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HomeMy WebLinkAboutMiscellaneous - 21 CAROLINE WAY 4/30/2018`� Q DSA I Dewing & Schmid Architects 30 Monument Square September 3, 2009 Suite 200B Concord, MA 01742 Tel 978.371.7500 Edgewood Retirement Community Fax 978.371.3388 #21 & #35 Caroline Way Wiggins-Loux (E Units) 280 Elm Street South Dartmouth, MA 02748 Mr. Gerald A. Brown Tel 508.999.0440 Inspector of Buildings Fax 508.999.7709 Town of North Andover 1600 Osgood Street www.dsarch.com North Andover, MA 01845 Mr. Brown, We're writing to explain our position regarding the covered entries for #21 & #35 Caroline Way. Edgewood received a negative determination from the Zoning Board of Appeals for its request to encroach within the 100 foot CCRC setback. This ruling required Edgewood to explore an alternate cottage design in order to comply with CCRC (Continuing Care Retirement Center), bylaw setback of 100 feet and respect the 50 wetlands buffer. The new design is linear in form, rather than "L" shaped as the other cottages are. In simple terms, we moved the garage from the front to the side of the main structure, thus lengthening it, but reducing its depth. This provided a front face (and entry door) that is set very close the setback and the rear face set very close to the 50 foot wetlands buffer. We knew cover would be required at the entry door as a practical matter (climate), but more so for the fact that we are providing a non-traditional on -grade entry, specific to the needs of the end user, the elderly. We designed the cover to be supported by brackets rather than columns & footings, specifically to comply with the bylaw. Please note, no other cottages employ bracketed roof supports. We believed we were in full compliance with the 100 foot setback until just before we submitted these cottages to the Town for a permit, when it was brought to our attention that there was language specific to the CCRC, section 7.3 Yards (setbacks) which states that the setback excludes eaves and uncovered steps. We don't have steps, so technically we comply, but we didn't feel confident that this technicality was in keeping with the spirit of the bylaw. Edgewood and the entire design team didn't want there to be any misunderstanding, so the question was brought to the Town's attention during permitting. It has been our directive from Edgewood and our intent, to fully comply with the bylaw. The covered entries are shown on the approved Planning Board application, though they may not be specifically noted. Sincerely, R. Jerrey Dearing, AIA Principal Date.. TOWN OF NORTH ANDOVER Mow PERMIT FOR WIRING This certifies that... . . ................................ ................... I ...... I ......................... has permission to perform. .................................................. wiring in the building of .... ........................................... at:,.-,-'./ .......... ...... ................... .............. ,North Andover, Mass. Fee4!.Z/,.. Lic. Noo' .. ......... .................. .... ....... ELEcriucAL INspEcTo Check # Zd 8706 Commonwealth of Massachusetts Official Use Only Permit No. �� Department of Fire Services u,p- Occupancy and Fee Checked % BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ( C), S27 CMR 12.00 (PLEASE PRINT IAr INK OR TYPE ALL INFORMATION) Date: is 10q City or Town of: A). A W liayCIZ To the Inspe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) al i q LZO L.I D E: W Owner or Tenant 1pw oiab 1E_7LJ P -1c M lyT Telephone No. Owner's Address �tj-15 QZiG .0013 sa Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Ti,\E7,L1 l o& Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service ?mc) Amps JJ_Q / qO Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity I— Z�oQ AmQ Location and Nature of Proposed Electrical Work: Witt 101W 5 jS)G,LE rAMiLy 1pLQ1rLL11J�'r Comnlatinn nfthe following table nrav be waived by the Inspector of Wires. Attach additional detatt tJ desirea, or as requirea Dy ine tnapeciur ul .. a as., Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Interstate Electrical Servi sprpor..at' LIC.N .