT
DIMENSIONS OF POSTS
DIIVIENSIONS OF GIRDERS
HEIGHT OF FOUNDATION '
THICKNESS /d
SIZE OF FOOTING
Zzi " X j)
MATERIAL OF CHIlVINEY Z L l
IS BUILDING ON SOLID OR FILLED LAND 5 L !
IS BUILDING CONNECTED TO NATURAL GAS LINE Y6j
TARA LEIGH DEVELOPMENT, LLC
185 Hickory Hill Road, North Andover, MA 01845
978-687-2635 fax 978-689-2310
Agreement for Construction Services
March 9, 2003
Between:
Constr. Spvsr. # 055417
HIC # 107679
Fed. ID #04-3516982
Client: John and Leslie Zahoruiko Contractor: Tara Leigh Development, LLC
182 Hillside Road 185 Hickory Hill Road
North Andover, MA 01845 North Andover, MA 01845
978-989-9992 978-687-2635
Location of Work: 182 Hillside Road, N. Andover, MA 01845
Description of Work to be Completed: Family room/bedrooms addition; see attached Scope of Work/Plans
Attachments: Scope of Work
Plans
Limited Warranty
Proposed Work Schedule: Proposed Start Date March 31, 2003
Proposed Completion Date May 30, 2003
Payment Schedule: At Time of Agreement 20% $16,136.80
Foundation, floor frame Complete 20% $16,136.80
Frame, roof Complete 20% $16,136.80
Windows, siding, rough mechanicals Complete 20% $16,136.80
Completed, including insulation, plaster, trim,
paint, flooring, deck 20% $16,136.80
Total as Proposed 100% $80,684.00
1
TARA LEIGH DEVELOPMENT, LLC
185 Hickory Hill Road, North Andover, MA 01845
978-687-2635 fax 978-689-2310
Permits: By this Agreement, Client acknowledges its authority and authorizes the Contractor to apply for and
acquire all necessary construction -related permits (From time to time there are additional permits and
approvals required prior to building permits, which have not been provided for in this Agreement. These
may include Special Permits, Conservation Commission Conditions, Planning Board Approval, or Zoning
Variances, among others, and these are not included, if necessary). Unless specified in attached Scope
of Work, costs of permits, as well as any costs for application or documentation required to apply will
be passed through to Client, over and above the terms of this Agreement, for reimbursement. Client
acknowledges that no work can begin until all necessary permits are in hand, and that Contractor will
use good and reasonable efforts to acquire the necessary permits, but Contractor does not control the
timely issuance of said permits. Client agrees to endorse all applications as required to acquire permits.
All work and schedules, as well as that of any subcontractors, will be subject to all applicable permits
being available on a timely basis, and will be performed by licensed and insured professionals whenever
required.
General Conditions & Definitions:
1. This Agreement constitutes the entire agreement.
2. Any changes are to be documented in writing and signed by all parties. Any changes will be paid for at
the time of the change request, prior to the changed work being undertaken. TLD, LLC reserves
the right to not accept specific requests for changes if and when acceptance of those change
requests adversely affects integrity of work product or schedule.
3. Additional work will be billed at the rate of $45.00 per hour for licensed labor, $28.00 per hour for
common labor unless otherwise agreed.
4. Work sites will be left in equivalent condition to those existing prior to contracted work; unless
specifically agreed, no existing site conditions will be improved.
5. Any specific work hours which are restricted by local statute, agreement or association, and which
adversely affect contractors' normal work schedule will cause completion time to be extended
accordingly.
6. Completion time will be extended due to any delayed inspection services, beyond those specified by
the current Massachusetts State Building Code.
7. Contract will be considered Substantially Complete when all work has been initially completed; repairs
and warranty are beyond the scope of Substantial Completion and final payment will not be
withheld due to repairs and warranty items.
8. Non-payment or delayed payment according to the Payment Schedule will result in work stoppage for
the duration of any payment delays, and completion time extended accordingly.
9. Late payment will result in a finance charge applied to the entire balance due at an annual rate of 18%.
10. Only those work items specified in the "Scope of Work" and "Plans" are included in this contract, and
this specifically excludes any items not specified, such as upgrades to electric service, water
service, furnace/boiler, or other unspecified systems.
2
TARA LEIGH DEVELOPMENT, LLC
185 Hickory Hill Road, North Andover, MA 01845
978-687-2635 fax 978-689-2310
Scope of Work
Construct an addition/extension per attached plans and specifications (including 16`z 22` family room, two
lower level bedrooms) including all demolition, cleanup, disposal, site stabilization and redressing.
Demolish and dispose existing deck.
All materials and specifications to match as closely as possible/available with the existing structure,
including 2x6 wall frame, plywood sheathing, Andersen windows, vinyl siding, plaster finish, painted trim,
R-19 walls, R-30 ceiling, R-19 floor, 10" thick poured concrete foundation, 4" thick concrete slab
Construct 28'x10' pressure -treated deck with stairs to grade
Replace sliding door in existing dining area
Electrical to include wiring for CATV (3), telephone (3), wiring for ceiling fan in family room.
HVAC to be extended from existing circuits.
Gas fireplace with wood mantle trim (per Heat -N -Glow options provided)
Wall paint, (2) coats linen flat
Provide access through existing basement to new bedrooms
Demolition, reframe, enlarge and finish lower bathroom/utility area
Allowances:
Carpet in bedrooms $24.00 per yard materials and labor
Tile $600.00 materials and labor
Tub, toilet, vanity, sink/counter, faucets $1,000.00 materials
Revisions 3/9/03:
New 75+- gallon HWH ($1500.)
(2) Additional gable -end windows ($600.)
Oak floor in Family room; reflects change of additional carpet in BR's and Oak ($1,784.)
3
TARA LEIGH DEVELOPMENT, LLC
185 Hickory Hill Road, North Andover, MA 01845
978-687-2635 fax 978-689-2310
Additional Conditions for Residential/Home Improvement Contracts ONLY:
1. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
2. All home improvement contractors and subcontractors shall be registered, and any inquiries about a
contractor or subcontractor relating to a registration should be directed to:
Director, Home Improvement Contractor Registration
One Ashburton Place, Room 1301
Boston, MA 02108
Tel. (617) 727-8598
3. Client is entitled to a three-day right of cancellation under MGL c.93, ss48; MGL c. 140D, ss 10 or
MGL c. 255D ssl4, as may be applicable.
4. Client is entitled to owner's rights and warranties under the provisions of 780 CMR R6 and MGL c.
142A.
5. Unless otherwise specified or notified, there is no lien or security interest given on the residence as a
consequence of this contract.
6. Any and all necessary construction -related permits are necessary for work to commence.
7. It is the obligation of the contractor to obtain such permits as the owner's agent.
8. Any owners who secure their own construction -related permits or deal with unregistered contractors
shall be excluded from access to the Guaranty Fund.
9.The contractor and homeowner hereby mutually agree in advance that in the event the contractor has a
dispute concerning this contract, the contractor may submit such dispute to a private arbitration service
which has been approved by the Office of Consumer Affairs and Business Regulations and the consumer
shall be required to submit to such arbitration as provided in MGL. c. 142A.
Owner
Contractor
This Agreement is available to contract only at the time of presentation.
Agreed this �/ day of March, 2003, by:
Client Contractor
2
MECcheck Compliance Report
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
Data filename: Untitled
TITLE: Zahoruiko Addition
CITY: North Andover
STATE: Massachusetts
HDD: 6322
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non -Electric Resistance)
DATE: 03/14/03
DATE OF PLANS: 3/11/03
COMPANY INFORMATION:
Tara Leigh Development LLC
COMPLIANCE: Passes
Maximum UA = 114
Your Home= 100
12.3% Better Than Code
yaLA 13-17—ana 3
Permit Numb&
Checked By/Date
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building
plans, specifications, and other calculations submitted with the permit application. The proposed building has
been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to
comply with the mandatory requirements listed in the MECcheck Inspection Checklist.
The heating load for this building, and the cooling load if
Standard Design Conditions found in the Code. The HV/
be no greater than 125% of the design load,4s specified
ite, has been determined using the applicable
nent selected to heat or cool the building shall
780CMR 1310 and J4.4.
Date 3
Gross
Glazing
Area or
Cavity
Cont.
or Door
Perimeter R -Value
R -Value
U -Factor UA
Ceiling 1: Flat Ceiling or Scissor Truss
352
0.0
30.0
11
Wall 1: Wood Frame, 16" o.c.
486
0.0
19.0
27
Window 1: Wood Frame, Double Pane with Low -E
165
0.280 46
Basement Wall 1:
Solid Concrete or Masonry, 8.0' ht/4.0' bg/8.0' insul
352
0.0
19.0
16
Furnace 1: Forced Hot Air, 90 AFUE
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building
plans, specifications, and other calculations submitted with the permit application. The proposed building has
been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to
comply with the mandatory requirements listed in the MECcheck Inspection Checklist.
The heating load for this building, and the cooling load if
Standard Design Conditions found in the Code. The HV/
be no greater than 125% of the design load,4s specified
ite, has been determined using the applicable
nent selected to heat or cool the building shall
780CMR 1310 and J4.4.
Date 3
MECcheck Inspection Checklist
Massachusetts Energy Code
MECcheck Software Version 3.3 Release lb
DATE: 03/14/03
TITLE: Zahormko Addition
Bldg.