-.A-5217 Licensee: Pasquale A. Alibrandi Signature I (If appl icablinter "exe i i" in the license number line.) Bus. Tel. No.:9 7 8 — 6 6 7 — 5 2 0 0 � 6 Address: Tregie Cove Rd. , N. Billerica, MA 01 862 Alt.Tel.No.: *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PEI 1WT FEE: a 67 is 77 Signature Telephone No. No. of Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. ❑ Qrnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners p JI tl Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained No. of Waste Disposers P Totals: Detection/Alertin Devices No. of Dishwashers , Space/Area Heating KW Local Q Municipal Connection El Other ) HeatinAppliances KW g Security Systems:* No. of Dryers No. of Devices or E quivalent No. of Water No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: Attach additional detatt tJ desirea, or as requirea Dy ine tnapeciur ul .. a as., Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Interstate Electrical Servi sprpor..at' LIC.N .-.A-5217 Licensee: Pasquale A. Alibrandi Signature I (If appl icablinter "exe i i" in the license number line.) Bus. Tel. No.:9 7 8 — 6 6 7 — 5 2 0 0 � 6 Address: Tregie Cove Rd. , N. Billerica, MA 01 862 Alt.Tel.No.: *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PEI 1WT FEE: a 67 is 77 Signature Telephone No. /? - I ��, el (C�j 0 1 0 Date. k. .. vr?�. ........... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... has permission to perform ..... 6�5...klf JIL ..... .................... wiring in the building of ... -0 at.c;2/ ..... ................ North Andover, Mass. Fee .... ............... Lic. No. 1,PjK)..4-: .............. . k�2ICALEC40R Check# INREMm 1\ Commonwealth of MassachusettsFOccupan Official Use Only NEW 10 Department of Fire Services o.WE �� kiBOARD OF FIRE PREVENTION VREGULATIONS cy and Fee Checked ] (leave blank 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 W INK OR TYPE ALL INFORMATION) Date: 6 — ,-- City or Town of. NORTH ANDOVER To the By this application the undersigned gives notice of his or her intention to perform the ele electrical wpector ork described below. Location (Street & Number) z / (r,L,,, lj,�, / , — Owner or Tenant 41r1l. Owner's Address Telephone No. Is this permit in conjunction with a building permit? y� Purpose of BuildingNO ❑ (Check Appropriate Boz) �S� Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Estimated Value of Electrical Work. /. !0'a. H.xiulcn aaamonai detail tf desired, or as required by the Inspector of Wires. (When required by municipal.policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent The undersigned certifies that such Covera a ism force, and has exhibited proof of same to the permit issuing office.CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete - FIRM NAME:St/ h VEt i7 ,ts 4.il ,�l�% ��� .S LIC. NO.: � fS�. Licensee: (J ��j Va- tn Signature p ,, (Ifapplicable, enter "exempt" in the license number line.) LIC. NO.: .2 .- Y 7,r/ Address: f !t1 S 201 . l�r� f � `dyis� Bus. Tel. No.: '� f�7fl *Per M.G.L c. 147, s. 57-61, security work re wires D „ „ 7 AIL Tel. No.: q epartment o Public Safety S License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) ❑ owner El owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $ 1 Information a fad Instructions Massachusetts General Laws chapter 152 requires all emp f oyers 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 includir-tg 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 shaU 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 license or permit to operate a busiess or ito 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 performianee of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the corttracting 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), addresses) and phone numbers) along with their certificates) 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' 00rnpensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidmvit may be submitted to the Department of Industrial Accid nts 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 .app.Iication fo;.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' oompermtion policy, please -call the Department at the nurmber. listed below. Self=insured companies should enter their self-insumnce,iicanse 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 permittlicense number which w itl be used as a reference number. In addition, an applicant that must submit multiple pennit/licerrse 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 6e affidavit that has be= 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 f dare 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 Ince to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a =11. The Department's address, telephone and fax number. The Commonwce lth of Massachusetts Department of Industrial Accidents Office of Luvestbigntions 600 Washington Street Boston, MA 02111 TeL # 617-7274900 ext 406 or 1-8.77-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia The Commonwealth of Massachusetts ' kj i Department of Industrial Accidents Elf" Office of Investigations NEU 600 Mlashington Street Boston, M/t 02111 r ? www nzassgov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A P iicant Information Please Print LeQibl NaIIie (Business/owiza6on/Individual)'-!5�///U,t-;�I 1j91e4l,.Q f Address: 9h f�- CitylStaxe/Zip: Phone #:. 9 7 J-2- !4 K7,2 -- A %,2-- F2.E3 you an employer? check the apProprlate hoz: I rite a employer with % 4. TYPe of Project (regnir�: ❑ I am a general contractor and Iemployees (full and/or part-time).* have hired the sub-eortt<actors b• ❑ New construction I am proprietor. or partner- listed ori the attached sheet.! 7• ❑ Remodeling ship and have no employees These sub -contractors have working for me in aci workers' comp. insurance. g' ❑ Demolition n'• 9. Building [No workers' comp. insurance 5. ❑ We are a corporation and its ❑ ng addition 3. �required ] officers have exercised their 1Q•❑ Electrical repairs or additions , I am s homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No•workers' comp. c, 152, § 1(4), and we have no I. insurance .re aired. t 12.❑ Roof repairs q ] .empltsyees. [No workers' COMP. insurance required.] i 3.❑ •%ny applicant that checks boitti I must 9191) fill out the section below showing their workets com t Homeownepensation rs who submit this affidavit indicating they are doing an work and then ham outside c ntmeton; pmust submit licy a new affidavit indi ZCntracton; that check this box mustaffached an additional sheatshowiz - the Rama of the sub-cotrtractots and tieeir world rs' cc rte• •s: -. catiag such r r•• •�� rrfARa3tiOn. ! am an eWloyer that is pro>idwg:workers I co easadon - informadom // mP ensuraace for my emPloyees: Below is the policy and yob site Insurance Company Name: ' C�/Qij i 7, (4 � Policy # or Self -ins. Lie. #:- C '_ S Expiration Date: Sob Site Address: Z— J-� City/State2ip!4/V V,Gr/f ? Attach a copy of the workers'. compensation Policy declaration page (showing the policy number esti ezpiratioa date). Failure to secure covers a as r - 4 g 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. ! do hereby cerci under the pains pen ofPedzuy that the information Provided above is true and eonra Si titre: Date: Phone #: i 7 L Eicia use only. Do not write in this area, to be completed by city or town official n Permit/L'ecenseorify (circle doe):Health 2. Building Department 3. Cky/Town Clerk 4. Electrical Inspector 5. Plumbing Ittspeetor son• Phone #: r CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 485 (3/17/09) Date: October 21, 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 Caroline Way Unit E MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Edgewood Retirement Community 575 Osgood Street North Andover Ma 01845 Building Inspector a rA fA cd 9 u :=o :moo o � C L N O C � O c, C.i CL W W C V: Cl CDCD E CD y.+ C O :w. c N y O : u cm N _R O �: L N N CD 3 c ; m� C C ' Cc O '= C N W coo Em CM� ® v V L \ : �C,3co O v oao Q o i m c = m :moo F- CD aoH •� N m uiW LL m r••• C O•N LU .E V fl v C7! v m Om�c CLy CZ m O fl 2 m DL y •ODCLO- E CD ca y=.r N Cl N O ca CD C: cm C CC m 0 cmSc N m t 0 Z O O f 0 O E C L O V CD 0. O y- s CD Cm co h C CC) CID L-A= C CD CDCL ® L R o a CL CMC .�.� ♦r CIDv C CD CD CLCO2 C C A C C � H cl M/ U) W W w CA i w � n G�2 u `� w � c a G ��oa c G U) v o-100 n0 aC/) cc u :=o :moo o � C L N O C � O c, C.i CL W W C V: Cl CDCD E CD y.+ C O :w. c N y O : u cm N _R O �: L N N CD 3 c ; m� C C ' Cc O '= C N W coo Em CM� ® v V L \ : �C,3co O v oao Q o i m c = m :moo F- CD aoH •� N m uiW LL m r••• C O•N LU .E V fl v C7! v m Om�c CLy CZ m O fl 2 m DL y •ODCLO- E CD ca y=.r N Cl N O ca CD C: cm C CC m 0 cmSc N m t 0 Z O O f 0 O E C L O V CD 0. O y- s CD Cm co h C CC) CID L-A= C CD CDCL ® L R o a CL CMC .�.� ♦r CIDv C CD CD CLCO2 C C A C C � H cl M/ U) W W w CA i Registered Architectural and Engineering Services Construction Control Affidavit Project Number_ DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #21 Caroline Way, North Andover, MA 01845 Scope of Project: 22 Individual Cottages In accordance with Section 116.0 of the Massachusetts State Building Code I, Allen Dewing Jr., MA Registration #4301 being a registered professional engineer/architect, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project X'Z Architectural Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code. All acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Upon completion of the Work, I shall submit a final the project for occupancy. .0 - as to the satisfactory completion and readiness of Na. 4301 cn CONCORD, 5 MA 7H OF M��''�G z iA ri _" i� � ' I'len