Dept.
Use
Ceilings:
1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 continuous insulation
Comments:
Above -Grade Walls:
1. Wall 1: Wood Frame, 16" o.c., R-19.0 continuous insulation
Comments:
Basement Walls:
1. Basement Wall 1: Solid Concrete or Masonry, 8.0' ht/4.0' bg/8.0' insul,
R-19.0 continuous insulation
Comments:
Windows:
[ ] I 1. Window 1: Wood Frame, Double Pane with Low -E, U -factor: 0.280
For windows without labeled U -factors, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
I Comments:
Heating and Cooling Equipment:
[ ] I 1. Furnace 1: Forced Hot Air, 90 AFUE or higher
Make and Model Number
I
Air Leakage:
[ ] I Joints, penetrations, and all other such openings in the building envelope that are sources of air
leakage must be sealed.
[ ] I When installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture
and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space.
2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfin (0.944
L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled.
Vapor Retarder:
[ ] Required on the warm -in -winter side of all non vented framed ceilings, walls, and floors.
Materials Identification:
[ ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
[ ] Insulation R -values, glazing U -factors, and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
Ducts shall be insulated per Table J4.4.7.1.
Duct Construction:
All accessible joints, seams, and connections of supply and return ductwork located outside
conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed
using mastic and fibrous backing tape installed according to the manufacturer's installation
instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted.
The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
Thermostats are required for each separate HVAC system. A manual or automatic means to
partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided.
Heating and Cooling Equipment Sizing:
Rated output capacity of the heating/cooling system is not greater than 125% of the design load as
specified in Sections 780CMR 1310 and J4.4.
Circulating Hot Water Systems:
Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
HVAC piping conveying fluids above 120 °F or chilled fluids below 55 °F must be insulated to the
levels in Table 2.
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range ( F) 2" Runouts 1" and Less 1.25" to 2" 2.5" to 4"
Heating Systems
Low Pressure/Temperature
201-250
Insulation Thickness in Inches by Pipe
Sizes
Heated Water
Non -Circulating Runouts
Circulating
Mains and Runouts
Temperature ( F)
UUto 1„
Up to 1.25"
1.5" to 2.0"
Over 2"
170-180
0.5
1.0
1.5
2.0
140-160
0.5
0.5
1.0
1.5
100-130
0.5
0.5
0.5
1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range ( F) 2" Runouts 1" and Less 1.25" to 2" 2.5" to 4"
Heating Systems
Low Pressure/Temperature
201-250
1.0
1.5
1.5
2.0
Low Temperature
120-200
0.5
1.0
1.0
1.5
Steam Condensate (for feed water)
Any
1.0
1.0
1.5
2.0
Cooling Systems
Chilled Water, Refrigerant,
40-55
0.5
0.5
0.75
1.0
and Brine
Below 40
1.0
1.0
1.5
1.5
NOTES TO FIELD (Building Department Use Only)
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT :;�L6J ,J_,;�I!'P/yyjJ v� PHONE
LOCATION: Assessor's Map Number g C PARCEL Z
SUBDIVISION tN% LOT (S) _
STREET �S IAQ_ ST. NUMBER P7 Z
************************************OFFICIAL USE ONLY***********************************
REC9MMENPATI9N%0F TOWN AGENTS:
VATION'AD'111iINISTRA
DATE APPROVED
DATE REJECTED
FOOD INSPECTOR -HEALTH DATE APPROVED
'i r DATE REJECTED
1� "I _/, L
SEPTIC INSPECTOR -HEALTH DATE APPROVED
. DATE REJECTED
COM
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENTC'�o,131/C de Ie
RECEIVED BY BUILDING INSPECTOR
Revised 9\97 jm
FIVER
3
p► NNINCr, ujip, TMENT
TE
3- /z -b3
Name
PIS L
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Please Print
City AJ t .A4"r I A44l Phone #
I am a homeowner performing all work myself.
01 1 am a sole proprietor and have no one working in any capacity
ED I am an employer providing workers' compensation for my employees working on this job.
Companv name:
Address
City Phone #
Insurance. Co. Po1icV#
Company name:
Address
City: Phone #-
Insurance Co. Policv #
Failure to secure coverage as required. under Section 25AMGL 152 can lead to the imposition of criminal penalties of.afine up to 61,500.00
and/or one years' imprisonments welLas_civil.p�enalties 'Fto"the
lcnn-dAs3MP WORK ORDERand_a.fine_of..(,$]D.O.OD)-atlay.against.me I
understated that a copy of this statement may be forwar Office of Investigations of the DIA for coverage verification.