Dewing Jr. F:\DSA Project Files\Edgewood 0706\05. Project Word Documents\a. Correspondence and Transmittals\vi. Misc m Registered Engineering Services Structural Construction Control Affidavit. at Completion of Structural Work. PrniertNtlmher I)SA Prniert#(17(}6W) For the aboti e named project and that, to the best of my knowledge, such plans, computations and APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION Building Permit # 4R-1� i ADDRESS/LOCATION OF PROPERTY :_3 CckD, d/ Map Parcel Lot Number SUBDIVISION DATE REQUESTED FILEDIREADY FOR INSPECTION CLOSING DATE ON PROPERTY:_ jJk FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL BE. CHARGED IF TNF ATPI IP -Ti 10= DOES NOT MEET ALL APPLICABLE CODES. Permit, Issued to: Address SIGNED CONSERVATION PLANNING ROUTIN 71 f p a, p 1 DPW - WATER METER SEWERNVATERCONNECTION ?114�6q NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYIINSPECTION REQUEST DPW Signature File: Application for OC form revised Jan 2007 Date ..?,�!C1 S ....... 31 �' TOWN OF NORTH ANDOVER t O D • PERMIT FOR. GAS INSTALLATION This certifies that ..,.�,fti?sr r r�� ;��!� �� has permission for gas installation ............ in the buildings of ........... ......... . at . r ,1...��i'.� !� t'ti ..` V ...... North Andover, Mass. Fee. Lic. No. -/?Y).?. . ...� . AS INSPECTOR Check # L/ ?) u 6821 FDCTURES iz 1 rA Z FW.. Y � w 0 Z !— O 2 d} Z OWC O `S F O W g W O W W .m I- aaCL OC re V Z fb p� . O W to W = X A fazallowozo uj W i- ~t— W _V O 0� O O g O Q 9° F>>> O Installing.Company Business Of Licensed PlumbedGas F INSURANCE COVERAGE: - - - - I have a current Ilabift.1rawrAncepolicy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes ® No ❑ N you have checked Yet please 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 142 of the Massachusetts General Laws, and that my signature on this permit appihation waives this requirement, Check One Only Owner ❑ Agent ❑ By checking tate box 0;1 hereby caroti► that all of Urs detaits and information I have submitted (or entered) regarding this application are true and accurate to the beet of my Knowledge and that all plumbing work and instellations performed under the permit Issued for this application will be in cornplienm with all Pertinent Provision of the Mamchusetts State Plumbing Code and Chapter 142 of the General Laws. By Q Ph,mir� Title 91 Gas FIRM Master LP Installer 0 License Number: i w -r% MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GAS FITTING City/Town•_! Y ©tA 4n dove r m& Date: � �1 �/ � Permits Building t ocationo5 l� t} Gi _oamws Name• Ea `�,f-mods Re lj l" m ",�t Type of Occupancy: Commend ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: �Aiteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FDCTURES iz 1 rA Z FW.. Y � w 0 Z !— O 2 d} Z OWC O `S F O W g W O W W .m I- aaCL OC re V Z fb p� . O W to W = X A fazallowozo uj W i- ~t— W _V O 0� O O g O Q 9° F>>> O Installing.Company Business Of Licensed PlumbedGas F INSURANCE COVERAGE: - - - - I have a current Ilabift.1rawrAncepolicy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes ® No ❑ N you have checked Yet please 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 142 of the Massachusetts General Laws, and that my signature on this permit appihation waives this requirement, Check One Only Owner ❑ Agent ❑ By checking tate box 0;1 hereby caroti► that all of Urs detaits and information I have submitted (or entered) regarding this application are true and accurate to the beet of my Knowledge and that all plumbing work and instellations performed under the permit Issued for this application will be in cornplienm with all Pertinent Provision of the Mamchusetts State Plumbing Code and Chapter 142 of the General Laws. By Q Ph,mir� Title 91 Gas FIRM Master LP Installer 0 License Number: i w -r% Date. TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SACNUS` r This certifies that ........ ... ter............ . has permission to perform . - '`.--. Plumbing in the buildings of at . -!. 1 .. C t . ... t/.. �c . Fee�//7J: Lic. No. / :!6` .%� Check # c./ <a ...... , North Andover, Mass. ............ PLUMB:kGANSPECTOR FIXTURES MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING Cityffown: +VA A hI )e%( MA. Date: I _b Permit# 7� Building Locadon: o2 i C a r6 b n sL LA t/ Owners Name: CJ6 R e+ rQ,.,-co ,;t Ccsm m z Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: �, Alteration: ❑_ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑. No ❑ FIXTURES INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes No ❑ N you have checked Yes, please 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 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ 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 an 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 ojthe General Laws. By Tide City/rows Type of License: i� Plumber W riumner/r )� Master ❑Journeyman License Number. 