/do hereby certify under the par and penalties of p ' ry that the information provided above is true and correcctt
Signature Date / � 43
Print
Official use only do not write in this area to be completed by city or town official'
7&
City or Town nsing.
El
Building Dept
❑Check if immediate response is required ❑
Licensing Board
❑
Selectman's Office
Contact person: Phone #: ❑
Health Department
❑
Other
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number:`'CS\ 055417
Btrtl date 04105/':960
Expires 0¢/05%2004 Tr. no: 21586
Restricted: 60
THOMAS D ZAHORUIKO
185 HICKORY HILL RD --
N
D- N ANDOVER, MA 01845 Administrator
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 107679
Expiration: 8/5/2004
Type: Individual
THOMAS DAVID ZAHORUIKO
Thomas Zahoruiko
185 Hickory Hill Road��
North Andover, MA 01845 -
Administrator
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:
C k N15 ' -VSSS
(Location of Facility)
Signature f Permit Applicant
3)
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
Nov.24 ':: 22:58 00E0 SANFAX200 series
MORTGAG'" PLOT PLAN
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Town of North Andover
Office of the Conservation Department
Community Development and Services Division
27 Charles Street ��
Julie Pam -no North Andover, Massachusetts 01845 Telephone (978) 688-9530
Conservation Administrator Fax (978) 688-9542
March 14, 2003
Thomas Zahoruiko
Tara Leigh Development LLC
185 Hickory Hill Road
North Andover, MA 01845
RE: Proposal to build an addition at 182 Hillside Road
Dear Mr. Zahoruiko:
This letter is in regard to your proposal to construct a 22' by 16' addition to an existing
single family home located at 182 Hillside Road. A drainage ditch exists along the
northern and eastern property boundary line and you inquired whether .the ditch is a
jurisdictional wetland resource area. I have reviewed the property and it appears the
ditch is conveying overland flow from the surrounding properties. The ditch is
approximately 200 feet in length, one to two feet in width and approximately one foot
in depth. The ditch is not flowing from a resource area and appears to flow into a
culvert under Route 114. Vegetation surrounding the ditch is dominated by a quaking
aspen overstory. Bordering vegetated wetland along the ditch appears to be very
limited.
I am of the professional opinion that the ditch would not be subject to protection under
the Massachusetts Wetland Protection Act and North Andover Wetland Protection
Bylaw. Work may proceed without a filing with the North Andover Conservation
Commission. The addition must not be constructed so as to interfere with the natural
drainage flow of the ditch.
If you have any questions, please feel free to contact me.
Sincerely,
Administrator
cc: NACC
Robert Nicetta, Building Inspector
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Nuv.24 ':' 22:58 00E0 SANFAX200 series
MORTGAGE.. PLOT P -LAN
1:1. 3
EK SURVEY
17 ROYAL STREET, i.AWRENCE, MA. 01841 Tel. 508--975--1413
MORTGAGOR _ DEED REQ', PG. Z:7F.,
ADDRESS OF PRINCIPLE BUILDING PLAN REF. X030
1�It4NLbll 2t X14 ,_ DATE OF INSPEC110N _ Nov, iL/ 46
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IOM M)a mot•tgo a Inspecu0n was perparsd ,�'�1 ';h' i FURTHER SAIL cT2pH�AT IN MY PRq�ONAI.
P*Ct�Y for htotgdge purposes and b not to o� � OPINION the ifi_nW�M volare/s and cooav*wy
4 tNt>td 1t cud stlrity4- Ek IAJI%WY 6acdp4 Y '� twtbuildlnys, �Q
to n••t% 'Tty fot• dd�d RUDEL �; with the satbaeic —"`—
��ss No. 389at� t^agttk�rtrtents o! the. tonal
vtllonail by dn" other thdn the said margo w '� xonlny adInanows, and that no wtohre'achmwdv
Ind hu "'WOns Ia omectlon vM Its W*ov"- STE'�`�° of mci* Im"v month etthot gray dam"
n�OdR+ fly cn. 01 g. to sold mortgagor. " '�oN,�c tt,Kobo prohwty Ilnas axaopt an eiKmvn.
MTMCATION TO: .
jjT, property Is not !h a Flood H=and Arno.
r1c*uff0otfatt 4 bond (A tho It>rot M of W"y tnarkwo 13 Z Prcp.cty Ism n tlaadl' ftord AIA(h
&01h" Ond dM >nbt t9Prt tit d y �clrvey, tfi�Idr�I d& ((lfotfiQuork Is Mftu"oliAt tb ins Flood Hazard,
4fabis 1howtt ore not tb be pend for th• ea�x WIthinent of Road Flaznr'd tir ttnbnird iFo10 � !'bdaot Road
it^ap�tty lits••. Insuronos Rats Map Pond f z 3Vof6 -Qpo'G c ���, Jq3