13437 z z in Y �- O tl V W IL $ N= z F Y M a a CO IX t- w t2 -.1rn a z Q Lu OJ m Q w W G g l- Z. � O 9� z� O v a w w x LL Qn Y i3:00 Co F' _ z- Q LL 3 a. Y. Q= w w uj u! < v a m t- a m = W D a O W i- 0>> O W .j a 0 O D t9 = Y o o z z m t- E- z -j a it a a a _ I.- u. iY N N F n O SUB BSMT. BASEMENT I—FLOOR 2 FLOOR Y'u FLOOR 4 FLOOR WH FLOOR WH FLOOR 7rH FLOOR 8 FLOOR Check One Only Certificate # lnstalling.Company Name: ManSfield PluenbinLO&Heating;IrtC_ ER Corporation 25fi1- E Andress: 36 Jackman St. cityrrown Georgetown ❑ Partnership Business Tei: 1978}35'2-593Fax: {978}352-5410_ `-- ❑ Firm/Company Name of Licensed PlumberTimothy J. ManSfiel INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes No ❑ N you have checked Yes, please 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 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ 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 an 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 ojthe General Laws. By Tide City/rows Type of License: i� Plumber W riumner/r )� Master ❑Journeyman License Number. 13437 Date .�. .?.....! TOWN OF N RT ANDOVER p PERMIT FO PLUMBING .o A'ay This certifies that ............1, ....'/.^/�f..�1.......... ..... / / has permission to perform .-.- ......J ......................... . plumbing in the buildings of -.... ..G -..... , North Andover, Mass. at ........ ,-_ r Fee 1. Zf . Lic. No.... /./jam! ... . PLUMBING INSPECTOR Check # 8073 I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes R) No ❑ If you have checked Yes, please 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 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ details and this application are true and accurate to the best of mv Knowledge and mat an 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 pftfie General Laws. .4 BY Type of License: Me Plumber signawmr i_7ignsea vimpoer W JourneMaster ono Nn y man License Number. 13437 Aononven rnccrcc ucc nw vi MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: j krlh 406L)et- MA. Date. 5, 1ql() Permit# FIXTURES Building Location:_`'�!5 11JOwners Name: Reil rn�l horn rr� Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New:J] Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes R) No ❑ If you have checked Yes, please 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 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ details and this application are true and accurate to the best of mv Knowledge and mat an 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 pftfie General Laws. .4 BY Type of License: Me Plumber signawmr i_7ignsea vimpoer W JourneMaster ono Nn y man License Number. 13437 Aononven rnccrcc ucc nw vi FIXTURES Z Z N Y O v Lu N EL z 30 % 9a ta- Y g U z a 0 y 0 W 0 m W 2 d Q W ro O 0_ rn Y y u) a X QQ Y~$ F= O a O 3_ V Q. Z> O O J z Q= W w _ W o a s m to o w v_, a 0 t- 0. t. O O_a- 3 3 a u. W W 0 SUB BSMT. BASEMENT 9 J 115T FLOOR - 2 FLOOR 3 FLOOR 4 FLOOR WR—FLOOR -i - 'FLOOR —FR—FLOOR 8 THFLOOR Check One Only Certificate # Installing, Company Name Mansfield P1umbing&Hsatin9,1nc._ 2561—C [X Corporation Addiew: 36 Jackman St. _... cityrrown "Georgetown -- ; ❑ Partnership Business Tel: (978)352-5493 Fax: (978}352-541{}_ y -- - ❑ Firm/Company Name of Licensed Plumber.TimOthy J. M'ans"fel I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes R) No ❑ If you have checked Yes, please 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 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ details and this application are true and accurate to the best of mv Knowledge and mat an 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 pftfie General Laws. .4 BY Type of License: Me Plumber signawmr i_7ignsea vimpoer W JourneMaster ono Nn y man License Number. 13437 Aononven rnccrcc ucc nw vi i - f Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number: DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: .#21 Caroline Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Mechanical Other (Specify) Architectural Fire Protection Structural Electrical For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with die documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. goals"* Geoffrey S. Conway, P.E. Date % c E Y F Z-" S. CONWAYJ� STRUCTURAL •q �!o.32753